Table of Contents

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

FORM 10-Q

 

 

 

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2012.

 

¨ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                      to                      .

Commission File Number: 1-35490

 

 

EXPRESS SCRIPTS HOLDING COMPANY

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   45-2884094

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

One Express Way, St. Louis, MO   63121
(Address of principal executive offices)   (Zip Code)

Registrant’s telephone number, including area code: (314) 996-0900

 

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes   x     No   ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes   x     No   ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer   x    Accelerated filer   ¨
Non-accelerated filer   ¨   (Do not check if a smaller reporting company)    Smaller reporting company   ¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes   ¨      No   x

 

Common stock outstanding as of July 31, 2012:

     810,750,000         Shares   

 

 

 


Table of Contents

EXPRESS SCRIPTS HOLDING COMPANY

INDEX

 

Part I  

Financial Information

     3   
  Item 1.    Financial Statements (unaudited)      3   
     a) Unaudited Consolidated Balance Sheet      3   
     b) Unaudited Consolidated Statement of Operations      4   
     c) Unaudited Consolidated Statement of Comprehensive Income      5   
     d) Unaudited Consolidated Statement of Changes in Stockholders’ Equity      6   
     e) Unaudited Consolidated Statement of Cash Flows      7   
     f) Notes to Unaudited Consolidated Financial Statements      8   
  Item 2.    Management’s Discussion and Analysis of Financial Condition and Results of Operations      34   
  Item 3.    Quantitative and Qualitative Disclosures About Market Risk      48   
  Item 4.    Controls and Procedures      48   

Part II

  Other Information      49   
  Item 1.    Legal Proceedings      49   
  Item 1A.    Risk Factors      51   
  Item 2.    Unregistered Sales of Equity Securities and Use of Proceeds      61   
  Item 3.    Defaults Upon Senior Securities – (Not Applicable)   
  Item 4.    Mine Safety Disclosures – (Not Applicable)   
  Item 5.    Other Information – (Not Applicable)   
  Item 6.    Exhibits      61   
Signatures      62   
Index to Exhibits      63   

 

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PART I. FINANCIAL INFORMATION

Item 1. Financial Statements

EXPRESS SCRIPTS HOLDING COMPANY

Unaudited Consolidated Balance Sheet

 

     June 30,      December 31,  

(in millions)

   2012      2011  

Assets

     

Current assets:

     

Cash and cash equivalents

   $ 1,420.0       $ 5,620.1   

Restricted cash and investments

     28.9         17.8   

Receivables, net

     5,997.8         1,915.7   

Inventories

     1,423.8         374.4   

Deferred taxes

     335.9         45.8   

Prepaid expenses and other current assets

     454.9         84.2   
  

 

 

    

 

 

 

Total current assets

     9,661.3         8,058.0   

Property and equipment, net

     1,768.5         416.2   

Goodwill

     29,358.6         5,485.7   

Other intangible assets, net

     17,203.4         1,620.9   

Other assets

     66.7         26.2   
  

 

 

    

 

 

 

Total assets

   $ 58,058.5       $ 15,607.0   
  

 

 

    

 

 

 

Liabilities and Stockholders’ Equity

     

Current liabilities:

     

Claims and rebates payable

   $ 6,904.1       $ 2,874.1   

Accounts payable

     2,020.5         928.1   

Accrued expenses

     1,989.9         656.0   

Short-term loan payable

     1,039.6         —     

Current maturities of long-term debt

     889.7         999.9   
  

 

 

    

 

 

 

Total current liabilities

     12,843.8         5,458.1   

Long-term debt

     16,312.3         7,076.4   

Other liabilities

     6,774.1         598.8   
  

 

 

    

 

 

 

Total liabilities

     35,930.2         13,133.3   
  

 

 

    

 

 

 

Commitments and contingencies (Note 12)

     

Stockholders’ Equity:

     

Preferred stock, 15.0 shares authorized, $0.01 par value per share; and no shares issued and outstanding

     —           —     

Common stock, 2,985.0 shares authorized, $0.01 par value per share; shares issued: 809.6 and 690.7, respectively; shares outstanding: 809.6 and 484.6, respectively

     8.1         6.9   

Additional paid-in capital

     20,918.1         2,438.2   

Accumulated other comprehensive income

     8.1         17.0   

Retained earnings

     1,194.0         6,645.6   
  

 

 

    

 

 

 
     22,128.3         9,107.7   

Common stock in treasury at cost, zero and 206.1 shares, respectively

     —           (6,634.0
  

 

 

    

 

 

 

Total stockholders’ equity

     22,128.3         2,473.7   
  

 

 

    

 

 

 

Total liabilities and stockholders’ equity

   $ 58,058.5       $ 15,607.0   
  

 

 

    

 

 

 

See accompanying Notes to Unaudited Consolidated Financial Statements

 

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EXPRESS SCRIPTS HOLDING COMPANY

Unaudited Consolidated Statement of Operations

 

     Three Months Ended     Six Months Ended  
     June 30,     June 30,  

(in millions, except per share data)

   2012     2011     2012     2011  

Revenues (1)

   $ 27,692.5      $ 11,361.4      $ 39,825.1      $ 22,455.9   

Cost of revenues (1)

     25,579.6        10,577.3        36,880.2        20,926.3   
  

 

 

   

 

 

   

 

 

   

 

 

 

Gross profit

     2,112.9        784.1        2,944.9        1,529.6   

Selling, general and administrative

     1,580.8        204.8        1,848.3        397.9   
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating income

     532.1        579.3        1,096.6        1,131.7   
  

 

 

   

 

 

   

 

 

   

 

 

 

Other (expense) income:

        

Undistributed gain from joint venture

     4.3        —          4.3        —     

Interest income

     2.3        1.5        4.6        1.9   

Interest expense and other

     (175.2     (50.3     (307.2     (90.0
  

 

 

   

 

 

   

 

 

   

 

 

 
     (168.6     (48.8     (298.3     (88.1
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     363.5        530.5        798.3        1,043.6   

Provision for income taxes

     192.6        196.3        359.6        382.9   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

   $ 170.9      $ 334.2      $ 438.7      $ 660.7   
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average number of common shares outstanding during the period:

        

Basic

     807.8        502.6        646.6        515.7   

Diluted

     823.9        507.0        663.2        520.3   

Basic earnings per share

   $ 0.21      $ 0.66      $ 0.68      $ 1.28   

Diluted earnings per share

   $ 0.21      $ 0.66      $ 0.66      $ 1.27   

 

1  

Includes retail pharmacy co-payments of $3,519.1 million and $1,457.1 million for the three months ended June 30, 2012 and 2011, respectively, and $5,015.7 million and $2,983.6 million for the six months ended June 30, 2012 and 2011, respectively.

See accompanying Notes to Unaudited Consolidated Financial Statements

 

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EXPRESS SCRIPTS HOLDING COMPANY

Unaudited Consolidated Statement of Comprehensive Income

 

     Three Months Ended     Six Months Ended  
     June 30,     June 30,  

(in millions)

   2012     2011     2012     2011  

Net income

   $ 170.9      $ 334.2      $ 438.7      $ 660.7   

Other comprehensive income (loss), net of tax:

        

Foreign currency translation adjustment

     (10.5     (0.4     (8.9     0.9   
  

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

   $ 160.4      $ 333.8      $ 429.8      $ 661.6   
  

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying Notes to Unaudited Consolidated Financial Statements

 

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EXPRESS SCRIPTS HOLDING COMPANY

Unaudited Consolidated Statement of Changes in Stockholders’ Equity

 

       Number
of Shares
    Amount  

(in millions)

   Common
Stock
    Common
Stock
    Additional
Paid-in
Capital
    Accumulated
Other
Comprehensive
Income
    Retained
Earnings
    Treasury
Stock
    Total  

Balance at December 31, 2011

     690.7      $ 6.9      $ 2,438.2      $ 17.0      $ 6,645.6      $ (6,634.0   $ 2,473.7   

Net income

     —          —          —          —          438.7        —          438.7   

Other comprehensive income

     —          —          —          (8.9     —          —          (8.9

Cancellation of treasury shares in connection with Merger activity

     (204.7     (2.0     (728.5     —          (5,890.3     6,620.8        —     

Issuance of common shares in connection with Merger activity

     318.0        3.2        18,841.6        —          —          —          18,844.8   

Changes in stockholders’ equity related to employee stock plans

     5.6        —          366.8        —          —          13.2        380.0   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balance at June 30, 2012

     809.6      $ 8.1      $ 20,918.1      $ 8.1      $ 1,194.0      $ —        $ 22,128.3   

See accompanying Notes to Unaudited Consolidated Financial Statements

 

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EXPRESS SCRIPTS HOLDING COMPANY

Unaudited Consolidated Statement of Cash Flows

 

     Six Months Ended  
     June 30,  

(in millions)

   2012     2011  

Cash flows from operating activities:

    

Net income

   $ 438.7      $ 660.7   

Adjustments to reconcile net income to net cash provided by operating activities:

    

Depreciation and amortization

     670.2        126.2   

Non-cash adjustments to net income

     95.6        124.4   

Deferred financing fees

     26.9        2.4   

Changes in operating assets and liabilities, net of effects of acquisition:

    

Accounts receivable

     175.8        (223.6

Claims and rebates payable

     (453.1     (135.6

Other net changes in operating assets and liabilities

     302.1        148.6   
  

 

 

   

 

 

 

Net cash flows provided by operating activities

     1,256.2        703.1   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Acquisition of business, net of cash acquired

     (10,283.6     —     

Purchases of property and equipment

     (66.6     (54.1

Other

     (11.2     2.4   
  

 

 

   

 

 

 

Net cash used in investing activities

     (10,361.4     (51.7
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Proceeds from long-term debt, net of discounts

     7,353.6        1,494.0   

Repayment of long-term debt

     (2,500.1     (0.1

Proceeds (repayment) of revolving credit line, net

     (600.0     100.0   

Proceeds from accounts receivable financing facility

     600.0        —     

Repayment of accounts receivable financing facility

     (1.7     —     

Excess tax benefit relating to employee stock compensation

     15.6        25.9   

Net proceeds from employee stock plans

     141.1        23.1   

Deferred financing fees

     (103.2     (10.9

Treasury stock acquired

     —          (2,515.7
  

 

 

   

 

 

 

Net cash provided by (used in) financing activities

     4,905.3        (883.7
  

 

 

   

 

 

 

Effect of foreign currency translation adjustment

     (0.2     (0.4

Net decrease in cash and cash equivalents

     (4,200.1     (232.7

Cash and cash equivalents at beginning of period

     5,620.1        523.7   
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 1,420.0      $ 291.0   
  

 

 

   

 

 

 

See accompanying Notes to Unaudited Consolidated Financial Statements

 

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EXPRESS SCRIPTS HOLDING COMPANY

NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS

Note 1 – Summary of significant accounting policies

On July 20, 2011, Express Scripts, Inc. (“ESI”) entered into a definitive merger agreement (the “Merger Agreement”) with Medco Health Solutions, Inc. (“Medco”), which was amended by Amendment No. 1 thereto on November 7, 2011, providing for the combination of ESI and Medco under a new holding company named Aristotle Holding, Inc. The transactions contemplated by the Merger Agreement (the “Merger”) were consummated on April 2, 2012. Aristotle Holding, Inc. was renamed Express Scripts Holding Company (the “Company” or “Express Scripts”) concurrently with the consummation of the Merger. “We,” “our” or “us” refers to Express Scripts Holding Company and its subsidiaries. For financial reporting and accounting purposes, ESI was the acquirer of Medco. The consolidated financial statements reflect the results of operations and financial position of ESI for 2011 periods and through April 1, 2012. However, references to amounts for periods after the closing of the Merger on April 2, 2012 relate to Express Scripts.

Express Scripts’ significant accounting policies, normally included in financial statements prepared in conformity with generally accepted accounting principles, have been omitted from this Form 10-Q pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). Express Scripts believes the disclosures contained in this Form 10-Q are adequate to fairly state the information when read in conjunction with the Notes to the Consolidated Financial Statements included in ESI’s Annual Report on Form 10-K for the year ended December 31, 2011. Upon consummation of the Merger on April 2, 2012, Medco’s significant accounting policies were conformed to ESI’s significant accounting policies. However, two Medco historical accounting policies have been adopted related to the Medicare prescription drug program and the Cash balance pension plans.

Medicare Prescription Drug Program. Express Scripts’ revenues include premiums associated with our Medicare prescription drug program (“PDP”) risk-based product offerings. These products involve prescription dispensing for beneficiaries enrolled in the Centers for Medicare & Medicaid Services (“CMS”)-sponsored Medicare Part D Prescription Drug Program (“Medicare Part D”) prescription drug benefit. We also offer numerous customized benefit plan designs to employer group retiree plans under the Medicare Part D prescription drug benefit.

The PDP premiums are determined based on our annual bid and related contractual arrangements with CMS. The PDP premiums are primarily comprised of amounts received from CMS as part of a direct subsidy and an additional subsidy from CMS for low-income member premiums, as well as premium payments received from members. These premiums are recognized ratably to revenues over the period in which members are entitled to receive benefits. Premiums received in advance of the applicable benefit period are deferred and recorded in accrued expenses on the consolidated balance sheet. There is a possibility that the annual costs of drugs may be higher or lower than premium revenues. As a result, CMS provides a risk corridor adjustment for the standard drug benefit that compares our actual annual drug costs incurred to the targeted premiums in our CMS-approved bid. Based on specific collars in the risk corridor, we will receive from CMS additional premium amounts or be required to refund to CMS previously received premium amounts. We calculate the risk corridor adjustment on a quarterly basis based on drug cost experience to date and record an adjustment to revenues with a corresponding receivable from or payable to CMS reflected on the consolidated balance sheet.

In addition to PDP premiums, there are certain co-payments and deductibles (the “cost share”) due from members based on prescription orders by those members, some of which are subsidized by CMS in cases of low-income membership. Beginning in 2011, non-low-income members received a cost share benefit under the coverage gap discount program with brand pharmaceutical manufacturers. For subsidies received in advance, the amount is deferred and recorded in accrued expenses on the consolidated balance sheet. If there is cost share due from members, pharmaceutical manufacturers or CMS, or premiums due from members, the amount is accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, cost share amounts are reconciled with CMS and the corresponding receivable or payable is settled. The cost share is treated consistently as other co-payments derived from providing Pharmacy Benefit Management (“PBM”) services, as a component of revenues on the consolidated statement of operations.

 

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Express Scripts’ cost of revenues includes the cost of drugs dispensed by our mail-order pharmacies or retail network for members covered under our Medicare PDP product offerings and is recorded at cost as incurred. We receive a catastrophic reinsurance subsidy from CMS for approximately 80% of costs incurred by individual members in excess of the individual annual out-of-pocket maximum. The subsidy is reflected as an offsetting credit in cost of revenues to the extent that catastrophic costs are incurred. Catastrophic reinsurance subsidy amounts received in advance are deferred and recorded in accrued expenses on the consolidated balance sheet. If there are catastrophic reinsurance subsidies due from CMS, the amount is accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, catastrophic reinsurance amounts are reconciled with CMS and the corresponding receivable or payable is settled.

Pension Plans . Express Scripts has elected to determine the projected benefit obligation for cash balance pension plans as the value of the benefits to which employees participating in the plans would be entitled if they separated from service immediately. The amount by which the projected benefit obligation exceeds the fair value of the pension plan assets is recorded in other liabilities on the consolidated balance sheet.

The determination of our expense for pension plans is based on management’s assumptions, which are developed with the assistance of actuaries. We reassess the plan assumptions on a regular basis. The expected rate of return for the pension plan represents the average rate of return to be earned on the plan assets over the period the benefits included in the benefit obligation are to be paid. The expected return on plan assets is determined by multiplying the expected long-term rate of return by the fair value of the plan assets and contributions, offset by expected return on expected benefit payments. In developing the expected rate of return we consider long-term compounded annualized returns of historical market data, as well as historical actual returns on our plan assets. Using this reference information, we develop forward-looking return expectations for each asset class and a weighted average expected long-term rate of return for a targeted portfolio allocated across these investment categories. As a result of this analysis, for 2012, the expected rate of return assumption is 7.5% for the pension plans.

We believe the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) necessary to state fairly the unaudited consolidated balance sheet at June 30, 2012, the unaudited consolidated statement of operations and unaudited consolidated statement of comprehensive income for the three and six months ended June 30, 2012 and 2011, the unaudited consolidated statement of changes in stockholders’ equity for the six months ended June 30, 2012, and the unaudited consolidated statement of cash flows for the six months ended June 30, 2012 and 2011. Operating results for the three and six months ended June 30, 2012 include integration related expenses and are not necessarily indicative of the results that may be expected for the year ending December 31, 2012.

Note 2 – Fair value measurements

Accounting guidance regarding fair value measurement establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value. These tiers include: Level 1, defined as observable inputs such as quoted prices in active markets for identical assets or liabilities; Level 2, defined as inputs other than quoted prices for similar assets and liabilities in active markets that are either directly or indirectly observable; and Level 3, defined as unobservable inputs for which little or no market data exists, therefore requiring an entity to develop its own assumptions.

Financial assets accounted for at fair value on a recurring basis include cash equivalents of $903.4 million and $1,817.4 million, restricted cash and investments of $28.9 million and $17.8 million, and trading securities (included in other assets) of $7.8 million and $14.1 million at June 30, 2012 and December 31, 2011, respectively. These assets are carried at fair value based on quoted prices in active markets for identical securities (Level 1 inputs). Cash equivalents include investments in AAA-rated money market mutual funds with maturities of less than 90 days.

 

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The carrying value of cash and cash equivalents (Level 1), accounts receivable, claims and rebates payable, and accounts payable approximated fair values due to the short-term maturities of these instruments. The fair value, which approximates the carrying value, of our bank credit facility (Level 2) was estimated using either quoted market prices or the current rates offered to us for debt with similar maturities. The carrying values and the fair values of our senior notes are shown, net of unamortized discount, in the following table:

 

     June 30, 2012      December 31, 2011  

(in millions)

   Carrying
Amount
     Fair
Value
     Carrying
Amount
     Fair
Value
 

March 2008 Senior Notes (acquired)

           

7.125% senior notes due 2018

   $ 1,436.3       $ 1,483.2       $ —         $ —     

6.125% senior notes due 2013

     310.7         310.8         —           —     
  

 

 

    

 

 

    

 

 

    

 

 

 
     1,747.0         1,794.0         —           —     

June 2009 Senior Notes

           

6.250% senior notes due 2014

     998.2         1,092.0         997.8         1,085.0   

7.250% senior notes due 2019

     497.4         631.5         497.3         593.1   

5.250% senior notes due 2012

     —           —           999.9         1,017.5   
  

 

 

    

 

 

    

 

 

    

 

 

 
     1,495.6         1,723.5         2,495.0         2,695.6   

September 2010 Senior Notes (acquired)

           

2.75% senior notes due 2015

     512.9         514.5         —           —     

4.125% senior notes due 2020

     508.0         532.5         —           —     
  

 

 

    

 

 

    

 

 

    

 

 

 
     1,020.9         1,047.0         —           —     

May 2011 Senior Notes

           

3.125% senior notes due 2016

     1,495.2         1,566.0         1,494.6         1,493.7   

November 2011 Senior Notes

           

3.500% senior notes due 2016

     1,249.7         1,323.8         1,249.7         1,265.3   

4.750% senior notes due 2021

     1,239.8         1,393.8         1,239.4         1,295.8   

2.750% senior notes due 2014

     899.2         922.5         899.0         907.8   

6.125% senior notes due 2041

     698.4         863.8         698.4         755.3   
  

 

 

    

 

 

    

 

 

    

 

 

 
     4,087.1         4,503.9         4,086.5         4,224.2   

February 2012 Senior Notes

           

2.650% senior notes due 2017

     1,486.5         1,527.0         —           —     

2.100% senior notes due 2015

     995.7         1,010.0         —           —     

3.900% senior notes due 2022

     979.1         1,050.0         —           —     
  

 

 

    

 

 

    

 

 

    

 

 

 
     3,461.3         3,587.0         —           —     
  

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ 13,307.1       $ 14,221.4       $ 8,076.1       $ 8,413.5   
  

 

 

    

 

 

    

 

 

    

 

 

 

The fair values of our senior notes were estimated based on observable market information (Level 2 inputs). In determining the fair value of liabilities, we took into consideration the risk of nonperformance. Nonperformance risk refers to the risk that the obligation will not be fulfilled and affects the value at which the liability would be transferred to a market participant. This risk did not have a material impact on the fair value of our liabilities.

Note 3 – Changes in business

As a result of the Merger on April 2, 2012, Medco and ESI each became 100% owned subsidiaries of Express Scripts and former Medco and ESI stockholders became owners of stock in Express Scripts, which is listed for trading on the NASDAQ stock exchange. Upon closing of the Merger, former ESI stockholders owned approximately 59% of Express Scripts and former Medco stockholders owned approximately 41%. Per the terms of the Merger Agreement, upon consummation of the Merger on April 2, 2012, each share of Medco common stock was converted into (i) the right to receive $28.80 in cash, without interest and (ii) 0.81 shares of Express Scripts stock. Holders of Medco stock options, restricted stock units, and deferred stock units received replacement awards at an exchange ratio of 1.3474 Express Scripts stock awards for each Medco award owned, which is equal to the sum of (i) 0.81 and (ii) the quotient obtained by dividing (1) $28.80 (the cash component of the Merger consideration) by (2) an amount equal to the average of the closing prices of ESI common stock on the NASDAQ for each of the 15 consecutive trading days ending with the fourth complete trading day prior to the completion of the Merger.

 

 

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Based on the opening price of Express Scripts’ stock on April 2, 2012, the purchase price was comprised of the following:

 

(in millions)

      

Cash paid to Medco stockholders (1)

   $ 11,309.6   

Value of shares of common stock issued to Medco stockholders (2)

     17,963.8   

Value of stock options issued to holders of Medco stock options (3) (4)

     706.1   

Value of restricted stock units issued to holders of Medco restricted stock units (3)

     174.9   
  

 

 

 

Total consideration

   $ 30,154.4   

 

(1) Equals Medco outstanding shares multiplied by $28.80 per share.
(2) Equals Medco outstanding shares immediately prior to the Merger multiplied by the exchange ratio of 0.81, multiplied by the Express Scripts opening share price on April 2, 2012 of $56.49.
(3) In accordance with applicable accounting guidance, the fair value of replacement awards attributable to precombination service is recorded as part of the consideration transferred in the Merger, while the fair value of replacement awards attributable to postcombination service is recorded separately from the business combination and recognized as compensation cost in the post-acquisition period over the remaining service period.
(4) The fair value of the Company’s equivalent stock options was estimated using the Black-Scholes valuation model utilizing various assumptions. The expected volatility of the Company’s common stock price is a blended rate based on the average historical volatility over the expected term based on daily closing stock prices of ESI and Medco common stock. The expected term of the option is based on Medco historical employee stock option exercise behavior as well as the remaining contractual exercise term.

Express Scripts believes the Merger will combine the expertise of two complementary pharmacy benefit managers to further efforts to lower the cost of prescription drugs and improve the quality of care.

The unaudited consolidated statement of operations for Express Scripts for the three months and six months ended June 30, 2012 includes Medco’s total revenues and net loss, which includes integration expense and amortization, following consummation of the Merger on April 2, 2012 of $15.7 billion and $(35.3) million, respectively.

The following unaudited pro forma information presents a summary of Express Scripts’ combined results of operations for six months ended June 30, 2012 and 2011 as if the Merger and related financing transactions had occurred at January 1, 2011. The following pro forma financial information is not necessarily indicative of the results of operations as they would have been had the transactions been effected on the assumed date, nor is it necessarily an indication of trends in future results for a number of reasons, including, but not limited to, differences between the assumptions used to prepare the pro forma information, basic shares outstanding and dilutive equivalents, cost savings from operating efficiencies, potential synergies, and the impact of incremental costs incurred in integrating the businesses:

 

    

Three Months Ended

June 30,

    

Six Months Ended

June 30,

 

(in millions, except per share data)

   2012      2011      2012      2011  

Total revenues

   $ 27,692.5       $ 28,411.1       $ 55,823.5       $ 56,540.9   

Net income

   $ 297.2       $ 146.8       $ 603.9       $ 188.0   

Basic earnings per share

   $ 0.37       $ 0.18       $ 0.75       $ 0.22   

Diluted earnings per share

   $ 0.36       $ 0.18       $ 0.74       $ 0.22   

Pro forma net income for the three and six months ended June 30, 2011 includes total non-recurring amounts of $355.8 million and $827.9 million, respectively, related to estimated severance payments, accelerated stock-based compensation, and transaction and integration costs incurred in connection with the Merger. These amounts represent the best available estimates as of the date of issuance. Actual costs recorded in the year ended December 31, 2012 may differ materially from estimates utilized for pro forma purposes.

 

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The Merger is accounted for under the acquisition method of accounting with ESI treated as the acquirer for accounting purposes. The purchase price has been allocated based on the estimated fair value of net assets acquired and liabilities assumed at the date of the acquisition. Express Scripts retained third-party valuation advisors to conduct analyses of the assets acquired and liabilities assumed in order to assist in the determination of the preliminary purchase price allocation. The preliminary purchase price allocation may be subject to further refinement and may result in significant changes. These changes will primarily relate to the fair value of obligations acquired. Express Scripts expects that if any refinements become necessary, they will be completed by April 2013. There can be no assurance that such finalization will not result in material changes. The following table summarizes Express Scripts’ preliminary estimates of the fair values of the assets acquired and liabilities assumed in the Medco acquisition:

 

(in millions)

   Amounts Recognized
as of  Acquisition Date
 

Current assets

   $ 6,878.6   

Property and equipment

     1,397.6   

Goodwill

     23,878.6   

Acquired intangible assets

     16,112.7   

Other noncurrent assets

     48.3   

Current liabilities

     (8,911.4

Long-term debt

     (3,008.3

Deferred income taxes

     (5,886.7

Other noncurrent liabilities

     (355.0
  

 

 

 

Total

   $ 30,154.4   
  

 

 

 

A portion of the excess of purchase price over tangible net assets acquired has been allocated to intangible assets consisting of customer contracts in the amount of $15,751.0 million with an estimated weighted average amortization period of 15.4 years. Additional intangible assets consist of trade names in the amount of $353.0 million with an estimated weighted average amortization period of 10 years and miscellaneous intangible assets of $8.7 million with an estimated weighted average amortization period of 5 years. The acquired intangible assets have been preliminarily valued using an income approach and are being amortized on a basis that approximates the pattern of benefit.

The excess of purchase price over tangible net assets and identified intangible assets acquired has been preliminarily allocated to goodwill in the amount of $23,878.6 million. The majority of the goodwill recognized as part of the Medco acquisition is reported under our PBM segment and reflects our expected synergies from combining operations, such as improved economies of scale and cost savings. None of the goodwill recognized is expected to be deductible for income tax purposes and is not amortized.

As a result of the Merger on April 2, 2012, we acquired the receivables of Medco. The gross contractual amounts receivable and fair value of these receivables as of the acquisition date are shown below. Of the gross amounts due under the contracts as of the date of acquisition, we estimated $14.5 million related to client accounts receivables to be uncollectible.

 

(in millions)

   Gross
Contractual
Amounts
Receivable
     Fair
Value
 

Manufacturer Accounts Receivables

   $ 1,895.2       $ 1,895.2   

Client Accounts Receivables

     2,432.2         2,408.9   
  

 

 

    

 

 

 

Total

   $ 4,327.4       $ 4,304.1   
  

 

 

    

 

 

 

ESI and Medco each retain a one-sixth ownership in SureScripts. As a result of the Merger, the combined companies in total retain a one-third ownership in SureScripts. Due to the increased ownership percentage, we now account for the investment in SureScripts using the equity method and have recorded an undistributed gain of $4.3 million for the three months and six months ended June 30, 2012.

 

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Note 4 – Property and equipment

Property and equipment, at cost, consists of the following:

 

     June 30,     December 31,  

(in millions)

   2012     2011  

Land and buildings

   $ 239.7      $ 11.3   

Furniture

     101.9        36.7   

Equipment

     528.9        345.4   

Computer software

     1,300.8        398.0   

Leasehold improvements

     188.4        107.7   
  

 

 

   

 

 

 

Total property and equipment

     2,359.7        899.1   

Less accumulated depreciation

     (591.2     (482.9
  

 

 

   

 

 

 

Property and equipment, net

   $ 1,768.5      $ 416.2   
  

 

 

   

 

 

 

Depreciation expense for the three and six months ended June 30, 2012 was $84.5 million and $110.9 million, respectively, and for the three and six months ended June 30, 2011 was $24.5 million and $48.8 million, respectively. Internally developed software, net of accumulated depreciation was $695.8 million and $72.9 million at June 30, 2012 and December 31, 2011, respectively. We capitalized $27.7 million and $30.4 million of internally developed software during the three and six months ended June 30, 2012, respectively.

Note 5 – Goodwill and other intangible assets

During the second quarter of 2012, we reorganized our segments to better reflect our structure following the Merger. Our new segment structure is composed of our domestic and Canadian PBM segment and our Other Business Operations segment. See Note 13 – Segment information for further description of the services performed by each segment. Historical segment information has been retrospectively adjusted to reflect the effect of these changes. The following is a summary of our goodwill and other intangible assets for our two reportable segments PBM and Other Business Operations:

 

     June 30, 2012      December 31, 2011  

(in millions)

   Gross
Carrying
Amount
     Accumulated
Amortization
    Net
Carrying
Amount
     Gross
Carrying
Amount
     Accumulated
Amortization
    Net
Carrying
Amount
 

Goodwill

               

PBM

   $ 28,015.5       $ (107.4   $ 27,908.1       $ 5,512.6       $ (107.4   $ 5,405.2   

Other Business Operations

     1,450.5         —          1,450.5         80.5         —          80.5   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 
   $ 29,466.0       $ (107.4   $ 29,358.6       $ 5,593.1       $ (107.4   $ 5,485.7   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 

Other intangible assets

               

PBM

               

Customer contracts

   $ 17,276.4       $ (1,020.8   $ 16,255.6       $ 2,018.5       $ (494.7   $ 1,523.8   

Trade names

     225.6         (5.6     220.0         3.6         —          3.6   

Miscellaneous

     121.6         (18.5     103.1         123.0         (60.1     62.9   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 
     17,623.6         (1,044.9     16,578.7         2,145.1         (554.8     1,590.3   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 

Other Business Operations

               

Customer relationships

     559.7         (62.5     497.2         68.4         (38.5     29.9   

Trade names

     130.8         (3.3     127.5         0.7         —          0.7   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 
     690.5         (65.8     624.7         69.1         (38.5     30.6   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 

Total other intangible assets

   $ 18,314.1       $ (1,110.7   $ 17,203.4       $ 2,214.2       $ (593.3   $ 1,620.9   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

   

 

 

 

 

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The aggregate amount of amortization expense of other intangible assets for our operations was $529.4 million and $40.1 million for the three months ended June 30, 2012 and 2011, respectively, and $586.2 million and $79.8 million for the six months ended June 30, 2012 and 2011, respectively. In accordance with applicable accounting guidance, amortization for customer contracts related to our agreement to provide PBM services to members of the affiliated health plans of WellPoint has been included as an offset to revenues in the amount of $28.5 million for the three months ended June 30, 2012 and 2011 and $57.0 million for the six months ended June 30, 2012 and 2011. The aggregate amount of amortization expense of other intangible assets for our operations is expected to be approximately $1,639.9 million for 2012, $2,084.3 million for 2013, $1,808.3 million for 2014, $1,787.4 million for 2015 and $1,768.2 million for 2016. These estimates may be revised once preliminary valuation procedures are completed for intangible assets acquired in connection with the Merger discussed in Note 3 – Changes in business. The weighted average amortization period of intangible assets subject to amortization is 15 years in total, and by major intangible class is 2 to 20 years for customer-related intangibles, 10 years for trade name intangibles and 3 to 30 years for miscellaneous intangible assets.

A summary of the change in the net carrying value of goodwill by business segment is shown in the following table:

 

(in millions)

   PBM      Other
Business
Operations
    Total  

Balance at December 31, 2011

   $ 5,405.2       $ 80.5      $ 5,485.7   

Acquisitions (1)

     22,502.9         1,375.7        23,878.6   

Foreign currency translation

     —           (5.7     (5.7
  

 

 

    

 

 

   

 

 

 

Balance at June 30, 2012

   $ 27.908.1       $ 1,450.5      $ 29,358.6   
  

 

 

    

 

 

   

 

 

 

 

(1) Represents the acquisition of Medco in April 2012.

Note 6 – Earnings per share

Basic earnings per share (“EPS”) is computed using the weighted average number of common shares outstanding during the period. Diluted EPS is computed in the same manner as basic earnings per share but adds the number of additional common shares that would have been outstanding for the period if the dilutive potential common shares had been issued. All shares are calculated under the “treasury stock” method. The following is the reconciliation between the number of weighted average shares used in the basic and diluted EPS calculations for all periods:

 

     Three Months Ended
June  30,
     Six Months Ended
June  30,
 

(in millions)

   2012 (1)      2011      2012 (1)      2011  

Weighted average number of common shares outstanding during the period – Basic EPS

     807.8         502.6         646.6         515.7   

Dilutive common stock equivalents:

           

Outstanding stock options, “stock-settled” stock appreciation rights, restricted stock units, and executive deferred compensation units

     16.1         4.4         16.6         4.6   
  

 

 

    

 

 

    

 

 

    

 

 

 

Weighted average number of common shares outstanding during the period – Diluted EPS (2 )

     823.9         507.0         663.2         520.3   
  

 

 

    

 

 

    

 

 

    

 

 

 

 

(1) The increase in the weighted average number of common shares outstanding for the three and six months ended June 30, 2012 for Basic and Diluted EPS resulted primarily from the issuance of 318.0 million shares in connection with the Merger.
(2) Excludes awards of 14.2 million and 2.6 million for the three months ended June 30, 2012 and 2011, respectively, and 14.6 million and 2.8 million for the six months ended June 30, 2012 and 2011, respectively. These were excluded because their effect was anti-dilutive.

 

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Note 7 – Financing

The Company’s debt, net of unamortized discounts and premiums, consists of:

 

     June 30,      December 31,  

(in millions)

   2012      2011  

Short-term debt:

     

Accounts receivable financing facility

   $ 600.0       $ —     

New revolving facility due August 29, 2016 with an average interest rate of 1.6% at June 30, 2012

     400.0         —     

Other

     39.6         —     
  

 

 

    

 

 

 

Total short-term loans payable

     1,039.6         —     
  

 

 

    

 

 

 

Long-term debt:

     

March 2008 Senior Notes (acquired)

     

7.125% senior notes due 2018

     1,436.3         —     

6.125% senior notes due 2013

     310.7         —     
  

 

 

    

 

 

 
     1,747.0         —     

June 2009 Senior Notes

     

6.250% senior notes due 2014

     998.2         997.8   

7.250% senior notes due 2019

     497.4         497.3   

5.250% senior notes due 2012

     —           999.9   
  

 

 

    

 

 

 
     1,495.6         2,495.0   

September 2010 Senior Notes (acquired)

     

2.750% senior notes due 2015

     512.9         —     

4.125% senior notes due 2020

     508.0         —     
  

 

 

    

 

 

 
     1,020.9         —     

May 2011 Senior Notes

     

3.125% senior notes due 2016

     1,495.2         1,494.6   

November 2011 Senior Notes

     

3.500% senior notes due 2016

     1,249.7         1,249.7   

4.750% senior notes due 2021

     1,239.8         1,239.4   

2.750% senior notes due 2014

     899.2         899.0   

6.125% senior notes due 2041

     698.4         698.4   
  

 

 

    

 

 

 
     4,087.1         4,086.5   

February 2012 Senior Notes

     

2.650% senior notes due 2017

     1,486.5         —     

2.100% senior notes due 2015

     995.7         —     

3.900% senior notes due 2022

     979.1         —     
  

 

 

    

 

 

 
     3,461.3         —     

Term facility due August 29, 2016 with an average interest rate of 2.1% at June 30, 2012

     3,894.8         —     

Other

     0.1         0.2   

Less: Current maturities of long-term debt

     889.7         999.9   
  

 

 

    

 

 

 

Total long-term debt

     16,312.3         7,076.4   
  

 

 

    

 

 

 

Total debt

   $ 18,241.6       $ 8,076.3   
  

 

 

    

 

 

 

 

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BANK CREDIT FACILITIES

On August 29, 2011, ESI entered into a credit agreement (the “new credit agreement”) with a commercial bank syndicate providing for a five-year $4.0 billion term loan facility (the “term facility”) and a $1.5 billion revolving loan facility (the “new revolving facility”). The term facility was used to pay a portion of the cash consideration paid in connection with the Merger, as discussed in Note 3 – Changes in business, to repay existing indebtedness, and to pay related fees and expenses. Subsequent to consummation of the Merger on April 2, 2012, the new revolving facility is available for general corporate purposes and replaced our $750.0 million credit facility upon funding of the term facility on April 2, 2012. The term facility and the new revolving facility both mature on August 29, 2016. As of June 30, 2012, $400.0 million was outstanding under the new revolving facility. Upon consummation of the Merger, Express Scripts assumed the obligations of ESI and became the borrower under the new credit agreement and new revolving facility.

The new credit agreement requires interest to be paid at the LIBOR or adjusted base rate options, plus a margin. The margin over LIBOR ranges from 1.25% to 1.75% for the term facility and 1.10% to 1.55% for the new revolving facility, and the margin over the base rate options ranges from 0.25% to 0.75% for the term facility and 0.10% to 0.55% for the new revolving facility, depending on our consolidated leverage ratio. Under the new credit agreement, we are required to pay commitment fees on the $1.5 billion new revolving facility. The commitment fee ranges from 0.15% to 0.20% depending on the Express Scripts’ consolidated leverage ratio.

On August 13, 2010, ESI entered into a credit agreement with a commercial bank syndicate providing for a three-year revolving credit facility of $750.0 million (the “2010 credit facility”). The 2010 credit facility was terminated and replaced by the new revolving facility on April 2, 2012, as described above.

BRIDGE FACILITY

On August 5, 2011, ESI entered into a credit agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, Citibank, N.A., as syndication agent, and the other lenders and agents named within the agreement. The credit agreement provided for a one-year unsecured $14.0 billion bridge term loan facility (the “bridge facility”) to be used to pay a portion of the cash consideration in connection with the Merger in the event that more favorable financing arrangements could not be secured. No amounts were withdrawn under the bridge facility, and subsequent to consummation of the Merger on April 2, 2012, ESI terminated the bridge facility.

FIVE-YEAR CREDIT FACILITIES

On April 30, 2007, Medco entered into a senior unsecured credit agreement, which was available for general working capital requirements. The facility consisted of a $1.0 billion, 5-year senior unsecured term loan and a $2.0 billion, 5-year senior unsecured revolving credit facility. The facility was due to mature on April 30, 2012. Medco refinanced the $2.0 billion senior unsecured revolving credit facility on January 23, 2012. Upon completion of the Merger, the $1.0 billion senior unsecured term loan and all associated interest, and the $1.0 billion then outstanding under the senior unsecured revolving credit facility, were repaid in full and terminated.

ACCOUNTS RECEIVABLE FINANCING FACILITY

Upon consummation of the Merger, Express Scripts assumed a $600 million, 364-day renewable accounts receivable financing facility that is collateralized by Medco’s pharmaceutical manufacturer rebates accounts receivable. As of June 30, 2012, Express Scripts has drawn down $600.0 million, none of which was repaid, under the facility. Express Scripts pays interest on amounts borrowed under the agreement based on the funding rates of the bank-related commercial paper programs that provide the financing, plus an applicable margin and liquidity fee determined by Express Scripts’ credit rating. This facility is renewable annually as the option of Express Scripts and the banks.

 

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Table of Contents

INTEREST RATE SWAP

Medco entered into five interest rate swap agreements in 2004. These swap agreements, in effect, converted $200 million of Medco’s $500 million of 7.250% senior notes due 2013 to variable interest rate debt. Under the terms of these swap agreements, Medco received a fixed rate of interest of 7.25% on $200 million and paid variable interest rates based on the six-month LIBOR plus a weighted average spread of 3.05%. The payment dates under the agreements coincided with the interest payment dates on the hedged debt instruments and the difference between the amounts paid and received is included in interest expense. These swaps were settled on May 7, 2012. Express Scripts received $10.1 million for settlement of the swaps and the associated accrued interest receivable through May 7, 2012, and recorded a loss of $1.5 million related to the carrying amount of the swaps and bank fees.

SENIOR NOTES

On February 6, 2012, Express Scripts issued $3.5 billion of Senior Notes (the “February 2012 Senior Notes”) in a private placement with registration rights, including:

 

   

$1.0 billion aggregate principal amount of 2.100% Senior Notes due 2015 (“February 2015 Senior Notes”)

 

   

$1.5 billion aggregate principal amount of 2.650% Senior Notes due 2017 (“February 2017 Senior Notes”)

 

   

$1.0 billion aggregate principal amount of 3.900% Senior Notes due 2022 (“February 2022 Senior Notes”)

The net proceeds were used to pay a portion of the cash consideration paid in the Merger and to pay related fees and expenses.

We may redeem some or all of each series of February 2012 Senior Notes prior to maturity at a price equal to the greater of (1) 100% of the aggregate principal amount of any notes being redeemed, plus accrued and unpaid interest; or (2) the sum of the present values of the remaining scheduled payments of principal and interest on the notes being redeemed, not including unpaid interest accrued to the redemption date, discounted to the redemption date on a semiannual basis at the treasury rate plus 30 basis points with respect to any February 2015 Senior Notes being redeemed, 35 basis points with respect to any February 2017 Senior Notes being redeemed, or 40 basis points with respect to any February 2022 Senior Notes being redeemed plus, in each case, unpaid interest on the notes being redeemed, accrued to the redemption date. The February 2012 Senior Notes, issued by Express Scripts, are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed on a senior unsecured basis by ESI and most of our current 100% owned domestic subsidiaries, including, following the consummation of the Merger, Medco and certain of Medco’s 100% owned domestic subsidiaries.

Following the consummation of the Merger on April 2, 2012, several series of senior notes issued by Medco are reported as debt obligations of Express Scripts on a consolidated basis:

 

   

$500.0 million aggregate principal amount of 7.250% senior notes due 2013

 

   

$300.0 million aggregate principal amount of 6.125% senior notes due 2013

 

   

$500.0 million aggregate principal amount of 2.750% senior notes due 2015

 

   

$1,200.0 million aggregate principal amount of 7.125% senior notes due 2018

 

   

$500.0 million aggregate principal amount of 4.125% senior notes due 2020

On May 7, 2012, the Company redeemed Medco’s $500.0 million aggregate principal amount of 7.250% senior notes due 2013. These notes were redeemable at a redemption price equal to the greater of (i) 100% of the principal amount of the notes being redeemed, or (ii) the sum of the present values of 107.25% of the principal amount of these notes being redeemed, plus all scheduled payments of interest on the notes discounted to the redemption date at a semi-annual equivalent yield to a comparable U.S. Treasury security for such redemption date plus 50 basis points. Total cash payments related to these notes were $549.4 million comprised of principal, redemption costs and interest.

On June 15, 2012, $1.0 billion aggregate principal amount of 5.250% senior notes due 2012, issued by ESI, matured and were redeemed.

 

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COVENANTS

Our bank financing arrangements contain covenants that restrict our ability to incur additional indebtedness, create or permit liens on assets and engage in mergers or consolidations. The covenants also include minimum interest coverage ratios and maximum leverage ratios. The 6.125% senior notes due 2013 and the 7.125% senior notes due 2018 issued by Medco are also subject to an interest rate adjustment in the event of a downgrade in the ratings to below investment grade. At June 30, 2012, we believe we were in compliance in all material respects with all covenants associated with our debt instruments (including credit agreements and terms of our senior notes).

Note 8 – Income taxes

As a result of the Merger, we recognized additional income tax contingencies and unfavorable impacts to our effective tax rate. Our effective tax rate increased to 53.0% and 45.0% for the three and six months ended June 30, 2012, respectively, as compared to 37.0% and 36.7% for the same periods in 2011 due to both recurring and nonrecurring events. The state apportionment and income tax filing positions of the combined organization has increased our recurring effective tax rate by approximately 1.9%. Nonrecurring charges, described below, increased our effective tax rate for the three and six months ended June 30, 2012 by 10.9%, and 5.6%, respectively.

Due to the adoption of common income tax return filing methods between ESI and Medco, we recorded a nonrecurring $23.2 million income tax contingency related to prior year income tax return filings. We also recorded a nonrecurring charge of $16.4 million resulting from the reversal of the deferred tax asset previously established for transaction-related costs that became nondeductible upon the consummation of the Merger. Lastly, unrelated to the Merger, we recorded a nonrecurring charge of $5.2 million in the first quarter of 2012 due to changes in our unrecognized tax benefits.

As of June 30, 2012, our gross income tax contingencies increased to $368.6 million primarily due to the acquisition of Medco. A reconciliation of our beginning and ending amount of unrecognized tax benefits is as follows:

 

     June 30,  
(in millions)    2012  

Balance at January 1, 2012

   $ 32.3   

Additions for tax positions related to prior years (1)

     322.2   

Reductions for tax positions related to prior years

     (0.2

Additions for tax positions related to the current year

     14.8   

Reductions as a result of a lapse of the applicable statute of limitations

     (0.5
  

 

 

 

Ending Balance

   $ 368.6   
  

 

 

 

 

(1) Includes an aggregate $291.3 million of Medco income tax contingencies recorded through the Medco opening balance sheet.

Included in our unrecognized tax benefits are $215.3 million of net uncertain tax positions that would impact our effective tax rate if recognized.

For the six months ended June 30, 2012, we recorded $8.1 million of interest and penalties in our unaudited consolidated statement of operations and $43.6 million of interest and penalties recorded through the Medco opening balance sheet resulting in a $55.4 million cumulative balance of accrued interest and penalties in our unaudited consolidated balance sheet. Interest was computed on the difference between the tax position recognized in accordance with accounting guidance and the amount previously taken or expected to be taken in our tax returns.

The Internal Revenue Service (“IRS”) is examining the consolidated 2008 and 2009 U.S. federal income tax returns for both ESI and Medco. Both of these audits are anticipated to be concluded in 2013. The majority of the income tax contingencies are subject to statutes of limitations that are scheduled to expire by the end of 2016.

Note 9 – Common stock

On May 27, 2011, ESI entered into agreements to repurchase shares of its common stock for an aggregate purchase price of $1,750.0 million under an Accelerated Share Repurchase (ASR) arrangement. During 2011, ESI settled $1,725.0 million of the ASR agreement and received 33.4 million shares. On April 27, 2012, we settled the remaining portion of the ASR agreement and received 0.1 million additional shares, resulting in a total of 33.5 million shares received under the agreement.

 

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Upon consummation of the Merger on April 2, 2012, all ESI shares held in treasury were no longer outstanding and were cancelled and retired and ceased to exist. Express Scripts eliminated the value of treasury shares, at cost, recorded on the unaudited consolidated balance sheet immediately prior to the Merger as a reduction to retained earnings and paid-in capital.

The Board of Directors of Express Scripts has not yet adopted a stock repurchase program to allow for the repurchase of shares of Express Scripts.

Note 10 – Stock-based compensation plans

In March 2011, ESI’s Board of Directors adopted the ESI 2011 Long-Term Incentive Plan (the “2011 LTIP”), which provides for the grant of various equity awards with various terms to our officers, directors and key employees selected by the Compensation Committee of the Board of Directors. The 2011 LTIP was approved by ESI’s stockholders in May 2011 and became effective June 1, 2011. Upon consummation of the Merger, the Company assumed sponsorship of the 2011 LTIP. Under the 2011 LTIP, we may issue stock options, stock-settled stock appreciation rights (“SSRs”), restricted stock units, restricted stock awards, performance share awards, and other types of awards. The maximum number of shares available for awards under the 2011 LTIP is 30 million. The maximum term of stock options, SSRs, restricted stock and performance shares granted under the 2011 LTIP is 10 years. Subsequent to the effective date of the 2011 LTIP, no additional awards will be granted under the 2000 Long-Term Incentive Plan (“2000 LTIP”), which provided for the grant of various equity awards with various terms to our officers, directors and key employees selected by the Compensation Committee of the Board of Directors.

Effective upon the closing of the Merger, the Company assumed the sponsorship of the Medco Health Solutions, Inc. 2002 Stock Incentive Plan, originally adopted by Medco, allowing Express Scripts to issue awards under this plan. As of June 30, 2012, 14.3 million shares are available under this plan. Under the Medco Health Solutions, Inc. 2002 Stock Incentive Plan, Medco granted, and Express Scripts may grant, stock options, restricted stock units, and other types of awards to employees and directors. Medco’s awards granted under the 2002 Stock Incentive Plan are subject to accelerated vesting upon change in control and termination.

As part of the consideration transferred in the Merger, Express Scripts issued 41.5 million replacement stock options to holders of Medco stock options, valued at $706.1 million, and 7.2 million replacement restricted stock units to holders of Medco restricted stock units, valued at $174.9 million. See Note 3 – Changes in business, for further discussion of valuation.

STOCK OPTIONS AND SSRs

Express Scripts grants stock options and SSRs to certain officers, directors and employees to purchase shares of Express Scripts Holding Company common stock at the fair market value on the date of grant. ESI’s SSRs and stock options granted under both the 2000 LTIP and 2011 LTIP have three-year graded vesting. Medco’s options granted under the 2002 Stock Incentive Plan generally vest over three years. Due to the nature of the awards, we use the same valuation methods and accounting treatments for SSRs and stock options.

 

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A summary of the status of stock options and SSRs as of June 30, 2012, and changes during the six months ended June 30, 2012, is presented below:

 

(share data in millions)

   Shares     Weighted-
Average
Grant Date
Fair Value
 

ESI outstanding at January 1, 2012

     13.7      $ 34.54   

Medco outstanding converted at April 2, 2012

     41.5        38.61   

Granted

     3.6        53.03   

Exercised

     (5.9     27.44   

Forfeited/Cancelled

     (0.5     46.31   
  

 

 

   

 

 

 

Express Scripts outstanding at June 30, 2012

     52.4      $ 39.72   
  

 

 

   

 

 

 

Express Scripts exercisable at June 30, 2012

     34.4      $ 34.99   
  

 

 

   

 

 

 

The fair value of options and SSRs granted is estimated on the date of grant using a Black-Scholes multiple option-pricing model with the following weighted average assumptions:

 

    

Three Months Ended

June 30,

  

Six Months Ended

June 30,

     2012    2011    2012    2011

Expected life of option

   3-5 years    3-5 years    2-5 years    3-5 years

Risk-free interest rate

   0.4%-0.8%    0.9%-2.0%    0.3%-0.9%    0.9%-2.2%

Expected volatility of stock

   29%-38%    36%-38%    29%-38%    36%-39%

Expected dividend yield

   None    None    None    None

The fair value of Medco converted grants was estimated on the date of the Merger using a Black-Scholes multiple option-pricing model with the following weighted average assumptions:

 

     At April 2, 2012
     Medco
Converted
Grants

Expected life of option

   2 years

Risk-free interest rate

   0.4 %

Expected volatility of stock

   32.9%

Expected dividend yield

   None

The Black-Scholes model requires subjective assumptions, including future stock price volatility and expected time to exercise, which greatly affect the calculated values. The expected term and forfeiture rate of options granted is derived from historical data on employee exercises and post-vesting employment termination behavior, as well as expected behavior on outstanding options. The risk-free rate is based on the U.S. Treasury rates in effect during the corresponding period of grant. The expected volatility is based on the historical volatility of our stock price. These factors could change in the future, which would affect the stock-based compensation expense in future periods.

At June 30, 2012, the weighted-average remaining contractual lives of stock options and SSRs outstanding and stock options and SSRs exercisable were 6.5 years and 5.8 years, respectively, and the aggregate intrinsic value (the amount by which the market value of the underlying stock exceeds the exercise price of the option) of shares outstanding and shares exercisable was $846.5 million and $717.5 million, respectively.

 

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The total grant date fair value of shares vested in 2012 was $127.2 million. Express Scripts expects the majority of outstanding non-vested options and SSRs to vest. The activity related to non-vested options is as follows:

 

(share data in millions)

   Shares     Weighted-
Average
Grant Date
Fair Value
 

ESI non-vested at January 1, 2012

     5.8      $ 13.35   

Medco non-vested converted at April 2, 2012

     16.9        17.99   

Granted

     3.6        15.07   

Vested

     (7.9     15.97   

Forfeited

     (0.4     16.31   
  

 

 

   

 

 

 

Express Scripts non-vested at June 30, 2012

     18.0      $ 16.81   
  

 

 

   

 

 

 

RESTRICTED STOCK UNITS AND PERFORMANCE SHARES

Express Scripts grants restricted stock units to certain officers, directors and employees and performance shares to certain officers and employees. ESI’s restricted stock units granted under both the 2000 LTIP and the 2011 LTIP have a three-year graded vesting and the performance shares cliff vest at the end of the three years. The number of performance shares that ultimately vest is dependent upon achieving specific performance targets. Prior to vesting, these shares are subject to forfeiture to us without consideration upon termination of employment under certain circumstances. The original amount of performance share grants is subject to a multiplier of 2.5 based on certain performance metrics. Medco’s restricted stock units and performance shares granted under the 2002 Stock Incentive Plan generally vest over three years (director options vest in one year). During the first six months of 2012, approximately 0.2 million additional performance shares were granted to certain officers for exceeding certain performance metrics.

A summary of the status of restricted stock and performance shares as of June 30, 2012, and changes during the six months ended June 30, 2012, is presented below:

 

(share data in millions)

   Shares     Weighted-
Average
Grant Date
Fair Value
 

ESI outstanding at January 1, 2012

     1.3      $ 41.92   

Medco outstanding converted at April 2, 2012

     7.2        56.49   

Granted

     0.3        53.03   

Other (1)

     0.2        52.04   

Released

     (2.0     47.51   

Forfeited/Cancelled

     (0.1     53.72   
  

 

 

   

 

 

 

Express Scripts outstanding at June 30, 2012

     6.9      $ 56.08   
  

 

 

   

 

 

 

Express Scripts vested and deferred at June 30, 2012

     0.8      $ 56.49   
  

 

 

   

 

 

 

 

(1) Represents additional performance shares issued above the original value for exceeding certain performance metrics.

 

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Summarized information related to non-vested restricted stock units held by Express Scripts’ employees and directors is as follows:

 

(share data in millions)

   Shares     Weighted-
Average
Grant Date
Fair Value
 

ESI non-vested at January 1, 2012

     1.3      $ 41.92   

Medco non-vested converted at April 2, 2012

     6.3        56.49   

Granted

     0.3        53.03   

Other (1)

     0.2        52.04   

Vested

     (1.9     47.34   

Forfeited

     (0.1     53.72   
  

 

 

   

 

 

 

Express Scripts non-vested at June 30, 2012

     6.1      $ 55.00   
  

 

 

   

 

 

 

 

(1) Represents additional performance shares issued above the original value for exceeding certain performance metrics.

We recognized stock-based compensation expense of $230.0 million and $13.4 million in the three months ended June 30, 2012 and 2011, respectively, and $246.2 million and $25.3 million in the six months ended June 30, 2012 and 2011, respectively. The increases for the three months and six months ended June 30, 2012 include stock-based compensation expense acceleration associated with the termination of certain Medco employees. Unamortized stock-based compensation as of June 30, 2012 was $159.4 million for stock options and SSRs and $168.3 million for restricted stock and performance shares.

Note 11 – Pension and other post-retirement benefits

In connection with the Merger, Express Scripts acquired Medco’s pension and other post-retirement benefit obligations, which were re-measured and recorded at fair value on the acquisition date.

For the pension plans, Express Scripts has elected to determine the projected benefit obligation as the value of the benefits to which employees would be entitled if they separated from service immediately. Under this approach, the liability is equal to the employee’s account value as of the measurement date. After re-measurement upon the acquisition, the fair value of the projected benefit obligation was $291.5 million and the plan assets at fair value totaled $217.0 million, representing an unfunded status and resulting in a balance sheet liability of $74.5 million.

In January 2011, Medco amended its pension plans, freezing the benefit for all participants effective in the first quarter of 2011. After the plan freeze, participants did not accrue any benefits under the plans, and the plans have been closed to new entrants since February 28, 2011. For the three months ended June 30, 2012, the net benefit for Express Scripts’ pension plans consisted of the following components:

 

(in millions)

   Three Months Ended
June  30, 2012
 

Service cost

     —     

Interest cost

     2.1   

Expected return on plan assets

     (4.1
  

 

 

 

Net pension benefit

   $ (2.0
  

 

 

 

Medco’s unfunded postretirement healthcare benefit plan was discontinued for all active non-retirement eligible employees in January 2011. The elimination of the post-retirement healthcare benefit for all active nonretirement-eligible employees was accounted for as a curtailment of the plan. For the three months ended June 30, 2012, the net cost for these post-retirement benefits consisted of interest cost of less than $0.1 million.

The Company paid $2.3 million in the second quarter of 2012, and expects to contribute an additional $14.8 million for the remaining minimum pension funding requirement under the Internal Revenue Code during 2012.

 

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Note 12 – Commitments and contingencies

We have entered into noncancellable agreements to lease certain office and distribution facilities with remaining terms from one to ten years. The majority of our lease agreements include renewal options which would extend the agreements from one to five years. The future minimum lease payments due under noncancellable operating leases are shown below (in millions):

 

     Minimum Lease Payments  

2012 (1)

   $ 49.6   

2013

     79.8   

2014

     64.4   

2015

     43.3   

2016

     34.0   

Thereafter

     62.8   
  

 

 

 
   $ 333.9   
  

 

 

 

 

(1) Represents remaining six months of 2012.

As of June 30, 2012, we have certain required future purchase commitments for prescription products, supplies, services and fixed assets related to the normal course of business. We do not expect potential payments under these provisions to materially affect results of operations or financial condition based upon reasonably likely outcomes derived by reference to historical experience and current business plans. These future purchase commitments (in millions) are summarized below:

 

     Future Purchase Commitments  

2012 (1)

   $ 274.3   

2013

     329.7   

2014

     343.0   

2015

     2.0   

2016

     1.1   

Thereafter

     1.1   
  

 

 

 
   $ 951.2   
  

 

 

 

 

(1) Represents remaining six months of 2012.

In the ordinary course of business there have arisen various legal proceedings, investigations, recoupment demands or claims now pending against us or our subsidiaries. In accordance with applicable accounting guidance, we record accruals for certain of our outstanding legal proceedings, investigations or claims when it is probable that a liability will be incurred and the amount of loss can be reasonably estimated. We evaluate, on a quarterly basis, developments in legal proceedings, investigations or claims that could affect the amount of any accrual, as well as any developments that would make a loss contingency both probable and reasonably estimable. We disclose the amount of the accrual if the financial statements would be otherwise misleading, which was not the case for the six months ending June 30, 2012 or 2011.

We record self-insurance accruals based upon estimates of the aggregate liability of claim costs in excess of our insurance coverage. Accruals are estimated using certain actuarial assumptions followed in the insurance industry and our historical experience. The majority of these claims are legal claims and our liability estimate is primarily related to the cost to defend these claims. We do not accrue for settlements, judgments, monetary fines or penalties until such amounts are probable and estimable. Under authoritative accounting guidance, if the range of probable loss is broad, the liability accrued should be based on the lower end of the range.

When a loss contingency is not both probable and estimable, we do not establish an accrued liability. However, if the loss (or an additional loss in excess of the accrual) is at least a reasonable possibility and material, then we disclose an estimate of the possible loss or range of loss, if such estimate can be made, or disclose that an estimate cannot be made.

 

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The assessments of whether a loss is probable or a reasonable possibility, and whether the loss or a range of loss is estimable, often involve a series of complex judgments about future events. We are often unable to estimate a range of reasonably possible losses, particularly where (i) the damages sought are substantial or indeterminate, (ii) the proceedings are in the early stages, or (iii) the matters involve novel or unsettled legal theories or a large number of parties. In such cases, there is considerable uncertainty regarding the timing or ultimate resolution of such matters, including a possible eventual loss, fine, penalty or business impact, if any. Accordingly, for many proceedings, we are currently unable to estimate the loss or a range of possible loss. For a limited number of proceedings, we may be able to reasonably estimate the possible range of loss in excess of any accruals. However, we believe that such matters, individually and in the aggregate, when finally resolved, are not reasonably likely to have a material adverse effect on our consolidated cash flow or financial condition. We also believe that any amount that could be reasonably estimated in excess of accruals, if any, for such proceedings is not material. However, an adverse resolution of one or more of such matters could have a material adverse effect on our results of operations in a particular quarter or fiscal year.

While we believe our services and business practices are in compliance with applicable laws, rules and regulations in all material respects, we cannot predict the outcome of these claims at this time. An unfavorable outcome in one or more of these matters could result in the imposition of judgments, monetary fines or penalties, or injunctive or administrative remedies. We can give no assurance that such judgments, fines and remedies, and future costs associated with any such matters, would not have a material adverse effect on our financial condition, our consolidated results of operations or our consolidated cash flows.

In December 2011, we received a proposal from a client asserting claims regarding the interpretation of certain contractual terms. We responded with an offer to settle these issues that included a lump sum payment of $30.0 million. Based on authoritative accounting guidance, as of the year ended December 31, 2011, we determined that these communications indicated that a loss is both probable and estimable and we recorded an accrual of $30.0 million as an offset to revenues in the consolidated statement of operations for the year ended December 31, 2011. While we continue to work with this client, we have determined it is still necessary to maintain an accrual of $30.0 million as of June 30, 2012. Accordingly, there has been no impact to the unaudited consolidated statement of operations for the six months ended June 30, 2012. While no final agreement has been reached on the matter, the parties are engaged in active discussions and continue to work to resolve the open issues.

 

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Note 13 – Segment information

During the second quarter of 2012, we reorganized our segments to better reflect our structure following the Merger. Our new segment structure is composed of our domestic and Canadian PBM segment and our Other Business Operations segment.

The PBM segment engages in the following services for which it collects revenues and incurs expenses:

 

   

Domestic and Canadian retail network pharmacy management

 

   

retail drug card programs

 

   

home delivery pharmacy services

 

   

benefit design consultation

 

   

drug utilization review

 

   

drug formulary management programs

 

   

compliance and therapy management programs for our clients

 

   

a flexible array of Medicare Part D products to support clients’ benefits

 

   

specialty pharmacy, including the distribution of fertility pharmaceuticals requiring special handling or packaging

 

   

guidance and decision support for genomic medicine to patients, providers, payors and employees and comprehensive clinical programs

The Other Business Operations segment engages in the following services for which it collects revenues and incurs expenses:

 

   

distribution of pharmaceuticals and medical supplies to providers and clinics

 

   

healthcare account administration and implementation of consumer-directed healthcare solutions

 

   

other international retail network pharmacy management

 

   

home delivery pharmacy services in Germany

 

   

scientific evidence to guide the safe, effective and affordable use of medicines

 

   

diabetes prescriptions and testing supplies

Prior to the second quarter of 2012, our other international retail network pharmacy management business was included in the PBM segment. Additionally, during the third quarter of 2011 we reorganized our FreedomFP line of business from our Other Business Operations segment into our PBM segment. Historical segment information has been retrospectively adjusted to reflect the effect of these changes. Our PBM segment includes ESI’s and Medco’s integrated PBM operations in the United States and ESI’s PBM operations in Canada. Our Other Business Operations segment includes our other international operations, our Specialty Distribution lines of business, and other service operations.

Operating income is the measure used by our chief operating decision maker to assess the performance of each of our operating segments. The following table presents information about our reportable segments for the three and six months ended June 30, 2012 and 2011.

 

(in millions)

   PBM      Other
Business

Operations
    Total  

For the three months ended June 30, 2012

       

Product revenues:

       

Network revenues (1)

   $ 16,834.8       $ —        $ 16,834.8   

Home delivery and specialty revenues (2)

     9,791.6         —          9,791.6   

Other revenues

     —           707.8        707.8   

Service revenues

     239.8         118.5        358.3   
  

 

 

    

 

 

   

 

 

 

Total revenues

     26,866.2         826.3        27,692.5   

Depreciation and amortization expense

     582.1         23.1        605.2   

Operating income (loss)

     538.2         (6.1     532.1   

Undistributed gain from joint venture

          4.3   

Interest income

          2.3   

Interest expense and other

          (175.2
       

 

 

 

Income before income taxes

          363.5   

Capital expenditures

     42.1         5.8        47.9   

 

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(in millions)

   PBM      Other
Business

Operations
    Total  

For the three months ended June 30, 2011

       

Product revenues:

       

Network revenues (1)

   $ 7,389.0       $ —        $ 7,389.0   

Home delivery and specialty revenues (2)

     3,574.9         —          3,574.9   

Other revenues

     —           326.3        326.3   

Service revenues

     65.9         5.3        71.2   
  

 

 

    

 

 

   

 

 

 

Total revenues

     11,029.8         331.6        11,361.4   

Depreciation and amortization expense

     61.2         2.1        63.3   

Operating income

     575.1         4.2        579.3   

Interest income

          1.5   

Interest expense and other

          (50.3
       

 

 

 

Income before income taxes

          530.5   

Capital expenditures

     33.5         1.1        34.6   

For the six months ended June 30, 2012

       

Product revenues:

       

Network revenues (1)

   $ 24,518.6       $ —        $ 24,518.6   

Home delivery and specialty revenues (2)

     13,772.2         —          13,772.2   

Other revenues

     —           1,079.5        1,079.5   

Service revenues

     329.9         124.9        454.8   
  

 

 

    

 

 

   

 

 

 

Total revenues

     38,620.7         1,204.4        39,825.1   

Depreciation and amortization expense

     645.1         25.1        670.2   

Operating income

     1,099.8         (3.2     1,096.6   

Undistributed gain from joint venture

          4.3   

Interest income

          4.6   

Interest expense and other

          (307.2
       

 

 

 

Income before income taxes

          798.3   

Capital expenditures

     59.8         6.8        66.6   

For the six months ended June 30, 2011

       

Product revenues:

       

Network revenues (1)

   $ 14,647.1       $ —        $ 14,647.1   

Home delivery and specialty revenues (2)

     7,037.2         —          7,037.2   

Other revenues

     —           621.6        621.6   

Service revenues

     139.4         10.6        150.0   
  

 

 

    

 

 

   

 

 

 

Total revenues

     21,823.7         632.2        22,455.9   

Depreciation and amortization expense

     122.0         4.2        126.2   

Operating income

     1,124.6         7.1        1,131.7   

Interest income

          1.9   

Interest expense and other

          (90.0
       

 

 

 

Income before income taxes

          1,043.6   

Capital expenditures

     52.3         1.8        54.1   

 

(1) Includes retail pharmacy co-payments of $3,519.1 million and $1,457.1 million for the three months ended June 30, 2012 and 2011, respectively, and $5,015.7 million and $2,983.6 million for the six months ended June 30, 2012 and 2011, respectively.
(2) Includes home delivery, specialty and other including: (a) drugs distributed through patient assistance programs and (b) drugs we distribute to other PBMs’ clients under limited distribution contracts with pharmaceutical manufacturers, and (c) FreedomFP claims.

 

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The following table presents balance sheet information about our reportable segments:

 

(in millions)

   PBM      Other
Business
Operations
     Total  

Total Assets

        

As of June 30, 2012

   $ 56,842.5       $ 1,216.0       $ 58,058.5   

As of December 31, 2011

   $ 15,131.9       $ 475.1       $ 15,607.0   

PBM product revenues consist of revenues from the sale of prescription drugs by retail pharmacies in our retail pharmacy networks, revenues from the dispensing of prescription drugs from our home delivery pharmacies and distribution of certain fertility and specialty drugs. Other Business Operations product revenues consist of specialty distribution activities, the dispensing of prescription drugs from home delivery in Germany, and diabetes prescriptions and testing supplies. PBM service revenues include administrative fees associated with the administration of retail pharmacy networks contracted by certain clients, informed decision counseling services, and specialty distribution services. Other Business Operations service revenues include revenues from international retail network pharmacy management healthcare card administration.

The top five clients in the aggregate represent 37.4% and 40.6% of our consolidated revenue for the three and six months ended June 30, 2012, respectively. None of these clients on an individual basis exceed 12% of consolidated revenues for the three months ended June 30, 2012 and 17% for the six months ended June 30, 2012.

Revenues earned by our international businesses totaled $187.2 million and $15.4 million for the three months ended June 30, 2012 and 2011, respectively, and $206.5 million and $30.9 million for the six months ended June 30, 2012 and 2011, respectively. All other revenues were earned in the United States. Long-lived assets of our international businesses (consisting primarily of fixed assets) totaled $105.5 million and $26.8 million as of June 30, 2012 and December 31, 2011, respectively. All other long-lived assets are domiciled in the United States.

Within our Other Business Operations segment, we have initiated a strategic plan to sell a line of business. We have determined that results of operations for this line of business for both 2012 and 2011 are immaterial to both consolidated and segment results of operations, and we have therefore not presented these results separately for the current or prior period. Operating income (loss) totaled $0.2 million and $(0.2) million for the three months ended June 30, 2012 and 2011, respectively, and $0.3 million and $(0.4) million for the six months ended June 30, 2012 and 2011, respectively. Total assets for this line of business were $34.3 million as of June 30, 2012. The majority of these assets represent goodwill of $12.0 million, restricted cash of $13.3 million and cash of $2.5 million. As these amounts represent less than 0.1% of total consolidated assets, the assets were not classified as held for sale within the consolidated balance sheet. We believe no impairment exists for assets held by this line of business as of June 30, 2012.

 

27


Table of Contents

Note 14 – Condensed consolidating financial information

The senior notes issued by the Company, ESI and Medco are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed by our 100% owned domestic subsidiaries, other than certain regulated subsidiaries, and, with respect to notes issued by ESI and Medco, by us. The following condensed consolidating financial information has been prepared in accordance with the requirements for presentation of such information. The condensed consolidating financial information presented below is not indicative of what the financial position, results of operations, or cash flows would have been had each of the entities operated as an independent company during the period for various reasons, including, but not limited to, intercompany transactions and integration of systems. The condensed consolidating financial information has been retrospectively revised based on the current period structure that exists as of the most recent balance sheet date. The following presents the condensed consolidating financial information separately for:

 

  (i) Express Scripts (the Parent Company), the issuer of certain guaranteed obligations;

 

  (ii) ESI, the issuer of additional guaranteed obligations;

 

  (iii) Medco, the issuer of additional guaranteed obligations;

 

  (iv) Guarantor subsidiaries, on a combined basis (but excluding ESI and Medco), as specified in the indentures related to Express Scripts’, ESI’s and Medco’s obligations under the notes;

 

  (v) Non-guarantor subsidiaries, on a combined basis;

 

  (vi) Consolidating entries and eliminations representing adjustments to (a) eliminate intercompany transactions between or among the Parent Company, the guarantor subsidiaries and the non-guarantor subsidiaries, (b) eliminate the investments in our subsidiaries and (c) record consolidating entries; and

 

  (vii) Express Scripts and subsidiaries on a consolidated basis.

 

28


Table of Contents

Condensed Consolidating Balance Sheet

 

(in millions)

   Express
Scripts
Holding
Company
     Express
Scripts, Inc.
     Medco
Health
Solutions,
Inc.
     Guarantors      Non-
Guarantors
     Eliminations     Consolidated  

As of June 30, 2012

                   

Cash and cash equivalents

   $ —         $ 987.8       $ —         $ 59.4       $ 372.8       $ —        $ 1,420.0   

Restricted cash and investments

     —           —           —           10.8         18.1         —          28.9   

Receivables, net

     —           1,089.0         1,492.2         1,375.4         2,041.2         —          5,997.8   

Other current assets

     —           35.9         569.7         1,561.5         47.5         —          2,214.6   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total current assets

     —           2,112.7         2,061.9         3,007.1         2,479.6         —          9,661.3   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Property and equipment, net

     —           284.9         —           1,447.9         35.7         —          1,768.5   

Investments in subsidiaries

     30,697.0         6,954.0         4,849.9         —           —           (42,500.9     —     

Intercompany

     3,260.8         —           1,457.3         3,336.7         —           (8,054.8     —     

Goodwill

     —           2,921.4         20,389.8         5,887.3         160.1         —          29,358.6   

Other intangible assets, net

     81.9         1,170.5         14,375.1         1,512.0         63.9         —          17,203.4   

Other assets

     —           25.4         18.6         7.6         15.1         —          66.7   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total assets

   $ 34,039.7       $ 13,468.9       $ 43,152.6       $ 15,198.6       $ 2,754.4       $ (50,555.7   $ 58,058.5   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Claims and rebates payable

   $ —         $ 2,604.1       $ 4,300.0       $ —         $ —         $ —        $ 6,904.1   

Accounts payable

     —           305.2         —           1,601.3         114.0         —          2,020.5   

Accrued expenses

     68.1         235.8         242.8         1,135.8         307.4         —          1,989.9   

Short-term loan payable

     400.0         —           —           —           639.6         —          1,039.6   

Current maturities of long-term debt

     579.0         —           310.7         —           —           —          889.7   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total current liabilities

     1,047.1         3,145.1         4,853.5         2,737.1         1,061.0         —          12,843.8   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Long-term debt

     10,864.3         2,990.8         2,457.2         —           —           —          16,312.3   

Intercompany

     —           6,540.1         —           —           1,514.7         (8,054.8     —     

Other liabilities

     —           83.0         5,731.1         921.6         38.4         —          6,774.1   

Stockholders’ equity

     22,128.3         709.9         30,110.8         11,539.9         140.3         (42,500.9     22,128.3   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total liabilities and stockholders’ equity

   $ 34,039.7       $ 13,468.9       $ 43,152.6       $ 15,198.6       $ 2,754.4       $ (50,555.7   $ 58,058.5   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

As of December 31, 2011

                   

Cash and cash equivalents

   $ —         $ 5,522.2       $ —         $ 5.4       $ 92.5       $ —        $ 5,620.1   

Restricted cash and investments

     —           —           —           13.1         4.7         —          17.8   

Receivables, net

     —           1,289.4         —           592.3         34.0         —          1,915.7   

Other current assets

     —           33.8         —           453.1         17.5         —          504.4   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total current assets

     —           6,845.4         —           1,063.9         148.7         —          8,058.0   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Property and equipment, net

     —           293.0         —           105.2         18.0         —          416.2   

Investments in subsidiaries

     542.6         6,812.6         —           —           —           (7,355.2     —     

Intercompany

     5,988.4         —           —           3,953.8         —           (9,942.2     —     

Goodwill

     —           2,921.4         —           2,538.8         25.5         —          5,485.7   

Other intangible assets, net

     29.2         1,331.4         —           256.8         3.5         —          1,620.9   

Other assets

     —           22.1         —           2.5         1.6         —          26.2   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total assets

   $ 6,560.2       $ 18,225.9       $ —         $ 7,921.0       $ 197.3       $ (17,297.4   $ 15,607.0   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Claims and rebates payable

   $ —         $ 2,873.5       $ —         $ 0.6       $ —         $ —        $ 2,874.1   

Accounts payable

     —           686.6         —           238.4         3.1         —          928.1   

Accrued expenses

     —           256.5         —           362.5         37.0         —          656.0   

Short-term loan payable

     —           —           —           —           —           —          —     

Current maturities of long-term debt

     —           999.9         —           —           —           —          999.9   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total current liabilities

     —           4,816.5         —           601.5         40.1         —          5,458.1   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Long-term debt

     4,086.5         2,989.9         —           —           —           —          7,076.4   

Intercompany

     —           9,830.2         —           —           112.0         (9,942.2     —     

Other liabilities

     —           46.7         —           546.4         5.7         —          598.8   

Stockholders’ equity

     2,473.7         542.6         —           6,773.1         39.5         (7,355.2     2,473.7   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

Total liabilities and stockholders’ equity

   $ 6,560.2       $ 18,225.9       $ —         $ 7,921.0       $ 197.3       $ (17,297.47   $ 15,607.0   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

   

 

 

 

 

29


Table of Contents

Condensed Consolidating Statement of Operations

 

(in millions)

   Express
Scripts
Holding
Company
    Express
Scripts, Inc.
    Medco Health
Solutions,
Inc.
    Guarantors     Non-
Guarantors
    Eliminations     Consolidated  

For the three months ended June 30, 2012

  

           

Revenues

   $ —        $ 7,515.6      $ 14,484.4      $ 5,225.6      $ 466.9      $ —        $ 27,692.5   

Operating expenses

     —          7,182.0        14,439.3        5,145.2        393.9        —          27,160.4   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     —          333.6        45.1        80.4        73.0        —          532.1   

Undistributed gain from joint venture

     —          2.2        2.1        —          —          —          4.3   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Interest (expense) income, net

     (96.1     (51.5     (22.2     1.1        (4.2     —          (172.9
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (96.1     284.3        25.0        81.5        68.8        —          363.5   

Provision (benefit) for income taxes

     (33.0     158.8        18.6        52.9        (4.7     —          192.6   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) from continuing operations

     (63.1     125.5        6.4        28.6        73.5        —          170.9   

Equity in earnings of subsidiaries

     234.0        143.8        (41.7     —          —          (336.1     —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     170.9        269.3        (35.3     28.6        73.5        (336.1     170.9   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss), net of tax

     (10.5     (2.3     (8.2     —          (10.5     21.0        (10.5
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

   $ 160.4      $ 267.0      $ (43.5   $ 28.6      $ 63.0      $ (315.1   $ 160.4   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

For the three months ended June 30, 2011

              

Revenues

   $ —        $ 7,239.1      $ —        $ 4,084.2      $ 38.1      $ —        $ 11,361.4   

Operating expenses

     —          6,820.2        —          3,930.0        31.9        —          10,782.1   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     —          418.9        —          154.2        6.2        —          579.3   

Undistributed gain from joint venture

     —          —          —          —          —          —          —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Interest expense, net

     —          (47.5     —          (1.3     —          —          (48.8
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     —          371.4        —          152.9        6.2        —          530.5   

Provision for income taxes

     —          136.4        —          58.0        1.9        —          196.3   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) from continuing operations

     —          235.0        —          94.9        4.3        —          334.2   

Equity in earnings of subsidiaries

     334.2        99.2        —          —          —          (433.4     —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     334.2        334.2        —          94.9        4.3        (433.4     334.2   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss), net of tax

     (0.4     (0.4       —          (0.4     0.8        (0.4
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

   $ 333.8      $ 333.8      $ —        $ 94.9      $ 3.9      $ (432.6   $ 333.8   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

For the six months ended June 30, 2012

              

Revenues

   $ —        $ 15,078.0      $ 14,484.4      $ 9,710.2      $ 552.5      $ —        $ 39,825.1   

Operating expenses

     —          14,401.7        14,439.3        9,437.8        449.7        —          38,728.5   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     —          676.3        45.1        272.4        102.8        —          1,096.6   

Undistributed gain from joint venture

     —          2.2        2.1        —          —          —          4.3   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Interest expense, net

     (155.9     (119.7     (22.2     —          (4.8     —          (302.6
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (155.9     558.8        25.0        272.4        98.0        —          798.3   

Provision (benefit) for income taxes

     (56.2     265.2        18.6        133.4        (1.4     —          359.6   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) from continuing operations

     (99.7     293.6        6.4        139.0        99.4        —          438.7   

Equity in earnings of subsidiaries

     538.4        280.1        (41.7     —          —          (776.8     —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     438.7        573.7        (35.3     139.0        99.4        (776.8     438.7   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss), net of tax

     (8.9     (0.7     (8.2     —          (8.9     17.8        (8.9
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

   $ 429.8      $ 573.0      $ (43.5   $ 139.0      $ 90.5      $ (759.0   $ 429.8   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

30


Table of Contents

Condensed Consolidating Statement of Operations

 

(in millions)

   Express
Scripts
Holding
Company
     Express
Scripts, Inc.
    Medco Health
Solutions, Inc.
     Guarantors     Non-
Guarantors
    Eliminations     Consolidated  

For the six months ended June 30, 2011

  

             

Revenues

   $ —         $ 14,412.2      $ —         $ 7,981.4      $ 62.3      $ —        $ 22,455.9   

Operating expenses

     —           13,545.8        —           7,718.8        59.6        —          21,324.2   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     —           866.4        —           262.6        2.7        —          1,131.7   

Undistributed gain from joint venture

     —           —          —           —          —          —          —     
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Interest (expense) income, net

     —           (85.4     —           (3.0     0.3        —          (88.1
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     —           781.0        —           259.6        3.0        —          1,043.6   

Provision for income taxes

     —           283.5        —           96.0        3.4        —          382.9   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) from continuing operations

     —           497.5        —           163.6        (0.4     —          660.7   

Equity in earnings of subsidiaries

     660.7         163.2        —           —          —          (823.9     —     
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     660.7         660.7        —           163.6        (0.4     (823.9     660.7   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss), net of tax

     0.9         0.9           —          0.9        (1.8     0.9   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

   $ 661.6       $ 661.6      $ —         $ 163.6      $ 0.5      $ (825.7   $ 661.6   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

 

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Table of Contents

Condensed Consolidating Statement of Cash Flows

 

(in millions)

   Express
Scripts
Holding
Company
    Express
Scripts,

Inc.
    Medco Health
Solutions, Inc.
    Guarantors     Non-Guarantors     Eliminations      Consolidated  

For the six months ended June 30, 2012

               

Net cash flows provided by (used in) operating activities

   $ (31.9   $ 361.5      $ 514.3      $ 213.2      $ 199.1      $ —         $ 1,256.2   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Cash flows from investing activities:

               

Acquisition of business, net of cash acquired

     (10,283.6     —          —          —          —          —           (10,283.6

Purchase of property and equipment

     —          (29.9     —          (31.9     (4.8     —           (66.6

Other

     —          —          —          (0.2     (11.0     —           (11.2
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Net cash used in investing activities

     (10,283.6     (29.9     —          (32.1     (15.8     —           (10,361.4
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Cash flows from financing activities:

               

Proceeds from long-term debt, net of discounts

     7,353.6        —          —          —          —          —           7,353.6   

Repayment of long term debt

     —          (1,000.1     (1,500.0     —          —          —           (2,500.1

Proceeds (repayment) of revolving credit line

     400.0        —          (1,000.0     —          —          —           (600.0

Proceeds from accounts receivable financing facility

     —          —          —          —          600.0        —           600.0   

Repayment of accounts receivable financing facility

     —          —          —          —          (1.7     —           (1.7

Excess tax benefit relating to employee stock compensation

     15.6        —          —          —          —          —           15.6   

Net proceeds from employee stock plans

     110.3        —          30.8        —          —          —           141.1   

Deferred financing fees

     (52.4     (50.8     —          —          —          —           (103.2

Treasury stock acquired

     —          —          —          —          —          —           —     

Net transactions with parent

     2,488.4        (3,815.1     1,954.9        (127.1     (501.1     —           —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Net cash provided by (used in) financing activities

     10,315.5        (4,866.0     (514.3     (127.1     97.2        —           4,905.3   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Effect of foreign currency translation adjustment

     —          —          —          —          (0.2     —           (0.2
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Net increase (decrease) in cash and cash equivalents

     —          (4,534.4     —          54.0        280.3        —           (4,200.1

Cash and cash equivalents at beginning of period

     —          5,522.2        —          5.4        92.5        —           5,620.1   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

Cash and cash equivalents at end of period

   $ —        $ 987.8      $ —        $ 59.4      $ 372.8      $ —         $ 1,420.0   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

    

 

 

 

 

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Table of Contents

Condensed Consolidating Statement of Cash Flows

 

(in millions)

   Express
Scripts
Holding
Company
     Express
Scripts,
Inc.
    Medco
Health
Solutions,
Inc.
     Guarantors     Non-
Guarantors
    Eliminations     Consolidated  

For the six months ended June 30, 2011

                

Net cash flows provided by (used in) operating activities

   $ —         $ 573.2      $ —         $ 295.6      $ (2.5   $ (163.2   $ 703.1   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

                

Acquisition of business, net of cash acquired

     —           —          —           —          —          —          —     

Purchase of property and equipment

     —           (46.2     —           (4.1     (3.8     —          (54.1

Other

     —           —          —           2.1        0.3        —          2.4   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net cash used in investing activities

     —           (46.2     —           (2.0     (3.5     —          (51.7
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from financing activities:

                

Proceeds from long-term debt, net of discounts

     —           1,494.0        —           —          —          —          1,494.0   

Repayment of long term debt

     —           (0.1     —           —          —          —          (0.1

Proceeds (repayment) from revolving credit line, net

     —           100.0        —           —          —          —          100.0   

Proceeds from accounts receivable financing facility

     —           —          —           —          —          —          —     

Repayment of accounts receivable financing facility

     —           —          —           —          —          —          —     

Excess tax benefit relating to employee stock compensation

     —           25.9        —           —          —          —          25.9   

Net proceeds from employee stock plans

     —           23.1        —           —          —          —          23.1   

Deferred financing fees

     —           (10.9     —           —          —          —          (10.9

Treasury stock acquired

     —           (2,515.7     —           —          —          —          (2,515.7

Net transactions with parent

     —           98.7        —           (299.4     37.5        163.2        —     
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) financing activities

     —           (785.0     —           (299.4     37.5        163.2        (883.7
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Effect of foreign currency translation adjustment

     —           —          —           —          (0.4     —          (0.4
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net (decrease) increase in cash and cash equivalents

     —           (258.0     —           (5.8     31.1        —          (232.7

Cash and cash equivalents at beginning of period

     —           456.7        —           9.0        58.0        —          523.7   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ —         $ 198.7      $ —         $ 3.2      $ 89.1      $ —        $ 291.0   
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

 

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Table of Contents

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Forward Looking Statements and Associated Risks

Information we have included or incorporated by reference in this Quarterly Report on Form 10-Q, and information which may be contained in our other filings with the Securities and Exchange Commission (“the SEC”) and our press releases or other public statements, contain or may contain forward-looking statements. These forward-looking statements include, among others, statements of our plans, objectives, expectations (financial or otherwise) or intentions.

Our forward-looking statements involve risks and uncertainties. Our actual results may differ significantly from those projected or suggested in any forward-looking statements. We do not undertake any obligation to release publicly any revisions to such forward-looking statements to reflect events or circumstances occurring after the date hereof or to reflect the occurrence of unanticipated events. Any number of factors could cause our actual results to differ materially from those contemplated by any forward-looking statements, including, but not limited to the factors listed below:

STANDARD OPERATING FACTORS

 

   

our ability to remain profitable in a very competitive marketplace is dependent upon our ability to attract and retain clients while maintaining our margins, to differentiate our products and services from others in the marketplace, and to develop and cross-sell new products and services to our existing clients

 

   

our failure to anticipate and appropriately adapt to changes in the rapidly changing healthcare industry

 

   

changes in applicable laws or regulations, or their interpretation or enforcement, or the enactment of new laws or regulations, which apply to our business practices (past, present or future) or require us to spend significant resources in order to comply

 

   

changes to the healthcare industry designed to manage healthcare costs or alter healthcare financing practices

 

   

the termination, or an unfavorable modification, of our relationship with one or more key pharmacy providers, or significant changes within the pharmacy provider marketplace

 

   

our failure to execute on, or other issues arising under, certain key client contracts

 

   

changes relating to our participation in Medicare Part D, the loss of Medicare Part D eligible members, or our failure to otherwise execute on our strategies related to Medicare Part D

 

   

our failure to effectively execute on strategic transactions, or to integrate or achieve anticipated benefits from any acquired businesses

 

   

the impact of our debt service obligations on the availability of funds for other business purposes, and the terms and our required compliance with covenants relating to our indebtedness

 

   

a failure in the security or stability of our technology infrastructure, or the infrastructure of one or more of our key vendors, or a significant failure or disruption in service within our operations or the operations of such vendors

 

   

the termination, or an unfavorable modification, of our relationship with one or more key pharmaceutical manufacturers, or the significant reduction in payments made or discounts provided by pharmaceutical manufacturers

 

   

changes in industry pricing benchmarks

 

   

results in pending and future litigation or other proceedings which would subject us to significant monetary damages or penalties and/or require us to change our business practices, or the costs incurred in connection with such proceedings

 

   

our failure to attract and retain talented employees, or to manage succession and retention for our Chief Executive Officer or other key executives

 

   

other risks described from time to time in our filings with the SEC

 

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Table of Contents

FACTORS RELATED TO THE TRANSACTION WITH MEDCO

 

   

uncertainty around realization of the anticipated benefits of the transaction, including the expected amount and timing of cost savings and operating synergies and a delay or difficulty in integrating the businesses of Express Scripts, Inc. and Medco or in retaining clients of the respective companies

 

   

the impact of transaction and Merger-related costs on our financial results

 

   

uncertainty as to the long-term value of our common shares

These and other relevant factors and any other information included or incorporated by reference in this Report, and information which may be contained in our other filings with the SEC, should be carefully considered when reviewing any forward-looking statement. We note these factors for investors as permitted under the Private Securities Litigation Reform Act of 1995. Investors should understand that it is impossible to predict or identify all such factors or risks. As such, you should not consider either foregoing lists, or the risks identified in our SEC filings, to be a complete discussion of all potential risks or uncertainties.

See the more comprehensive description of risk factors in Part II — Item 1A — “Risk Factors” of this Quarterly Report on Form 10-Q.

 

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Table of Contents

OVERVIEW

On July 20, 2011, Express Scripts, Inc. (“ESI”) entered into a definitive merger agreement (the “Merger Agreement”) with Medco Health Solutions, Inc. (“Medco”), which was amended by Amendment No. 1 thereto on November 7, 2011, providing for the combination of ESI and Medco under a new holding company named Aristotle Holding, Inc. The transactions contemplated by the Merger Agreement (the “Merger”) were consummated on April 2, 2012. Aristotle Holding, Inc. was renamed Express Scripts Holding Company (the “Company” or “Express Scripts”) substantially concurrently with the consummation of the Merger. “We,” “our” or “us” refers to Express Scripts Holding Company and its subsidiaries. For financial reporting and accounting purposes, ESI was the acquirer of Medco. The consolidated financial statements (and other data, such as claims volume) reflect the results of operations and financial position of ESI for 2011 periods and through April 1, 2012. However, references to amounts for periods after the closing of the Merger on April 2, 2012 relate to Express Scripts.

As the largest full-service pharmacy benefit management (“PBM”) company in North America, we provide healthcare management and administration services on behalf of our clients, which include health maintenance organizations, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers’ compensation plans, and government health programs. Our integrated PBM services include network claims processing, home delivery services, patient care and direct specialty and fertility home delivery to patients, benefit plan design consultation, drug utilization review, formulary management, drug data analysis services, distribution of injectable drugs to patients’ homes and physicians’ offices, bio-pharma services, and fulfillment of prescriptions to low-income patients through manufacturer-sponsored patient assistance programs.

During the second quarter of 2012, we reorganized our segments to better reflect our structure following the Merger. Our new segment structure is composed of our domestic and Canadian PBM segment and our Other Business Operations segment. Through our Other Business Operations segment, we provide distribution of pharmaceuticals and medical supplies to providers and clinics, healthcare account administration and implementation of consumer-directed healthcare solutions, international retail network pharmacy management, home delivery pharmacy services in Germany, scientific evidence to guide the safe, effective and affordable use of medicines, and diabetes prescriptions and testing supplies. Our PBM segment includes ESI’s and Medco’s integrated PBM operations in the United States and ESI’s PBM operations in Canada. Our Other Business Operations segment includes our other international operations, our Specialty Distribution lines of business, and other service operations. Historical segment information has been retrospectively adjusted to reflect the effect of these changes.

Revenue generated by our segments can be classified as either tangible product revenue or service revenue. We earn tangible product revenue from the sale of prescription drugs by retail pharmacies in our retail pharmacy networks and from dispensing prescription drugs from our home delivery and specialty pharmacies. Service revenue includes administrative fees associated with the administration of retail pharmacy networks contracted by certain clients, medication counseling services and certain specialty distribution services. Tangible product revenue generated by our PBM and Other Business Operations segments represented 98.7% and 99.4% of revenues for the three months ended June 30, 2012 and 2011, respectively, and 98.9% and 99.3% of revenues for the six months ended June 30, 2012 and 2011, respectively.

In addition, as a result of the Merger, we are assessing our strategic options for many of our businesses included in our Other Business Operations segment for ultimate disposition. This assessment includes estimated goodwill of $500.0 million as of June 30, 2012. The impact from the sale or other disposition of these businesses is not expected to materially impact our ongoing earnings before other income (expense), interest, taxes, depreciation and amortization (“EBITDA”).

MERGER TRANSACTION

As a result of the Merger on April 2, 2012, Medco and ESI each became wholly owned subsidiaries of Express Scripts and former Medco and ESI stockholders became owners of stock in Express Scripts, which is listed for trading on the NASDAQ stock exchange. Upon closing of the Merger, former ESI stockholders owned approximately 59% of Express Scripts and former Medco stockholders owned approximately 41%.

 

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Table of Contents

EXECUTIVE SUMMARY AND TREND FACTORS AFFECTING THE BUSINESS

Our results in the second quarter of 2012 are driven by the addition of Medco to our book of business on April 2, 2012. The Merger impacted all components of our financial statements, including our revenues, expenses, and profits, the consolidated balance sheet, as well as claims volumes. Our results also reflect the successful execution of our business model, which emphasizes the alignment of our financial interests with those of our clients through greater use of generics and low-cost brands, home delivery and specialty pharmacy. We also benefited from better management of ingredient costs through renegotiation of supplier contracts, increased competition among generic manufacturers, and higher generic fill rate (77.4% compared to 73.9% in the same period of 2011). In addition, we are providing our clients with additional tools designed to generate higher generic fill rates, further increase the use of our home delivery and specialty pharmacy services and drive greater adherence.

The positive trends we saw in recent quarters, including lower drug purchasing costs and increased generic usage, are expected to continue to offset the negative impact of various marketplace forces affecting pricing and plan structure and the current adverse economic environment, among other factors, and thus continue to generate growth and improvements in our results of operations in the future.

As the regulatory environment evolves, we expect to continue to make investments designed to keep us ahead of the competition. These projects include preparation for changes to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), Medicare regulations and the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (“Health Reform Laws”).

CRITICAL ACCOUNTING POLICIES

The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Our estimates and assumptions are based upon a combination of historical information and various other assumptions believed to be reasonable under the particular circumstances. Actual results may differ from our estimates. For a full description of our critical accounting policies, please refer to the “Management’s Discussion and Analysis of Financial Condition and Results of Operations – Critical Accounting Policies” included in ESI’s Annual Report on Form 10-K for the year ended December 31, 2011, filed with the SEC on February 22, 2012. Upon consummation of the Merger on April 2, 2012, Medco’s critical accounting policies were conformed to ESI’s critical accounting policies. However, two Medco historical accounting policies have been adopted related to the Medicare prescription drug program and the Cash balance pension plans.

Medicare Prescription Drug Program. Express Scripts’ revenues include premiums associated with our Medicare prescription drug program (“PDP”) risk-based product offerings. These products involve prescription dispensing for beneficiaries enrolled in the Centers for Medicare & Medicaid Services (“CMS”)-sponsored Medicare Part D Prescription Drug Program (“Medicare Part D”) prescription drug benefit. We also offer numerous customized benefit plan designs to employer group retiree plans under the Medicare Part D prescription drug benefit.

The PDP premiums are determined based on our annual bid and related contractual arrangements with CMS. The PDP premiums are primarily comprised of amounts received from CMS as part of a direct subsidy and an additional subsidy from CMS for low-income member premiums, as well as premium payments received from members. These premiums are recognized ratably to revenues over the period in which members are entitled to receive benefits. Premiums received in advance of the applicable benefit period are deferred and recorded in accrued expenses on the consolidated balance sheet. There is a possibility that the annual costs of drugs may be higher or lower than premium revenues. As a result, CMS provides a risk corridor adjustment for the standard drug benefit that compares our actual annual drug costs incurred to the targeted premiums in our CMS-approved bid. Based on specific collars in the risk corridor, we will receive from CMS additional premium amounts or be required to refund to CMS previously received premium amounts. We calculate the risk corridor adjustment on a quarterly basis based on drug cost experience to date and record an adjustment to revenues with a corresponding receivable from or payable to CMS reflected on the consolidated balance sheet.

 

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Table of Contents

In addition to PDP premiums, there are certain co-payments and deductibles (the “cost share”) due from members based on prescription orders by those members, some of which are subsidized by CMS in cases of low-income membership. Beginning in 2011, non-low-income members received a cost share benefit under the coverage gap discount program with brand pharmaceutical manufacturers. For subsidies received in advance, the amount is deferred and recorded in accrued expenses on the consolidated balance sheet. If there is cost share due from members, pharmaceutical manufacturers or CMS, or premiums due from members, the amount is accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, cost share amounts are reconciled with CMS and the corresponding receivable or payable is settled. The cost share is treated consistently as other co-payments derived from providing PBM services, as a component of revenues on the consolidated statement of operations.

Express Scripts’ cost of revenues includes the cost of drugs dispensed by our mail-order pharmacies or retail network for members covered under our Medicare PDP product offerings and is recorded at cost as incurred. We receive a catastrophic reinsurance subsidy from CMS for approximately 80% of costs incurred by individual members in excess of the individual annual out-of-pocket maximum. The subsidy is reflected as an offsetting credit in cost of revenues to the extent that catastrophic costs are incurred. Catastrophic reinsurance subsidy amounts received in advance are deferred and recorded in accrued expenses on the consolidated balance sheet. If there are catastrophic reinsurance subsidies due from CMS, the amount is accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, catastrophic reinsurance amounts are reconciled with CMS and the corresponding receivable or payable is settled.

Pension Plans . Express Scripts has elected to determine the projected benefit obligation for cash balance pension plans as the value of the benefits to which employees participating in the plans would be entitled if they separated from service immediately. The amount by which the projected benefit obligation exceeds the fair value of the pension plan assets is recorded in other liabilities on the consolidated balance sheet.

The determination of our expense for pension plans is based on management’s assumptions, which are developed with the assistance of actuaries. We reassess the plan assumptions on a regular basis. The expected rate of return for the pension plan represents the average rate of return to be earned on the plan assets over the period the benefits included in the benefit obligation are to be paid. The expected return on plan assets is determined by multiplying the expected long-term rate of return by the fair value of the plan assets and contributions, offset by expected return on expected benefit payments. In developing the expected rate of return we consider long-term compounded annualized returns of historical market data, as well as historical actual returns on our plan assets. Using this reference information, we develop forward-looking return expectations for each asset class and a weighted average expected long-term rate of return for a targeted portfolio allocated across these investment categories. As a result of this analysis, for 2012, the expected rate of return assumption is 7.5% for the pension plans.

CLIENTS

We are a provider of PBM services to several market segments. Our clients include HMOs, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers’ compensation plans and government health programs. We provide specialty services to customers who also include HMOs, health insurers, third-party administrators, employers, union-sponsored benefit plans, government health programs, office-based oncologists, renal dialysis clinics, ambulatory surgery centers, primary care physicians, retina specialists, and others. Refer to Note 13 – Segment information for a discussion of client concentration.

 

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Table of Contents

RESULTS OF OPERATIONS

PBM OPERATING INCOME

During the second quarter of 2012, we reorganized our segments to better reflect our structure following the Merger. Our new segment structure is composed of our domestic and Canadian PBM segment and our Other Business Operations segment.

The PBM segment engages in the following services for which it collects revenues and incurs expenses:

 

   

Domestic and Canadian retail network pharmacy management

 

   

retail drug card programs

 

   

home delivery pharmacy services

 

   

benefit design consultation

 

   

drug utilization review

 

   

drug formulary management programs

 

   

compliance and therapy management programs for our clients

 

   

a flexible array of Medicare Part D Prescription Drug Program products to support clients’ benefits

 

   

specialty pharmacy, including the distribution of fertility pharmaceuticals requiring special handling or packaging

 

   

guidance and decision support for genomic medicine to patients, providers, payors and employees and comprehensive clinical programs

The Other Business Operations segment engages in the following services for which it collects revenues and incurs expenses:

 

   

distribution of pharmaceuticals and medical supplies to providers and clinics

 

   

healthcare account administration and implementation of consumer-directed healthcare solutions

 

   

other international retail network pharmacy management

 

   

home delivery pharmacy services in Germany

 

   

scientific evidence to guide the safe, effective and affordable use of medicines

 

   

diabetes prescriptions and testing supplies

Prior to the second quarter of 2012, our other international retail network pharmacy management business was included in the PBM segment. Additionally, during the third quarter of 2011 we reorganized our FreedomFP line of business from our Other Business Operations segment into our PBM segment. Historical segment information has been retrospectively adjusted to reflect the effect of these changes. Our PBM segment includes ESI’s and Medco’s integrated PBM operations in the United States and ESI’s PBM operations in Canada. Our Other Business Operations segment includes our other international operations, our Specialty Distribution lines of business, and other service operations.

Prior to the Merger, ESI and Medco had historically used slightly different methodologies to report claims; however, we believe the differences between the claims reported by ESI and Medco would not be material had the same methodology applied. We have since combined these two approaches into one methodology to be used by the Company going forward. This change was made prospectively beginning April 2, 2012. We have not restated the number of claims in prior periods, because the differences are not material.

 

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Table of Contents
     Three Months Ended      Six Months Ended  
     June 30,      June 30,  

(in millions)

   2012      2011      2012      2011  

Product revenues

           

Network revenues (1)

   $ 16,834.8       $ 7,389.0       $ 24,518.6       $ 14,647.1   

Home delivery and specialty revenues (2)

     9,791.6         3,574.9         13,772.2         7,037.2   

Service revenues

     239.8         65.9         329.9         139.4   
  

 

 

    

 

 

    

 

 

    

 

 

 

Total PBM revenues

     26,866.2         11,029.8         38,620.7         21,823.7   

Cost of PBM revenues (1)

     24,856.9         10,259.5         35,792.4         20,320.7   
  

 

 

    

 

 

    

 

 

    

 

 

 

PBM gross profit

     2,009.3         770.3         2,828.3         1,503.0   

PBM SG&A expenses

     1,471.1         195.2         1,728.5         378.4   
  

 

 

    

 

 

    

 

 

    

 

 

 

PBM operating income

   $ 538.2       $ 575.1       $ 1,099.8       $ 1,124.6   
  

 

 

    

 

 

    

 

 

    

 

 

 

Claims (3)

           

Network

     285.6         148.0         438.6         296.8   

Home delivery and specialty (2)

     38.4         13.3         52.4         26.4   
  

 

 

    

 

 

    

 

 

    

 

 

 

Total PBM claims

     324.0         161.3         491.0         323.2   
  

 

 

    

 

 

    

 

 

    

 

 

 

Total adjusted PBM claims (4)

     397.4         185.6         590.2         371.6   

 

(1) Includes retail pharmacy co-payments of $3,519.1 million and $1,457.1 million for the three months ended June 30, 2012 and 2011, respectively, and $5,015.7 million and $2,983.6 million for the six months ended June 30, 2012 and 2011, respectively.
(2) Includes home delivery, specialty and other including: (a) drugs distributed through patient assistance programs, (b) drugs we distribute to other PBMs’ clients under limited distribution contracts with pharmaceutical manufacturers, and (c) FreedomFP claims.
(3) Claims are calculated based on an updated methodology started April 2, 2012. The prior periods have not been recalculated using the new methodology because we believe the differences would not be material, as discussed above.
(4) Total adjusted claims reflect home delivery claims multiplied by 3, as home delivery claims typically cover a time period 3 times longer than retail claims.

Product Revenues for the three months ended June 30, 2012: Network pharmacy revenues increased by $9,445.8 million, or 127.8%, in the three months ended June 30, 2012 over the same period of 2011. Approximately $9,188.7 million of this increase relates to the acquisition of Medco and inclusion of its revenues for the three months ended June 30, 2012. The remaining increase relates primarily to inflation on branded drugs offset by an increase in the generic fill rate. Our consolidated network generic fill rate increased to 78.7% of network claims in the three months ended June 30, 2012 as compared to 75.2% in the same period of 2011 for ESI on a stand-alone basis.

Home delivery and specialty revenues increased $6,216.7 million, or 173.9%, in the three months ended June 30, 2012 from the same period in 2011. Approximately $5,794.8 million of this increase relates to the acquisition of Medco and inclusion of its revenues for the three months ended June 30, 2012. Of the remaining increase, approximately $226.4 million is primarily due to higher claims volume attributed to the success of mail conversion programs and approximately $195.5 million relates to inflation on branded drugs offset by an increase in the generic fill rate. Our consolidated home delivery generic fill rate increased to 70.5% of home delivery claims in the three months ended June 30, 2012 as compared to 62.7% in the same period of 2011 for ESI on a stand-alone basis.

Product Revenues for the six months ended June 30, 2012: Network pharmacy revenues increased by $9,871.5 million, or 67.4%, in the six months ended June 30, 2012 over the same period of 2011. Approximately $9,188.7 million of this increase relates to the acquisition of Medco and inclusion of its revenues for the three months ended June 30, 2012. Of the remaining increase, approximately $533.0 million of this increase relates to inflation on branded drugs offset by an increase in the generic fill rate and approximately $149.8 million is primarily due to higher claims volume. Our consolidated network generic fill rate increased to 78.4% of network claims in the six months ended June 30, 2012 as compared to 75.1% in the same period of 2011 for ESI on a stand-alone basis.

 

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Home delivery and specialty revenues increased $6,735.0 million, or 95.7%, in the six months ended June 30, 2012 from the same period in 2011. Approximately $5,794.8 million of this increase relates to the acquisition of Medco and inclusion of its revenues for the three months ended June 30, 2012. Of the remaining increase, approximately $493.0 million relates to inflation on branded drugs offset by an increase in the generic fill rate and approximately $447.2 million is primarily due to higher claims volume attributed to the success of mail conversion programs. Our consolidated home delivery generic fill rate increased to 69.4% of home delivery claims in the six months ended June 30, 2012 as compared to 62.2% in the same period of 2011 for ESI on a stand-alone basis.

Cost of PBM revenues increased $14,597.4 million, or 142.3%, and $15,471.7 million, or 76.1%, in the three and six months ended June 30, 2012, respectively, from the same periods of 2011. Approximately $14,101.4 million of this increase relates to the acquisition of Medco and inclusion of its costs of revenues for the three months ended June 30, 2012. The remaining increase in the three and six months ended June 30, 2012 is due primarily to $11.9 million of transaction and integration costs for the three and six months ended June 30, 2012 and increased volume and increased inflation on branded drugs offset by the generic fill rate.

Our PBM gross profit increased $1,239.0 million, or 160.8%, and $1,325.3 million, or 88.2%, for the three and six months ended June 30, 2012, respectively, as compared to the same periods of 2011. Gross profit for the three and six months ended June 30, 2012 increased due to the acquisition of Medco, as well as better management of ingredient costs and cost savings from the increase in the aggregate generic fill rate.

Selling, general and administrative expense (“SG&A”) for our PBM segment for the three months ended June 30, 2012 increased by $1,275.9 million, or 653.6%, as compared to the same period of 2011. Approximately $846.3 million of this increase relates to the acquisition of Medco and inclusion of its SG&A for the three months ended June 30, 2012. The remaining increase primarily relates to $343.9 million of transaction and integration costs, as well as management incentive compensation.

SG&A for our PBM segment for the six months ended June 30, 2012 increased by $1,350.1 million, or 356.8%, as compared to the same period of 2011. Approximately $846.3 million of this increase relates to the acquisition of Medco and inclusion of its SG&A for the six months ended June 30, 2012. The remaining increase primarily relates to $370.6 million of transaction and integration costs, as well as management incentive compensation.

PBM operating income decreased $36.9 million, or 6.4% and $24.8 million, or 2.2% for the three and six months ended June 30, 2012 as compared to the same periods of 2011, based on the various factors described above.

 

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OTHER BUSINESS OPERATIONS OPERATING INCOME

During the second quarter of 2012, we reorganized our segments to better reflect our structure following the Merger. Our new segment structure is composed of our domestic and Canadian PBM segment and our Other Business Operations (“Other Business Ops”) segment. For further description of the services performed by each segment, refer to the discussion under the caption “PBM Operating Income” contained within “Results of Operations.” Historical segment information has been retrospectively adjusted to reflect the effect of these changes.

 

    

Three Months Ended

June 30,

    

Six Months Ended

June 30,

 

(in millions)

   2012     2011      2012     2011  

Product revenues

   $ 707.8      $ 326.3       $ 1,079.5      $ 621.6   

Service revenues

     118.5        5.3         124.9        10.6   
  

 

 

   

 

 

    

 

 

   

 

 

 

Total Other Business Ops revenues

     826.3        331.6         1,204.4        632.2   

Cost of Other Business Ops revenues

     722.7        317.8         1,087.8        605.6   
  

 

 

   

 

 

    

 

 

   

 

 

 

Other Business Ops gross profit

     103.6        13.8         116.6        26.6   

Other Business Ops SG&A expenses

     109.7        9.6         119.8        19.5   
  

 

 

   

 

 

    

 

 

   

 

 

 

Other Business Ops operating (loss) income

   $ (6.1   $ 4.2       $ (3.2   $ 7.1   
  

 

 

   

 

 

    

 

 

   

 

 

 

Claims

         

Home delivery and specialty

     2.3        0.0         2.3        0.0   
  

 

 

   

 

 

    

 

 

   

 

 

 

Total adjusted Other Business Ops claims (1)

     6.9        0.0         6.9        0.0   

 

(1) Total adjusted claims reflect home delivery claims multiplied by 3, as home delivery claims typically cover a time period 3 times longer than retail claims.

Other Business Ops: Other Business Ops operating (loss) income decreased by $10.3 million, or 245.2%, and $10.3 million, or 145.1%, for the three and six months ended June 30, 2012 from the same period of 2011. Approximately $8.4 million of this decrease relates to the acquisition of Medco and inclusion of its operating loss for the three and six months ended June 30, 2012. The remaining decrease primarily relates to higher costs due to product mix which were partially offset by decreases in volume across all lines of business within the segment.

OTHER (EXPENSE) INCOME

Net interest expense and other increased $119.8 million and $210.2 million in the three and six months ended June 30, 2012, respectively, as compared to the same periods of 2011. These increases are primarily due to interest associated with senior notes issued in May 2011 and debt issued in connection with the Merger.

PROVISION FOR INCOME TAXES

Our effective tax rate increased to 53.0% and 45.0% for the three and six months ended June 30, 2012, respectively, as compared to 37.0% and 36.7% for the same periods in 2011 due to both recurring and nonrecurring events. The state apportionment and income tax filing positions of the combined organization has increased our recurring effective tax rate by approximately 1.9%. Nonrecurring charges increased our effective tax rate for the three end six months ended June 30, 2012 by 10.9% and 5.6%, respectively.

 

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Due to the adoption of common income tax return filing methods between ESI and Medco, we recorded a nonrecurring $23.2 million income tax contingency related to prior year income tax return filings. We also recorded a nonrecurring charge of $16.4 million resulting from the reversal of the deferred tax asset previously established for transaction-related costs that became nondeductible upon the consummation of the Merger. Lastly, unrelated to the Merger, we recorded a nonrecurring charge of $5.2 million in the first quarter of 2012 due to changes in our unrecognized tax benefits.

NET INCOME AND EARNINGS PER SHARE

Net income for the three and six months ended June 30, 2012 decreased $163.3 million, or 48.9%, and $222.0 million, or 33.6%, respectively, over the same periods of 2011. Basic and diluted earnings per share both decreased 68.2% for the three months ended June 30, 2012 over the same period of 2011. For the six months ended June 30, 2012, basic and diluted earnings per share decreased 46.9% and 48.0%, respectively, over the same period of 2011. These decreases are primarily due to transaction costs incurred in connection with the Merger, as well as an increase in shares outstanding in connection with the Merger, interest expense, financing fees, and commitment fees, partially offset by increased gross profit and treasury share repurchases during 2011.

EBITDA

We have provided below a reconciliation of EBITDA to net income as we believe it is the most directly comparable measure calculated under accounting principles generally accepted in the United States:

 

EBITDA (1)   

Three Months Ended

June 30,

    

Six Months Ended

June 30,

 

(in millions, except per claim data)

   2012     2011      2012     2011  

Net income

   $ 170.9      $ 334.2       $ 438.7      $ 660.7   

Income taxes

     192.6        196.3         359.6        382.9   

Depreciation and amortization

     605.2        63.3         670.2        126.2   

Interest expense, net

     172.9        48.8         302.6        88.1   

Undistributed gain from joint venture

     (4.3     —           (4.3     —     
  

 

 

   

 

 

    

 

 

   

 

 

 

EBITDA

     1,137.3        642.6         1,766.8        1,257.9   

Adjustments to EBITDA

         

Transaction and integration costs

     355.8        —           382.5        —     
  

 

 

   

 

 

    

 

 

   

 

 

 

Adjusted EBITDA

     1,493.1        642.6         2,149.3        1,257.9   

Total adjusted claims

     404.3        185.7         597.1        371.8   
  

 

 

   

 

 

    

 

 

   

 

 

 

Adjusted EBITDA per adjusted claim (2)

   $ 3.69      $ 3.46       $ 3.60      $ 3.38   

 

(1) EBITDA is earnings before other income (expense), interest, taxes, depreciation and amortization, or alternatively calculated as operating income plus depreciation and amortization. EBITDA is presented because it is a widely accepted indicator of a company’s ability to service indebtedness and is frequently used to evaluate a company’s performance. EBITDA, however, should not be considered as an alternative to net income, as a measure of operating performance, as an alternative to cash flow, as a measure of liquidity or as a substitute for any other measure computed in accordance with accounting principles generally accepted in the United States. In addition, our definition and calculation of EBITDA may not be comparable to that used by other companies.
(2) Adjusted EBITDA per adjusted claim is a supplemental measurement used by analysts and investors to help evaluate overall operating performance. We have calculated adjusted EBITDA excluding certain charges recorded each year, as these charges are not considered an indicator of ongoing company performance. Adjusted EBITDA per adjusted claim is calculated by dividing adjusted EBITDA by the adjusted claim volume for the period. This measure is used as an indicator of EBITDA performance on a per-unit basis. Adjusted EBITDA, and as a result, EBITDA per adjusted claim, are affected by the changes in claim volumes between retail and mail-order, the relative representation of brand-name, generic and specialty pharmacy drugs, as well as the level of efficiency in the business.

 

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LIQUIDITY AND CAPITAL RESOURCES

OPERATING CASH FLOW, CAPITAL EXPENDITURES AND FINANCING

For the six months ended June 30, 2012, net cash provided by operations increased $553.1 million to $1,256.2 million compared to the same period of 2011. Changes in working capital resulted in cash inflow of $24.8 million in the six months ended June 30, 2012 compared to a cash outflow of $210.6 million over the same period of 2011, resulting in a total change of $235.4 million. The cash flow increase was primarily due to the Merger as well as the timing and receipt of accounts receivable. This increase was offset by a decrease in net income of $222.0 million in the six months ended June 30, 2012 compared to the same period of 2011.

Net cash used in investing activities increased $10,309.7 million for the six months ended June 30, 2012 over the same period of 2011 primarily due to cash outflows in connection with the Merger offset against net cash acquired from Medco as of April 2, 2012. Capital expenditures increased compared to the prior period due primarily to integration-related investments. We intend to continue to invest in infrastructure and technology that we believe will provide efficiencies in operations, facilitate growth and enhance the service we provide to our clients. Anticipated capital expenditures will be funded primarily from operating cash flow or, to the extent necessary, with borrowings under our revolving credit facility, discussed below.

Net cash provided by financing activities increased $5,789.0 million for the six months ended June 30, 2012 compared to the same period in 2011. This increase is primarily due to proceeds of $3,458.9 million from the issuance of senior notes during the three months ended March 31, 2012 and proceeds of $4,000.0 million in connection with the term facility used to fund the Merger. The increase was offset by $1,500.0 million redemption of senior notes and $2,000.0 million retirement of Medco’s five year credit facilities.

Medco held a $1,000.0 million senior unsecured revolving credit facility and a $1,000.0 million senior unsecured term loan at the time of the Merger on April 2, 2012. Immediately upon consummation of the Merger, we repaid the credit facility, term loan and all associated interest.

On May 7, 2012, the Company redeemed Medco’s $500.0 million aggregate principal amount of 7.25% senior notes due 2013. These notes were redeemable at a redemption price equal to the greater of (i) 100% of the principal amount of the notes being redeemed, or (ii) the sum of the present values of 107.25% of the principal amount of these notes being redeemed, plus all scheduled payments of interest on the notes discounted to the redemption date at a semi-annual equivalent yield to a comparable U.S. Treasury security for such redemption date plus 50 basis points. Total cash payments related to these notes were $549.4 million comprised of principal, redemption costs and interest. In connection with this redemption, on May 7, 2012 Medco settled five interest rate swap agreements entered into in 2004.

On June 15, 2012, $1.0 billion aggregate principal amount of 5.250% senior notes due 2012, issued by ESI, matured and were redeemed.

We anticipate that our current cash balances, cash flows from operations and our revolving credit facility will be sufficient to meet our cash needs and make scheduled payments for our contractual obligations and current capital commitments. However, if needs arise, we may decide to secure external capital to provide additional liquidity. New sources of liquidity may include additional lines of credit, term loans, or issuance of notes or common stock, all of which are allowable, with certain limitations, under our existing credit agreement and other debt instruments. While our ability to secure debt financing in the short term at rates favorable to us may be moderated due to various factors, including the financing incurred in connection with the Merger, market conditions or other factors, we believe our liquidity options discussed above should be sufficient to meet our anticipated cash flow needs.

 

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CHANGES IN BUSINESS

As a result of the Merger on April 2, 2012, Medco and ESI each became wholly owned subsidiaries of the Company and former Medco and ESI stockholders became owners of stock in Express Scripts, which is listed for trading on the NASDAQ. Upon closing of the Merger, former ESI stockholders own approximately 59% of Express Scripts and former Medco stockholders own approximately 41%. Per the terms of the Merger Agreement, each share of Medco common stock was converted into (i) the right to receive $28.80 in cash, without interest and (ii) 0.81 shares of Express Scripts stock. Holders of Medco stock options, restricted stock units, and deferred stock units received a replacement award at an exchange ratio of 1.3474 Express Scripts awards for each Medco award earned, which is equal to the sum of (i) 0.81 and (ii) the quotient obtained by dividing (1) $28.80 (the cash component of the Merger consideration) by (2) an amount equal to the average of the closing prices of ESI common stock on the NASDAQ for each of the 15 consecutive trading days ending with the fourth complete trading day prior to the completion of the Merger. Based on the opening price of Express Scripts’ stock on April 2, 2012, total consideration was $30.2 billion, composed of $11.3 billion in cash, $18.0 billion in common stock of the Company, and $0.9 billion of replacement stock options and restricted stock units. We believe the Merger will combine the expertise of two complementary pharmacy benefit managers to accelerate efforts to lower the cost of prescription drugs and improve the quality of care.

We regularly review potential acquisitions and affiliation opportunities. We believe available cash resources, bank financing or the issuance of additional common stock could be used to finance future acquisitions or affiliations. There can be no assurance we will make new acquisitions or establish new affiliations in 2012 or thereafter, other than the Merger with Medco.

STOCK REPURCHASE PROGRAM

Upon consummation of the Merger on April 2, 2012, all ESI shares held in treasury were no longer outstanding and were cancelled and retired and ceased to exist.

The Board of Directors of Express Scripts has not yet adopted a stock repurchase program to allow for the repurchase of shares of Express Scripts.

ACCELERATED SHARE REPURCHASE

On May 27, 2011, ESI entered into agreements to repurchase shares of its common stock for an aggregate purchase price of $1,750.0 million under an Accelerated Share Repurchase (ASR) arrangement. During 2011, ESI settled $1,725.0 million of the ASR agreement and received 33.4 million shares. On April 27, 2012, we settled the remaining portion of the ASR agreement and received 0.1 million additional shares, resulting in a total of 33.5 million shares received under the agreement.

BANK CREDIT FACILITIES

On August 29, 2011, ESI entered into a credit agreement (the “new credit agreement”) with a commercial bank syndicate providing for a five-year $4.0 billion term loan facility (the “term facility”) and a $1.5 billion revolving loan facility (the “new revolving facility”). The term facility was used to pay a portion of the cash consideration paid in connection with the Merger, as discussed in Note 3 – Changes in business, to repay existing indebtedness, and to pay related fees and expenses. Subsequent to consummation of the Merger on April 2, 2012, the new revolving facility is available for general corporate purposes and replaced our $750.0 million credit facility upon funding of the term facility on April 2, 2012. The term facility and the new revolving facility both mature on August 29, 2016. As of June 30, 2012, $400.0 million was outstanding under the new revolving facility. Upon consummation of the Merger, Express Scripts assumed the obligations of ESI and became the borrower under the new credit agreement and new revolving facility.

On August 13, 2010, ESI entered into a credit agreement with a commercial bank syndicate providing for a three-year revolving credit facility of $750.0 million (the “2010 credit facility”). The 2010 credit facility was terminated and replaced by the new revolving facility on April 2, 2012, as described above.

Our credit agreements contain covenants that restrict our ability to incur additional indebtedness, create or permit liens on assets and engage in mergers or consolidations. The covenants under the new credit agreement exempt such agreed upon actions taken in connection with the Merger. The covenants also include minimum interest coverage ratios and maximum leverage ratios. At June 30, 2012, we believe we were in compliance in all material respects with all covenants associated with our credit agreements.

 

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See Note 7 – Financing for more information on our credit facilities.

BRIDGE FACILITY

On August 5, 2011, ESI entered into a credit agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, Citibank, N.A., as syndication agent, and the other lenders and agents named within the agreement. The credit agreement provided for a one-year unsecured $14.0 billion bridge term loan facility (the “bridge facility”) to be used to pay a portion of the cash consideration in connection with the Merger in the event that more favorable financing arrangements could not be secured. No amounts were withdrawn under the bridge facility, and subsequent to consummation of the Merger on April 2, 2012, ESI terminated the bridge facility.

FIVE-YEAR CREDIT FACILITIES

On April 30, 2007, Medco entered into a senior unsecured credit agreement, which was available for general working capital requirements. The facility consisted of a $1.0 billion, 5-year senior unsecured term loan and a $2.0 billion, 5-year senior unsecured revolving credit facility. The facility was due to mature on April 30, 2012. Medco refinanced the $2.0 billion senior unsecured revolving credit facility on January 23, 2012. Upon completion of the Merger, the $1.0 billion senior unsecured term loan and all associated interest, and the $1.0 billion then outstanding under the senior unsecured revolving credit facility, were repaid in full and terminated.

ACCOUNTS RECEIVABLE FINANCING FACILITY

Upon consummation of the Merger, Express Scripts assumed a $600 million, 364-day renewable accounts receivable financing facility that is collateralized by Medco’s pharmaceutical manufacturer rebates accounts receivable. As of June 30, 2012, Express Scripts has drawn down $600.0 million, none of which was repaid, under the facility. Express Scripts pays interest on amounts borrowed under the agreement based on the funding rates of the bank-related commercial paper programs that provide the financing, plus an applicable margin and liquidity fee determined by Express Scripts’ credit rating. This facility is renewable annually as the option of Express Scripts and the banks.

INTEREST RATE SWAP

Medco entered into five interest rate swap agreements in 2004. These swap agreements, in effect, converted $200 million of Medco’s $500 million of 7.250% senior notes due 2013 to variable interest rate debt. Under the terms of these swap agreements, Medco received a fixed rate of interest of 7.25% on $200 million and paid variable interest rates based on the six-month LIBOR plus a weighted average spread of 3.05%. The payment dates under the agreements coincided with the interest payment dates on the hedged debt instruments and the difference between the amounts paid and received is included in interest expense. These swaps were settled on May 7, 2012. Express Scripts received $10.1 million for settlement of the swaps and the associated accrued interest receivable through May 7, 2012, and recorded a loss of $1.5 million related to the carrying amount of the swaps and bank fees.

SENIOR NOTES

On February 6, 2012, we issued $3.5 billion of Senior Notes in a private placement with registration rights, including:

 

   

$1.0 billion aggregate principal amount of 2.100% Senior Notes due 2015

 

   

$1.5 billion aggregate principal amount of 2.650% Senior Notes due 2017

 

   

$1.0 billion aggregate principal amount of 3.900% Senior Notes due 2022

 

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On November 14, 2011, we issued $4.1 billion of Senior Notes in a private placement with registration rights, including:

 

   

$900 million aggregate principal amount of 2.750% Senior Notes due 2014

 

   

$1.25 billion aggregate principal amount of 3.500% Senior Notes due 2016

 

   

$1.25 billion aggregate principal amount of 4.750% Senior Notes due 2021

 

   

$700 million aggregate principal amount of 6.125% Senior Notes due 2041

The net proceeds were used to pay a portion of the cash consideration paid in the Merger and to pay related fees and expenses (see Note 3 – Changes in business).

On May 2, 2011, ESI issued $1.5 billion aggregate principal amount of 3.125% Senior Notes due 2016. The proceeds were used to repurchase treasury shares.

On September 10, 2010, Medco issued $1.0 billion of Senior Notes, including:

 

   

$500 million aggregate principal amount of 2.75% Senior Notes due 2015

 

   

$500 million aggregate principal amount of 4.125% Senior notes due 2020

The net proceeds were used for general corporate purposes, which including funding the United BioSource Corporation (“UBC”) acquisition.

On June 9, 2009, ESI issued $2.5 billion of Senior Notes, including:

 

   

$1.0 billion aggregate principal amount of 5.250% Senior Notes due 2012

 

   

$1.0 billion aggregate principal amount of 6.250% Senior Notes due 2014

 

   

$500 million aggregate principal amount of 7.250% Senior Notes due 2019

The net proceeds were used for the acquisition of WellPoint’s NextRx PBM Business. On June 15, 2012, the Company redeemed ESI’s $1.0 billion aggregate principal amount of 5.250% senior notes due 2012 (see Note 7 – Financing for further discussion).

On March 18, 2008, Medco issued $1.5 billion of Senior Notes, including:

 

   

$300.0 million aggregate principal amount of 6.125% Senior Notes due 2013

 

   

$1.2 billion aggregate principal amount of 7.125% Senior Notes due 2018

The net proceeds were used to reduce debts held on Medco’s revolving credit facility, which funded the PolyMedica Corporation (“Liberty”) and CCS Infusion Management, LLC (“CCS”) acquisitions.

See Note 7 – Financing for more information on our Senior Notes borrowings.

 

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CONTRACTUAL OBLIGATIONS AND COMMERCIAL COMMITMENTS

The following table sets forth our schedule of current maturities of our long-term debt as of June 30, 2012, future minimum lease payments due under noncancellable operating leases of our continuing operations, and purchase commitments (in millions):

 

     Payments due by period as of June 30, 2012  

Contractual obligations

   Total      2012 (1)      2013-2014      2015-2016      Thereafter  

Long-term debt (2)

   $ 16,903.5       $ 490.5       $ 4,366.3       $ 6,226.6       $ 5,820.1   

Future minimum lease payments

     333.9         49.6         144.2         77.3         62.8   

Purchase commitments (3)

     951.2         274.3         672.7         3.1         1.1   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total contractual cash obligations

   $ 18,188.6       $ 814.4       $ 5,183.2       $ 6,307.0       $ 5,884.0   
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

 

(1) Represents remaining six months of 2012.
(2) These payments exclude the interest expense on our revolving credit facility, which requires us to pay interest on LIBOR plus a margin. Our interest payments fluctuate with changes in LIBOR and in the margin over LIBOR we are required to pay (see “Note 7 – Financing – Bank Credit Facilities”), as well as the balance outstanding on our revolving credit facility. Interest payments on our Senior Notes are fixed, and have been included in these amounts.
(3) These amounts consist of required future purchase commitments for prescription products, supplies, services and fixed assets in the normal course of business. We do not expect potential payments under these provisions to materially affect results of operations or financial condition. This conclusion is based upon reasonably likely outcomes derived by reference to historical experience and current business plans.

We have a remaining minimum pension funding requirement of $14.8 million under the Internal Revenue Code during 2012.

OTHER MATTERS

As previously noted in ESI’s Annual Report on Form 10-K for the year ended December 31, 2011, the contract with Walgreens Co. (“Walgreens”) expired on December 31, 2011. Prior to expiration of the contract with Walgreens, we provided a full array of tools and resources to help members efficiently transfer prescriptions to other conveniently located pharmacies. As announced on July 19, 2012, Express Scripts and Walgreens have reached a multi-year pharmacy network agreement with rates and terms under which Walgreens will participate in our broadest Express Scripts retail pharmacy network available to new and existing clients, as of September 15, 2012. Express Scripts will work to provide a smooth transition for those plan sponsors who will include Walgreen’s pharmacies in their network.

IMPACT OF INFLATION

Changes in prices charged by manufacturers and wholesalers for pharmaceuticals affect our revenues and cost of revenues. Most of our contracts provide that we bill clients based on a generally recognized price index for pharmaceuticals.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

We are exposed to market risk from changes in interest rates related to debt outstanding under our credit agreement. Our earnings are subject to change as a result of movements in market interest rates. At June 30, 2012, we had $3,453.7 million of obligations, net of cash, which were subject to variable rates of interest under our credit agreements. A hypothetical increase in interest rates of 1% would result in an increase in annual interest expense of approximately $34.5 million (pre-tax), presuming that obligations subject to variable interest rates remained constant.

Item 4. Controls and Procedures

We maintain a comprehensive set of disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (“Exchange Act”)) designed to provide reasonable assurance that information required to be disclosed in our filings under the Exchange Act is recorded, processed, summarized and reported accurately and within the time periods specified in the SEC’s rules and forms. Under the supervision and with the participation of our management, including our Chairman, President and Chief Executive Officer and our Executive Vice President and Chief Financial Officer, we have evaluated the effectiveness of the design and operation of our disclosure controls and procedures as of the end of the period covered by this report. Based upon this evaluation, the Chairman, President and Chief Executive Officer and the Executive Vice President and Chief Financial Officer concluded that the design and operation of these disclosure controls and procedures are effective in providing reasonable assurance of the achievement of the objectives described above.

On April 2, 2012, the Company acquired Medco Health Solutions, Inc. (“Medco”). As a result of the Medco acquisition, the Company has incorporated internal controls over significant processes specific to the acquisition that it believes to be appropriate and necessary in consideration of the level of related integration. As the Company further integrates the Medco business, it will continue to review the internal controls and may take further steps to ensure that the internal controls are effective and integrated appropriately.

Except as described in the preceding paragraph, during the quarter ended June 30, 2012, there was no change in our internal control over financial reporting that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

 

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PART II. OTHER INFORMATION

Item 1. Legal Proceedings

We and/or our subsidiaries are parties to a number of lawsuits, claims, government inquiries, investigations, charges and proceedings in which unspecified damages are sought. We cannot ascertain with any certainty at this time the monetary damages or injunctive relief that any of the opposing parties may seek to recover. We also cannot provide any assurance that the outcome of any of these matters, or some number of them in the aggregate, will not be materially adverse to our financial condition, consolidated results of operations, cash flows or business prospects. In addition, the expenses of defending these cases may have a material adverse effect on our financial results.

In the Quarterly Report on Form 10-Q for the quarter ended March 31, 2012, we described certain proceedings related to Medco which affect us following the closing of the Merger. The following developments have occurred since the filing of our Annual Report on Form 10-K for the year ended December 31, 2011 and the Quarterly Report on Form 10-Q for the quarter ended March 31, 2012, relating to proceedings involving both legacy ESI and Medco:

 

   

Jerry Beeman, et al. v. Caremark, et al. (Case No.021327, United States District Court for the Central District of California). On December 12, 2002, a complaint was filed against Express Scripts and NextRX LLC f/k/a Anthem Prescription Management LLC and several other pharmacy benefit management companies. The complaint, filed by several California pharmacies as a putative class action, alleges rights to sue as a private attorney general under California law. The complaint alleges that we, and the other defendants, failed to comply with statutory obligations under California Civil Code Section 2527 to provide our California clients with the results of a bi-annual survey of retail drug prices. On July 12, 2004, the case was dismissed with prejudice on the grounds that the plaintiffs lacked standing to bring the action. On June 2, 2006, the United States Court of Appeals for the Ninth Circuit reversed the district court’s opinion on standing and remanded the case to the district court. The district court’s denial of defendants’ motion to dismiss on California state first amendment constitutionality grounds is currently on appeal to the Ninth Circuit. Plaintiffs have filed a motion for class certification, but that motion has not been briefed pending the outcome of the appeal. On July 19, 2011, the Ninth Circuit affirmed the district court’s denial of defendants’ motion to dismiss. On August 16, 2011, defendants filed a petition for rehearing en banc for the Ninth Circuit’s reconsideration of its ruling on defendants’ motion to dismiss, which was granted on October 31, 2011. On June 6, 2012, the Ninth Circuit certified the first amendment issue for the Supreme Court of California’s review and requested an authoritative decision on the question of California constitutional law. The Supreme Court of California accepted the Ninth Circuit’s request on July 18, 2012, and we await the Court’s ruling.

 

   

Irwin v. WellPoint Health Networks, et. al. (Judicial Arbitration and Mediation Services). On March 25, 2003, plaintiff filed a complaint in California state court against WellPoint Health Networks and certain related entities, including one of the acquired NextRX subsidiaries (collectively “WellPoint”), ESI, and other PBMs alleging his right to sue under California’s Unfair Competition Law (UCL). ESI was dismissed in 2008, but WellPoint remains a defendant. This case purported to be a class action against the PBM defendants on behalf of self-funded, non-ERISA health plans and individuals with no prescription drug benefits that have purchased drugs at retail rates. On May 6, 2004, WellPoint invoked an arbitration clause and the case against WellPoint was stayed and sent to arbitration. On February 24, 2006, plaintiff served an arbitration demand against WellPoint alleging that numerous WellPoint business practices violated the UCL and making claims on behalf of California residents who paid taxes, California residents who were beneficiaries of non-ERISA health plans, and California residents who obtained prescription benefits from non-ERISA health plans. On October 11, 2006, WellPoint filed its response to the arbitration demand. No further activity occurred until July 16, 2012, when WellPoint filed a motion to dismiss plaintiff’s arbitration demand for failure to prosecute the case for over nine years.

 

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Several lawsuits were filed by stockholders of Medco challenging the Merger following the announcement on July 21, 2011, that ESI and Medco had entered into a definitive merger agreement. The complaints in the actions name as defendants Medco and/or various members of Medco’s board of directors as well as ESI and certain of its subsidiaries that are party to the merger agreement. Twenty-two complaints were filed in three different venues: the Court of Chancery of the State of Delaware, in the United States District Court for the District of New Jersey, and in the Superior Court of the State of New Jersey. The plaintiffs in the purported class action complaints generally alleged, among other things, that (i) the members of Medco’s board of directors breached their fiduciary duties to Medco and its stockholders by authorizing the proposed merger and (ii) ESI and three of its subsidiaries - Plato Merger Sub, Inc., the Company (then Aristotle Holding, Inc.) and Aristotle Merger Sub, Inc. - aided and abetted the alleged breaches of fiduciary duty by Medco and its directors. The plaintiffs sought, among other things, to enjoin the defendants from consummating the merger transaction on the agreed-upon terms, and unspecified compensatory damages, together with the costs and disbursements of the action. A class was certified in the Court of Chancery of the State of Delaware. The cases filed in the Superior Court of the State of New Jersey were stayed on August 26, 2011. On November 7, 2011, the parties entered into a memorandum of understanding in which they agreed upon the terms of settlement, and plaintiffs agreed to withdraw applications for preliminary injunction of the acquisition and stay all further litigation pending court approval of the settlement. The terms of the settlement are reflected in the Amendment No. 1 to Agreement and Plan of Merger, which was included as Exhibit 2.1 to ESI’s Current Report on Form 8-K filed November 8, 2011. On April 18, 2012, the United States District of New Jersey approved the settlement and dismissed the cases before it. On May 30, 2012, the Court of Chancery of the State of Delaware dismissed the cases before it with prejudice. On June 12, 2012, the cases pending before the Superior Court of New Jersey were dismissed by consent of parties.

Additional information regarding such matters is contained in Item 3 – Legal Proceedings in each of Express Scripts’ and Medco’s Annual Reports on Form 10-K for the year ended December 31, 2011.

In addition, in the ordinary course of our business there have arisen various legal proceedings, investigations or claims now pending against our subsidiaries and us. The effect of these actions on future financial results is not subject to reasonable estimation because considerable uncertainty exists about the outcomes. Where insurance coverage is not available for such claims, or in our judgment, is not cost-effective, we maintain self-insurance reserves to reduce our exposure to future legal costs, settlements and judgments related to uninsured claims. Our self-insured reserves are based upon estimates of the aggregate liability for the costs of uninsured claims incurred and the retained portion of insured claims using certain actuarial assumptions followed in the insurance industry and our historical experience. It is not possible to predict with certainty the outcome of these claims, and we can give no assurance that any losses in excess of our insurance and any self-insurance reserves will not be material.

 

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Item 1A—Risk Factors

Our business is subject to certain risks and uncertainties. In evaluating the business and prospects of Express Scripts Holding Company, you should carefully consider the risk factors presented below, which are restated in their entirety as compared to the risk factors presented in ESI’s Form 10-K for the year ended December 31, 2011 prior to the completion of the Merger. You should consider these risk factors together with other matters described in ESI’s and Medco’s Annual Reports on Form 10-K for the year ended December 31, 2011, in this Quarterly Report on Form 10-Q and in our, ESI’s and Medco’s other filings with the SEC.

The following general risk factors have been amended from our Quarterly Report on Form 10-Q for the quarter ended March 31, 2012:

We operate in a complex and evolving regulatory environment. Changes in applicable laws or regulations, or their interpretation or enforcement, or the enactment of new laws or regulations, could require us to make changes to how we operate our business or result in the imposition of penalties. Further, we may be required to spend significant resources in order to comply with new or existing laws and regulations.

If we lose our relationship, or our relationship otherwise changes in an unfavorable manner, with one or more key pharmacy providers, or if significant changes occur within the pharmacy provider marketplace, or if other issues arise with respect to our pharmacy networks, our business could be impaired.

A substantial portion of our revenue is concentrated in certain significant client contracts. Our failure to execute on, or other issues arising under, the contracts could adversely affect our financial results. Further, conditions or trends impacting certain of our key clients could result in a negative impact on our financial performance.

See further discussion of these general risk factors below.

General Risk Factors

We operate in a very competitive industry, and competition could compress our margins and impair our ability to attract and retain clients. Our failure to differentiate our products and services in the marketplace could magnify the impact of the competitive environment.

Our ability to remain competitive is dependent upon our ability to attract new clients and retain existing clients, as well as cross-sell additional services to our clients. We operate in a highly competitive environment and in an industry that is subject to significant market pressures brought about by customer demands, legislative and regulatory activity and other market factors. Historically in the PBM industry, competition in the marketplace has also caused many PBMs, including us, to reduce the prices charged to clients for core services and share a larger portion of the formulary fees and related revenues received from pharmaceutical manufacturers with clients. This combination of lower pricing and increased revenue sharing, as well as increased demand for enhanced service offerings and higher service levels, puts pressure on operating margins, which have historically been offset by a variety of positive trends including lower drug purchasing costs, increased generic usage, drug price inflation and increased rebates. Our failure or inability to maintain these positive trends, or identify and implement new ways to mitigate pricing pressures, could impact our ability to attract or retain clients or could negatively impact our margins.

In addition, our clients are well informed and organized and can easily move between us and our competitors. These factors together with the impact of the competitive marketplace or other significant differentiating factors between our offerings and those of our competitors may make it difficult for us to retain existing clients, sell to new clients and cross-sell additional services to clients, which could materially adversely affect our business and financial results.

In a highly competitive marketplace such as the PBM industry, a competitor’s business offering and reputation within the industry can have a substantial impact on its ability to attract and retain clients. This requires us to differentiate our business offerings by innovating and delivering products and services that demonstrate value to our clients, particularly in response to market changes from public policy. Further, the reputational impact of a service-related event, or our failure to innovate and deliver products and services that demonstrate value to our clients, may affect our ability to retain or grow profitable clients which could have a material adverse effect on our financial results.

 

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The managed care industry has undergone substantial consolidation in recent years, and we believe this trend is likely to continue. If one or more of our managed care clients is acquired, and the acquiring entity is not a client, then we may be unable to retain all or a portion of the impacted business. If such acquisitions, individually or in the aggregate, are material, they could have a material adverse effect on our business, the results of our operations and financial position.

The delivery of healthcare-related products and services is an evolving and rapidly changing industry. Our failure to anticipate or appropriately adapt to changes in the industry could have a negative impact on our ability to compete and adversely affect our business operations and financial results.

While we believe we are well positioned in our industry, we have designed our business model to compete within the current industry structure. Any significant shift in the structure of the PBM industry could affect the environment in which we compete. A large intra- or inter-industry merger or a new business model entrant could alter the industry dynamics and adversely affect our business and financial results as our client contracts are generally three years and our pharmaceutical manufacturer and retail contracts are generally non-exclusive and terminable on relatively short notice by either party. Our failure to anticipate or appropriately adapt to changes in the industry could negatively impact our competitive position and adversely affect our business operations and financial results.

We operate in a complex and evolving regulatory environment. Changes in applicable laws or regulations, or their interpretation or enforcement, or the enactment of new laws or regulations, could require us to make changes to how we operate our business or result in the imposition of penalties. Further, we may be required to spend significant resources in order to comply with new or existing laws and regulations.

Numerous state and federal laws and regulations affect our business and operations. The categories include, among others, the following:

 

   

healthcare fraud and abuse laws and regulations, which prohibit certain types of payments and referrals as well as false claims made in connection with health benefit programs

 

   

ERISA and related regulations, which regulate many aspects of healthcare plan arrangements

 

   

state legislation regulating PBMs or imposing fiduciary status on PBMs

 

   

consumer protection and unfair trade practice laws and regulations

 

   

network pharmacy access laws, including “any willing provider” and “due process” legislation, that affect aspects of our pharmacy network contracts

 

   

wholesale distributor laws

 

   

legislation imposing benefit plan design restrictions, which limit how our clients can design their drug benefit plans

 

   

various licensure laws, such as managed care and third party administrator licensure laws

 

   

drug pricing legislation, including “most favored nation” pricing

 

   

pharmacy laws and regulations

 

   

state insurance regulations applicable to our insurance subsidiaries

 

   

privacy and security laws and regulations, including those under HIPAA and HITECH

 

   

the Medicare prescription drug coverage rules

 

   

other Medicare and Medicaid reimbursement regulations, including subrogation

 

   

the federal Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (the “Health Reform Laws”)

 

   

federal laws related to our Department of Defense arrangement

 

   

federal antitrust laws related to our pharmacy, pharmaceutical manufacturer, and client relationships

 

   

international laws

These and other regulatory matters are discussed in more detail in ESI’s Annual Report on Form 10-K for the fiscal year ended December 31, 2011 (the “ESI Form 10-K”) under “Part I — Item 1 — Business — Government Regulation and Compliance” and in Medco’s Annual Report on Form 10-K for the fiscal year ended December 31, 2011 (the “Medco 2011 Form 10-K”) under “Part I — Item 1 — Business — Corporate Compliance and Government Regulation — Government Regulation”.

 

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We believe that we are operating our business in substantial compliance with all existing legal requirements material to us. There are, however, significant uncertainties regarding the application of many of these legal requirements to our business, and state and federal law enforcement agencies and regulatory agencies from time to time have initiated investigations or litigation involving certain aspects of our (including Medco’s) business or our competitors’ businesses. Accordingly, we cannot provide any assurance that one or more of these agencies will not interpret or apply these laws in a manner adverse to our business, or, if there is an enforcement action brought against us, that our interpretation would prevail. In addition, there are numerous proposed healthcare laws and regulations at the federal and state levels, many of which could materially affect our ability to conduct our business or adversely affect our financial results. We are unable to predict whether additional federal or state legislation or regulatory initiatives may be enacted in the future relating to our business or the healthcare industry in general, or what effect any such legislation or regulations might have on us. Due to these uncertainties, we may be required to spend significant resources in connection with such investigations or litigation or to comply with new or existing laws and regulations.

Various governmental agencies have conducted investigations into certain PBM business practices. Many of these investigations have resulted in other PBMs agreeing to civil penalties, including the payment of money and corporate integrity agreements. We cannot predict what effect, if any, the governmental investigations and audits may ultimately have on us or on the PBM industry generally (for additional information regarding investigations, see “Part I—Item 3—Legal Proceedings” in the ESI 2011 Form 10-K and “Part II—Item 1—Legal Proceedings” in the Express Scripts Form 10-Q for the quarter ended March 31, 2012 and herein).

The District of Columbia previously enacted a statute that purports to declare that a PBM is a fiduciary with respect to its clients, although the statute was overturned by federal courts in the District of Columbia (see “Part I—Item 1 – Business – Government Regulations and Compliance – State Fiduciary Legislation” in the ESI 2011 Form 10-K). However, other states are considering but have not yet enacted similar fiduciary statutes, and we cannot predict what effect, if any, these and similar statutes, if enacted, may have on our business and financial results, nor can we predict how courts may view such laws.

Most of our activities involve the receipt or use of protected health information concerning individuals. In addition, we use aggregated and anonymized data for research and analysis and other permitted business purposes and in some cases provide access to data to pharmaceutical manufacturers and third party data aggregators in accordance with applicable law. Various federal and state laws, including HIPAA, regulate and restrict the use, disclosure and security of protected health information and new legislation is proposed from time to time in various states. Also, we have begun to expand into other countries, which have additional or potentially more stringent requirements, such as those applicable to the European Union nations, on the retention, use, transmission or disclosure of personally identifiable information. To date, no such domestic or foreign laws have been adopted that materially impact our ability to provide services, but there can be no assurance that federal or state domestic governments or foreign governments will not enact legislation, impose restrictions or adopt interpretations of existing laws that could have a material adverse effect on our business and financial results.

Policies designed to manage healthcare costs or alter healthcare financing practices may adversely impact our business and our financial results.

Certain proposals are made from time to time in the United States to manage healthcare costs, including prescription drug costs. These have included proposals such as “single-payer” government funded healthcare, changes in reimbursement rates, restrictions on access or therapeutic substitution, limits on more efficient delivery channels, taxes on goods and services, price controls on prescription drugs, and other significant healthcare reform proposals. We are unable to predict whether any such proposals will be enacted, or the specific terms thereof. Certain of these proposals, however, if enacted, may adversely impact our business and our financial results.

In March 2010, the federal government enacted the Health Reform Laws, which will be gradually phased in through 2020 (see “Part I — Item 1 — Business — Government Regulation and Compliance – Federal Healthcare Reform” in the ESI 2011 Form 10-K and “Part I — Item 1 — Business — Corporate Compliance and Government Regulation — Government Regulation” in the Medco 2011 Form 10-K). The Health Reform Laws contain many provisions that directly or indirectly apply to us, our clients, pharmaceutical manufacturers, healthcare providers and others with whom we do business, including:

 

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PBM disclosure requirements in the context of Medicare Part D and the anticipated health benefit exchanges

 

   

creation of government-regulated health benefits exchanges and new requirements for health plans offered by insurance companies, employers and other plan sponsors

 

   

medical loss ratio requirements, which require insurers to spend a specified percentage of premium revenues on incurred claims or healthcare quality improvements, and require some of our clients to report certain types of PBM proprietary information

 

   

various health insurance taxes

 

   

changes to the calculation of average manufacturer price (“AMP”) of drugs and an increase in the rebate amounts drug manufacturers must pay to states for drugs reimbursed by state Medicaid programs, including through Medicaid managed care organizations

 

   

imposition of new fees on pharmaceutical manufacturers and importers of brand-name prescription drugs

 

   

expansion of the 340B drug discount program, which limits the costs of certain outpatient drugs to qualified health centers and hospitals

 

   

closing of the so-called donut hole under Medicare Part D by lowering beneficiary coinsurance amounts

 

   

elimination of the tax deduction for employers who receive Medicare Part D retiree drug subsidy payments

 

   

mandated changes to client plan designs

 

   

changes to certain healthcare fraud and abuse laws

 

   

impact of the Durable Medical Equipment, Prosthetics and Supplies Competitive Bid Program (the “DMEPOS Program”), and/or changes to the reimbursement rates, on our business involving certain durable medical equipment items, including diabetes testing supplies

If we lose our relationship, or our relationship otherwise changes in an unfavorable manner, with one or more key pharmacy providers, or if significant changes occur within the pharmacy provider marketplace, or if other issues arise with respect to our pharmacy networks, our business could be impaired.

More than 60,000 retail pharmacies, which represent more than 95% of all United States retail pharmacies, participated in one or more of both ESI’s and Medco’s networks at June 30, 2012. As announced on July 19, 2012, Express Scripts and Walgreens have reached a multi-year pharmacy network agreement with rates and terms under which Walgreens will participate in the broadest Express Scripts retail pharmacy network available to new and existing clients. Walgreens will be part of the broadest network of pharmacies available to Express Scripts clients, as of September 15, 2012. Medco’s network participation with Walgreens remains in place under existing terms.

The ten largest retail pharmacy chains, represented approximately 62% of the total number of stores in ESI’s largest network as of June 30, 2012. In certain geographic areas of the United States, our networks may be comprised of higher concentrations of one or more large pharmacy chains. Some contracts with retail pharmacies, which are non-exclusive, are generally terminable on relatively short notice by either party. If one or more of the larger pharmacy chains terminates its relationship with us, or is able to renegotiate terms that are substantially less favorable to us, our members’ access to retail pharmacies and/or our business could be materially adversely affected. In addition, the overall composition of our pharmacy networks, or reduced access under our networks, could have a negative impact on our claims volume and/or our competitiveness in the marketplace, cause us to fall short of certain guarantees in our contracts with clients, or otherwise impair our business or financial condition. The likelihood of our relationships with such pharmacy chains being adversely affected may be increased to the extent that large pharmacy chains enter the PBM business.

A substantial portion of our revenue is concentrated in certain significant client contracts. Our failure to execute on, or other issues arising under, the contracts could adversely affect our financial results. Further, conditions or trends impacting certain of our key clients could result in a negative impact on our financial performance.

As described in greater detail in the discussion of our business in Item 1 of the ESI 2011 Form 10-K, ESI has long term contracts with WellPoint, Inc. (“WellPoint”) and the United States Department of Defense (“DoD”). ESI’s top 5 clients, including WellPoint and DoD, collectively represented 56.7% and 55.2% of its revenue during 2011 and 2010, respectively. Under its current agreement, ESI is providing pharmacy benefit services to WellPoint through December 31, 2019. The agreement with the DoD consists of an initial one-year contract and five one-year renewal options, with the final option expiring on October 31, 2014. Medco’s largest client, UnitedHealth Group, represented approximately $11,700 million, or 17%, of Medco’s net revenues during 2011. Although none of

 

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Medco’s other clients individually represented more than 10% of its net revenues in 2011, Medco’s top 10 clients as of December 31, 2011, including UnitedHealth Group, represented approximately 46% of its net revenues during 2011. On July 21, 2011, Medco announced that its pharmacy benefit services agreement with UnitedHealth Group would not be renewed, although Medco will continue to provide services under the current agreement and thereafter through a transition agreement. In addition to UnitedHealth Group, other major clients representing approximately 13% of Medco’s net revenues for 2011 did not renew their contracts with Medco for 2012 as a result of acquisitions by competitors or transitioning in the normal course of business.

Any further loss of one or more of our (including legacy ESI’s or Medco’s) large clients terminate or do not renew contracts for any reason, our financial results could be materially adversely affected and we could experience a negative reaction in the investment community resulting in stock price declines or other adverse effects. If we are not able to replace this lost business by generating new sales with comparable operating margins or successfully executing other corporate strategies, our revenues and results of operations could suffer. In addition, if certain of our key clients are negatively impacted by business conditions or other trends, or if such clients otherwise fail to successfully maintain or grow their business, our business and financial results could be adversely impacted.

Regulatory or business changes relating to our participation in Medicare Part D, the loss of Medicare Part D eligible members, or our failure to otherwise execute on our strategies related to Medicare Part D, may adversely impact our business and our financial results.

Certain of our subsidiaries have been approved to function as a Part D prescription drug plan (“PDP”) sponsor for purposes of making employer/union-only group waiver plans available for eligible clients. Also, Medco’s insurance subsidiaries have been approved by CMS to participate in the Medicare Part D program as a national PDP sponsor to provide direct services to Medicare Part D eligible members. We also provide other products and services in support of our clients’ Medicare Part D plans or federal Retiree Drug Subsidy and act as a PDP. We have made, and may be required to make further, substantial investments in the personnel and technology necessary to administer our Medicare Part D strategy. There are many uncertainties about the financial and regulatory risks of participating in the Medicare Part D program, and we can give no assurance that these risks will not materially adversely impact our business and our financial results in future periods.

Our subsidiaries are subject to various contractual and regulatory compliance requirements associated with participating in Medicare Part D. As insurers organized and licensed under applicable state laws, these subsidiaries are subject to certain aspects of state laws regulating the business of insurance in all jurisdictions in which they offer PDP services. As PDP sponsors, these subsidiaries are required to comply with certain federal Medicare Part D laws and regulations applicable to PDP sponsors. Additionally, the receipt of federal funds made available through the Part D program by us, our affiliates, or clients is subject to compliance with the Part D regulations and established laws and regulations governing the federal government’s payment for healthcare goods and services, including the anti-kickback laws and the federal False Claims Act. Similar to our requirements with other clients, our policies and practices associated with operating our PDP are subject to audit. If material contractual or regulatory non-compliance was to be identified, monetary penalties and/or applicable sanctions, including suspension of enrollment and marketing or debarment from participation in Medicare programs, could be imposed. Further, the adoption or promulgation of new or more complex regulatory requirements associated with Medicare may require us to incur significant compliance-related costs which could adversely impact our business and our financial results.

In addition, due to the availability of Medicare Part D, some of our employer clients may decide to stop providing pharmacy benefit coverage to retirees, instead allowing the retirees to choose their own Part D plans, which could cause a reduction in utilization for our services. Extensive competition among Medicare Part D plans could also result in the loss of Medicare members by our managed care customers, which would also result in a decline in our membership base. Like many aspects of our business, the administration of the Medicare Part D program is complex. Any failure to execute the provisions of the Medicare Part D program may have an adverse effect on our financial position, results of operations or cash flows. As discussed above, in March 2010, comprehensive healthcare reform was enacted into federal law through the passage of the Health Reform Laws. Additionally, as described above, the Health Reform Laws contain various changes to the Part D program and could have a financial impact on our PDP and our clients’ demand for our other Part D products and services.

 

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We have historically engaged in strategic transactions, including the acquisition of other companies or businesses, and will likely engage in similar transactions in the future. Our failure to effectively execute on such transactions or to integrate any acquired businesses could adversely impact our operating results, and any such transactions will likely cause us to incur significant transaction costs and require significant resources and management attention .

We have historically engaged in strategic transactions, including the acquisition of other companies and businesses. These transactions typically involve the integration of core business operations and technology infrastructure platforms that require significant management attention and resources. A failure or delay in the integration process could have a material adverse affect on our financial results. In addition, such transactions may yield higher operating costs, greater customer attrition or more significant business disruption than may have been anticipated. Further, even if we are able to integrate the business operations successfully, there can be no assurance that such transactions will result in the realization of the expected benefits of synergies, cost savings, innovation and operational efficiencies, or that any realized benefits will be achieved within a reasonable period of time.

Strategic transactions, including the pursuit of such transactions, require us to incur significant costs. These costs are typically non-recurring expenses related to the assessment, due diligence, negotiation and execution of the transaction. We may incur additional costs to retain key employees as well as transaction fees and costs related to executing integration plans. Although we would generally expect the realization of efficiencies related to the integration of businesses to offset incremental transaction and acquisition-related costs over time, this net benefit may not be achieved in the near term, or at all.

Certain risks related to the recently completed Medco transaction are described in greater detail below under “—Transaction-Related Risk Factors.”

Our debt service obligations reduce the funds available for other business purposes, and the terms and covenants relating to our indebtedness could adversely impact our financial performance and liquidity.

We currently have debt outstanding (see summary of indebtedness within Note 7 – Financing), including indebtedness of ESI and Medco guaranteed by us. Our debt service obligations reduce the funds available for other business purposes. Increases in interest rates on variable rate indebtedness would increase our interest expense and could materially adversely affect our financial results.

We are subject to risks normally associated with debt financing, such as the insufficiency of cash flow to meet required debt service payment obligations and the inability to refinance existing indebtedness. In addition, certain of our debt instruments contain covenants which limit our ability to incur additional indebtedness, create or permit liens on assets, and engage in mergers, consolidations, or disposals. The covenants under our credit agreement also include a minimum interest coverage ratio and a maximum leverage ratio. If we fail to satisfy these covenants, we would be in default under the credit agreement and/or the senior notes indentures, and may be required to repay such debt with capital from other sources or not be able to draw down against our revolving credit facility. Under such circumstances, other sources of capital may not be available to us, or be available only on unattractive terms. See Note 7 – Financing to our consolidated financial statements included in this Quarterly Report on Form 10-Q.

Our ability to conduct operations depends on the security and stability of our technology infrastructure as well as the effectiveness of, and our ability to execute, business continuity plans across our operations. A failure in the security of our technology infrastructure or a significant disruption in service within our operations could materially adversely affect our business, the results of our operations and our financial position.

We maintain, and are dependent on, a technology infrastructure platform that is essential for many aspects of our business operations. It is imperative that we securely store and transmit confidential data, including personal health information, while maintaining the integrity of our confidential information. We have designed our technology infrastructure platform to protect against failures in security and service disruption. However, any failure to protect against a security breach or a disruption in service could materially adversely impact our business operations and our financial results. Our technology infrastructure platform requires an ongoing commitment of significant resources to maintain and enhance systems in order to keep pace with continuing changes as well as evolving industry and regulatory standards. In addition, we may from time to time obtain significant portions of our

 

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systems-related or other services or facilities from independent third parties, which may make our operations vulnerable to such third parties’ failure to adequately perform. In the event we or our vendors experience malfunctions in business processes, breaches of information systems, failure to maintain effective and up-to-date information systems or unauthorized or non-compliant actions by any individual, this could disrupt our business operations or impact patient safety, result in customer and member disputes, damage our reputation, expose us to risk of loss, litigation or regulatory violations, increase administrative expenses or lead to other adverse consequences.

We operate dispensing pharmacies, call centers, data centers and corporate facilities that depend on the security and stability of technology infrastructure. Any service disruption at any of these facilities due to failure or disruption of technology, malfunction of business process, disaster or catastrophic event could, temporarily or indefinitely, significantly reduce, or partially or totally eliminate our ability to process and dispense prescriptions and provide products and services to our clients and members. Any such service disruption at these facilities or to this infrastructure could have a material adverse effect on our business operations and our financial results.

If we lose relationships with one or more key pharmaceutical manufacturers, or if the payments made or discounts provided by pharmaceutical manufacturers decline, our business and financial results could be adversely affected.

We maintain contractual relationships with numerous pharmaceutical manufacturers that may provide us with, among other things:

 

   

discounts for drugs we purchase to be dispensed from our home delivery pharmacies

 

   

rebates based upon distributions of drugs from our home delivery pharmacies and through pharmacies in our retail networks

 

   

administrative fees for managing rebate programs, including the development and maintenance of formularies which include the particular manufacturer’s products

 

   

access to limited distribution specialty pharmaceuticals

If several of these contractual relationships are terminated or materially altered by the pharmaceutical manufacturers, our business and financial results could be materially adversely affected. In addition, formulary fee programs have been the subject of debate in federal and state legislatures and various other public and governmental forums. Changes in existing laws or regulations, in interpretations of existing laws or regulations, or the adoption of new laws or regulations relating to any of these programs may materially adversely affect our business.

Changes in industry pricing benchmarks could materially impact our financial performance.

Contracts in the prescription drug industry, including our contracts with retail pharmacy networks and with PBM and specialty pharmacy clients, generally use “average wholesale price” or “AWP”, which is published by a third party, as a benchmark to establish pricing for prescription drugs. In 2011, First DataBank, a significant provider of AWP information, discontinued publishing such information. This and other recent events have raised uncertainties as to whether certain third parties will continue to publish AWP, which may result in the inability of payors, pharmacy providers, PBMs and others in the prescription drug industry to continue to utilize AWP as it has previously been calculated. In the event that AWP is no longer published or if we adopt other pricing benchmarks for establishing prices within the industry, we can give no assurance that the short or long-term impact of such changes to industry pricing benchmarks will not have a material adverse effect on our business and financial results in future periods.

Legislation and other regulations affecting drug prices are discussed in more detail in the ESI 2011 Form 10-K under “Part I — Item 1 — Business — Government Regulation and Compliance – Legislation and Regulation Affecting Drug Prices”.

 

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Pending and future litigation or other proceedings could subject us to significant monetary damages or penalties and/or require us to change our business practices, either of which could have a material adverse effect on our business operations and our financial results or condition.

We are subject to risks relating to litigation, regulatory proceedings, and other similar actions in connection with our business operations, including the dispensing of pharmaceutical products by our home delivery pharmacies, services rendered in connection with our disease management offering, and our pharmaceutical services operations. A list of the significant proceedings pending against us (including both ESI and Medco) is included under “Part I—Item 3—Legal Proceedings” in the ESI 2011 Form 10-K and “Part II—Item 1—Legal Proceedings” in the Express Scripts Form 10-Q for the quarter ended March 31, 2012 and herein, including certain proceedings that purport to be class action lawsuits. These proceedings seek unspecified monetary damages and/or injunctive relief. While we believe these proceedings are without merit and intend to contest them vigorously, we cannot predict with certainty the outcome of any such proceeding. If one or more of these proceedings has an unfavorable outcome, we cannot provide any assurance that it would not have a material adverse effect on our business and financial results, including our ability to attract and retain clients as a result of the negative reputational impact of such an outcome. Further, while certain costs are covered by insurance, we may incur uninsured costs that are material to our financial performance in the defense of such proceedings.

Commercial liability insurance coverage continues to be difficult to obtain for companies in our business sector which can cause unexpected volatility in premiums and/or retention requirements dictated by insurance carriers. We have established certain self-insurance accruals to cover anticipated losses within our retained liability for previously reported claims and the cost to defend these claims. There can be no assurance that general, professional, managed care errors and omissions, and/or other liability insurance coverage will be reasonably available in the future or such insurance coverage, together with our self-insurance accruals, will be adequate to cover future claims. A claim, or claims, in excess of our insurance coverage could have a material adverse effect on our business and financial results.

We face significant competition in attracting and retaining talented employees. Further, managing succession and retention for our Chief Executive Officer and other key executives is critical to our success, and our failure to do so could have an adverse impact on our future performance.

We believe that our ability to retain an experienced workforce and our ability to hire additional qualified employees is essential to meet current and future goals and objectives. There is no guarantee that we will be able to attract and retain such employees or that competition among potential employers will not result in increasing salaries. An inability to retain existing employees or attract additional employees could have a material adverse effect on our business operations and our financial results.

We would be adversely affected if we fail to adequately plan for succession of our Chief Executive Officer, senior management and other key employees. While we have succession plans in place and we have employment arrangements with certain key executives, these do not guarantee that the services of these executives will continue to be available to us.

Following the Merger with Medco, we are subject to new risks applicable to Medco and its subsidiaries in businesses which we did not engage in prior to the Merger or where our involvement was limited.

Medco and its subsidiaries are subject to certain risks that were not applicable to ESI, or where the risks prior to the Merger were minimal, due to Medco’s involvement in businesses due to the limited or non-existent involvement of ESI. Such risks could have a material adverse effect on our business, financial condition and results of operations, and include the following:

 

   

revenues from the sale of diabetes testing supplies under Medco’s Liberty brand depend on the continued availability of reimbursement by government and private insurance plans and a complex and time-consuming billing and collection process, which exposes us to increased billing, cash application and credit risks

 

   

the Liberty diabetes testing supply business is subject to the DMEPOS Program, which could result in the reduction in reimbursement rates and could negatively affect our operating results

 

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Medco’s Part D product offerings require premium payment from members for the ongoing benefit, as well as amounts due from CMS, and as a result of the demographics of the calculations, as well as the potential magnitude and timing of settlement for amounts due from CMS, these accounts receivable are subject to billing and realization risk in excess of what is experienced in the core PBM business

 

   

Additional government scrutiny and audit activity related to government program business services by Medco, including audits that Accredo Health Group and Liberty face or may face which result in payment or offset of prior reimbursement from the government

 

   

the clinical research services business depends on the willingness of companies in the pharmaceutical and biotechnology industries to continue to outsource clinical development and our reputation for independent, high-quality scientific research and evidence development

 

   

following the Merger, we have international operations in various countries throughout Europe, North America and Asia, resulting in risks inherent in these operations, including, without limitation, relating to (1) vigorous regulation of the biotechnology and pharmaceutical industries; (2) compliance with a variety of ever-changing foreign laws and regulations; (3) difficulty of enforcing agreements, intellectual property rights and collection of receivables abroad; (4) tax rates, withholding requirements, the imposition of tariffs, exchange controls or other restrictions, including restrictions on repatriation; (5) complexities of managing a multinational organization; (6) general economic and political conditions or terrorist activities in foreign countries; (7) exchange rate fluctuations; and (8) longer payment cycles of foreign customers

Transaction-Related Risk Factors

In addition to the general risk factors above, investors should consider the following risk factors arising from the Merger. The risk factors below should be read in conjunction with the risk factors above and the other information contained in this report as our business, financial condition or results of operations could be adversely affected if any of these risks actually occur.

The anticipated benefits of the Merger with Medco may not be realized fully and may take longer to realize than expected.

The success of the Merger will depend, in part, on our ability to successfully combine the businesses of ESI and Medco and realize the anticipated benefits, including synergies, cost savings, innovation and operational efficiencies, from the combination. If we are unable to achieve these objectives within the anticipated time frame, or at all, the anticipated benefits may not be realized fully or at all, or may take longer to realize than expected and the value of our common stock may be harmed.

The Merger involves the integration of Medco’s businesses with ESI’s business, which is a complex, costly and time-consuming process. We have not previously completed a transaction comparable in size or scope to the Merger with Medco. The integration of two companies may result in material challenges, including, without limitation:

 

   

the diversion of management’s attention from ongoing business concerns and performance shortfalls at one or both of the companies as a result of the devotion of management’s attention to the integration

 

   

managing a larger combined company

 

   

maintaining employee morale and retaining key management and other employees

 

   

integrating two unique corporate cultures, which may prove to be incompatible

 

   

the possibility of faulty assumptions underlying expectations regarding the integration process

 

   

retaining existing clients and attracting new clients on profitable terms

 

   

consolidating corporate and administrative infrastructures and eliminating duplicative operations

 

   

coordinating geographically separate organizations

 

   

unanticipated issues in integrating information technology, communications and other systems

 

   

unanticipated changes in applicable laws and regulations

 

   

managing tax costs or inefficiencies associated with integrating the operations of the combined company

 

   

unforeseen expenses or delays associated with the Merger

 

   

making any necessary modifications to internal financial control standards to comply with the Sarbanes-Oxley Act of 2002 and the rules and regulations promulgated thereunder

 

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Some of these factors will be outside of our control and any one of them could result in increased costs, decreases in the amount of expected revenues and diversion of management’s time and energy, which could materially impact our business, financial condition and results of operations.

The integration may result in additional and unforeseen expenses, and the anticipated benefits of the integration plan may not be realized. Delays or issues encountered in the integration process could have a material adverse effect on the revenues, expenses, operating results and financial condition of the combined company. Although we expect significant benefits, such as synergies, cost savings, innovation and operational efficiencies, to result from the Merger, there can be no assurance that we will actually realize any of these anticipated benefits.

Our financial results will depend on our ability to maintain Express Scripts, Inc.’s and Medco’s legacy client relationships.

A substantial portion of our revenues are received under long-term client relationships. Our success in the period following the Merger will depend in part on our ability to maintain these client relationships. Certain of these clients may elect to end or decide not to renew their existing relationships with us. If we are unable to maintain these client relationships, our business, financial results and financial condition could be adversely affected.

We have incurred, and will continue to incur, significant transaction and merger-related costs in connection with the Merger.

We have incurred, and will continue to incur, significant costs in connection with the integration process. The substantial majority of these costs will be non-recurring expenses related to the facilities and systems consolidation costs. We may incur additional costs to maintain employee morale and to retain key employees. We will also incur transaction fees and costs related to formulating and revising integration plans. Additional unanticipated costs may be incurred in the integration of Medco’s businesses. Although we expect that the elimination of duplicative costs, as well as the realization of other efficiencies related to the integration of the businesses, should allow us to more than offset incremental transaction and merger-related costs over time, this net benefit may not be achieved in the near term, or at all.

The market price of our common stock may decline as a result of the Merger.

The market price of the common stock of the combined company may decline as a result of the Merger if, among other things, we are unable to achieve the expected growth in earnings, or if our operational cost savings estimates are not realized, or if the transaction costs related to the Merger and integration are greater than expected. The market price also may decline if we do not achieve the perceived benefits of the Merger as rapidly or to the extent anticipated by financial or industry analysts or if the effect of the Merger on our financial results is not consistent with the expectations of financial or industry analysts.

 

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Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

Until consummation of the Merger on April 2, 2012, ESI had a stock repurchase program, under which no purchases were made during the quarter. Upon consummation of the Merger on April 2, 2012, all ESI shares held in treasury were cancelled and retired. The Board of Directors of the Company has not yet adopted a stock repurchase program to allow for the repurchase of shares of Express Scripts.

Item 6. Exhibits

(a) See Index to Exhibits below.

 

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SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

 

 

 

EXPRESS SCRIPTS HOLDING COMPANY

(Registrant)

Date: August 7, 2012   By:   /s/ George Paz
  George Paz, Chairman, President and Chief Executive Officer
Date: August 7, 2012   By:    /s/ Jeffrey Hall
  Jeffrey Hall, Executive Vice President and Chief Financial Officer

 

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INDEX TO EXHIBITS

(Express Scripts Holding Company – Commission File Number 1-35490)

 

Exhibit

Number

  

Exhibit

2.1 2    Stock and Interest Purchase Agreement among Express Scripts, Inc. and WellPoint, Inc., dated April 9, 2009, incorporated by reference to Exhibit No. 2.1 to Express Scripts, Inc.’s Current Report on Form 8-K filed April 14, 2009, File No. 000-20199.
2.2 2    Agreement and Plan of Merger, dated as of July 20, 2011, by and among Express Scripts, Inc., Medco Health Solutions, Inc., Aristotle Holding, Inc., Aristotle Merger Sub, Inc. and Plato Merger Sub, Inc., incorporated by reference to Exhibit 2.1 to Express Scripts, Inc.’s Current Report on Form 8-K filed July 22, 2011, File No. 000-20199.
2.3    Amendment No. 1 to Agreement and Plan of Merger, dated as of November 7, 2011, by and among Express Scripts, Inc., Medco Health Solutions, Inc., Aristotle Holding, Inc., Aristotle Merger Sub, Inc., and Plato Merger Sub, Inc., incorporated by reference to Exhibit 2.1 to Express Scripts, Inc.’s Current Report on Form 8-K filed November 8, 2011, File No. 000-20199.
3.1    Amended and Restated Certificate of Incorporation of the Company, incorporated by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K filed April 2, 2012.
3.2    Amended and Restated Bylaws of the Company, incorporated by reference to Exhibit 3.2 to the Company’s Current Report on Form 8-K filed April 2, 2012.
4.1    Ninth Supplemental Indenture, dated as of May 29, 2012, among Express Scripts Holding Company, Express Scripts, Inc., the subsidiaries of Express Scripts, Inc. party thereto, Medco Health Solutions, Inc., the subsidiaries of Medco Health Solutions, Inc. party thereto and Wells Fargo Bank, National Association, as Trustee, incorporated by reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed June 4, 2012.
4.2    Ninth Supplemental Indenture, dated as of May 29, 2012, among Express Scripts Holding Company, Express Scripts, Inc., the subsidiaries of Express Scripts, Inc. party thereto, Medco Health Solutions, Inc., the subsidiaries of Medco Health Solutions, Inc. party thereto and Union Bank, N.A., as Trustee, incorporated by reference to Exhibit 4.2 to the Company’s Current Report on Form 8-K filed June 4, 2012.
4.3    Second Supplemental Indenture, dated as of May 29, 2012, among Express Scripts Holding Company, Express Scripts, Inc., the subsidiaries of Express Scripts, Inc. party thereto, Medco Health Solutions, Inc., the subsidiaries of Medco Health Solutions, Inc. party thereto and U.S. Bank Trust National Association, as Trustee, incorporated by reference to Exhibit 4.3 to the Company’s Current Report on Form 8-K filed June 4, 2012.
4.4    Subsidiary Guaranty, dated as of April 2, 2012, by and among the subsidiaries of the Parent party thereto as guarantors, in favor of Credit Suisse, as supplemented by that certain counterpart dated as of May 29, 2012, incorporated by reference to Exhibit 4.4 to the Company’s Current Report on Form 8-K filed June 4, 2012.
10.1 1    Express Scripts, Inc. 2011 Long-Term Incentive Plan (as amended and restated effective April 2, 2012).
10.2 1    Express Scripts, Inc. Employee Stock Purchase Plan (as amended and restated effective April 2, 2012).
10.3 1    Express Scripts, Inc. Executive Deferred Compensation Plan of 2005 (as amended and restated effective April 2, 2012).
10.4 1    Medco Health Solutions, Inc. 2002 Stock Incentive Plan (as amended and restated effective April 2, 2012).
10.5 1    Form of Restricted Stock Unit Grant Notice for Non-Employee Directors used with respect to grants of restricted stock units by the Company under the Express Scripts, Inc. 2011 Long-Term Incentive Plan.
10.6 1    Form of Stock Option Grant Notice for Non-Employee Directors used with respect to grants of stock options by the Company under the Express Scripts, Inc. 2011 Long-Term Incentive Plan.

 

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Exhibit

Number

  

Exhibit

11.1    Statement regarding computation of earnings per share. (See Note 6 to the unaudited consolidated financial statements.)
31.1 1    Certification by George Paz, as Chairman, President and Chief Executive Officer of Express Scripts Holding Company, pursuant to Exchange Act Rule 13a-14(a).
31.2 1    Certification by Jeffrey Hall, as Executive Vice President and Chief Financial Officer of Express Scripts Holding Company, pursuant to Exchange Act Rule 13a-14(a).
32.1 1    Certification by George Paz, as Chairman, President and Chief Executive Officer of Express Scripts Holding Company, pursuant to 18 U.S.C. § 1350 and Exchange Act Rule 13a-14(b).
32.2 1    Certification by Jeffrey Hall, as Executive Vice President and Chief Financial Officer of Express Scripts Holding Company, pursuant to 18 U.S.C. § 1350 and Exchange Act Rule 13a-14(b).
101.1 1    XBRL Taxonomy Instance Document.
101.2 1    XBRL Taxonomy Extension Schema Document.
101.3 1    XBRL Taxonomy Extension Calculation Linkbase Document.
101.4 1    XBRL Taxonomy Extension Definition Linkbase Document.
101.5 1    XBRL Taxonomy Extension Label Linkbase Document.
101.6 1    XBRL Taxonomy Extension Presentation Linkbase Document.

 

1 Filed herein.
2 The Stock and Interest Purchase Agreement listed in Exhibit 2.1 and the Merger Agreement listed in Exhibit 2.2 (collectively, the “Agreements”) are not intended to modify or supplement any factual disclosures about the parties thereto, including the Company, and should not be relied upon as disclosure about such parties without consideration of the periodic and current reports and statements that the parties thereto file with the SEC. The terms of the Agreements govern the contractual rights and relationships, and allocate risks, among the parties in relation to the transactions contemplated by the Agreements. In particular, the representations and warranties made by the parties in the Agreements reflect negotiations between, and are solely for the benefit of, the parties thereto and may be limited or modified by a variety of factors, including: subsequent events, information included in public filings, disclosures made during negotiations, correspondence between the parties and disclosure schedules and disclosure letters, as applicable, to the Agreements. Accordingly, the representations and warranties may not describe the actual state of affairs at the date they were made or at any other time and you should not rely on them as statements of fact. In addition, the representations and warranties made by the parties in the Agreements may be subject to standards of materiality applicable to the contracting parties that differ from those applicable to investors. The schedules to the Agreements have been omitted pursuant to Item 601(b)(2) of Regulation S-K and will be furnished supplementally to the SEC upon request.

 

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Exhibit 10.1

Express Scripts, Inc. 2011 Long-Term Incentive Plan

(as amended and restated effective April 2, 2012)

1. Establishment and Purpose. Express Scripts, Inc. previously established, effective June 1, 2011, an incentive compensation plan known as the “Express Scripts, Inc. 2011 Long-Term Incentive Plan” (“Plan”). This document is an amendment and restatement of the Express Scripts, Inc. Long-Term Incentive Plan in effect as of April 2, 2012 and reflects, among other things, the assumption of the Plan by Express Scripts Holding Company. The purpose of the Plan is to motivate key personnel to produce a superior return to the stockholders of the Company and its Affiliates by offering such individuals an opportunity to realize stock appreciation, by facilitating stock ownership, and by rewarding them for achieving a high level of corporate performance. This Plan is also intended to facilitate recruiting and retaining key personnel of outstanding ability.

2. Definitions. The capitalized terms used in this Plan have the meanings set forth below.

(a) “Affiliate” means any corporation that is a Subsidiary of the Company and, for purposes other than the grant of Incentive Stock Options, any limited liability company, partnership, corporation, joint venture, or any other entity in which the Company or any such Subsidiary owns an equity interest.

(b) “Agreement” means a written contract entered into between the Company or an Affiliate and a Participant or, in the discretion of the Committee, a written certificate issued by the Company or an Affiliate to a Participant, in either case, containing or incorporating the terms and conditions of an Award in such form (not inconsistent with this Plan) as the Committee approves from time to time, together with all amendments thereof, which amendments may be made unilaterally by the Company (with the approval of the Committee) unless such amendments are deemed by the Committee to be materially adverse to the Participant and are not required as a matter of law, or such other relevant written contract entered into between the Company or an Affiliate and a Participant and approved by the Committee.

(c) “Associate” means any full-time or part-time employee (including an officer or director who is also an employee) of the Company or an Affiliate. Except with respect to grants of Incentive Stock Options, “Associate” shall also include any Non-Employee Director serving on the Company’s Board of Directors. References in this Plan to “employment” and related terms (except for references to “employee” in this definition of “Associate” or in Section 7(a)(i)) shall include the providing of services as a Non-Employee Director. Except as specifically provided herein with respect to Non-Employee Directors serving on the Company’s Board of Directors, the term “Associate” shall not include an individual who is determined in good faith by the Company to be an independent contractor. If, for any period of time, an individual has been determined in good faith by the Company not to be a common-law employee, and a court or government agency subsequently makes a determination that the individual was in fact a common-law employee during that period of time, then (i) such determination shall not entitle the individual to any retroactive rights under the Plan, and (ii) the individual’s prospective rights under the Plan shall be determined solely in accordance with the terms of the Plan.

(d) “Award” means a grant made under this Plan in the form of Options, Stock Appreciation Rights, Restricted Stock, Restricted Stock Units, Performance Shares or any Other Award, whether singly, in combination or in tandem.

(e) “Board” means the Board of Directors of the Company.


(f) “Cause” shall mean the willful failure by a Participant to perform his duties with the Company, a Parent or a Subsidiary or the willful engaging in conduct which is injurious to the Company, a Parent or any Subsidiary, monetarily or otherwise, as determined by the Committee in its sole discretion.

(g) “Change in Control” shall mean any of the following:

(i) Individuals who constitute the Incumbent Board cease for any reason to constitute at least a majority of the Board;

(ii) More than 25% of the (x) combined voting power of the then outstanding voting securities of the Company entitled to vote generally in the election of directors (“Outstanding Company Voting Securities”) or (y) the then outstanding Shares of Stock (“Outstanding Company Common Stock”) is directly or indirectly acquired or beneficially owned (as defined in Rule 13d-3 under the Exchange Act, or any successor rule thereto) by any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the Exchange Act), provided, however, that the following acquisitions and beneficial ownership shall not constitute Changes in Control pursuant to this paragraph 2(f)(ii);

(A) any acquisition or beneficial ownership by the Company or a Subsidiary, or

(B) any acquisition or beneficial ownership by any employee benefit plan (or related trust) sponsored or maintained by the Company or one of more of its Subsidiaries.

(iii) Consummation of a reorganization, merger, share exchange or consolidation (a “Business Combination”), unless in each case following such Business Combination,

(A) all or substantially all of the individuals and entities who were the beneficial owners, respectively, of the Outstanding Company Common Stock and Outstanding Company Voting Securities immediately prior to such Business Combination beneficially own, directly or indirectly, more than 50% of, respectively, the then outstanding shares of common stock and the combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors or other governing body, as the case may be, of the entity resulting from such Business Combination (including, without limitation, an entity that as a result of such transaction owns the Company through one or more subsidiaries);

(B) no individual, entity or group (excluding any employee benefit plan (or related trust) of the Company or such corporation resulting from such Business Combination) beneficially owns, directly or indirectly, more than 25% of, respectively, the then outstanding shares of common stock of the corporation resulting from such Business Combination or the combined voting power of the then outstanding voting securities of such corporation entitled to vote generally in the election of directors or other governing body of the entity resulting from such Business Combination, except to the extent that such individual, entity or group owned more than 25% of the Outstanding Company Common Stock or Outstanding Company Voting Securities prior to the Business Combination; and

(C) at least a majority of the members of the board of directors or other governing body of the entity resulting from such Business Combination were members of the Incumbent Board at the time of the execution of the initial agreement, or of the action of the Board, approving such Business Combination.


(iv) The Company shall sell or otherwise dispose of all or substantially all of the assets of the Company (in one transaction or a series of transactions).

(v) The stockholders of the Company shall approve a plan to liquidate or dissolve the Company and the Company shall commence such liquidation or dissolution.

(h) “Change in Control Date” shall mean, in the case of a Change in Control defined in clauses (i) through (iv) of the definition thereof, the date on which the event occurs, and in the case of a Change in Control defined in clause (v) of the definition thereof, the date on which the Company shall commence such liquidation or dissolution.

(i) “Code” means the Internal Revenue Code of 1986, as amended and in effect from time to time, or any successor statute.

(j) “Committee” means the committee of directors appointed by the Board to administer this Plan. In the absence of a specific appointment, “Committee” shall mean the Compensation Committee of the Board.

(k) “Company” means Express Scripts Holding Company, a Delaware corporation, or any successor to all or substantially all of its businesses by merger, consolidation, purchase of assets, share exchange, reorganization or otherwise.

(l) “Disability” means that the Participant has suffered physical or mental incapacity of such nature as to prevent him from engaging in or performing the principal duties of his customary employment or occupation on a continuing or sustained basis, provided that, if a Participant has entered into an employment agreement with the Company, the Committee, in its sole discretion, may determine to substitute the definition set forth in such agreement. All determinations as to the date and extent of disability of any Participant shall be made by the Committee upon the basis of such evidence as it deems necessary or desirable.

(m) “Exchange Act” means the Securities Exchange Act of 1934, as amended; “Exchange Act Rule 16b-3” means Rule 16b-3 promulgated by the Securities and Exchange Commission under the Exchange Act or any successor regulation.

(n) “Fair Market Value” as of any date means, unless otherwise expressly provided in this Plan:

(i) (A) the closing sales price of a Share on the composite tape for New York Stock Exchange (“NYSE”) listed shares, or if Shares are not quoted on the composite tape for NYSE listed shares, on the Nasdaq Global Select Market or any similar system then in use or, (B) if clause (i)(A) is not applicable, the mean between the closing “bid” and the closing “asked” quotation of a Share on the Nasdaq Global Select Market or any similar system then in use, or (C) if the Shares are not quoted on the NYSE composite tape or the Nasdaq Global Select Market or any similar system then in use, the closing sale price of a Share on the principal United States securities exchange registered under the Exchange Act on which the Shares are listed, in any case on the specified date, or, if no sale of Shares shall have occurred on that date, on the immediately preceding day on which a sale of Shares occurred, or


(ii) if clause (i) is not applicable, what the Committee determines in good faith to be 100% of the fair market value of a Share on that date.

In the case of an Incentive Stock Option, if such determination of Fair Market Value is not consistent with the then current regulations of the Secretary of the Treasury, Fair Market Value shall be determined in accordance with said regulations. The determination of Fair Market Value shall be subject to adjustment as provided in Section 13(f) hereof.

(o) “Fundamental Change” means a dissolution or liquidation of the Company, a sale of substantially all of the assets of the Company, a merger or consolidation of the Company with or into any other corporation, regardless of whether the Company is the surviving corporation, or a statutory share exchange involving capital stock of the Company.

(p) “Incentive Stock Option” means any Option designated as such and granted in accordance with the requirements of Section 422 of the Code or any successor to such section.

(q) “Incumbent Board” means the group of directors consisting of (i) those individuals who, as of the effective date of the Plan, constituted the Board of Directors of Express Scripts, Inc.; and (ii) any individuals who become directors subsequent to such effective date whose appointment, election or nomination for election by the stockholders of the Company was approved by a vote of at least a majority of the directors then comprising the Incumbent Board. The Incumbent Board shall exclude any individual whose initial assumption of office occurred (i) as a result of an actual or threatened election contest with respect to the election or removal of directors or other actual or threatened solicitation of proxies or consents by or on behalf of a Person (other than a solicitation of proxies by the Incumbent Board) or (ii) with the approval of the Incumbent Board but by reason of any agreement intended to avoid or settle a proxy contest.

(r) “Non-Employee Director” means a director of the Company who is not an employee of the Company, a Parent or a Subsidiary.

(s) “Non-Qualified Stock Option” means an Option other than an Incentive Stock Option.

(t) “Option” means a right to purchase Stock (or, if the Committee so provides in an applicable Agreement, Restricted Stock), including both Non-Qualified Stock Options and Incentive Stock Options.

(u) “Other Award” means an Award of Stock, an Award based on Stock other than Options, Stock Appreciation Rights, Restricted Stock, Restricted Stock Units or Performance Shares, or a cash-based Award.

(v) “Parent” means a “parent corporation,” as that term is defined in Section 424(e) of the Code, or any successor provision.

(w) “Participant” means an Associate to whom an Award is made.

(x) “Performance Period” means the period of time as specified in an Agreement over which Awards are to vest or be earned.

(y) “Performance Shares” means a contingent award of a specified number of Performance Shares, with each Performance Share equivalent to one or more Shares or a fractional Share or a Unit expressed in terms of one or more Shares or a fractional Share, as specified in the applicable Agreement, a variable percentage of which may vest or be earned depending upon the extent of achievement of specified performance objectives during the applicable Performance Period.


(z) “Plan” means this 2011 Long-Term Incentive Plan, as amended and in effect from time to time.

(aa) “Restricted Stock” means Stock granted under Section 10 hereof so long as such Stock remains subject to one or more restrictions.

(bb) “Restricted Stock Units” means Units of Stock granted under Section 10 hereof.

(cc) “Retirement” shall mean, except as otherwise provided in an Agreement, termination of employment after either (i) attainment of age 65, or (ii) the normal retirement age specified in the provisions of a retirement plan maintained by the Company for its employees generally.

(dd) “Senior Executive” means any Associate who is an employee of the Company and whose base salary is determined by reference to Salary Grades M3 and above (as such salary grades are in effect on the effective date of this Plan), or, if the Company modifies its salary grades after such effective date, in the most nearly comparable salary grades for senior executives of the Company under such modified system as determined by the Committee in its sole discretion.

(ee) “Share” means a share of Stock.

(ff) “Stock” means the Company’s common stock, $0.01 par value per share (as such par value may be adjusted from time to time) or any securities issued in respect thereof by the Company or any successor to the Company as a result of an event described in Section 13(f).

(gg) “Stock Appreciation Right” means a right, the value of which is determined relative to appreciation in value of Shares pursuant to an Award granted under Section 8 hereof.

(hh) “Subsidiary” means a “subsidiary corporation,” as that term is defined in Section 424(f) of the Code, or any successor provision.

(ii) “Successor” with respect to a Participant means the legal representative of an incompetent Participant and, if the Participant is deceased, the legal representative of the estate of the Participant or the person or persons who may, by bequest or inheritance, or under the terms of an Award or forms submitted by the Participant to the Committee under Section 13(h) hereof, acquire the right to exercise an Option or Stock Appreciation Right or receive cash and/or Shares issuable in satisfaction of an Award in the event of a Participant’s death.

(jj) “Term” means the period during which an Option or Stock Appreciation Right may be exercised or the period during which the restrictions placed on Restricted Stock or any other Award are in effect.

(kk) “Unit” means a bookkeeping entry that may be used by the Company or an Affiliate to record and account for the grant of Stock, Units of Stock, Stock Appreciation Rights and Performance Shares expressed in terms of Units of Stock until such time as the Award is paid, canceled, forfeited or terminated.


(ll) “Vice President” means any Associate who is an employee of the Company or an Affiliate and whose base salary is determined by reference to Salary Grades M1 through and including M2 (as such salary grades are in effect on the effective date of this Plan), or, if the Company modifies its salary grades after such effective date, in the most nearly comparable salary grades for vice presidents of the Company under such modified system as determined by the Committee in its sole discretion.

Except when otherwise indicated by the context, reference to the masculine gender shall include, when used, the feminine gender and any term used in the singular shall also include the plural.

3. Administration.

(a) Authority of Committee. The Committee shall administer this Plan or delegate its authority to do so as provided in Section 3(c) hereof. The Committee shall have exclusive power (acting alone or, to the extent the Committee deems appropriate for purposes of Exchange Act Rule 16b-3, in conjunction with the full Board), subject to the limitations contained in this Plan, to make Awards and to determine when and to whom Awards will be granted, and the form, amount and other terms and conditions of each Award, subject to the provisions of this Plan. The Committee, subject to the limitations contained in this Plan, may determine whether, to what extent and under what circumstances Awards may be settled, paid or exercised in cash, Shares or other Awards or other property, or canceled, forfeited or suspended. The Committee shall have the authority to interpret this Plan and any Award or Agreement made under this Plan, to establish, amend, waive and rescind any rules and regulations relating to the administration of this Plan, to determine the terms and provisions of any Agreement entered into hereunder (not inconsistent with this Plan), and to make all other determinations necessary or advisable for the administration of this Plan. The Committee may correct any defect, supply any omission or reconcile any inconsistency in this Plan or in any Award in the manner and to the extent it shall deem desirable. All determinations of the Committee in the administration of this Plan, as described herein, shall be final, binding and conclusive, including, without limitation, as to any adjustments pursuant to Section 13(f). A majority of the members of the Committee shall constitute a quorum for any meeting of the Committee. Notwithstanding the foregoing, in administering this Plan with respect to Awards for Non-Employee Directors, the Board shall exercise the powers of the Committee.

(b) Limitations. Notwithstanding anything herein to the contrary, the Committee shall not have the right, without stockholder approval, to (i) reduce or decrease the purchase price for an outstanding Option or Stock Appreciation Right, (ii) cancel an outstanding Option or Stock Appreciation Right for the purpose of replacing or re-granting such Option or Stock Appreciation Right with a purchase price that is less than the original purchase price, (iii) extend the expiration date of an Option or Stock Appreciation Right, (iv) deliver payment in exchange for the cancellation of an Option, the purchase price of which exceeds the Fair Market Value of the Shares underlying such Option, (v) modify, amend, or waive the terms and conditions of Awards to persons who are considered “reporting persons” for purposes of Section 16 of the Exchange Act, other than on account of death, disability, retirement, Change in Control, or a termination of employment in connection with a business transfer, or (vi) waive or amend any terms, conditions, restrictions, or limitations on an Award to a person who is not a “reporting person” for purposes of Section 16 of the Exchange Act, except to the extent that the terms and conditions which are modified, amended, or waived, relate to no more than five percent (5%) of the number of Shares initially available under the Plan.

(c) Delegation of Authority. The Committee may delegate all or any part of the administration of this Plan to one or more committees, or to senior managers of the Company, and may authorize further delegation by such committees to senior managers of the Company, in each case to the extent permitted by Delaware law; provided that, determinations regarding the timing, pricing, amount and terms of any Award to a “reporting person” for purposes of Section 16 of the Exchange Act shall be made only by the Committee; and provided further that, no such delegation may be made that would cause Awards or other transactions under this Plan to cease to be exempt from Section 16(b) of the Exchange Act or cause an Award intended to qualify for favorable treatment under Section 162(m) of the Code not to qualify for, or to cease to qualify for, the favorable treatment under Section 162(m) of the Code. Any such delegation may be revoked by the Committee at any time.


(d) Board Authority. Any authority granted to the Committee may also be exercised by the Board or another committee of the Board, except to the extent that the grant or exercise of such authority would cause any Award intended to qualify for favorable treatment under Section 162(m) of the Code to cease to qualify for the favorable treatment under Section 162(m) of the Code. To the extent that any permitted action taken by the Board conflicts with action taken by the Committee, the Board action shall control. Without limiting the generality of the foregoing, to the extent the Board has delegated any authority under this Plan to another committee of the Board, such authority shall not be exercised by the Committee unless expressly permitted by the Board in connection with such delegation.

(e) Awards for Non-Employee Directors. The Board (which may delegate the determination to a Committee of the Board) may from time to time determine that each individual who is elected or appointed to the office of director as a Non-Employee Director receive an Award (other than Incentive Stock Options) as compensation, in whole or in part, for such individual’s services as a director. In determining the level and terms of such Awards for Non-Employee Directors, the Board may consider such factors as compensation practices of comparable companies with respect to directors, consultants’ recommendations, and such other information as the Board may deem appropriate.

4. Shares Available; Maximum Payouts.

(a) Shares Available. The maximum number of Shares available for Awards under the Plan shall be Thirty Million (30,000,000), including Awards made pursuant to the Plan prior to this amendment and restatement. Stock Options and Stock Appreciation Rights awarded shall reduce the number of shares available for Awards by one share for every one share subject to such Award; provided that Stock Appreciation Rights that may be settled only in cash shall not reduce the number of Shares available for Awards. Awards of Restricted Stock, Restricted Stock Units, Performance Shares, and Other Awards settled in Shares shall reduce the number of Shares available for Awards by one Share for every one Share awarded, up to twenty percent (20%) of the total number of Shares available; beyond that, Restricted Stock Restricted Stock Units, Performance Shares, and Other Awards settled in Shares shall reduce the number of Shares available for Awards by three Shares for every one Share awarded. Restricted Stock Units that may be settled only in cash shall not reduce the number of Shares available for Awards. Shares issued under this Plan may be authorized and unissued shares or issued shares held as treasury shares. Shares purchased on the open market shall not increase the Shares available under the Plan.

(b) Shares Not Applied to Limitations. The following will not be applied to the Share limitations of subsection 4(a) above: (i) dividends or dividend equivalents paid in cash in connection with outstanding Awards, (ii) Awards which by their terms may be settled only in cash, (iii) any Shares subject to an Award under the Plan which Award is forfeited, cancelled, terminated, expires or lapses for any reason, and (iv) Shares and any Awards that are granted through the settlement, assumption, or substitution of outstanding awards previously granted, or through obligations to grant future awards, as the result of a merger, consolidation, or acquisition of the employing company with or by the Company. If a Participant tenders previously owned Shares or has the Company withhold Shares in satisfaction of any tax withholding requirement or payment of the purchase price of an Award, such Shares tendered or withheld will not be available again for an Award under the Plan; provided, however, that any Shares so used to satisfy tax withholdings for Restricted Stock, Restricted Stock Units, Performance Shares, or Other Awards may again be used for an Award under this Plan.


(c) Award Limitations. No Participant may receive any combination of Awards relating to more than 1,000,000 Shares in the aggregate, or a cash-based bonus Award with a value that exceeds $10,000,000 in the aggregate, in any fiscal year of the Company under this Plan (subject to adjustment under Section 13(f) hereof).

5. Eligibility. Awards may be granted under this Plan to any Associate at the discretion of the Committee.

6. General Terms of Awards.

(a) Awards. Awards under this Plan may consist of Options (either Incentive Stock Options or Non-Qualified Stock Options), Stock Appreciation Rights, Performance Shares, Restricted Stock, Restricted Stock Units, or Other Awards.

(b) Amount of Awards. Each Agreement shall set forth the number of Shares of Restricted Stock, Stock, Stock Units, or Performance Shares, or the amount of cash, subject to such Agreement, or the number of Shares to which the Option applies or with respect to which payment upon the exercise of the Stock Appreciation Right is to be determined, as the case may be, together with such other terms and conditions applicable to the Award (not inconsistent with this Plan) as determined by the Committee in its sole discretion.

(c) Term. Each Agreement, other than those relating solely to Awards of Stock without restrictions, shall set forth the Term of the Award and any applicable Performance Period, as the case may be, but in no event shall the Term of an Award or the Performance Period be longer than ten years after the date of grant; provided, however, that the Committee may, in its discretion, grant Awards with a longer term to Participants who are located outside the United States. An Agreement with a Participant may permit acceleration of vesting requirements and of the expiration of the applicable Term upon such terms and conditions as shall be set forth in the Agreement, which may, but, unless otherwise specifically provided in this Plan, need not, include, without limitation, acceleration resulting from the occurrence of the Participant’s death or Disability. Acceleration of the Performance Period of Performance Shares and other performance-based Awards shall be subject to Section 9(b) or Section 12 hereof, as applicable.

(d) Agreements. Each Award under this Plan shall be evidenced by an Agreement setting forth the terms and conditions, as determined by the Committee, that shall apply to such Award, in addition to the terms and conditions specified in this Plan.

(e) Transferability. Except as otherwise permitted by the Committee, during the lifetime of a Participant to whom an Award is granted, only such Participant (or such Participant’s legal representative) may exercise an Option or Stock Appreciation Right or receive payment with respect to any other Award. Except as otherwise permitted by the Committee, no Award of Restricted Stock (prior to the expiration of the restrictions), Restricted Stock Units, Options, Stock Appreciation Rights, Performance Shares or Other Award (other than an award of Stock without restrictions) may be sold, assigned, transferred, exchanged, or otherwise encumbered, and any attempt to do so (including pursuant to a decree of divorce or any judicial declaration of property division) shall be of no effect. Notwithstanding the immediately preceding sentence, an Agreement may provide that an Award shall be transferable to a Successor in the event of a Participant’s death.

(f) Termination of Employment. The extent to which the Participant shall have the right to exercise and/or retain an Award following termination of the Participant’s employment with the Company or its Affiliates, shall be as set forth in an Agreement. Such provisions shall be determined in the sole discretion of the Committee, shall be included in the Agreement, need not be uniform among Awards issued pursuant to this Plan, and may reflect distinctions based on the reasons for termination.


(g) Change in Control. The treatment of Awards upon a Change in Control shall be set forth in an Agreement; provided, however, that in no event may the vesting of any Award be accelerated as a result of a Change in Control until on or after the Change in Control Date. In the event the terms of the relevant Agreement and the terms of this Section 6(g) should conflict, the terms of this Section shall govern.

(h) Rights as Stockholder. A Participant shall have no right as a stockholder with respect to any securities covered by an Award until the date the Participant becomes the holder of record.

(i) Performance Conditions. The Committee may require the satisfaction of certain performance goals as a condition to the grant or vesting of any Award provided under the Plan.

7. Stock Options.

(a) Terms of All Options.

(i) Grants. Each Option shall be granted pursuant to an Agreement as either an Incentive Stock Option or a Non-Qualified Stock Option. Only Non-Qualified Stock Options may be granted to Associates who are not employees of the Company or an Affiliate. In no event may Options known as reload options be granted hereunder.

(ii) Purchase Price. The purchase price of each Share subject to an Option shall be determined by the Committee and set forth in the applicable Agreement, but shall not be less than 100% of the Fair Market Value of a Share as of the date the Option is granted. The purchase price of the Shares with respect to which an Option is exercised shall be payable in full at the time of exercise, provided that, to the extent permitted by law and in accordance with rules adopted by the Committee, Participants may simultaneously exercise Options and sell the Shares thereby acquired pursuant to a brokerage or similar relationship and use the proceeds from such sale to pay the purchase price of such Shares. The purchase price may be paid in cash or, if the Committee so permits, through delivery or tender to the Company of Shares held, either actually or by attestation, by such Participant (in each case, such Shares having a Fair Market Value as of the date the Option is exercised equal to the purchase price of the Shares being purchased pursuant to the Option) or through a net or cashless form of exercise as permitted by the Committee, or, if the Committee so permits, a combination thereof, unless otherwise provided in the Agreement. Further, the Committee, in its discretion, may approve other methods or forms of payment of the purchase price, and establish rules and procedures therefor.

(iii) Exercisability. Each Option shall be exercisable in whole or in part on the terms provided in the Agreement. An Option that vests solely on the basis of the passage of time (and not on the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about the first anniversary of the Option grant date. An Option that vests based on performance standards may, in the discretion of the Committee, vest as rapidly as immediate vesting on or about the first anniversary of the Option grant date. Notwithstanding the foregoing, vesting of an Option may be accelerated upon the occurrence of certain events as provided in the applicable Agreement. In no event shall any Option be exercisable at any time after its Term. When an Option is no longer exercisable, it shall be deemed to have lapsed or terminated.


(b) Incentive Stock Options. In addition to the other terms and conditions applicable to all Options:

(i) the aggregate Fair Market Value (determined as of the date the Option is granted) of the Shares with respect to which Incentive Stock Options held by an individual first become exercisable in any calendar year (under this Plan and all other incentive stock options plans of the Company and its Affiliates) shall not exceed $100,000 (or such other limit as may be required by the Code), if such limitation is necessary to qualify the Option as an Incentive Stock Option, and to the extent an Option or Options granted to a Participant exceed such limit such Option or Options shall be treated as Non-Qualified Stock Options;

(ii) an Incentive Stock Option shall not be exercisable and the Term of the Award shall not be more than ten years after the date of grant (or such other limit as may be required by the Code) if such limitation is necessary to qualify the Option as an Incentive Stock Option;

(iii) the Agreement covering an Incentive Stock Option shall contain such other terms and provisions which the Committee determines necessary to qualify such Option as an Incentive Stock Option; and

(iv) notwithstanding any other provision of this Plan if, at the time an Incentive Stock Option is granted, the Participant owns (after application of the rules contained in Section 424(d) of the Code, or its successor provision) Shares possessing more than ten percent of the total combined voting power of all classes of stock of the Company or its subsidiaries, (A) the option price for such Incentive Stock Option shall be at least 110% of the Fair Market Value of the Shares subject to such Incentive Stock Option on the date of grant and (B) such Option shall not be exercisable after the date five years from the date such Incentive Stock Option is granted.

8. Stock Appreciation Rights.

(a) Grant. An Award of a Stock Appreciation Right shall entitle the Participant, subject to terms and conditions determined by the Committee, to receive upon exercise of the Stock Appreciation Right all or a portion of the excess of (i) the Fair Market Value of a specified number of Shares as of the date of exercise of the Stock Appreciation Right over (ii) a specified price which shall not be less than 100% of the Fair Market Value of such Shares as of the date of grant of the Stock Appreciation Right (“purchase price”). A Stock Appreciation Right may be granted in connection with a previously or contemporaneously granted Option, or independent of any Option. If issued in connection with an Option, the Committee may impose a condition that exercise of a Stock Appreciation Right cancels the Option with which it is connected and exercise of the connected Option cancels the Stock Appreciation Right. Each Stock Appreciation Right may be exercisable in whole or in part on the terms provided in the applicable Agreement. No Stock Appreciation Right shall be exercisable at any time after its Term. When a Stock Appreciation Right is no longer exercisable, it shall be deemed to have lapsed or terminated. Except as otherwise provided in the applicable Agreement, upon exercise of a Stock Appreciation Right, payment to the Participant (or to his or her Successor) shall be made in the form of cash, Stock or a combination of cash and Stock (as determined by the Committee if not otherwise specified in the Award) as promptly as practicable after such exercise. The Agreement may provide for a limitation upon the amount or percentage of the total appreciation on which payment (whether in cash and/or Stock) may be made in the event of the exercise of a Stock Appreciation Right.


(b) Exercisability. Each Stock Appreciation Right shall vest in whole or in part on the terms provided in the Agreement. A Stock Appreciation Right that vests solely on the basis of the passage of time (and not on the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about the first anniversary of the Stock Appreciation Right grant date. A Stock Appreciation Right that vests based on performance standards may, in the discretion of the Committee, vest as rapidly as immediate vesting on the first anniversary of the Option grant date. Notwithstanding the foregoing, the vesting of a Stock Appreciation Right may be accelerated upon the occurrence of certain events as provided in the applicable Agreement. In no event shall any Stock Appreciation Right be exercisable at any time after its Term. When a Stock Appreciation Right is no longer exercisable, it shall be deemed to have lapsed or terminated.

9. Performance Shares.

(a) Initial Award. An Award of Performance Shares shall entitle a Participant (or a Successor) to future payments based upon the achievement of performance targets established in writing by the Committee. Payment shall be made in cash or Stock, or a combination of cash and Stock, as determined by the Committee. Such performance targets shall be determined by the Committee in its sole discretion. The Agreement may establish that a portion of the maximum amount of a Participant’s Award will be paid for performance which exceeds the minimum target but falls below the maximum target applicable to such Award. The Agreement shall also provide for the timing of such payment.

(b) Acceleration and Adjustment. The applicable Agreement may permit an acceleration of the Performance Period and an adjustment of performance targets and payments with respect to some or all of the Performance Shares awarded to a Participant, upon such terms and conditions as shall be set forth in the Agreement, upon the occurrence of certain events, which may, but need not, include without limitation a Fundamental Change, the Participant’s death or Disability, a change in accounting practices of the Company or its Affiliates, a reclassification, stock dividend, stock split or stock combination, or other event as provided in Section 13(f) hereof. Notwithstanding the foregoing, an Award subject to this Section 9 shall vest or be earned no more rapidly than immediate vesting on the first anniversary of the Award grant date, except as may be provided in the applicable Agreement.

(c) Valuation. To the extent that payment of a Performance Share is made in cash, a Performance Share earned after conclusion of a Performance Period shall have a value equal to the Fair Market Value of a Share on the last day of such Performance Period.

(d) Voting; Dividends. Participants holding Performance Shares shall have no voting rights with respect to such Awards and shall have no dividend rights with respect to Shares subject to such Performances Shares other than as the Committee so provides, in its discretion, in an Agreement; provided, that, any such dividends shall be subject to such restrictions and conditions as the Committee may establish with respect to the Performance Shares and shall be payable only at the same time as the underlying Performance Shares may become earned, vested, and payable.

10. Restricted Stock and Restricted Stock Unit Awards.

(a) Grant. All or any part of any Restricted Stock or Restricted Stock Unit Award may be subject to such conditions and restrictions as may be established by the Committee, and set forth in the applicable Agreement, which may include, but are not limited to, continuous service with the Company, a requirement that a Participant pay a purchase price for such Award, the achievement of specific performance goals, and/or applicable securities laws restrictions. During any period during which an Award of Restricted Stock or Restricted Stock Units is restricted and subject to a substantial risk of forfeiture, (i) Participants holding Restricted Stock Awards may exercise full voting rights with respect to such Shares and shall be entitled to receive all dividends and other distributions paid with respect to such Shares while they are so restricted and (ii) Participants holding Restricted Stock Units shall have no voting rights with respect to such Awards and shall have no dividend rights with respect to Shares subject


to such Restricted Stock Units other than as the Committee so provides, in its discretion, in an Agreement. Any dividends or dividend equivalents may be paid currently or may be credited to a Participant’s account and may be subject to such restrictions and conditions as the Committee may establish.

(b) Vesting. An Award of Restricted Stock or Restricted Stock Units that vests solely on the basis of the passage of time (and not on the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about the first anniversary of the Award grant date, or, in the case of a Restricted Stock or Restricted Stock Units Award that vests based on performance standards, such Award may, in the discretion of the Committee, vest as rapidly as immediate vesting on the first anniversary of the Award grant date; provided, however, that up to five percent (5%) of the Shares initially available under the Plan may be granted as Restricted Stock Awards that vest more rapidly than ratably over such three-year period or immediately following such one-year period, as applicable. Notwithstanding the foregoing, the vesting of a Restricted Stock or Restricted Stock Units Award may be accelerated upon the occurrence of certain events as provided in the applicable Agreement.

11. Other Awards. The Committee may from time to time grant Other Awards under this Plan, including without limitation those Awards pursuant to which a cash bonus award may be made or pursuant to which Shares may be acquired in the future, such as Awards denominated in Stock, Stock Units, securities convertible into Stock and phantom securities. The Committee, in its sole discretion, shall determine, and provide in the applicable Agreement for, the terms and conditions of such Awards provided that such Awards shall not be inconsistent with the terms and purposes of this Plan. The Committee may, in its sole discretion, direct the Company to issue Shares subject to restrictive legends and/or stop transfer instructions which are consistent with the terms and conditions of the Award to which such Shares relate. In addition, the Committee may, in its sole discretion, issue such Other Awards subject to the performance criteria under Section 12 hereof.

12. Performance-Based Awards.

(a) Application to Covered Employee. Notwithstanding any other provision of the Plan, if the Committee determines at the time any Award is granted to a Participant that such Participant is, or is likely to be as of the end of the tax year in which the Company would claim a tax deduction in connection with such Award, a “covered employee” within the meaning of Section 162(m)(3) of the Code, then the Committee may provide that this Section 12 is applicable to such Award. Notwithstanding the foregoing, the Committee may provide, in its discretion, that an Award granted to any other Participant is subject to this Section 12, to the extent the Committee deems appropriate, whether or not Section 162(m) of the Code is or would be applicable with respect to such Participant.

(b) Performance Goals. Awards under the Plan may be made subject to the achievement of performance goals established by the Committee relating to one or more business criteria (“Performance Criteria”) pursuant to Section 162(m) of the Code. Performance Criteria may be applied to the Company, an Affiliate, a Parent, a Subsidiary, division, business unit, corporate group or individual or any combination thereof and may be measured in absolute levels or relative to another company or companies, a peer group, an index or indices or Company performance in a previous period. Performance may be measured annually or cumulatively over a longer period of time. Performance Criteria that may be used to establish performance goals are: earnings or earnings per share before income tax (profit before taxes), net earnings or net earnings per share (profit after tax), compound annual growth in earnings per share, inventory, total or net operating asset turnover, operating income, total stockholder return, compound stockholder return, return on equity, average return on invested capital, pre-tax and pre-interest expense return on average invested capital, which may be expressed on a current value basis, sales


growth, operating or profit margins, market share or market penetration, successful transition of the Company’s clients to new claim adjudication platforms, achievement goals related to of post-merger integrations goals, achievement of goals related to customer service, satisfaction or retention, achievement of employee diversity satisfaction or turnover goals, and achievement of general sales, marketing, operating or workplan goals. Performance will be evaluated by excluding the effect of any extraordinary, unusual or non-recurring items that occur during the applicable Performance Period. The performance goals for each Participant and the amount payable if those goals are met shall be established in writing for each specified period of performance by the Committee no later than 90 days after the commencement of the period of service to which the performance goals relate and while the outcome of whether or not those goals will be achieved is substantially uncertain. However, in no event will such goals be established after 25% of the period of service to which the goals relate has elapsed. The performance goals shall be objective. Such goals and the amount payable for each performance period if the goals are achieved shall be set forth in the applicable Agreement. Following the conclusion or acceleration of each Performance Period, the Committee shall determine the extent to which (i) Performance Criteria have been attained, (ii) any other terms and conditions with respect to an Award relating to such Performance Period have been satisfied, and (iii) payment is due with respect to a performance-based Award. No amounts shall be payable to any Participant for any Performance Period unless and until the Committee certifies that the Performance Criteria and any other material terms were in fact satisfied.

(c) Adjustment of Payment. With respect to any Award that is subject to this Section 12, the Committee may adjust downwards, but not upwards, the amount payable pursuant to such Award. The applicable Agreement may permit an acceleration of the Performance Period and an adjustment of performance targets and payments with respect to some or all of the performance-based Award(s) awarded to a Participant, upon such terms and conditions as shall be set forth in the Agreement, upon the occurrence of certain events, which may, but need not, include without limitation a Fundamental Change, the Participant’s death or Disability, a change in accounting practices of the Company or its Affiliates, a reclassification, stock dividend, stock split or stock combination, or other event as provided in Section 13(f) hereof; provided, however, that any such acceleration or adjustment shall be made only to the extent and in a manner consistent with Section 162(m) of the Code. Notwithstanding the foregoing, an Award subject to this Section 12 shall vest or be earned no more rapidly than immediate vesting on the first anniversary of the Award grant date, except as may be provided in the applicable Agreement.

(d) Other Restrictions. The Committee shall have the power to impose such other restrictions on Awards subject to this Section 12 as it may deem necessary or appropriate to ensure that such Awards satisfy all requirements for “performance-based compensation” within the meaning of Section 162(m)(4)(C) of the Code, or any successor provision thereto.

13. General Provisions.

(a) Effective Date of this Plan. This Plan originally became effective as of June 1, 2011 after approval and ratification by the holders of common stock of Express Scripts, Inc. at its annual meeting held on May 4, 2011. This amendment and restatement is effective April 2, 2012 and was approved and ratified on March 29, 2012 by the holders of the Company’s common stock.

(b) Duration of this Plan; Date of Grant. This Plan shall remain in effect until June 1, 2021 or until all Shares subject to the Plan shall have been purchased or acquired according to the Plan’s provisions, whichever occurs first, unless this Plan is sooner terminated pursuant to Section 13(e) hereof. The date and time of approval by the Committee of the granting of an Award shall be considered the date and time at which such Award is made or granted, or such later effective date as determined by the Committee, notwithstanding the date of any Agreement with respect to such Award; provided, however,


that the Committee may grant Awards other than Incentive Stock Options to Associates or to persons who are about to become Associates, to be effective and deemed to be granted on the occurrence of certain specified contingencies, provided that if the Award is granted to a non-Associate who is about to become an Associate, such specified contingencies shall include, without limitation, that such person becomes an Associate.

(c) Right to Terminate Employment. Nothing in this Plan or in any Agreement shall confer upon any Participant who is an employee of the Company the right to continue in the employment of the Company or any Affiliate or affect any right which the Company or any Affiliate may have to terminate or modify the employment of the Participant with or without cause.

(d) Tax Withholding. The Company shall withhold from any payment of cash or Stock to a Participant or other person under this Plan an amount sufficient to cover any required withholding taxes, including the Participant’s social security and Medicare taxes (FICA) and federal, state and local income tax with respect to income arising from payment of the Award. The Company shall have the right to require the payment of any such taxes before issuing any Stock pursuant to the Award. In lieu of all or any part of a cash payment from a person receiving Stock under this Plan, the Committee may, in the applicable Agreement or otherwise, permit a person to cover all or any part of the required withholdings, and to cover any additional withholdings up to the amount needed to cover the person’s full FICA and federal, state and local income tax with respect to income arising from payment of the Award, through a reduction of the numbers of Shares delivered to such person or a delivery or tender to the Company of Shares held by such person, in each case valued in the same manner as used in computing the withholding taxes under applicable laws.

(e) Amendment, Modification and Termination of this Plan. Except as provided in this Section 13(e), the Board may at any time amend, modify, terminate or suspend this Plan. Except as provided in this Section 13(e), the Committee may at any time alter or amend any or all Agreements under this Plan to the extent permitted by law and subject to the requirements of Section 2(b), in which event, as provided in Section 2(b), the term “Agreement” shall mean the Agreement as so amended. Amendments are subject to approval of the stockholders of the Company only as required by applicable law or regulation, or if the amendment increases the total number of shares available under this Plan. No termination, suspension or modification of this Plan may materially and adversely affect any right acquired by any Participant (or a Participant’s legal representative) or any Successor or permitted transferee under an Award granted before the date of termination, suspension or modification, unless otherwise provided in an Agreement or otherwise or required as a matter of law. It is conclusively presumed that any adjustment for changes in capitalization provided for in Sections 9(b), 12(c) or 13(f) hereof does not adversely affect any right of a Participant or other person under an Award.

(f) Adjustment for Changes in Capitalization. Appropriate adjustments in the aggregate number and type of securities that may be issued, represented, and available for Awards under this Plan, in the limitations on the number and type of securities that may be issued to an individual Participant, in the number and type of securities and amount of cash subject to Awards then outstanding, in the Option purchase price as to any outstanding Options, in the purchase price as to any outstanding Stock Appreciation Rights, and, subject to Sections 9(b) and 12(c) hereof, in outstanding Performance Shares and payments with respect to outstanding Performance Shares, and comparable adjustments, if applicable, to any outstanding Other Award, automatically shall be made to give effect to adjustments made in the number or type of Shares through a Fundamental Change, divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off or other relevant change, provided that fractional Shares shall be rounded to the nearest whole Share, for which purpose one-half share shall be rounded down to the nearest whole Share.


(g) Other Benefit and Compensation Programs. Payments and other benefits received by a participant under an Award shall not be deemed a part of a Participant’s regular, recurring compensation for purposes of any termination, indemnity or severance pay laws and shall not be included in, nor have any effect on, the determination of benefits under any other employee benefit plan, contract or similar arrangement provided by the Company or an Affiliate, unless expressly so provided by such other plan, contract or arrangement or the Committee determines that an Award or portion of an Award should be included to reflect competitive compensation practices or to recognize that an Award has been made in lieu of a portion of competitive cash compensation.

(h) Beneficiary Upon Participant’s Death. To the extent that the transfer of a participant’s Award at death is permitted by this Plan or under an Agreement, (i) a Participant’s Award shall be transferable to the beneficiary, if any, designated on forms prescribed by and filed with the Committee and (ii) upon the death of the Participant, such beneficiary shall succeed to the rights of the Participant to the extent permitted by law and this Plan. If no such designation of a beneficiary has been made, the Participant’s legal representative shall succeed to the Awards, which shall be transferable by will or pursuant to laws of descent and distribution to the extent permitted by this Plan or under an Agreement.

(i) Unfunded Plan. This Plan shall be unfunded and the Company shall not be required to segregate any assets that may at any time be represented by Awards under this Plan. Neither the Company, its Affiliates, the Committee, nor the Board shall be deemed to be a trustee of any amounts to be paid under this Plan nor shall anything contained in this Plan or any action taken pursuant to its provisions create or be construed to create a fiduciary relationship between the Company and/or its Affiliates, and a Participant or Successor. To the extent any person acquires a right to receive an Award under this Plan, such right shall be no greater than the right of an unsecured general creditor of the Company.

(j) Limits of Liability.

(i) Any liability of the Company to any Participant with respect to an Award shall be based solely upon contractual obligations created by this Plan and the Agreement.

(ii) Except as may be required by law, neither the Company nor any member or former member of the Board or the Committee, nor any other person participating (including participation pursuant to a delegation of authority under Section 3(c) hereof) in any determination of any question under this Plan, or in the interpretation, administration or application of this Plan, shall have any liability to any party for any action taken, or not taken, in good faith under this Plan.

(iii) To the full extent permitted by law, each member and former member of the Committee and each person to whom the Committee delegates or has delegated authority under this Plan shall be entitled to indemnification by the Company against any loss, liability, judgment, damage, cost and reasonable expense incurred by such member, former member or other person by reason of any action taken, failure to act or determination made in good faith under or with respect to this Plan.

(k) Compliance with Applicable Legal Requirements. The Company shall not be required to issue or deliver a certificate for Shares distributable pursuant to this Plan unless the issuance of such certificate complies with all applicable legal requirements including, without limitation, compliance with the provisions of applicable state securities laws, the Securities Act of 1933, as amended and in effect from time to time or any successor statute, the Exchange Act and the requirements of the exchanges, if any, on which the Company’s Shares may, at the time, be listed.


(l) Deferrals and Settlements. The Committee may require or permit Participants to elect to defer the issuance of Shares or the settlement of Awards in cash under such rules and procedures as it may establish under this Plan. It may also provide that deferred settlements include the payment or crediting of interest on the deferral amounts.

14. Substitute Awards. Awards may be granted under this Plan from time to time in substitution for Awards held by employees of other corporations who are about to become Associates, or whose employer is about to become a Subsidiary of the Company, as the result of a merger or consolidation of the Company or a Subsidiary of the Company with another corporation, the acquisition by the Company or a Subsidiary of the Company of all or substantially all the assets of another corporation or the acquisition by the Company or a Subsidiary of the Company of at least 50% of the issued and outstanding stock of another corporation. The terms and conditions of the substitute Awards so granted may vary from the terms and conditions set forth in this Plan to such extent as the Board at the time of the grant may deem appropriate to conform, in whole or in part, to the provisions of the Awards in substitution for which they are granted, but with respect to Awards which are Incentive Stock Options, no such variation shall be permitted which affects the status of any such substitute option as an Incentive Stock Option.

15. Governing Law. To the extent that federal laws do not otherwise control, this Plan and all determinations made and actions taken pursuant to this Plan shall be governed by the laws of Delaware, without giving effect to principles of conflicts of laws, and construed accordingly.

16. Severability. In the event any provision of this Plan shall be held illegal or invalid for any reason, the illegality or invalidity shall not affect the remaining parts of this Plan, and this Plan shall be construed and enforced as if the illegal or invalid provision had not been included.

17. Prior Plans. Notwithstanding the adoption of this Plan by the Board and approval of this Plan by the Company’s stockholders as provided by Section 13(a) hereof, the Express Scripts, Inc. 2000 Long-Term Incentive Plan, as amended (the “2000 Plan”), shall remain in effect, but grants pursuant to the 2000 Plan shall not be made after the effective date of this Plan. All grants and awards that were made under the 2000 Plan shall be governed by the terms of the 2000 Plan. For the avoidance of doubt, each grant and award that was made under the terms of the Express Scripts, Inc. 2011 Long-Term Incentive Plan outstanding as of April 2, 2012 has been assumed under this Plan as amended and restated and, to the extent applicable, such grants and awards that represented awards in respect of common stock of Express Scripts, Inc. shall, upon such assumption, represent awards in respect of Shares of the Company.

18. Deferred Compensation. If any Award would be considered deferred compensation as defined under Code Section 409A and would fail to meet the requirements of Code Section 409A, then such Award shall be null and void.

Exhibit 10.2

EXPRESS SCRIPTS, INC.

EMPLOYEE STOCK PURCHASE PLAN

(As amended and restated effective April 2, 2012)

1. Purpose. The purpose of the Plan is to provide employees of the Company and its Designated Subsidiaries with an opportunity to purchase Common Stock of the Company through accumulated payroll deductions. It is the intention of the Company to have the Plan qualify as an “Employee Stock Purchase Plan” under Section 423 of the Internal Revenue Code of 1986, as amended. The provisions of the Plan shall, accordingly, be construed so as to extend and limit participation in a manner consistent with the requirement of that section of the Code. This Plan is an amendment and restatement of the Express Scripts, Inc. Employee Stock Purchase Plan in effect as of April , 2012.

2. Definitions.

(a) “Board” shall mean the Board of Directors of the Company.

(b) “Code” shall mean the Internal Revenue Code of 1986, as amended.

(c) “Common Stock” shall mean the Common Stock, par value $0.01, of the Company.

(d) “Company” shall mean Express Scripts Holding Company, a Delaware corporation, and, unless the context requires otherwise, any Designated Subsidiary.

(e) “Compensation” shall mean all regular straight time gross earnings, overtime earnings, bonuses and commissions, and without reduction for contributions to any 401(k) plan sponsored by the Company.

(f) “Contributions” shall mean all amounts credited to the account of a participant pursuant to the Plan.

(g) “Designated Subsidiary” shall mean any Subsidiary which has been designated by the Board from time to time in its sole discretion as eligible to participate in the Plan.

(h) “Employee” shall mean any person who is an employee of the Company for tax purposes whose customary employment with the Company is at least twenty (20) hours per week and more than five (5) months in a calendar year. For purposes of the Plan, the employment relationship shall be treated as continuing intact while the individual is on short term disability or other leave of absence approved by the Company. Where the period of leave exceeds 90 days and the individual’s right to reemployment is not guaranteed either by statute or by contract, the employment relationship shall be deemed to have terminated on the 91st day of such leave.

(i) “Enrollment Date” shall mean the first business day of each Participation Period.


(j) “Exchange Act” shall mean the Securities Exchange Act of 1934, as amended.

(k) “Offering Date” shall mean the first business day of each Offering Period of the Plan.

(l) “Offering Period” shall mean a period of one (1) month commencing on the first day of each calendar month except as otherwise indicated by the Company.

(m) “Participation Period” shall mean a period of three (3) months commencing on January 1, April 1, July 1 and October 1 of each year except as otherwise indicated by the Company.

(n) “Plan” shall mean this Employee Stock Purchase Plan.

(o) “Plan Recordkeeper” shall mean a third-party vendor which may, at the discretion of the Company, be selected to administer the Plan.

(p) “Purchase Date” shall mean the last day of each Offering Period of the Plan.

(q) “Subsidiary” shall mean a corporation, domestic or foreign, of which not less than 50% of the voting shares are held by the Company or a Subsidiary, whether or not such corporation now exists or is hereafter organized or acquired by the Company or a Subsidiary.

3. Eligibility.

(a) Any person who is an Employee of the Company as of the first Offering Date of a given Participation Period, who has continuously been an Employee for at least thirty-one (31) days, and who is not a “senior executive” of the Company, as such term may be defined from time to time by the Board (or any committee administering the Plan in accordance with Section 13 hereof), shall be eligible to participate in Offering Periods of such Participation Period under the Plan, subject to the requirements of Section 5(a) and the limitations imposed by Section 423(b) of the Code.

(b) Any provisions of the Plan to the contrary notwithstanding, no Employee shall be granted an option under the Plan (i) if, immediately after the grant, such Employee (or any other person whose stock would be attributed to such an Employee pursuant to Section 424(d) of the Code) would own stock and/or hold outstanding options to purchase stock possessing five percent (5%) or more of the total combined voting power or value of all classes of stock of the Company or of any Subsidiary, or (ii) if such option would permit his or her rights to purchase stock under all employee stock purchase plans (described in Section 423 of the Code) of the Company and its Subsidiaries to accrue at a rate which exceeds twenty-five thousand dollars ($25,000) of fair market value of such stock (determined at the time such option is granted) for each calendar year in which such option is outstanding at any time.


4. Offering Periods. The Plan shall be implemented by a series of Offering Periods, each with a duration of one (1) month, with new Offering Periods commencing on the first day of each calendar month (or at such other time or times as may be determined by the Board of Directors). The Plan shall continue until terminated in accordance with Section 19 hereof. The Board shall have the power to change the duration and/or the frequency of the Offering Period with respect to future offerings without stockholder approval if such change is announced at least fifteen (15) days prior to the scheduled beginning of the first Offering Period to be affected.

The Offering Periods shall be grouped into three-month Participation Periods commencing on or about January 1, April 1, July 1 and October 1 of each year (or at such other time or times as may be determined by the Board of Directors). Employees shall be allowed to make elections with respect to their participation in the Plan with respect to each Participation Period (subject to Section 5 and the other terms hereof).

5. Participation.

(a) An eligible Employee may become a participant in the Plan by enrolling through such procedures as may be provided by the Company from time to time, which may include enrollment through the Plan Recordkeeper. An enrollment in effect for a participant for a particular Participation Period will continue in effect for subsequent Participation Periods if the participant remains an eligible Employee and has not withdrawn from participation in the Plan pursuant to Section 10. For the avoidance of doubt, an enrollment in effect under the Express Scripts, Inc. Employee Stock Purchase Plan as of April 2, 2012 shall be assumed by and continue in effect under this Plan as amended if the participant remains an eligible Employee and has not withdrawn from participation in the Plan pursuant to Section 10.

(b) Payroll deductions shall commence on the first payroll following the Enrollment Date and shall end on the last payroll paid in the Participation Period to which the subscription agreement is applicable, unless sooner terminated by the participant as provided in Section 10 hereof.

(c) By enrolling in the Plan, each participant will be deemed to have authorized the establishment of a brokerage account in his or her name at a securities brokerage firm, which firm shall serve as custodial agent for the purpose of holding shares purchased under the Plan. The account will be governed by, and subject to, the terms and conditions of a written agreement with the firm approved by the Board or the committee administering the Plan, which agreement shall, among other things, reflect the restrictions contained in Section 21(c) and Section 21(d).

(d) Subject to the limitations of Section 3 hereof and Section 423(b)(8) of the Code, all cash dividends, if any, paid with respect to shares of Common Stock purchased under the Plan and held in a participant’s account established under Section 5(c) shall be automatically invested in shares of Common Stock purchased at One Hundred Percent (100%) of fair market value (as determined under Section 7(b)) on the next Purchase Date. All non-cash distributions on Common Stock purchased under the Plan and held in a participant’s account established under Section 5(c) (other than stock dividends which constitute, and are treated as, a change in capitalization under Section 18(a)) shall be paid to the participant as soon as practical.


6. Method of Payment of Contributions.

(a) The participant shall elect to have payroll deductions made each pay period during the Participation Period in an amount not less than one percent (1%) and not more than ten percent (10%), in whole number percentage increments, of such participant’s Compensation in each pay period. All payroll deductions made by a participant shall be credited to his or her account under the Plan. A participant may not make any additional payments into such account. Except as otherwise provided in this Section 6(a), all Employees granted options under the Plan shall have the same rights and privileges.

(b) A participant may increase or decrease his or her payroll deductions through such procedures as may be provided by the Company from time to time, which may include procedures provided through the Plan Recordkeeper. The change may be made at any time during a Participation Period but will not become effective sooner than the next pay period thereafter. The Board or the committee administering the Plan, at its discretion, may limit the number of participation rate changes during any Participation Period or Offering Period and may, in its discretion, require up to five (5) business days prior written notice.

(c) A participant may discontinue his or her participation in the Plan as provided in Section 10 hereof.

(d) Notwithstanding the foregoing, to the extent necessary to comply with Section 423(b)(8) of the Code and Section 6(a) hereof, a participant’s payroll deductions may be decreased to zero percent (0%) at any time during the Participation Period. Payroll deductions shall recommence at the rate provided in such participant’s subscription agreement at the beginning of the first Offering Period which is scheduled to end in the following calendar year, unless terminated by the participant as provided in Section 10 hereof.

(e) At the time of each exercise of a participant’s option, and at the time any Common Stock issued under the Plan to a participant is disposed of, the participant must adequately provide for the Company’s federal, state or other tax withholding obligations, if any, that arise upon the exercise of the option or the disposition of the Common Stock. At any time, the Company may, but will not be obligated to, withhold from the participant’s compensation the amount necessary for the Company to meet applicable withholding obligations, including but not limited to, any withholding required to make available to the Company any tax deductions or benefits attributable to the sale or early disposition of Common Stock by the participant.

7. Grant of Option.

(a) On the Offering Date of each Offering Period, each eligible Employee participating in such Offering Period shall automatically be deemed to have been granted an option to purchase on the Purchase Date a number of shares of the Company’s Common Stock determined by dividing such Employee’s Contributions accumulated prior to such Purchase Date and retained in the participant’s account as of the Purchase Date by ninety-five percent (95%) of the fair market value of the Company’s Common Stock on the Purchase Date; provided, however, that in no event shall an Employee be permitted to purchase during each Offering Period more than 333 shares (subject to any adjustment pursuant to Section 18) and provided further that such purchase shall be subject to the limitations set forth in Section 3(b). The fair market value of the Company’s Common Stock shall be determined as provided in Section 7(b).


(b) The fair market value of the Company’s Common Stock on a given date shall be equal to the closing sales price of Common Stock on the date of determination (or, in the event that the Common Stock is not traded on such date, on the immediately preceding trading date on which there was a closing sales price), as reported by The Nasdaq Global Select Market or, in the event the Common Stock is listed on a different stock exchange, the fair market value per share shall be the closing sales price on such exchange on the date of determination (or, in the event that the Common Stock is not traded on such date, on the immediately preceding trading date), as reported in The Wall Street Journal. In the absence of any listing of the Common Stock on The Nasdaq Global Select Market or on any established stock exchange, the fair market value of the Common Stock on a given date shall be determined in good faith by the Board.

8. Exercise of Option. Unless a participant withdraws from the Plan as provided in Section 10 hereof, his or her option for the purchase of shares will be exercised automatically on the Purchase Date of the Offering Period, and the maximum whole number of shares subject to such option will be purchased at the applicable option price with the accumulated Contributions in his or her account, subject to the limitations in this Plan. The shares purchased upon exercise of an option hereunder shall be held in the participant’s account established under Section 5(c) pursuant to Section 21(c) and Section 21(d). During his or her lifetime, a participant’s option to purchase shares hereunder is exercisable only by him or her.

9. Delivery. As promptly as practicable after the Purchase Date of each Offering Period, the Company shall arrange the delivery by direct deposit into the account established for each participant under Section 5(c), the shares purchased upon exercise of his or her option. Any cash remaining to the credit of a participant’s account under the Plan after a purchase by him or her of shares on the Purchase Date, other than amounts representing fractional shares, will be returned to him or her as soon as practicable. Amounts representing fractional shares will be carried forward for use in subsequent purchases.

10. Voluntary Withdrawal; Termination of Employment.

(a) A participant may withdraw from participation in an Offering Period under the Plan at any time prior to five (5) business days prior to the Purchase Date of the Offering Period through such procedures as may be provided by the Company from time to time including through the Plan Recordkeeper. Following such withdrawal from the Plan, no further Contributions for the purchase of shares will be made during the Participation Period and payroll deductions shall not resume at the beginning of the succeeding Participation Period unless the participant re-enrolls in the Plan. If a participant specifically requests, such participant may withdraw all, but not less than all, of the Contributions credited to his or her account under the Plan which have not been used to purchase shares of the Company’s Common Stock which will be paid to him or her as soon as practicable after the end of such Offering Period, and his or her option for the current period will be automatically terminated; otherwise, such Contributions shall be used to purchase shares of the Company’s Common Stock in the ordinary course.


(b) A participant’s withdrawal from an offering will not have any effect upon his or her eligibility to participate in a succeeding Participation Period or in any similar plan which may hereafter be adopted by the Company.

(c) Upon a participant’s ceasing to be an Employee prior to the Purchase Date of an Offering Period for any reason, including retirement or death, the Contributions credited to his or her account and not yet applied to the purchase of shares will be applied to the purchase of shares under the Plan on such Purchase Date.

(d) In the event an Employee’s salary grade level is elevated or title or position is changed so as to make an Employee a “senior executive” of the Company during the Offering Period in which the Employee is a participant, he or she will be deemed to have elected to withdraw from the Plan and Contributions credited to his or her account will be returned to him or her and his or her option terminated.

11. Interest. No interest shall accrue on the Contributions of a participant in the Plan.

12. Stock.

(a) The maximum number of shares of the Company’s Common Stock which shall be made available for purchase under the Plan shall be 2,715,272.8507 shares, which is the equivalent of the remaining number of shares of common stock of Express Scripts, Inc. that were available under the Express Scripts, Inc. Employee Stock Purchase Plan in effect as of April 2, 2012. The maximum number of shares available for purchase under the Plan shall be subject to further adjustment upon changes in capitalization of the Company as provided in Section 18 hereof. These shares may be newly issued or may be purchased for the Plan on the open market or from private sources. If the total number of shares which would otherwise be subject to options granted pursuant to Section 7(a) on the Offering Date of an Offering Period exceeds the number of shares then available under the Plan (after deduction of all shares for which options have been exercised or are then outstanding), the Company shall make a pro rata allocation of the shares remaining available for option grant in as uniform a manner as shall be practicable and as it shall determine to be equitable. In such event, the Company shall give written notice of such reduction of the number of shares subject to the option to each Employee affected thereby and shall similarly reduce the rate of Contributions, if necessary.

(b) The participant will have no interest or voting right in shares covered by his or her option until such option has been exercised.

(c) Shares to be delivered to a participant under the Plan will be registered in the name of the participant or in the “Street Name” of a Company approved broker, subject to Section 21 hereof.

13. Administration. The Board, or a committee named by the Board, shall supervise and administer the Plan and shall have full power to adopt, amend and rescind any rules deemed desirable and appropriate for the administration of the Plan and not inconsistent with the Plan, to construe and interpret the Plan, and to make all other determinations necessary or advisable for the administration of the Plan. The composition of the committee shall be in accordance with the


requirements to obtain or retain any available exemption from the operation of Section 16(b) of the Exchange Act pursuant to Rule 16b-3 promulgated thereunder. To aid in the administration of the Plan, the Board or the committee may appoint a Plan administrator and allocate to it certain limited responsibilities to carry out the directives of the Board or the committee in all phases of the administration of the Plan.

14. Designation of Beneficiary.

(a) A participant may designate a beneficiary who is to receive shares and cash, if any, from the participant’s account under the Plan in the event of such participant’s death subsequent to the end of an Offering Period but prior to delivery to him or her of such shares and cash. If a participant is married and the designated beneficiary is not the spouse, spousal consent shall be required for such designation to be effective. Such designation shall be made through such procedures as may be provided by the Company from time to time including through the Plan Recordkeeper.

(b) Such designation of beneficiary may be changed by the participant (and his or her spouse, if any) at any time through such procedures as may be provided by the Company from time to time including through the Plan Recordkeeper. In the event of the death of a participant and in the absence of a beneficiary validly designated under the Plan who is living at the time of such participant’s death, the Company shall deliver such shares and/or cash to the executor or administrator of the estate of the participant, or if no such executor or administrator has been appointed (to the knowledge of the Company), the Company, in its discretion, may deliver such shares and/or cash to the spouse or to any one or more dependents or relatives of the participant, or if no spouse, dependent or relative is known to the Company, then to such other person as the Company may designate.

15. Transferability. Neither Contributions credited to a participant’s account nor any rights with regard to the exercise of an option or to receive shares under the Plan may be assigned, transferred, pledged or otherwise disposed of in any way (other than by will, the laws of descent and distribution, or as provided in Section 14 hereof) by the participant. Any such attempt at assignment, transfer, pledge or other disposition shall be without effect, except that the Company may treat such act as election to withdraw all Contributions in accordance with Section 10 hereof.

16. Use of Funds. All Contributions received or held by the Company under the Plan may be used by the Company for any corporate purpose, and the Company shall not be obligated to segregate such Contributions.

17. Reports. Individual accounts will be maintained for each participant in the Plan. Statements of account will be given to participating Employees promptly following the Purchase Date, which statements will set forth the amount of Contributions, the per share purchase price, the number of shares purchased, the remaining cash balance, if any, and the dividends received, if any, for the period covered. Such statements may be delivered electronically by the Company or the Plan Recordkeeper.


18. Adjustments Upon Changes in Capitalization; Corporate Transactions.

(a) Changes in Capitalization . Subject to any required action by the stockholders of the Company, the number of shares of Common Stock covered by each option under the Plan which has not yet been exercised and the number of shares of Common Stock which have been authorized for issuance under the Plan but have not yet been placed under option (collectively, the “Reserves”), as well as the price per share of Common Stock covered by each option under the Plan which has not yet been exercised, shall be appropriately adjusted for any changes in the Common Stock resulting from a stock split, reverse stock split, stock dividend, combination or reclassification of the Common Stock, or any similar changes in the Company’s capitalization. Such adjustment shall be made by the Board or the committee administering this Plan, whose determination in that respect shall be final, binding and conclusive. Except as expressly provided herein, no issue by the Company of shares of stock of any class, or securities convertible into shares of stock of any class, shall affect, and no adjustment by reason thereof shall be made with respect to, the number or price of shares of Common Stock subject to an option.

(b) Corporate Transactions . In the event of the proposed dissolution or liquidation of the Company, the Offering Period will terminate immediately prior to the consummation of such proposed action, unless otherwise provided by the Board. In the event of a proposed sale of all or substantially all of the assets of the Company, or the merger of the Company into another corporation, each option under the Plan shall be assumed or an equivalent option shall be substituted by such successor corporation or a parent or subsidiary of such successor corporation, unless the Board determines, in the exercise of its sole discretion and in lieu of such assumption or substitution, to shorten the Offering Period then in progress by setting a new Purchase Date (the “New Purchase Date”). If the Board shortens the Offering Period then in progress in lieu of assumption or substitution in the event of a merger or sale of assets, the Board shall notify each participant in writing, at least ten (10) days prior to the New Purchase Date, that the Purchase Date for his or her option has been changed to the New Purchase Date and that his or her option will be exercised automatically on the New Purchase Date, unless prior to such date he or she has withdrawn from the Offering Period as provided in Section 10 hereof. For purposes of this paragraph, an option granted under the Plan shall be deemed to have been assumed or substituted if, following the sale of assets or merger, the option confers the right to purchase, for each share of Common Stock subject to the option immediately prior to the sale of assets or merger, the consideration (whether stock, cash or other securities or property) received in the sale of assets or merger by holders of Common Stock for each share of Common Stock held on the effective date of the transaction (and if such holders were offered a choice of consideration, the type of consideration chosen by the holders of the majority of the outstanding shares of Common Stock); provided, however, that if such consideration received in the sale of assets or merger was not solely common stock of the successor corporation or its parent (as defined in Section 424(e) of the Code), the Board may, with the consent of the successor corporation and the participant, provide for the consideration to be received upon exercise of the option to be solely common stock of the successor corporation or its parent equal in fair market value to the per share consideration received by holders of Common Stock in the sale of assets or merger. For the avoidance of doubt, each option under the Express Scripts, Inc. Employee Stock Purchase Plan outstanding as of April 2, 2012 has been assumed under this Plan and, following such assumption, confers the right to purchase Common Stock of the Company.


19. Amendment or Termination.

(a) The Board may at any time terminate or amend the Plan. Except as provided in Section 19, no such termination may affect options previously granted, nor may an amendment make any change in any option theretofore granted which adversely affects the rights of any participant; provided, that no shares may be issued or sold pursuant to any amendment increasing the maximum number of shares issuable under the Plan unless the stockholders of the Company have approved the amendment within 12 months of its adoption by the Board. If such stockholder approval is not obtained within such 12-month period, the amendment shall be void and of no force or effect and the amounts withheld from Employees with respect to such increased shares shall be returned to them. In addition, to the extent necessary to comply with Rule 16b-3 under the Exchange Act, or under Section 423 of the Code (or any successor rule or provision or any applicable law or regulation), the Company shall obtain stockholder approval in such a manner and to such a degree as so required.

(b) Without stockholder approval and without regard to whether any participant rights may be considered to have been adversely affected, the Board (or its committee) shall be entitled to change the Offering Periods and Purchase Periods, limit the frequency and/or number of changes in the amount withheld during an Offering Period, establish the exchange ratio applicable to amounts withheld in currency other than U.S. dollars, permit payroll withholding in excess of the amount designated by a participant in order to adjust for delays or mistakes in the Company’s processing of properly completed withholding elections, establish reasonable waiting and adjustment periods and/or accounting and crediting procedures to ensure that amounts applied toward the purchase of Common Stock for each participant properly correspond with amounts withheld from the participant’s Compensation, and establish such other limitations or procedures as the Board (or its committee) determines in its sole discretion as advisable which are consistent with the Plan.

20. Notices. All notices or other communications by a participant to the Company under or in connection with the Plan shall be deemed to have been duly given when received in the form specified by the Company at the location, or by the person, designated by the Company for the receipt thereof.

21. Conditions Upon Issuance of Shares.

(a) Shares shall not be issued with respect to an option unless the exercise of such option and the issuance and delivery of such shares pursuant thereto shall comply with all applicable provisions of law, domestic or foreign, including, without limitation, the Securities Act of 1933, as amended, the Exchange Act, the rules and regulations promulgated thereunder, and the requirements of The Nasdaq Global Select Market or any stock exchange upon which the shares may then be listed, and shall be further subject to the approval of counsel for the Company with respect to such compliance.

(b) As a condition of the exercise of an option, the Company may require the person exercising such option to represent and warrant at the time of any such exercise that the shares are being purchased only for investment and without any present intention to sell or distribute such shares if, in the opinion of counsel for the Company, such a representation is required by any of the aforementioned applicable provisions of law.


(c) Each participant agrees, by enrolling in the Plan, to promptly give the Company prior written notice of any withdrawal of shares held in the participant’s account established under Section 5(c), or any disposition of shares purchased under the Plan, where such withdrawal or disposition occurs within two (2) years after the date of grant of the option pursuant to which such shares were purchased, provided that any such withdrawal or disposition shall be subject to Section 21(d).

(d) Prior to the participant’s termination of employment with the Company, a participant may withdraw some or all of the whole shares of Common Stock held in the participant’s account established under Section 5(c), provided that, unless the Board or the committee administering the Plan otherwise permits in its sole discretion, each participant agrees, by enrolling in the Plan, that he or she may not withdraw any shares of Common Stock purchased under the Plan until six (6) months have expired following the Purchase Date on which such shares were purchased.

22. Term of Plan; Effective Date. The Plan became effective upon its adoption by the Board of Directors of Express Scripts, Inc. on November 24, 1998, subject to its approval by the stockholders of Express Scripts, Inc. which was obtained May 26, 1999. The Plan has been amended and restated since that date, and, most recently, was assumed by the Company pursuant to action of the Board effective April 2, 2012 and approval of the shareholders of the Company on March 29, 2012. The Plan shall continue in effect for a term of ten (10) years from March 1, 2008 unless sooner terminated under Section 19 hereof.

23. Additional Restrictions of Rule 16b-3. The terms and conditions of options granted hereunder to, and the purchase of shares by, persons subject to Section 16 of the Exchange Act shall comply with the applicable provisions of Rule 16b-3. This plan shall be deemed to contain, and such options shall contain, and the shares issued upon exercise thereof shall be subject to, such additional conditions and restrictions as may be required by Rule 16b-3 to qualify for the maximum exemption from Section 16 of the Exchange Act with respect to Plan transactions.

Exhibit 10.3

EXPRESS SCRIPTS, INC.

EXECUTIVE DEFERRED COMPENSATION PLAN

OF 2005

(As amended and restated effective April 2, 2012)


TABLE OF CONTENTS

 

             PAGE  
1.   PURPOSE      1   
2.   DEFINITIONS      1   
  2.1  

Accounting Date

     1   
  2.2  

Basic Company Credit

     1   
  2.3  

Beneficiary

     1   
  2.4  

Board

     1   
  2.5  

Business Day

     2   
  2.6  

Code

     2   
  2.7  

Committee

     2   
  2.8  

Common Stock

     2   
  2.9  

Common Stock Fund

     2   
  2.10  

Company

     2   
  2.11  

Company Credits

     2   
  2.12  

Compensation

     2   
  2.13  

Compensation Account(s)

     2   
  2.14  

Credit Date

     2   
  2.15  

Deferred Bonus

     3   
  2.16  

Deferred Compensation

     3   
  2.17  

Disability

     3   
  2.18  

Effective Date

     3   
  2.19  

Election

     3   
  2.20  

Employee

     3   
  2.21  

Fair Market Value

     3   
  2.22  

In-Service Account

     4   
  2.23  

Participant

     4   
  2.24  

Past Service Credit

     4   
  2.25  

Plan

     4   
  2.26  

Plan Year

     4   
  2.27  

Retirement

     4   
  2.28  

Retirement Account

     4   
  2.29  

Service Year

     5   
  2.30  

Special Bonus

     5   
  2.31  

Stock Unit(s)

     5   
  2.32  

Termination

     5   
3.   ADMINISTRATION      5   
4.   ELIGIBILITY      5   
5.   PARTICIPANT ACCOUNTS      6   


6.   ELECTION TO PARTICIPATE      7   
  6.1  

In General

     7   
  6.2  

Investment Alternatives For Existing Balances

     7   
7.   COMPANY CREDITS AND SPECIAL AND DEFERRED BONUSES      8   
  7.1  

Vesting

     8   
  7.2  

Forfeiture

     9   
8.   DISTRIBUTION      9   
  8.1  

Retirement Account

     9   
  8.2  

In-Service Account

     9   
  8.3  

Termination or Disability

     9   
  8.4  

Death

     10   
  8.5  

Form of Distribution

     10   
9.   FINANCIAL HARDSHIP      10   
10.   BENEFICIARY DESIGNATION      11   
11.   UNSECURED GENERAL CREDITOR STATUS OF EMPLOYEE      11   
12.   SHARES; ADJUSTMENTS IN EVENT OF CHANGES IN CAPITALIZATION      12   
13.   INALIENABILITY OF BENEFITS      12   
14.   CLAIMS PROCEDURE      12   
15.   GOVERNING LAW      15   
16.   AMENDMENTS      15   
17.   TIME FOR PAYMENT      15   


EXPRESS SCRIPTS, INC.

EXECUTIVE DEFERRED COMPENSATION PLAN OF 2005

1. PURPOSE

The purpose of this Express Scripts, Inc. Executive Deferred Compensation Plan of 2005 (the “Plan”) is to provide eligible key employees of the Company with an opportunity to defer compensation to be earned by them from the Company as a means of saving for retirement or other future purposes and to provide such employees with competitive retirement and capital accumulation benefits. In addition, the Plan is intended to provide eligible key employees additional incentive to remain employed by the Company and to attract certain executive-level employees.

Express Scripts, Inc. previously adopted the Express Scripts, Inc. Executive Deferred Compensation Plan, as amended and restated effective January 1, 2003 (“Prior Plan”). Effective December 31, 2004, Express Scripts, Inc. amended the Prior Plan to cease future deferrals thereunder after December 31, 2004, and the Prior Plan is intended to be grandfathered for purposes of Section 409A of the Code. Effective January 1, 2005, Express Scripts, Inc. set forth in a separate document the terms of the Plan, which apply to amounts deferred or that first become vested hereunder after December 31, 2004. This document is an amendment and restatement of the Plan in effect as of April 2, 2012 and reflects, among other things, the assumption of the Plan by Express Scripts Holding Company. The Plan and the Prior Plan shall continue to be set forth in separate documents, and this amendment and restatement of the Plan does not amend the Prior Plan that is intended to be grandfathered for purposes of Section 409A of the Code. The Prior Plan and the Plan shall be considered one plan set forth in two separate documents.

2. DEFINITIONS

The following definitions shall be applicable throughout the Plan:

2.1 Accounting Date .

“Accounting Date” means each Business Day on which a calculation concerning a Participant’s Compensation Account is performed, or as otherwise defined by the Committee.

2.2 Basic Company Credit .

“Basic Company Credit” means an amount, if any, credited to a Participant’s Retirement Account as described in Section 7.

2.3 Beneficiary .

“Beneficiary” means the person or persons designated by the Participant in accordance with Section 10, or if no person or persons are so designated, the estate of a deceased Participant.

2.4 Board .

“Board” means the Board of Directors of Express Scripts Holding Company or its designee.

 

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2.5 Business Day .

“Business Day” means a day on which the Nasdaq Global Select Market is open for trading activity.

2.6 Code .

“Code” means the Internal Revenue Code of 1986, as amended.

2.7 Committee .

“Committee” means the Compensation Committee of the Board.

2.8 Common Stock .

“Common Stock” means the Common Stock, $0.01 par value, of Express Scripts Holding Company.

2.9 Common Stock Fund .

“Common Stock Fund” means that investment option, approved by the Committee, in which a Participant’s Compensation Accounts may be deemed to be invested and may earn income (or incur losses) based on a hypothetical investment in Common Stock.

2.10 Company .

“Company” means Express Scripts Holding Company, its divisions, subsidiaries and affiliates.

2.11 Company Credits .

“Company Credits” means amounts credited as either Basic Company Credits or Past Service Credits by the Company to Compensation Accounts, in the sole discretion of the Committee, pursuant to Section 7.

2.12 Compensation .

“Compensation” means all (a) salary, commissions, payments under the Company’s Annual Bonus Plan (but not expense or other reimbursement or allowances) currently payable by the Company to a Participant, and (b) compensation in the form of Common Stock which the Employee may elect to convert to Stock Units if permitted by, and in accordance with, the terms of the grant of such compensation. For purposes of this Plan, the Committee may determine the amounts that will be considered Compensation with respect to any Participant.

2.13 Compensation Account(s) .

“Compensation Account(s)” means the Retirement Account and/or the In-Service Accounts.

2.14 Credit Date.

 

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“Credit Date” means each date on which Deferred Compensation is credited to Compensation Accounts in accordance with rules prescribed by the Committee.

2.15 Deferred Bonus.

“Deferred Bonus” means an amount, if any, designated as such by the Committee and credited to a Participant’s Compensation Account.

2.16 Deferred Compensation.

“Deferred Compensation” means the Compensation elected by the Participant to be deferred pursuant to the Plan.

2.17 Disability.

“Disability” means the Participant (a) is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or can be expected to last for a continuous period of not less than 12 months, or (b) is, by reason of any medically determinable physical or mental impairment which can be expected to result in death or can be expected to last for a continuous period of not less than 12 months, receiving income replacement benefits for a period of not less than 3 months under an accident and health plan covering employees of the Company.

2.18 Effective Date.

“Effective Date” means the effective date of the Plan, January 1, 2005.

2.19 Election.

“Election” means a Participant’s delivery of a written notice of election to the Committee or its designee electing to defer payment of a specified percentage of his or her Compensation (in accordance with rules prescribed by the Committee) either until Retirement, death or such other time as further permitted by the Committee.

2.20 Employee.

“Employee” means an individual classified by the Committee as a full-time, regular salaried employee of the Company.

2.21 Fair Market Value.

“Fair Market Value” means, as of any specified date, the closing sales price of a share of Common Stock, as reported on the Nasdaq Global Select Market on that date (or, if there are no sales on that date, the last preceding date on which there was a sale), or, in the event the Common Stock is listed on a stock exchange, the closing sales price of a share of Common Stock, as reported on such exchange on that date (or, if there are no sales on that date, the last preceding date on which there was a sale). In the absence of any listing of the Common Stock on the Nasdaq Global Select Market or on any established stock exchange, Fair Market Value means the fair market value of the Common Stock on any specified date as determined in good faith by the Committee.

 

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2.22 In-Service Account.

“In-Service Account” means the account or accounts to which a Participant elects to contribute Deferred Compensation and, to the extent permitted in an award as described in Section 5, Special Bonuses and/or Deferred Bonuses, and from which, pursuant to Section 8.2, distributions are made. The portion of any In-Service Account which was not vested under the Prior Plan as of December 31, 2004 shall be hypothetically transferred and credited to the In-Service Account under this Plan and shall be subject to the vesting provisions hereunder from the date first credited under the Prior Plan.

2.23 Participant.

“Participant” means an Employee selected by the Committee to be eligible to participate in the Plan.

2.24 Past Service Credit.

“Past Service Credit” means an amount, if any, credited to a Participant’s Retirement Account as described in Section 7.

2.25 Plan.

“Plan” means this Express Scripts, Inc. Executive Deferred Compensation Plan of 2005, as amended from time to time.

2.26 Plan Year.

“Plan Year” means the annual period commencing January 1 and ending the following December 31.

2.27 Retirement.

“Retirement” means a Participant’s termination of employment after attaining age 55 and having a combination of full years of age plus Service Years totaling at least 65.

2.28 Retirement Account.

“Retirement Account” means the account to which a Participant elects to contribute Deferred Compensation and to which Company Credits, Special Bonuses and/or Deferred Bonuses (subject to any election described in Section 5) are made, and from which, pursuant to Section 8.1, distributions are made. The portion of any Retirement Account which was not vested under the Prior Plan as of December 31, 2004 shall be hypothetically transferred and credited to the Retirement Account under this Plan and shall be subject to the vesting provisions hereunder from the date first credited under the Prior Plan.

 

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2.29 Service Year.

“Service Year” means, as designated by the Committee, such year or portion thereof during which the services have been rendered by a Participant for which Compensation is payable.

2.30 Special Bonus.

“Special Bonus” means an amount, if any, designated as such by the Committee and credited to a Participant’s Compensation Account.

2.31 Stock Unit(s).

“Stock Unit(s)” means the share equivalents credited to the Common Stock Fund of a Participant’s Compensation Account in accordance with Sections 5, 6 and 7.

2.32 Termination.

“Termination” means termination of services as an Employee for any reason other than Retirement. Such determination of whether a Termination has occurred shall be made in a manner consistent with Section 409A of the Code and the regulations and other guidance issued thereunder to avoid adverse tax consequences thereunder.

3. ADMINISTRATION

Full power and authority to construe, interpret and administer the Plan shall be vested in the Committee. This power and authority includes, but is not limited to, selecting which Employees are eligible to participate in the Plan, selecting Compensation eligible for deferral, selecting investment indices, establishing the level of Company Credits (if any) to the Plan, establishing deferral terms and conditions, receiving and approving beneficiary designation forms, and adopting modifications, amendments and procedures as may be deemed necessary, appropriate or convenient by the Committee. Decisions of the Committee shall be final, conclusive and binding upon all parties. The Committee, in its sole discretion, may delegate day-to-day administration of the Plan to an employee or employees of the Company or to a third-party administrator. The Committee may also rely on outside counsel, independent accountants or other consultants or advisors for advice and assistance in fulfilling its administrative duties under the Plan.

4. ELIGIBILITY

Employees at the vice-president level or higher shall be eligible to participate in the Plan commencing on the first date they are employed by the Company in such capacity; provided that if such date is on or after November 1 in any Plan Year or if such Employee already participates in a deferred compensation arrangement that would be aggregated with this Plan for purposes of Section 409A of the Code and the regulations and guidance issued thereunder, such Employee shall not be eligible to participate in the Plan until the following January 1. The Committee shall have the ability to impose restrictions on the eligibility of new Employees as it considers appropriate.

 

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5. PARTICIPANT ACCOUNTS

Upon a Participant’s initial election to participate in the Plan, there shall be established a Retirement Account and an In-Service Account, as designated by the Participant, to which there shall be credited any Deferred Compensation on or after January 1, 2005 with respect to services performed subsequent to such election as of each Credit Date. In addition, Company Credits, if any, made pursuant to Section 7 shall be allocated to a Participant’s Retirement Account in accordance with rules prescribed by the Committee. Each such Compensation Account shall be credited (or debited) on each Accounting Date with income (or loss) based upon a hypothetical investment in any one or more of the investment options available under the Plan, as prescribed by the Committee for the particular Compensation credited, which may include a Common Stock Fund. A Participant shall make two separate investment elections, one with respect to his or her Retirement Account and one with respect to his or her In-Service Accounts; provided, however, that earnings and losses on Deferred Compensation which relates to Compensation which would have been paid (absent the Election) in Common Stock shall initially be measured by reference to a hypothetical investment in the Common Stock Fund and shall be further subject to the terms of the grant of such Compensation.

A Participant’s Special Bonus and/or Deferred Bonus, if any, to the extent not yet deferred and vested under the Prior Plan as of December 31, 2004, shall be credited to the Participant’s Retirement Account, unless the Agreement or award providing for such bonus(es) provides that the Participant may elect to credit any or all of such amounts to his or her In-Service Account and the Participant so elects prior to the Plan Year in which such bonus(es) is earned and otherwise in accordance with rules prescribed by the Committee.

Each Participant at any time may have no more than two In-Service Accounts under this Plan and the Prior Plan, in the aggregate.

If all or any portion of a Participant’s Compensation Account(s) is measured by a hypothetical investment in the Common Stock Fund, that portion of the Participant’s Compensation Account(s) shall be credited on the first day of the calendar quarter following each Credit Date with Stock Units equal to the number of shares of Common Stock (including fractions of a share) that could have been purchased with the amount of such Deferred Compensation (plus earnings and less losses determined in accordance with the next sentence) at the Fair Market Value on such first day of such calendar quarter. For the period between such Credit Date and the first day of such calendar quarter, earnings and losses shall be measured by reference to a hypothetical investment selected by the Committee. As of any date for the payment of cash dividends on the Common Stock, the portion of the Participant’s Compensation Account(s) invested in the Common Stock Fund as of the dividend record date shall be credited with additional Stock Units calculated by dividing (i) the product of (a) the dollar value of the dividend declared in respect of a share of Common Stock multiplied by (b) the number of Stock Units credited to the Participant’s Compensation Account(s) as of the dividend record date by (ii) the Fair Market Value of a share of Common Stock on the dividend payment date.

 

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6. ELECTION TO PARTICIPATE

6.1 In General.

Any Employee selected by the Committee to participate in the Plan may elect to do so by delivering to the Committee or its designee an Election on a form prescribed by the Committee, designating the Compensation Account to which the Deferred Compensation is to be credited, electing the timing and form of distribution (if applicable), and setting forth the manner in which such Deferred Compensation shall be invested in accordance with Section 5. A Participant’s initial Election must be filed at such time as designated by the Committee, but in no event later than the day immediately preceding the first day of the Plan Year to which such Election relates. A Participant may submit a new Election for any subsequent year in order to change the election previously made. Such subsequent Election must be filed at such time as designated by the Committee, but in no event later than 15 days preceding the first day of the Plan Year to which such subsequent Election relates. If a specific election has not been made with respect to any Plan Year, the Election (if any) effective with respect to the immediately preceding Plan Year shall remain in effect. An effective Election may not be revoked or modified during a Plan Year with respect to that Plan Year.

Subject to Section 4, newly employed or eligible Employees who are eligible to participate in the Plan may elect to participate for the current Plan Year within the first 30 days after commencing employment or becoming eligible. Such election shall be effective on the first day of the month following the end of such 30-day period and shall apply only with respect to Compensation earned after the effective date of such election. Elections for subsequent Plan Years shall be made in accordance with the preceding paragraph.

Notwithstanding anything herein to the contrary, for the Plan Year beginning January 1, 2005, a Participant may elect to defer Compensation for such Plan Year by delivering to the Committee or its designee an Election on a form prescribed by the Committee on or before March 15, 2005 with respect to such Compensation that has not been paid or become payable at the time of delivery of such Election. Notwithstanding the provisos in Sections 8.1 and 8.2 or anything else herein to the contrary, a Participant may change an Election as to the timing and form of distribution (if applicable) under the Plan if such Election is filed no later than December 31, 2007 in accordance with the rules established by the Committee or its designee; provided, however, with respect to an Election on or after January 1, 2006 and on or before December 31, 2006, the Election may change the time and form of distribution only with respect to amounts that would not otherwise be payable in 2006 and may not cause an amount to be paid in 2006 that would not otherwise be payable in 2006; and, provided, further, with respect to an Election on or after January 1, 2007 and on or before December 31, 2007, the Election may change the time and form of distribution only with respect to amounts that would not otherwise be payable in 2007 and may not cause an amount to be paid in 2007 that would not otherwise be payable in 2007.

For the avoidance of doubt, any deferral election in effect under the Plan immediately prior to this amendment and restatement shall continue and be recognized as an Election hereunder for the year or other applicable period to which it relates. In addition, the amount deemed credited to an account under the Plan immediately prior to this amendment and restatement shall be credited to the applicable Compensation Account(s) hereunder.

6.2 Investment Alternatives For Existing Balances.

A Participant may elect to change an existing selection as to the investment alternatives in effect with respect to an existing Compensation Account (in increments prescribed by the Committee) as often, and with such restrictions, as determined by the Committee.

 

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7. COMPANY CREDITS AND SPECIAL AND DEFERRED BONUSES

In the sole discretion of the Committee, in a given Plan Year the Company may credit a specified percentage of a Participant’s Compensation to the Participant’s Retirement Account as a Basic Company Credit. The Committee, in its sole discretion, may cause the Company to credit such Basic Company Credit for all or any portion of the Participants in the Plan in such Plan Year. Further, the Committee may cause the Company to credit a Deferred Bonus and/or a Special Bonus to recognize significant efforts by Plan Participants as the Committee, in its sole discretion, deems appropriate. In addition, the Committee may cause the Company to credit a Past Service Credit to recognize past service as the Committee, in its sole discretion, deems appropriate. Such Basic Company Credit, Past Service Credit, Special Bonus and Deferred Bonus, if any, shall be credited to a Participant’s Retirement Account (except as provided in any election described in Section 5) and shall be subject to the limitations determined appropriate by the Committee, including the limitation contained in Section 8.3 and the limitations described below in this Section 7.

7.1 Vesting.

A Participant’s Deferred Compensation shall be immediately one-hundred percent (100%) nonforfeitable upon being credited to such Participant’s Retirement or In-Service Account; provided, however, that Deferred Compensation which relates to restricted shares of Common Stock shall vest in accordance with the terms of the restricted stock agreement to which they relate.

A Participant’s Basic Company Credit for a Plan Year shall become nonforfeitable three (3) years after the end of the Plan Year to which such Basic Company Credit relates.

A Participant’s Past Service Credit shall be fifty-percent (50%) nonforfeitable upon being credited to his or her Retirement Account. The remaining fifty-percent (50%) shall become nonforfeitable as follows: one (1) year after the end of the Plan Year in which the Past Service Credit is credited to the Participant’s Retirement Account, the Participant shall be one-third (1/3) vested in the remaining fifty percent (50%); two (2) years after the end of the Plan Year in which the Past Service Credit is credited to the Participant’s Retirement Account, the Participant shall be two-thirds (2/3) vested in the remaining fifty percent (50%); and three (3) years after the end of the Plan Year in which the Past Service Credit is credited to the Participant’s Retirement Account, the Participant shall be one-hundred percent (100%) vested in the remaining fifty percent (50%). A Participant’s Special Bonus and/or Deferred Bonus shall become vested in accordance with the terms of the Agreement or award providing for such bonus(es).

Upon a Participant’s Termination for any reason other than death, Disability or Retirement, he or she shall forfeit any nonvested benefits. Except as otherwise provided in an award, a Participant shall have a one-hundred percent (100%) nonforfeitable right to Basic Company Credits, Past Service Credits, Special Bonuses and Deferred Bonuses upon becoming eligible for Retirement or upon Termination due to death or Disability.

For the avoidance of doubt, amounts credited under this Plan prior to April 2, 2012 shall be subject to the vesting and forfeiture provisions of this Plan after such date.

 

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7.2 Forfeiture.

Upon a Participant’s Termination or Retirement, the Company reserves the right to withhold payment of a portion of a Participant’s Retirement Account attributable to Basic Company Credits, Past Service Credits, Special Bonuses and/or Deferred Bonuses made under Section 7 (and earnings thereon) in the event the Committee determines that the Participant has violated the Company’s standard noncompetition and nondisclosure agreement or any other employment agreement executed by the Participant, or otherwise acts against the interests of the Company, as determined by the Committee in its sole discretion.

8. DISTRIBUTION

8.1 Retirement Account.

In the event of a Participant’s Retirement, the Participant’s Retirement Account shall be distributed at the time and in the manner elected by the Participant in his or her Election. If no Election is made by a Participant as to the timing of distribution or form of payment of his or her Retirement Account, upon the Participant’s Retirement such account shall be paid in a single lump sum. A Participant may change this election to provide for a later distribution date; provided, that such election is filed in accordance with rules established by the Committee, and (a) such election shall not take effect until at least 12 months after the date on which such election is properly filed, (b) the first payment with respect to which such election is made shall be deferred for a period of not less than 5 years from the date such payment would otherwise have been made, and (c) any election related to a payment that was otherwise to be made at a specified time may not be made less than 12 months prior to the date of the first scheduled payment. Subject to the foregoing, the Election most recently accepted by the Committee shall govern the payout of any benefits under the Plan.

8.2 In-Service Account.

Deferred Compensation, Special Bonuses and/or Deferred Bonuses credited to a Participant’s In-Service Account shall be distributed at the time and in the manner elected by the Participant in his or her Election. A Participant may extend the deferral period by notifying the Company in accordance with the terms of the Plan and procedures established by the Committee. A previously elected deferral period for an In-Service Account may be extended only one time; provided, that such election is filed in accordance with rules established by the Committee, and (a) such election shall not take effect until at least 12 months after the date on which such election is properly filed, (b) the first payment with respect to which such election is made shall be deferred for a period of not less than 5 years from the date such payment would otherwise have been made, and (c) any election related to a payment that was otherwise to be made at a specified time may not be made less than 12 months prior to the date of the first scheduled payment. Subject to the foregoing, the Election most recently accepted by the Committee shall govern the payout of any benefits under the Plan.

8.3 Termination or Disability.

In the event of a Participant’s Termination or Disability, the Participant’s vested Compensation Accounts shall be distributed in a single lump sum to such Participant 30 days after his or her Termination or Disability. Upon Termination, all unvested amounts shall be immediately forfeited and removed from the Participant’s Accounts.

 

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8.4 Death.

In the event of the Participant’s death (a) while in the employment of the Company or (b) after the Participant’s Termination but prior to the payment of such Participant’s Compensation Accounts pursuant to Section 8.3, the Company shall pay the following amounts to the Participant’s Beneficiary in a single lump sum 30 days after the Participant’s date of death:

 

  (1) the remaining amounts, if any, in a Participant’s In-Service Account; and

 

  (2) the amounts in the Participant’s Retirement Account.

In the event of the Participant’s death following Retirement, the Company shall pay the amount in the Participant’s Retirement Account to the Participant’s Beneficiary in the form and at the time elected by the Participant pursuant to Section 6.1.

8.5 Form of Distribution.

Distribution of a Participant’s Compensation Accounts shall be made in cash; provided that, any amounts in a Participant’s Compensation Accounts invested in the Common Stock Fund shall be distributed to the Participant in whole shares of Common Stock with fractional shares paid in cash.

When required, the Company shall withhold from any distribution of cash or Common Stock to a Participant or other person under this Plan an amount sufficient to cover any required withholding taxes, including the Participant’s social security and Medicare taxes (FICA) and federal, state and local income tax with respect to income arising from payment of the Award. The Company shall have the right to require the payment of any such taxes before issuing any Common Stock comprising a part of such distribution. In lieu of all or any part of a cash payment from a person receiving Common Stock under this Plan, the Committee may permit a person to cover all or any part of the required withholdings, and to cover any additional withholdings up to the amount needed to cover the person’s full FICA and federal, state and local income tax with respect to income arising from payment the Common Stock portion of such distribution, through a reduction of the numbers of shares of Common Stock delivered to such person or a delivery or tender to the Company of other shares of Common Stock held by such person, in each case valued in the same manner as used in computing the withholding taxes under applicable laws.

9. FINANCIAL HARDSHIP

Upon the written request of a Participant or a Participant’s legal representative and a finding that continued deferral will result in an unforeseeable financial emergency to the Participant, the Committee (in its sole discretion) may authorize (a) the payment of all or a part of a Participant’s Compensation Accounts representing Deferred Compensation and earnings thereon in a single lump sum prior to his or her ceasing to be a Participant, or (b) a Participant to cease contributing Deferred Compensation to the Plan during a Plan Year. It is intended that the Committee’s determinations as to whether the Participant has suffered an “unforeseeable financial emergency”

 

10


shall be made consistent with the requirements under Section 409A of the Code and the regulations and guidance thereunder. An “unforeseeable financial emergency” means a severe financial hardship to the Participant, the Participant’s spouse, the Participant’s beneficiary or the Participant’s dependent (as defined in Code Section 152, without regard to Sections 152(b), (b)(2) and (d)(1)(B)); loss of the Participant’s property due to casualty; or other similar extraordinary and unforeseeable circumstances arising as a result of events beyond the control of the Participant. Any amounts distributed with respect to an emergency shall not exceed the amounts necessary to satisfy such emergency plus amounts necessary to pay taxes reasonably anticipated as a result of the distribution, after taking into account the extent to which such hardship is or may be relieved by the cancellation of the Participant’s deferral election under this Plan or through reimbursement or compensation by insurance or otherwise or by liquidation of the Participant’s assets (to the extent the liquidation of such assets would not itself cause severe financial hardship). The Committee may adopt procedures for determining when a hardship situation exists, including the use of independent advisors to make such determinations.

Any Participant receiving a hardship distribution may have no further amounts deferred under this Plan for a period of one year from the date of such distribution, and any subsequent deferral may only begin at the beginning of a subsequent Plan Year and in accordance with the procedures in Section 6. The Participant shall not repay to the Company amounts distributed pursuant to this Section 9.

10. BENEFICIARY DESIGNATION

A Participant may designate one or more persons (including a trust) to whom or to which payments are to be made if the Participant dies before receiving distribution of all amounts due under the Plan. A Beneficiary designation made under the Prior Plan shall apply to this Plan, unless subsequently changed as provided herein. A Participant may, at any time, elect to change the designation of a Beneficiary. A designation of Beneficiary will be effective only after the signed designation of Beneficiary is filed with the Committee or its designee while the Participant is alive and will cancel all designations of Beneficiary signed and filed earlier, including any designations of Beneficiary made under the Prior Plan. If the Participant fails to designate a Beneficiary as provided above or if all of a Participant’s Beneficiaries predecease him or her and he or she fails to designate a new Beneficiary, the remaining unpaid amounts shall be paid in one lump sum to the estate of such Participant. If all Beneficiaries of the Participant die after the Participant but before complete payment of all amounts due hereunder, the remaining unpaid amounts shall be paid in one lump sum to the estate of the last to die of such Beneficiaries.

11. UNSECURED GENERAL CREDITOR STATUS OF EMPLOYEE

The payments to Participants and their Beneficiaries hereunder shall be made from the general corporate assets of the Company. No person shall have any interest in any such assets by virtue of the provisions of this Plan. The Company’s obligation hereunder shall be an unfunded and unsecured promise to pay money in the future. To the extent that any person acquires a right to receive payments from the Company under the provisions hereof, such right shall be no greater than the right of any unsecured general creditor of the Company; no such person shall have nor acquire any legal or equitable right, interest or claim in or to any property or assets of the Company. Any accounts maintained under this Plan shall be hypothetical in nature and shall be maintained for bookkeeping purposes only. Neither the Plan nor any account shall hold any actual funds or assets.

 

11


12. SHARES; ADJUSTMENTS IN EVENT OF CHANGES IN CAPITALIZATION

An aggregate of 100,000 split-adjusted shares of common stock of Express Scripts, Inc. were initially allocated to the Prior Plan and reserved for the distribution of Compensation Accounts as described in Section 8.5 thereof. An additional 750,000 shares of Express Scripts, Inc. common stock were subsequently allocated to the Prior Plan, subject to adjustment under Section 12 thereof. Any shares allocated under the terms of the Prior Plan shall be deemed allocated under this Plan since the Prior Plan and this Plan are considered one plan set forth in two separate documents. Effective April 2, 2012, as a result of the assumption of the Plan by Express Scripts Holding Company, the shares of common stock of Express Scripts, Inc. were replaced with shares of Common Stock of the Company and an aggregate of 5,893,208 shares of Common Stock of the Company remained available under the Plan, including any shares allocated under the Prior Plan, as adjusted and subject to adjustment hereunder. The Company may, in its discretion, use shares held in the Treasury under this Plan in lieu of authorized but unissued shares of Common Stock.

In the event of any change in the outstanding Common Stock of the Company by reason of any stock split, share dividend, recapitalization, merger, consolidation, reorganization, combination, or exchange or reclassification of shares, split-up, split-off, spin-off, liquidation or other similar change in capitalization, or any distribution to common shareholders other than cash dividends, the number or kind of shares or Stock Units that may be credited under the Plan shall be automatically adjusted so that the proportionate interest of the Participants shall be maintained as before the occurrence of such event. Such adjustment shall be conclusive and binding for all purposes of the Plan.

13. INALIENABILITY OF BENEFITS

The interests of the Participants and their Beneficiaries under the Plan may not in any way be voluntarily or involuntarily transferred, alienated or assigned, nor subject to attachment, execution, garnishment or other such equitable or legal process. A Participant or Beneficiary cannot waive the provisions of this Section 13.

14. CLAIMS PROCEDURE

Any Participant, Beneficiary or any other person claiming benefits, eligibility, participation or any other right or interest under this Plan may file a written claim setting forth the basis of the claim with the Chief Executive Officer of the Company (“CEO”). A written notice of the CEO’s disposition of any such claim shall be furnished to the claimant within a reasonable time (not to exceed ninety (90) days) after the claim is received by the CEO. Notwithstanding the foregoing, the CEO may have additional time (not to exceed ninety (90) days) to decide the claim if special circumstances exist, provided that he advises the claimant, in writing and prior to the end of the initial ninety (90) day period, of the special circumstances giving rise to the need for additional time and the date on which he expects to decide the claim. If the claim is denied, in whole or in part, the notice of disposition shall include the specific reason for the denial, identify the specific provisions of the Plan upon which the denial is based, describe any additional material or information necessary to perfect the claim, explain why that material or information is necessary and describe the Plan’s review procedures, including the timeframes thereunder for a claimant to file a request for review and for the Committee to decide the claim. The notice shall also include a statement advising the claimant of his right to bring a civil action if his claim is denied, in whole or in part, upon review.

 

12


Within sixty (60) days after receiving the written notice of the CEO’s disposition of the claim, the claimant may request, in writing, review by the Committee of the CEO’s decision regarding his claim. Upon written request, the claimant shall be entitled to a review meeting with the Committee to present reasons why the claim should be allowed. The claimant or his authorized representative may submit a written statement in support of his claim, together with such comments, information and material relating to the claim, as he deems necessary or appropriate. The claimant or his duly authorized representative shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information which are relevant to the claimant’s claim and its review. If the claimant does not request review within sixty (60) days after receiving written notice of the CEO’s disposition of the claim, the claimant shall be deemed to have accepted the CEO’s written disposition.

The Committee shall make its decision on review and provide written notice thereof to the claimant within a reasonable time (not to exceed sixty (60) days) after the claim is received by the Committee. Notwithstanding the foregoing, the Committee may have additional time (not to exceed sixty (60) days) to decide the claim if special circumstances exist provided that the Committee advises the claimant, in writing, prior to the end of the initial sixty (60) day period, of the special circumstances giving rise to the need for additional time and the date on which it expects to decide the claim. In no event shall the Committee have more than one hundred twenty (120) days following its receipt of the claimant’s request for review to provide the claimant with written notice of its decision. The Committee shall have the right to request of and receive from claimant such additional information, documents or other evidence as the Committee may reasonably require. In the event that the Committee requests such additional information from the claimant, the period for making the benefit determination on review shall not take into account the period beginning on the date on which the Committee notifies the claimant in writing of the need for additional information and ending on the date on which the claimant responds to the request for additional information.

If the claim is denied upon review, in whole or in part, the notice of disposition shall include the specific reason for the denial, identify the specific provision of the Plan upon which the denial is based, include a statement advising the claimant of his right to receive, upon written request and free of charge, reasonable access to and copies of all documents, records and other information which are relevant to the claimant’s claim and include a statement advising the claimant of his right to bring a civil action under Section 502(a) of the Act if his claim is denied, in whole or in part, upon review.

Notwithstanding anything herein, if a claimant is denied a benefit because he or she is determined not to be disabled and he or she makes a claim pursuant to such denial, the provisions of this paragraph shall apply. Upon receipt of a claim, the reply period shall be forty-five (45) days. If, prior to the end of such 45-day period, the claims reviewer determines that, due to matters beyond the control of the Plan, a decision cannot be rendered, the period for making the determination may be extended for up to thirty (30) days, and the claims reviewer shall notify the claimant, prior to the expiration of such 45-day period, of the circumstances requiring an extension and the date by which the Plan expects to render a decision. If, prior to the end of the first 30-day extension period, the

 

13


claims reviewer determines that, due to matters beyond the control of the Plan, a decision cannot be rendered within that extension period, the period for making the determination may be extended for up to an additional thirty (30) days, and the claims reviewer shall notify the claimant, prior to the expiration of the first 30-day extension period, of the circumstances requiring the extension and the date by which the Plan expects to render a decision. In the case of any extension described in this paragraph, the notice of extension shall specifically explain the standards on which entitlement to a benefit is based, the unresolved issues that prevent a decision on the claim and the additional information needed to resolve those issues, and the claimant shall be afforded forty-five (45) days within which to provide the specified information. If information is requested, the period for making the benefit determination shall be tolled from the date on which notification of an extension is sent to the claimant until the date on which the claimant responds to the request for information. Within one hundred eighty (180) days after receiving the written notice of an adverse disposition of the claim, the claimant may request in writing, and shall be entitled to, a review of the benefit determination. In deciding an appeal of any adverse benefit determination that is based in whole or in part on a medical judgment, the Plan shall consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment. Such health care professional shall be an individual who is neither an individual who was consulted in connection with the adverse benefit determination that is the subject of the appeal nor the subordinate of any such individual. The medical or vocational experts whose advice was obtained on behalf of the Plan in connection with the claimant’s adverse benefit determination will be identified to the claimant. If the claimant does not request a review within one hundred eighty (180) days after receiving written notice of the original’s disposition of the claim, the claimant shall be deemed to have accepted the original written disposition. A decision on review shall be rendered in writing by the Plan within a reasonable period of time, but ordinarily not later than forty-five (45) days after receipt of the claimant’s request for review by the Plan, unless the Plan determines that special circumstances require an extension of time for processing the claim. If the Plan determines that an extension of time for processing is required, written notice of the extension shall be furnished to the claimant prior to the termination of the initial forty-five (45) period. In no event shall such extension exceed a period of forty-five (45) days from the end of the initial period. The extension notice shall indicate the special circumstances requiring an extension of time and the date by which the Plan expects to render the determination on review. In the event the extension is due to a claimant’s failure to submit information necessary to decide the claim, the claimant shall be afforded forty-five (45) days within which to provide the specified information, and the period for making the benefit determination on review shall be tolled from the date on which notification of the extension is sent to the claimant until the date on which the claimant responds to the request for additional information.

For purposes of this Section, a document, record or information will be considered “relevant’ if it (a) was relied upon by the CEO or Committee, as applicable, in making the benefit decision, (b) was submitted, considered or generated in the course of making such decision, even if it was not relied upon in making those decisions, or (c) demonstrates compliance with the administrative processes and safeguards established by the Plan to insure that the terms of the Plan have been followed and applied consistently.

 

14


To the extent permitted by law, a decision on review by the Committee shall be binding and conclusive upon all persons whomsoever. Completion of the claims procedure described in this Section shall be a mandatory precondition that must be complied with prior to commencement of a legal or equitable action in connection with the Plan by a person claiming rights under the Plan, or by another person claiming rights through such a person. The Committee may, in its sole discretion, waive these procedures as a mandatory precondition to such an action.

15. GOVERNING LAW

The provisions of this plan shall be interpreted and construed in accordance with the laws of the State of Missouri, except to the extent preempted by Federal law.

16. AMENDMENTS

The Committee may amend, alter or terminate this Plan at any time without the prior approval of the Board; provided, however, that the Committee may not, without approval by the Board, materially increase the benefits accruing to Participants under the Plan.

17. TIME FOR PAYMENT

Notwithstanding anything herein to the contrary, in the event that a Participant is determined to be a specified employee in accordance with Section 409A of the Code and the regulations and other guidance issued thereunder for purposes of any payment on termination of employment under this Plan, such payment(s) shall be made or begin, as applicable, on the first payroll date which is more than six months following the date of separation from service, to the extent required to avoid the adverse tax consequences to the Participant under Section 409A of the Internal Revenue Code of 1986, as amended.

All payments due and payable under the Plan on a fixed date shall be deemed to be made upon such fixed date if such payment is made on such date or a later date within the same calendar year or, if later, by the fifteenth day of the third calendar month following the specified date (provided the Participant is not entitled, directly or indirectly, to designate the taxable year of the payment). In addition, a payment is treated as made upon a fixed date under the Plan if the payment is made no earlier than 30 days before the designated payment date and the service provider is not permitted, directly or indirectly, to designate the taxable year of the payment.

IN WITNESS WHEREOF, this amendment and restatement to the Plan is effective as of April 2, 2012.

 

EXPRESS SCRIPTS HOLDING COMPANY

 

By:

   

Title:

   

 

15

Exhibit 10.4

MEDCO HEALTH SOLUTIONS, INC.

2002 STOCK INCENTIVE PLAN

(As amended and restated May 15, 2003, March 14, 2011, and April 2, 2012

and approved by shareholders on May 31, 2005, May 24, 2011, and March 29, 2012)


1. Purpose

The 2002 Stock Incentive Plan (the “Plan”) was previously established effective June 17, 2002. This document is an amendment and restatement of the Medco Health Solutions, Inc. 2002 Stock Incentive Plan in effect as of April 2, 2012 and reflects, among other things, the assumption of the Plan by Express Scripts Holding Company (the “Company”). The purpose of the Plan is to encourage employees of the Company, its parent, if any, its subsidiaries, its affiliates and its joint ventures to acquire Common Stock in the Company (“Common Stock”). It is believed that the Plan will serve the interests of the Company and its stockholders because it allows employees to have a greater personal financial interest in the Company through ownership of, or the right to acquire its Common Stock, which in turn will stimulate employees’ efforts on the Company’s behalf, and maintain and strengthen their desire to remain with the Company or one of its related entities. It is believed that the Plan will also assist in the recruitment of employees.

2. Administration

The Plan shall be administered by the Compensation Committee of the Board of Directors of the Company (the “Committee”). A Director of the Company may serve on the Committee only if he or she (i) is a “Non-Employee Director” for purposes of Rule 16b-3 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and (ii) satisfies the requirements of an “outside director” for purposes of Section 162(m) of the Internal Revenue Code (the “Code”). The Committee shall be responsible for the administration of the Plan including, without limitation, determining which Eligible Persons receive Incentives, the types of Incentives they receive under the Plan, the number of shares covered by Incentives granted under the Plan, and the other terms and conditions of such Incentives. Determinations by the Committee under the Plan including, without limitation, determinations of the Eligible Persons, the form, amount and timing of Incentives, the terms and provisions of Incentives and the writings evidencing Incentives, need not be uniform and may be made selectively among Eligible Persons who receive, or are eligible to receive, Incentives hereunder, whether or not such Eligible Persons are similarly situated.

The Committee shall have the responsibility of construing and interpreting the Plan, including the right to construe disputed or doubtful Plan provisions, and of establishing, amending and construing such rules and regulations as it may deem necessary or desirable for the proper administration of the Plan including adopting sub-plans and special rules to facilitate compliance or achieve desirable tax results or other Company objectives for grants made to employees outside the U.S. and to determine the consequences of termination of employment or other relationships for grants made to non-employee directors, independent contractors, leased employees or consultants when the grants are made. In addition, as to any Performance Share Award not intended to constitute “performance-based compensation” under Section 162(m) of the Code, at any time prior to the end of an Award Period (as defined in Section 9), the Committee may revise the Performance Goals and the computation of payment if unforeseen events occur which have a substantial effect on the performance of the Company, its parent, subsidiary, division, affiliate or joint venture of the Company and which, in the judgment of the Committee, make the application of the Performance Goals (as defined in Section 9) unfair (as determined in the sole discretion of the Committee) unless a revision is made. Any decision or action taken or to be taken by the Committee, arising out of or in connection with the construction, administration, interpretation and effect of the Plan and of its


rules and regulations, shall, to the maximum extent permitted by applicable law, be within its absolute discretion (except as otherwise specifically provided herein) and shall be final, binding and conclusive upon the Company, all Eligible Persons and any person claiming under or through any Eligible Person.

The Committee may delegate any or all of its power and authority hereunder to the Chief Executive Officer or President and such other officers as the Committee deems appropriate; provided, however, that the Committee may not delegate its authority with regard to (i) any matter or action affecting an officer subject to Section 16 of the Exchange Act; (ii) any matter related to Incentives intended to be qualified under Section 162(m) of the Code; or (iii) any matter or action related to grants of Incentives to Non-Employee Directors.

For the purpose of this section and all subsequent sections, the Plan shall be deemed to include this Plan and any sub-plans which, in the aggregate, shall constitute one Plan governed by the terms set forth herein.

3. Eligibility

 

  (a) Employees . Any person employed by the Company, its parent, if any, or its subsidiaries, its affiliates and its joint ventures, including officers, whether or not directors of the Company, and employees of a joint venture partner or affiliate of the Company who provide services to the joint venture with such partner or affiliate (each such person, an “Employee”), shall be eligible to participate in the Plan if designated by the Committee (“Eligible Persons”). Notwithstanding the foregoing, an individual who was an employee of Express Scripts, Inc. or its subsidiaries as of April 2, 2012 shall not be an Employee eligible to be designated as an Eligible Person by reason of such employment or continued employment with the Company thereafter.

 

  (b) Non-employees . The term “Employee” shall not include a non-employee director or a person hired as an independent contractor, leased employee or consultant, provided, however, that the Committee may determine that any such person is eligible to receive Incentives under the Plan (and, if such a determination is made as to any such person, such person shall be an Eligible Person under the Plan). Such person shall not participate in this Plan except to the extent that the Committee so determines, even if such person is subsequently determined to be an “employee” by any governmental or judicial authority.

 

  (c)

No Right To Continued Employment . Nothing in the Plan shall interfere with or limit in any way the right of the Company, its parent, its subsidiaries, its affiliates or its joint ventures to terminate the employment of any participant at any time, nor confer upon any participant the right to continue in the employ of the Company, its parent, its subsidiaries, its affiliates or its joint ventures. No Eligible Person shall have a right to receive an Incentive or any other benefit under this Plan or having been granted an Incentive or other benefit, to receive any additional Incentive or other benefit. Neither the award of an Incentive nor any benefits arising under such Incentives shall constitute an employment contract with the Company, its parent, its subsidiaries, its affiliates or its joint ventures, and accordingly, this Plan and the


benefits hereunder may be terminated at any time in the sole and exclusive discretion of the Company without giving rise to liability on the part of the Company, its parent, its subsidiaries, its affiliates or its joint ventures for severance (except as otherwise required under applicable local law). Except as may be otherwise specifically stated in any other employee benefit plan, policy or program, or as required under applicable local law, neither any Incentive under this Plan nor any amount realized from any such Incentive shall be treated as compensation for any purposes of calculating an employee’s benefit under any such plan, policy or program.

4. Term of the Plan

This Plan was initially adopted by Medco Health Solutions, Inc. effective on June 17, 2002 and originally approved by shareholders of Medco Health Solutions, Inc. on July 21, 2003. The Plan was extended pursuant to the amendments and restatements made on March 14, 2011 such that no Incentive shall be granted under the Plan after May 24, 2021, but the term and exercise of Incentives granted theretofore may extend beyond that date. This amendment and restatement is effective upon the consummation of that certain merger involving the Company, Express Scripts, Inc. and Medco Health Solutions, Inc. on April 2, 2012 and was approved by Express Scripts, Inc. as the sole shareholder of the Company on March 29, 2012. For the avoidance of doubt, each grant and award that was made under the terms of the Medco Health Solutions, Inc. 2002 Stock Incentive Plan outstanding as of April 2, 2012 has been assumed under this Plan as amended and restated and, to the extent applicable, such grants and awards that represented awards in respect of common stock of Medco Health Solutions, Inc. shall, upon such assumption, represent awards in respect of Common Stock of the Company, appropriately adjusted.

5. Incentives

 

  (a) Types of Incentives . Incentives under the Plan may be granted in any one or a combination of (i) Incentive Stock Options; (ii) Nonqualified Stock Options; (iii) Stock Appreciation Rights; (iv) Restricted Stock Grants, (v) Performance Shares, (vi) Share Awards and (vii) Phantom Stock Awards (Incentive Stock Options and Nonqualified Stock Options shall be referred to collectively as “Stock Options” and together with Restricted Stock Grants, Performance Shares, Share Awards and Phantom Stock Awards shall be referred to collectively as “Incentives”) Incentives other than Stock Options and Stock Appreciation Rights are “Full Value Awards.” All Incentives shall be subject to the terms and conditions set forth herein and to such other terms and conditions as may be established by the Committee.

 

  (b) No Repricing . Except in connection with a corporate transaction involving the company (including, without limitation, any stock dividend, stock split, extraordinary cash dividend, recapitalization, reorganization, merger, consolidation, split-up, spin-off, combination, or exchange of shares), the terms of outstanding awards may not be amended to reduce the option price of outstanding Stock Options or Stock Appreciation Rights or cancel outstanding Stock Options or in exchange for cash, other awards or Stock Options or with an option price that is less than the option price of the original Stock Options or Stock Appreciation Rights without stockholder approval.


6. Shares Available for Incentives

 

  (a) Shares Available . Subject to the provisions of Section 6(c), the maximum number of shares of Common Stock of the Company that may be issued under the Plan as of April 2, 2012 is thirteen million, nine hundred forty two thousand, eight hundred ninety four (13,942,894) which is the equivalent of the number of shares of common stock of Medco Health Solutions, Inc. that was available under the Medco Health Solutions, Inc. 2002 Stock Incentive Plan as of April 2, 2012, adjusted to reflect Common Stock of the Company.

For all grants made after December 31, 2010, the share reserve shall be reduced by (1) one common share for each common share issued with respect to a Stock Option or Stock Appreciation Right; and (b) 2.16 common shares for each common share issued with respect to Full Value Awards. Upon the exercise of a stock-settled Stock Appreciation Right, the number of shares subject to the Award that are then being exercised shall be counted against the maximum aggregate number of shares that may be issued under the Plan, on the basis of one share for every share subject thereto, regardless of the actual number of shares used to settle the Stock Appreciation Right upon exercise.

In addition to the foregoing, the following shares of Common Stock related to Incentives under this Plan may again be used for the grant of Incentives under the Plan: (i) shares related to Incentives paid in cash; (ii) shares related to Incentives that expire, are forfeited or cancelled or terminate for any other reason without issuance of shares of Common Stock; and (iii) any shares of Common Stock related to Incentives that are assumed, converted or substituted as a result of the acquisition of another company by the Company or a combination of the Company with another company. Regardless of when Incentives are granted, effective January 1, 2011, shares tendered in payment of the option price or grant price for Stock Options and Stock Appreciation Rights or shares withheld from Incentives (including Full Value Awards) for tax payments or withholding for taxes shall not be added back into the Plan.

Shares under this Plan may be delivered by the Company from its authorized but unissued shares of Common Stock or from issued and reacquired Common Stock held as treasury stock, or both. In no event shall fractional shares of Common Stock be issued under the Plan.

 

  (b) Limit on an Individual’s Incentives . In any calendar year, no Eligible Person may receive (i) Incentives (including Stock Options and Stock Appreciation Rights) covering more than two million, six hundred ninety four thousand, seven hundred seventy three (2,694,773) shares of the Company’s Common Stock (such number of shares shall be adjusted in accordance with Section 6(c)), or (ii) any Incentive if such person owns more than ten percent of the stock of the Company within the meaning of Section 422 of the Code, or (iii) any Incentive Stock Option, as defined in Section 422 of the Code, which would result in such person receiving a grant of Incentive Stock Options for stock that would have an aggregate fair market value in excess of $100,000, determined as of the time that the Incentive Stock Option is granted, that would be exercisable for the first time by such person during any calendar year.


  (c) Adjustment of Shares . In the event of a reorganization, recapitalization, stock split, stock dividend, combination of shares, merger, consolidation, rights offering, spin off, split off, split up or other event identified by the Committee, the Committee shall make such adjustments, if any, as it may deem appropriate in (i) the number and kind of shares authorized for issuance under the Plan, (ii) the number and kind of shares subject to outstanding Incentives, and (iii) the option price/grant price of Stock Options and Stock Appreciation Rights. For the purposes of (i) and (ii) above, fractions of a share will be rounded down to the nearest whole share (other than for Incentive Stock Options). Any such determination shall be final, binding and conclusive on all parties. Without limiting the foregoing, the shares available under this Plan were adjusted effective April 2, 2012 as reflected in Section 6(a) hereof, and all other references to numbers of shares, including with respect to previously granted awards, share limits and share reductions, are similarly adjusted effective April 2, 2012 as determined by the Committee and such adjustments shall be deemed to be incorporated herein, in each case, to the extent appropriate.

 

  (d) Minimum Vesting for Full Value Awards . With respect to at least 95% of Full Value Awards (other than Performance Share Awards) granted after December 31, 2010, vesting of such Incentives will occur over a minimum of three years from the grant date. For Performance Share Awards, at least 95% of these Incentives granted after December 31, 2010 will vest over a minimum of one year from the grant date.

7. Stock Options

The Committee may grant options qualifying as Incentive Stock Options as defined in Section 422 of the Code to employees of the Company or a parent or subsidiary corporation within the meaning of Section 424 of the Code, and options other than Incentive Stock Options (“Nonqualified Options”) (collectively “Stock Options”). Such Stock Options shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe:

 

  (a) Stock Option Price . The option price per share with respect to each Stock Option shall be determined by the Committee, but shall not be less than 100% of the Fair Market Value of the Common Stock (as defined below) on the date the Stock Option is granted, as determined by the Committee. Unless the Committee determines otherwise, “Fair Market Value” shall mean the closing stock price of a share of Common Stock, as reported on the Nasdaq Global Select Market (or any other reporting system selected by the Committee, in its sole discretion) on the date as of which the determination is being made or, if no sale of shares of Common Stock is reported on this date, on the next preceding day on which there were sales of shares of Common Stock reported.

 

  (b) Period of Stock Option . The period of each Stock Option shall be fixed by the Committee, provided that the period for all Stock Options shall not exceed ten (10) years from the grant. The Committee may, subsequent to the granting of any Stock Option, extend the term thereof, but in no event shall the extended term exceed ten years from the original grant date.


  (c) Exercise of Stock Option and Payment Therefore . No shares shall be issued until full payment of the option price has been made. The option price may be paid in cash or, if the Committee determines, in shares of Common Stock or a combination of cash and shares of Common Stock. If the Committee approves the use of shares of Common Stock as a payment method, the Committee shall establish such conditions as it deems appropriate for the use of Common Stock to exercise a Stock Option. Stock Options awarded under the Plan shall be exercised through such procedure or program as the Committee may establish or define from time to time, which may include a designated broker that must be used in exercising such Stock Options.

 

  (d) First Exercisable Date . The Committee shall determine how and when shares covered by a Stock Option may be purchased. The Committee may establish waiting periods, the dates on which Stock Options become exercisable or “vested” and, subject to paragraph (b) of this section, exercise periods. The Committee may accelerate the exercisability of any Stock Option or portion thereof.

 

  (e) Termination of Employment . Unless determined otherwise by the Committee, upon the termination of a Stock Option grantee’s employment (for any reason other than gross misconduct), outstanding Stock Options which were not exercisable at the date of such termination shall be immediately forfeited upon termination. The Committee, however, in its discretion, may provide that any Stock Options outstanding but not yet exercisable upon the termination of a Stock Option grantee’s employment may become exercisable in accordance with a schedule determined by the Committee. Such Stock Options shall expire unless exercised within such period of time after the date of termination of employment as may be established by the Committee, but in no event later than the expiration date of the Stock Option.

 

  (f) Termination Due to Misconduct . If a Stock Option grantee’s employment is terminated for gross misconduct, as determined by the Company, all outstanding Stock Options (regardless of whether vested or not upon termination) shall expire upon the date of such termination.

 

  (g) Limits on Incentive Stock Options . Except as may otherwise be permitted by the Code, an Eligible Person may not receive a grant of Incentive Stock Options for stock that would have an aggregate fair market value in excess of $100,000 (or such other amount as the Internal Revenue Service may decide from time to time), determined as of the time that the Incentive Stock Option is granted, that would be exercisable for the first time by such person during any calendar year. All shares that have been authorized to be issued under the Plan may be used for the grant of Incentive Stock Options.


8. Stock Appreciation Rights

The Committee may, in its discretion, grant a right to receive the appreciation in the fair market value of shares of Common Stock (“Stock Appreciation Right”) either singly or in combination with an underlying Stock Option granted hereunder. Such Stock Appreciation Right shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe:

 

  (a) Time and Period of Grant . If a Stock Appreciation Right is granted with respect to an underlying Stock Option, it may be granted at the time of the Stock Option grant or at any time thereafter but prior to the expiration of the Stock Option grant. If a Stock Appreciation Right is granted with respect to an underlying Stock Option, at the time the Stock Appreciation Right is granted the Committee may limit the exercise period for such Stock Appreciation Right, before and after which period no Stock Appreciation Right shall attach to the underlying Stock Option. In no event shall the exercise period for a Stock Appreciation Right granted with respect to an underlying Stock Option exceed the exercise period for such Stock Option. If a Stock Appreciation Right is granted without an underlying Stock Option, the term of the Stock Appreciation Right shall be set by the Committee, but in no event shall exceed ten (10) years from the grant.

 

  (b) Value of Stock Appreciation Right . If a Stock Appreciation Right is granted with respect to an underlying Stock Option, the grantee will be entitled to surrender the Stock Option which is then exercisable and receive in exchange an amount equal to the excess of the fair market value of the Common Stock on the date the election to surrender is received by the Company in accordance with exercise procedures established by the Company over the Stock Option price multiplied by the number of shares covered by the Stock Option which is surrendered. If a Stock Appreciation Right is granted without an underlying Stock Option, the grantee will receive upon exercise of the Stock Appreciation Right an amount equal to the excess of the fair market value of the Common Stock on the date the election to surrender such Stock Appreciation Right is received by the Company in accordance with exercise procedures established by the Company over the fair market value of the Common Stock on the date of grant multiplied by the number of shares covered by the grant of the Stock Appreciation Right. All Stock Appreciation Rights shall have a grant price that is not less than 100% of the Fair Market Value of the Common Stock on the date the Stock Appreciation Right is granted.

 

  (c) Payment of Stock Appreciation Right . Payment of a Stock Appreciation Right shall be in the form of shares of Common Stock, cash or any combination of shares and cash. The form of payment upon exercise of such a right shall be determined by the Committee either at the time of grant of the Stock Appreciation Right or at the time of exercise of the Stock Appreciation Right.

9. Performance Share Awards

The Committee may grant awards under which payment may be made in shares of Common Stock, cash or any combination of shares and cash if the performance of the Company or its parent, if any, or any subsidiary, affiliate or joint venture of the Company or based on an individual grantee’s performance, team, division or group performance or any other defined group that the Committee determines during the Award Period meets certain goals established by the Committee (“Performance Share Awards”). Such Performance Share Awards shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe:


  (a) Award Period and Performance Goals . The Committee shall determine and include in a Performance Share Award grant the period of time for which a Performance Share Award is made (“Award Period”). The Committee shall also establish performance objectives (“Performance Goals”) to be met by the Company, its parent, if any, subsidiary, affiliate or joint venture of the Company or individual grantee or team, division or group determined by the Committee during the Award Period as a condition to payment of the Performance Share Award. The Performance Goals may include any one or more of the following Company measures, as interpreted by the Committee, which (to the extent applicable) will be determined in accordance with GAAP: earnings per share; net-new sales; new named sales; client retention; client satisfaction; employee satisfaction; member satisfaction; revenue performance; corporate earnings performance; return on assets; return on equity; return on invested capital; cash flow; cash balances; market value added; economic value added; earnings before interest, taxes, depreciation and amortization; mail and total prescription volumes; mail penetration rate; cost and expense controls; drug trend management; clinical program effectiveness; generic dispensing rates; specialty segment performance; covered lives; productivity and growth in new markets, products and/or services. Performance Measures may be measured before or after taking taxes into consideration, in the discretion of the Committee. The Performance Goals may include minimum and optimum objectives or a single set of objectives. In determining attainment of Performance Goals, the Committee will exclude unusual or infrequently occurring items, charges for restructurings (employee severance liabilities, asset impairment costs, and exit costs), discontinued operations, extraordinary items and the cumulative effect of changes in accounting treatment, and may determine no later than ninety (90) days after the commencement of any applicable Award Period to exclude other items, each determined in accordance with GAAP (to the extent applicable) and as identified in the financial statements, notes to the financial statements or discussion and analysis of management. If the Committee desires that compensation payable pursuant to any Performance Share Award be qualified performance-based compensation within the meaning of Section 162(m) of the Code for covered employees, the Performance Goals (i) shall be established by the Committee no later than the end of the first quarter of the Award Period (or such other time designated by the United States Internal Revenue Service) and (ii) shall satisfy all other applicable requirements imposed under United States Treasury Regulations promulgated under Section 162(m) of the Code, including the requirement that such Performance Goals be stated in terms of an objective formula or standard.

 

  (b)

Payment of Performance Share Awards . The Committee shall establish the method of calculating the amount of payment to be made under a Performance Share Award if the Performance Goals are met, including the fixing of a maximum payment. The Performance Share Award shall be expressed in terms of shares of Common Stock and referred to as “Performance Shares.” After the completion of an Award Period, the performance of the Company, its parent, if any, subsidiary,


affiliate or joint venture of the Company or individual grantee or team, division or group (whichever is relevant under the terms of the Performance Share Award) shall be measured against the Performance Goals, and the Committee shall determine, in accordance with the terms of such Performance Share Award, whether all, none or any portion of a Performance Share Award shall be paid. The Committee, in its discretion, may elect to make payment in shares of Common Stock, cash or a combination of shares and cash. Any cash payment shall be based on the Fair Market Value of Performance Shares at the end of the Award Period.

 

  (c) Requirement of Employment . A grantee of a Performance Share Award must remain in the employ of the Company, its parent, if any, subsidiary, affiliate or joint venture until the completion of the Award Period in order to be entitled to payment under the Performance Share Award; provided that the Committee may, in its discretion, provide for a full or partial payment where such an exception is deemed equitable. However, to the extent that the Performance Share Award is intended to constitute performance-based compensation, the Committee shall only make exceptions in the event that the covered employee’s employment terminates due to death, disability or upon a change of control provided payments are not made until after the completion of the Award Period and certification that the Performance Goals have been attained as required pursuant to Section 162(m).

 

  (d) Dividend Equivalents . Dividend equivalents shall not be paid during the Award Period and may only be paid on vested Performance Shares to the extent determined by the Committee.

10. Restricted Stock Grants

The Committee may award shares of Common Stock to an Eligible Person, which shares shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe (“Restricted Stock Grant”):

 

  (a) Requirement of Employment . A grantee of a Restricted Stock Grant must remain in the employment of the Company or its parent, if any, its subsidiaries, its affiliates and its joint ventures during a period designated by the Committee (“Restriction Period”) in order to retain the shares under the Restricted Stock Grant. If the grantee’s employment with the Company or its parent, if any, its subsidiaries, its affiliates and its joint ventures terminates prior to the end of the Restriction Period, the Restricted Stock Grant shall terminate and the shares of Common Stock shall be returned immediately to the Company provided that the Committee may, at the time of the grant, provide for the employment restriction to lapse with respect to a portion or portions of the Restricted Stock Grant at different times during the Restriction Period. The Committee may, in its discretion, also provide for such complete or partial exceptions to the employment restriction as it deems equitable.

 

  (b) Restrictions on Transfer and Legend on Stock Certificates . During the Restriction Period, the grantee may not sell, assign, transfer, pledge or otherwise dispose of the shares of Common Stock. Each certificate for shares of Common Stock issued hereunder shall contain a legend giving appropriate notice of the restrictions in the grant.


  (c) Escrow Agreement . The Committee may require the grantee to enter into an escrow agreement providing that the certificates representing the Restricted Stock Grant will remain in the physical custody of an escrow holder until all restrictions are removed or expire.

 

  (d) Lapse of Restrictions . All restrictions imposed under the Restricted Stock Grant shall lapse upon the expiration of the Restriction Period if the conditions as to employment set forth above have been met. The grantee shall then be entitled to have the legend removed from the certificates and/or request shares to be transferred to him or her from the escrow holder, if any.

 

  (e) Dividends . The Committee shall, in its discretion, at the time of the Restricted Stock Grant, provide that any dividends declared on the Common Stock during the Restriction Period shall either be (i) paid to the grantee as soon as practicable after the dividend is declared, or (ii) accumulated for the benefit of the grantee and paid to the grantee only after the expiration of the Restriction Period.

 

  (f) Performance Goals . The Committee may designate whether any Restricted Stock Grant is intended to be “performance-based compensation” as that term is used in Section 162(m) of the Code. Any such Restricted Stock Grant designated to be “performance-based compensation shall be conditioned on the achievement of one or more Performance Goals (as defined in Section 9(a)), to the extent required by Section 162(m).

11. Other Share-Based Awards

 

  (a) Share Awards . The Committee may grant an award of shares of common stock (a “Share Award”) to any Eligible Person on such terms and conditions as the Committee may determine in its sole discretion.

 

  (b) Phantom Stock Awards . The Committee may, in its discretion, grant a right representing a number of hypothetical shares, including restricted stock units (a “Phantom Stock Award”), to any Eligible Person on such terms and conditions, including whether payment of such Phantom Stock Award will be in cash or shares, as the Committee may determine in its sole discretion.

12. Transferability

Each Incentive, other than Nonqualified Options, granted under the Plan shall not be transferable or assignable other than by will or the laws of descent and distribution and shall be exercisable during the grantee’s lifetime only by the grantee. Nonqualified Options shall not be transferable or assignable by the recipient, and may not be made subject to execution, attachment or similar procedures, other than by will or the laws of descent and distribution or pursuant to a domestic relations order within the meaning of Rule 16a-12 under the Exchange Act. Notwithstanding the foregoing, the Committee, in its discretion, may adopt rules permitting the transfer, solely as gifts


during the grantee’s lifetime, of Stock Options (other than Incentive Stock Options) to trusts or family partnerships for the benefit of immediate family members, but in no event will awards be transferable for value or consideration. For this purpose, immediate family member means the grantee’s spouse, parent, child, stepchild, grandchild and the spouses of such family members. The terms of a Stock Option shall be final, binding and conclusive upon the beneficiaries, executors, administrators, heirs and successors of the grantee.

13. Discontinuance or Amendment of the Plan

The Board of Directors may discontinue the Plan at any time and may from time to time amend or revise the terms of the Plan as permitted by applicable statutes, except that it may not, without the consent of the grantees affected, revoke or alter, in a manner unfavorable to the grantees of any Incentives hereunder, any Incentives then outstanding, nor may the Board amend the Plan without stockholder approval where the absence of such approval would cause the Plan to fail to comply with Rule 16b-3 under the Exchange Act, or any other requirement of applicable law or regulation.

14. No Constraint on Corporate Action

Nothing in the Plan shall be construed (i) to limit, impair or otherwise affect the Company’s right or power to make adjustments, reclassifications, reorganizations or changes of its capital or business structure, or to merge or consolidate, or dissolve, liquidate, sell or transfer all or any part of its business or assets, or (ii) except as provided in Section 13, to limit the right or power of the Company, its parent, or any subsidiary, affiliate or joint venture to take any action which such entity deems to be necessary or appropriate.

15. Withholding Taxes

The Company and its parent, if any, its subsidiaries, its affiliates and its joint ventures shall be entitled to collect income taxes, social insurance contributions, payment on account amounts, any local taxes and any other taxes related to the grant, vesting or exercise of Incentives or acquisition or sale of shares acquired under the Plan legally due by grantee and required to be withheld by the Company (or one of its affiliates) or grantee’s employer (“Tax Withholding Amounts”) by any of the following methods: (i) withholding from shares of Common Stock or cash issuable or due under the Incentive; (ii) withholding from compensation, salary, bonuses or any other amounts due to grantee; or (iii) forcing shares of Common Stock to be sold that are issued pursuant to Incentives and using the proceeds to cover the Tax Withholding Amounts. In addition and in accordance with any applicable administrative guidelines it establishes, the Committee may allow a grantee to pay the Tax Withholding Amounts by withholding from any payment of Common Stock due as a result of such Incentive, or by permitting the grantee to deliver to the Company, shares of Common Stock having a fair market value, as determined by the Committee, equal to the amount of the Tax Withholding Amounts. Regardless of when Incentives are granted, effective January 1, 2011, shares tendered in payment of the option price or grant price for Stock Options and Stock Appreciation Rights or withheld from Incentives (including Full Value Awards) for tax payments or withholding for taxes shall not be added back into the Plan.


16. Compliance with Section 16

With respect to Eligible Persons subject to Section 16 of the Exchange Act (“Section 16 Officers”), transactions under the Plan are intended to comply with all applicable conditions of Rule 16b-3 or its successor under the Exchange Act. To the extent that compliance with any Plan provision applicable solely to the Section 16 Officers is not required in order to bring a transaction by such Section 16 Officer into compliance with Rule 16b-3, it shall be deemed null and void as to such transaction, to the extent permitted by law and deemed advisable by the Committee and its delegees. To the extent any provision of the Plan or action by the Plan administrators involving such Section 16 Officers is deemed not to comply with an applicable condition of Rule 16b-3, it shall be deemed null and void as to such Section 16 Officers, to the extent permitted by law and deemed advisable by the Plan administrators.

17. Use of Proceeds

The proceeds received by the Company from the sale of stock under the Plan shall be added to the general funds of the Company and shall be used for such corporate purposes as the Board of Directors shall direct.

18. Change in Control

Unless otherwise provided in an award agreement, or for Incentives that do not constitute deferred compensation under Section 409A of the Code, unless determined by the Committee in its discretion, in the event of a Change in Control (as defined below), each Incentive outstanding as of the Change in Control shall be assumed, continued, or substituted with a new Incentive that has: (i) an intrinsic value equivalent to that of the original Incentive; and (ii) terms at least as beneficial to the grantee as those contained in the original award agreement. If within two years following a Change in Control, a grantee is terminated for any reason (or constructively terminated as determined by the Committee in its sole discretion) except for “Cause” (as defined below) all of the grantee’s outstanding Incentives which have not vested shall immediately vest and become exercisable (if applicable) and all restrictions on such awards or shares shall immediately lapse.

For purposes of this Section 18, the term “Cause” shall mean that a grantee: (i) has been convicted of, or entered a plea of nolo contendere to, a crime that constitutes a felony under U.S. Federal or state law or equivalent under any applicable foreign law; (ii) has engaged in willful gross misconduct in the performance of the grantee’s duties to the Company or a parent, subsidiary or affiliate; or (iii) has committed a material breach of any written agreement with the Company or any parent, subsidiary or affiliate with respect to confidentiality, noncompetition, nonsolicitation or similar restrictive covenant. The Committee shall have the discretion of determining whether a grantee has been terminated for Cause for the purposes of this Section 18.


A “Change in Control” shall mean the occurrence during the term of the Plan of any one of the following events:

 

  (a) An acquisition (other than directly from the Company) of any shares of Common Stock or other voting securities of the Company by any “Person” (for purposes of this Section only, as the term “person” is used for purposes of Section 13(d) or 14(d) of the Exchange Act), immediately after which such Person has “Beneficial Ownership” (within the meaning of Rule 13d-3 promulgated under the Exchange Act) of forty percent (40%) or more of either (i) the then outstanding shares of Common Stock or (ii) the combined voting power of the Company’s then outstanding voting securities entitled to vote for the election of directors (the “Voting Securities”); provided, however, in determining whether a Change in Control has occurred, shares of Common Stock or Voting Securities which are acquired in a “Non-Control Acquisition” (as hereinafter defined) shall not constitute an acquisition which would cause a Change in Control. A “Non-Control Acquisition” shall mean an acquisition by (i) an employee benefit plan (or a trust forming a part thereof) maintained by (A) the Company or (B) any corporation or other Person of which a majority of its voting power or its voting equity securities or equity interest is owned, directly or indirectly, by the Company (for purposes of this definition, a “Related Entity”), (ii) the Company or any Related Entity, or (iii) any Person in connection with a “Non-Control Transaction” (as hereinafter defined); or

 

  (b) The individuals who, immediately after the acquisition or transaction, are members of the Board of Directors of the Company (the “Incumbent Board”), (i) cease for any reason to constitute at least a majority of the members of the Board of Directors of the Company, or (ii) following a Merger (as hereinafter defined), do not constitute at least a majority of the board of directors of (x) the Surviving Corporation (as hereinafter defined), if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by a Parent Corporation, or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation (as hereinafter defined); provided, however, that if the election, or nomination for election by the Company’s common stockholders, of any new director was approved by a vote of at least a majority of the Incumbent Board, such new director shall, for purposes of this Plan, be considered as a member of the Incumbent Board; provided, further, however, that no individual shall be considered a member of the Incumbent Board if such individual initially assumed office as a result of an actual or threatened solicitation of proxies or consents by or on behalf of a Person other than the Board of Directors of the Company (a “Proxy Contest”), including by reason of any agreement intended to avoid or settle any Proxy Contest; or

 

  (c) The consummation of:

 

  (i) A merger, consolidation or reorganization with or into the Company or a direct or indirect subsidiary of the Company or in which securities of the Company are issued (a “Merger”), unless the Merger is a “Non-Control Transaction.” A “Non-Control Transaction” shall mean:


  (A) the stockholders of the Company immediately before such Merger own directly or indirectly immediately following the Merger at least fifty percent (50%) of the outstanding common stock and the combined voting power of the outstanding voting securities of (x) the corporation resulting from such Merger (the “Surviving Corporation”), if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by another corporation (a “Parent Corporation”), or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation;

 

  (B) the individuals who were members of the Incumbent Board immediately prior to the execution of the agreement providing for the Merger, constitute at least a majority of the members of the board of directors of, (x) the Surviving Corporation, if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by a Parent Corporation, or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation; and

 

  (C) no Person other than (1) the Company or another corporation that is a party to the agreement of Merger, (2) any Related Entity, or (3) any employee benefit plan (or any trust forming a part thereof) that, immediately prior to the Merger, was maintained by the Company or any Related Entity, or (4) any Person who, immediately prior to the Merger had Beneficial Ownership of forty percent (40%) or more of the then outstanding shares of Common Stock or Voting Securities, has Beneficial Ownership, directly or indirectly, of forty percent (40%) or more of the combined voting power of the outstanding voting securities or common stock of (x) the Surviving Corporation, if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by a Parent Corporation, or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation.

 

  (ii) A complete liquidation or dissolution of the Company; or

 

  (iii) The sale or other disposition of all or substantially all of the assets of the Company and its subsidiaries taken as a whole to any Person (other than a transfer to a Related Entity or under conditions that would constitute a Non-Control Transaction with the disposition of assets being regarded as a Merger for this purpose or the distribution to the Company’s stockholders of the stock of a Related Entity or any other assets).

Notwithstanding the foregoing, a Change in Control shall not be deemed to occur solely because any Person (the “Subject Person”) acquired Beneficial Ownership of more than the permitted amount of the then outstanding shares of Common Stock or Voting Securities as a result of the acquisition of shares of Common Stock or Voting Securities by the Company which, by reducing the number of shares of Common Stock or Voting Securities then outstanding, increases the


proportional number of shares Beneficially Owned by the Subject Persons; provided, that if a Change in Control would occur (but for the operation of this sentence) as a result of the acquisition of shares of Common Stock or Voting Securities by the Company, and after such share acquisition by the Company, the Subject Person becomes the Beneficial Owner of any additional shares of Common Stock or Voting Securities which increases the percentage of the then outstanding shares of Common Stock or Voting Securities Beneficially Owned by the Subject Person, then a Change in Control shall occur.

Also, notwithstanding the foregoing, to the extent that any Incentive constitutes a deferral of compensation subject to Code Section 409A, and if that Incentive provides for a change in the time or form of payment upon a Change in Control, then no Change in Control shall be deemed to have occurred upon an event described in this Section 18 unless the event would also constitute a change in ownership or effective control of, or a change in the ownership of a substantial portion of the assets of, the Company under Code Section 409A.

19. Governing Law

The Plan, and all agreements hereunder, shall be construed in accordance with and governed by the laws of the State of Delaware without giving effect to the principles of conflicts of laws.


ADDENDUM

TO THE

MEDCO HEALTH SOLUTIONS, INC.

2002 STOCK INCENTIVE PLAN

This addendum is intended to cause the Medco Health Solutions, Inc. 2002 Stock Incentive Plan (the “Plan”) to meet the requirements of a written plan as described in Q&A 21 of Internal Revenue Service Notice 2005-1 with respect to restricted stock units, performance shares or other share based awards subject to deferral (“Stock Units”) granted under the Plan. Capitalized terms used herein but not defined shall have the meaning ascribed to them in the Plan.

1. Deferrals of Stock Units Permitted

 

  (a) Receipt of stock or other payment pursuant to the conversion of a Stock Unit granted under the Plan may be deferred at the election of a grantee beyond the taxable year in which the Stock Unit vests and becomes non-forfeitable provided permitted by the Committee.

 

  (b) This deferral program is intended to meet the requirements of an unfunded “top-hat” plan maintained primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees, within the meaning of Sections 201(2), 301(a)(3) and 401(a)(1) of ERISA. No grantee shall be permitted to make a deferral election if such grantee’s participation in the deferral program would cause the Plan to fail to be treated as a top-hat plan.

 

  (c) Stock Units granted to members of the Board of Directors are not affected by this Addendum.

2. Deferral Period

 

  (a) The deferral may be until any of the following:

 

  (i) six months after the date of a grantee’s separation from service,

 

  (ii) the date the participant becomes disabled (within the meaning of Section 409A(a)(2)(C) of Code),

 

  (iii) death,

 

  (iv) a specified date (or pursuant to a fixed schedule),

 

  (v) to the extent provided in regulations, a change in the ownership or effective control of the Company, or in the ownership of a substantial portion of the assets of the Company, or

 

  (vi) the occurrence of an unforeseeable emergency (as defined in Section 409A of the Code or the regulations promulgated thereunder).


3. No Acceleration

Acceleration of the deferral period elected by the grantee shall not be permitted, except as provided in regulations promulgated under Section 409A of the Code.

4. Deferral Elections

Deferral elections shall be made in compliance with Section 409A of the Code. In accordance with IRS Notice 2005-1, deferral elections with respect to Stock Units outstanding but unvested as of March 15, 2005 may be made on or before March 15, 2005. Changes in the time and form of payments with respect to Stock Units for which an initial deferral is in effect shall be permitted in accordance with Section 409A(a)(4)(C) of the Code, the terms of which shall be incorporated into this Addendum.

5. Compliance with Section 409A

Awards granted under the Plans are intended to comply with the requirements of Section 409A of the Internal Revenue Code of 1986, as amended. In order to comply with Section 409A, Stock Units granted under the Plans to employees who are not participants in the 2006 Executive Severance Plan at the time of grant shall be administered such that a separation from service of the grantee does not result in deferred compensation as defined in Section 409A unless the recipient has made a voluntary deferral election. As a result, Stock Units shall be converted and paid as soon as practicable following the date on which the Stock Units vest and become non-forfeitable. Stock Units granted under the Plans to employees who are participants in the 2006 Executive Severance Plan shall be administered such that a separation from service of the grantee does not result in the acceleration of payment of a Stock Unit. As a result, Stock Units shall not be converted and paid prior to the “Vesting Date” specified on the Term Sheet issued in respect of the award. The purpose of the prior sentence is to document that, except in the case of death or termination Within Two Years following a Change in Control, Stock Units granted to a participant in the 2006 Executive Severance Plan are paid on a date certain unless the recipient has made a specific deferral election in writing.

6. Transition Relief

Notwithstanding the foregoing, Stock Units that have become vested on or before October 22, 2008 and have not been paid as of such date, shall, if held by an employee who is not a participant in the Executive Severance Plan, be paid on or about February 24, 2009. This provision has been added as of October 22, 2008 and is intended to comply with the 409A transition guidance.

7. Change in Control Provisions

In order to comply with Section 409A in connection with the payment of any Stock Units following or in connection with a “Change in Control,” the following applies:

 

  (a) The definition of Change in Control in Section 18 of the Plan shall apply for purposes of determining the extent to which an Incentive has vested.

 

  (b) Any payment provisions applicable to a Stock Unit that are conditioned upon the occurrence of a Change in Control shall only apply if the Change in Control is also a change in the ownership or effective control, or a change in the ownership of a substantial portion of the assets of the Company as defined in Treasury Regulation Section 1.409A-3(i)(5).

Exhibit 10.5

RESTRICTED STOCK UNIT GRANT NOTICE

FOR NON-EMPLOYEE DIRECTORS

Notice is hereby given of the following award of Restricted Stock Units (the “Award”), which entitles the Grantee to receive one share of the common stock, $0.01 par value per share (“Common Stock”), of Express Scripts Holding Company (the “Company”) for each Restricted Stock Unit pursuant to the following terms and conditions:

 

•         Grantee :

                                        

•         Grant Date :

                                        

•         Number of Restricted Stock Units :

                                        

•         Vesting Schedule : The Restricted Stock Units under the Award shall be vested in accordance with the following vesting schedule:

                                                                                                                                         

  

                                                                                                                                         

  

                                                                                                                                         

  

•         Other Provisions : The Award is granted subject to, and in accordance with, the terms of the Restricted Stock Unit Agreement (the “RSU Agreement”) attached hereto as Exhibit A , including Schedule 1 thereto, and the Express Scripts, Inc. 2011 Long-Term Incentive Plan (the “Plan”).

This Award is granted under, and governed by, the terms and conditions of this Grant Notice, the Plan and the RSU Agreement.

 

EXPRESS SCRIPTS HOLDING COMPANY
By:    
  [NAME]
  [TITLE]

Attachments:

Exhibit A— Restricted Stock Unit Agreement


EXHIBIT A

RESTRICTED STOCK UNIT AGREEMENT

FOR NON-EMPLOYEE DIRECTORS

Express Scripts Holding Company, a Delaware corporation (“Company”), has granted you (“Grantee”) an award of the number of Restricted Stock Units as set forth on the Grant Notice. Each Restricted Stock Unit shall entitle Grantee to receive one share of Common Stock upon vesting in the future in accordance with, and subject to, the terms and conditions set forth in your Restricted Stock Unit Grant Notice (“Grant Notice”) and this Restricted Stock Unit Agreement (“RSU Agreement”).

The Award is granted pursuant to the Express Scripts, Inc. 2011 Long-Term Incentive Plan, as amended from time to time (the “Plan”), pursuant to which restricted stock units, and other awards, may be granted to Non-Employee Directors of the Company. Except as otherwise specifically set forth herein, all capitalized terms utilized herein (including on Schedule 1 hereto) shall have the respective meanings ascribed to them in the Plan.

The details of your Award are as follows:

l. Grant of Restricted Stock Unit Award . Pursuant to action of the Board and/or a committee authorized by the Board, the Company hereby grants to Grantee an award (the “Award”) of the number of Restricted Stock Units as set forth on the Grant Notice. Each Restricted Stock Unit shall entitle Grantee to receive one share of Common Stock upon vesting in the future in accordance with, and subject to, the terms and conditions described herein.

2. Vesting and Forfeiture .

(a) Time Vesting . The Restricted Stock Units shall vest in one or more installments in accordance with the Vesting Schedule as set forth on the Grant Notice, with the vesting of each installment subject to the Grantee’s continued service as a member of the Board through the applicable vesting date.

(b) Accelerated Vesting . Any Restricted Stock Units which have not yet vested under subparagraph (a) above shall vest or be forfeited in accordance with the provisions of the Plan, and the terms of this Agreement (including Schedule 1 hereto).

(c) Forfeiture of Restricted Stock Units . If Grantee’s service as a member of the Board terminates for any reason, Grantee shall forfeit all rights with respect to any portion of the Award (and the underlying shares of Common Stock) that has not yet vested as of the effective date of the termination, except to the extent such Award vests upon such termination under Section 2(b).

3. Issuance of Common Stock . In accordance with the Vesting Schedule and subject to all the terms and conditions set forth in this Agreement or the Plan, upon an applicable vesting event, but in no event later than thirty (30) days following such event, the Company shall issue and deliver to Grantee the number of shares of Common Stock equal to the number of Restricted Stock Units which have become vested as a result of such event. The Company may, in its sole discretion, deliver such shares of Common Stock (a) by issuing Grantee a certificate of Common Stock representing the appropriate number of shares, (b) through electronic delivery to a brokerage or similar securities-holding account in the name of Grantee, or (c) through such other commercially reasonable means available for the delivery of securities.


4. Incorporation of the Plan by Reference; Conflicting Terms . The Award of Restricted Stock Units pursuant to this Agreement is granted under and expressly subject to, the terms and provisions of the Plan, which terms and provisions are incorporated herein by reference. Grantee hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof. In the event of any conflict between the terms of the Plan and the terms of this Agreement, the terms and provisions of the Plan shall govern.

5. Non-Transferability of Restricted Stock Units . The Restricted Stock Units may not be transferred in any manner and any purported transfer or assignment shall be null and void. Notwithstanding the foregoing, upon the death of Grantee, Grantee’s Successor shall have the right to receive any shares of Common Stock that may be deliverable hereunder, provided, that, for such purposes, the terms of the Plan and this Agreement shall be binding upon the executors, administrators, heirs, successors and assigns of Grantee.

6. Ownership Rights . The Restricted Stock Units do not represent a current interest in any shares of Common Stock. Grantee shall have no voting or other ownership rights in the Company arising from the Award of Restricted Stock Units under this Agreement. Notwithstanding the foregoing, unless otherwise determined by the Committee or the Board, and to the extent permitted by the Plan, Grantee shall participate in any cash dividend declared by the Board applicable to shares of Common Stock, which shall entitle Grantee to receive a cash payment for each Restricted Stock Unit, subject to the same Vesting Schedule and restrictions as the underlying Restricted Stock Unit and otherwise payable at the same time shares are issued and delivered to Grantee with respect to the underlying Restricted Stock Unit, in an amount that would otherwise be payable as dividends with respect to an equal number of shares of Common Stock.

7. Adjustments upon Changes in Capitalization or Corporate Acquisitions . Should any change be made to the Common Stock by reason of any Fundamental Change, divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off or other relevant change, appropriate adjustments shall be made to the total number and/or class of securities subject to this Award in order to reflect such change and thereby preclude a dilution or enlargement of benefits hereunder.

8. Board Discretion . This Award has been made pursuant to a determination made by the Board and/or one or more committees of the Board (as delegated by the Board). Notwithstanding anything to the contrary herein, and subject to the limitations of the Plan, the Board or its delegated committee(s) shall have plenary authority to: (a) interpret any provision of this Agreement or the Award; (b) make any determinations necessary or advisable for the administration of this Agreement or the Award; (c) make adjustments as it deems appropriate to the aggregate number and type of securities available under this Agreement to appropriately adjust for, and give effect to, any Fundamental Change, divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off or other relevant change; and (d) otherwise modify or amend any provision hereof, or otherwise with respect to the Award, in any manner that does not materially and adversely affect any right granted to Grantee by the express terms hereof, unless required as a matter of law, subject to the limitations stated in the Plan.

9. Tax Withholding . To the extent applicable and required by law, the Company shall withhold from Grantee’s compensation any required taxes, including social security and Medicare taxes, and federal, state and local income tax, with respect to the income arising from the vesting or payment in respect of any Restricted Stock Units under this Agreement. The Company shall have the right to require the payment of any such taxes before delivering any shares of Common Stock upon the vesting of any


Restricted Stock Unit. Grantee may elect to have any such withholding obligations satisfied by: (i) delivering cash; (ii) delivering part or all of the withholding payment in previously owned shares of Common Stock; and/or (iii) irrevocably directing the Company to reduce the number of shares that would otherwise be issued to Grantee upon the vesting of the Award by that number of whole shares of Common Stock having a fair market value, determined by the Company, in its sole discretion, equal to the amount of tax required to be withheld, but not to exceed the Company’s required minimum statutory withholding. Absent a specific election to the contrary by Grantee, such withholding obligations shall be satisfied pursuant to the method described in phrase (iii) of the preceding sentence.

10. Electronic Delivery . The Company may choose to deliver certain statutory or regulatory materials relating to the Plan in electronic form, including without limitation securities law disclosure materials. Without limiting the foregoing, by accepting this Award, Grantee hereby agrees that the Company may deliver the Plan prospectus and the Company’s annual report to Grantee in an electronic format. If at any time Grantee would prefer to receive paper copies of any document delivered in electronic form, the Company will provide such paper copies upon written request to the Investor Relations department of the Company.

11. No Right to Continued Service on the Board . Nothing in this Agreement shall be deemed to create any limitation or restriction on or otherwise affect such rights as the Company, the stockholders of the Company, or the Board otherwise would have to remove Grantee from the Board, to exclude Grantee from any slate of nominees for election to the Board, or to otherwise terminate Grantee’s service on the Board at any time for any reason.

12. Entire Agreement . This Agreement, including Schedule 1 hereto, and the Plan contain the entire understanding of the parties with respect to the subject matter hereof and supersede all prior agreements, understandings and negotiations between the parties.

13. Governing Law . To the extent federal law does not otherwise control, this Agreement shall be governed by the laws of Delaware, without giving effect to principles of conflicts of laws.

14. Compliance with Section 409A of the Internal Revenue Code . The Award is intended to comply with section 409A of the Code to the extent subject thereto, and shall be interpreted in accordance with section 409A of the Code and treasury regulations and other interpretive guidance issued thereunder, including without limitation any such regulations or other guidance that may be issued after the Grant Date. Notwithstanding any provision in the Plan, this Agreement or any other applicable Agreement to the contrary, no payment or distribution under this Agreement that constitutes an item of deferred compensation under section 409A of the Code and becomes payable by reason of Grantee’s termination of employment or service with the Company shall be made to Grantee until such termination of employment or service constitutes a separation from service within the meaning of section 409A of the Code. For purposes of this Award, each amount to be paid or benefit to be provided shall be construed as a separate identified payment for purposes of section 409A of the Code. Notwithstanding any provision in the Plan, this Agreement or any Applicable Employment Agreement to the contrary, and to the extent necessary to avoid the imposition of taxes under section 409A of the Code, (a) if Grantee is a specified employee within the meaning of section 409A of the Code, Grantee shall not be entitled to any payments upon a termination of employment or service until the earlier of: (i) the expiration of the six (6)-month period measured from the date of Grantee’s separation from service or (ii) the date of death; and (b) no Change in Control shall be deemed to have occurred hereunder unless such Change in Control constitutes a change in control event for purposes of section 409A of the Code. Upon the expiration of the applicable waiting period set forth in the preceding sentence, all payments and benefits deferred pursuant to this Section 14 (whether they would have otherwise been payable in a single lump sum or in installments in the absence of such deferral) shall be paid to Grantee in a lump sum as soon as practicable, but in no event later than sixty (60) calendar days, following such expired period, and any remaining payments due


under this Award will be paid in accordance with the normal payment dates specified for them herein. Notwithstanding any provision of the Plan, this Agreement or any Applicable Employment Agreement to the contrary, in no event shall the Company or any affiliate be liable to Grantee on account of an Award’s failure to (i) qualify for favorable U.S. or foreign tax treatment or (ii) avoid adverse tax treatment under U.S. or foreign law, including, without limitation, section 409A of the Code.


SCHEDULE 1

TERMINATION AND CHANGE IN CONTROL PROVISIONS UNDER THE

EXPRESS SCRIPTS, INC. 2011 LONG-TERM INCENTIVE PLAN

RESTRICTED STOCK UNIT AGREEMENT

FOR NON-EMPLOYEE DIRECTORS

I. Termination of Service of Non-Employee Director

(A) Generally . Except as provided herein, if Grantee’s service as a member of the Board terminates, then any Restricted Stock Units that have not vested as of the date of such termination shall terminate as of such date, and such unvested Restricted Stock Units shall be forfeited to the Company without payment therefor.

(B) Death or Disability . If Grantee’s service as a member of the Board terminates on account of death or Disability, Grantee shall vest in a number of Restricted Stock Units, to the extent outstanding, pro-rated for the portion of the period from the Date of Grant (as set forth on the Grant Notice) through the last vesting date on the Vesting Schedule set forth on the Grant Notice during which Grantee served as a member of the Board. As soon as practicable, the Company shall issue and deliver to Grantee the number of shares of Common Stock equal to the number of vested Restricted Stock Units (subject to any reductions for tax withholding or otherwise) calculated pursuant to the preceding sentence.

(C) Retirement . The termination of Grantee’s service as a member of the Board after attainment of age 65 for any reason other than death or Disability shall be considered a Retirement, subject to the following:

 

  1. Tenured Retirement . After attainment of age 70, Grantee’s Retirement shall be deemed to be a “Tenured Retirement”. Upon a Tenured Retirement, Grantee shall vest in all of the Restricted Stock Units then outstanding. As soon as practicable following such termination of service, the Company shall issue and deliver to Grantee the number of shares of Common Stock equal to the number of vested Restricted Stock Units (subject to any reductions for tax withholding or otherwise).

 

  2. Early Retirement . If Grantee has attained the age of 65, but not age 70, and has at least ten years of service on the Board, then Grantee’s Retirement shall be deemed to be an “Early Retirement”. Upon an Early Retirement, the following shall occur:

 

  (a) for any Restricted Stock Units then outstanding, a pro-rata portion thereof (determined as set forth below) shall vest immediately, and, as soon as practicable following such vesting, the Company shall issue and deliver to Grantee the number of shares of Common Stock equal to the number of such vested Restricted Stock Units;

 

  (b) the pro-rata portion of the Restricted Stock Units that shall vest under the preceding paragraph shall be a percentage which is equal to (i) the number of full months served by Grantee past age 65, divided by (ii) 60. The remaining portion of the Restricted Stock Units which are not eligible for vesting under the preceding paragraph shall be forfeited to the Company without payment upon Retirement.


  3. Death or Disability While Eligible for Retirement . If Grantee’s service as a member of the Board terminates because of his or her death or Disability and, at the time of such termination of service Grantee would have been eligible for either a Tenured Retirement or an Early Retirement, the Restricted Stock Units shall be treated as if Grantee’s service had terminated due to such applicable form of Retirement (rather than due to death or Disability, as applicable) if such treatment would result in a greater number of Restricted Stock Units becoming vested.

 

  4. Standard Retirement. Any Retirement that is not either a Tenured Retirement or an Early Retirement shall be deemed to be a Standard Retirement, which shall be treated in accordance with Section I(A) above.

II. Change in Control

(A) Acceleration of Vesting Upon Change in Control

(i) Acceleration of Vesting . Upon the occurrence of a Change in Control, the Restricted Stock Units shall, to the extent outstanding, vest in full.

(ii) Company Payment . Upon the occurrence of a Change in Control transaction, on the Change in Control Date the Restricted Stock Units still outstanding shall be automatically cancelled without further action by the Company or the Grantee, and the Company shall provide payment in connection with such cancellation at a per share price equal to the number of such Restricted Stock Units multiplied by the Change in Control Price (as defined below). The Change in Control Price shall mean the value, expressed in dollars, as of the date of receipt of the per share consideration received by the Company’s stockholders whose stock is acquired in a transaction constituting a Change in Control. In case such all or part of such consideration shall be in a form other than cash, the value of such consideration shall be as determined in good faith by a majority of the Board of Directors based on a written opinion by a nationally recognized investment banking firm, whose determination shall be described in a statement furnished to Participants.

Exhibit 10.6

STOCK OPTION GRANT NOTICE

FOR NON-EMPLOYEE DIRECTORS

Notice is hereby given of the following option grant (the “Option”) to purchase shares of common stock, $0.01 par value per share, of Express Scripts Holding Company (the “Company”) pursuant to the following terms and conditions:

 

•         Optionee :

                                                                 

•         Grant Date :

                                                                  

•         Exercise Price Per Share :

     $                                                           

•         Number of Option Shares :

                                                                  

•         Term/Expiration Date of Option :

                                                                  

•         Type of Option :

     Non-qualified Stock Option      

•         Vesting Schedule : The shares of common stock granted pursuant to the Option shall be vested and become exercisable in accordance with the following vesting schedule:

         -                                                                                                                                                                    

         -                                                                                                                                                                    

         -                                                                                                                                                                    

•         Other Provisions : The Option is granted subject to, and in accordance with, the terms of the Stock Option Agreement (the “Option Agreement”) attached hereto as Exhibit A , including Schedule 1 thereto, and the Express Scripts, Inc. 2011 Long-Term Incentive Plan (the “Plan”) attached hereto as Exhibit B .

This Option is granted under, and governed by, the terms and conditions of this Grant Notice, the Plan and the Option Agreement.

 

EXPRESS SCRIPTS HOLDING COMPANY
By:    
  [NAME]
  [TITLE]

Attachments:

Exhibit A— Stock Option Agreement

Exhibit B—Express Scripts, Inc. 2011 Long-Term Incentive Plan


EXHIBIT A

STOCK OPTION AGREEMENT

FOR NON-EMPLOYEE DIRECTORS

Express Scripts Holding Company, a Delaware corporation (“Company”), has granted you (“Optionee”) an option to purchase shares of common stock of the Company, $0.01 par value per share (“Common Stock”), pursuant to the terms and conditions set forth in your Stock Option Grant Notice (“Grant Notice”) and this Stock Option Agreement (“Option Agreement”).

The Option is granted pursuant to the Express Scripts, Inc. 2011 Long-Term Incentive Plan, as amended from time to time (the “Plan”), pursuant to which options, and other awards, may be granted to Non-Employee Directors of the Company. Except as otherwise specifically set forth herein, all capitalized terms utilized herein (including on Schedule 1 hereto) shall have the respective meanings ascribed to them in the Plan

The details of your Option are as follows:

1. Grant of Option . Pursuant to an action of the Board and or a committee authorized by the Board, the Company hereby grants to Optionee an option to purchase shares of Common Stock (the “Option”), subject to the terms and conditions described herein. The number of shares of Common Stock subject to your Option and the Exercise Price Per Share are set forth in the Grant Notice.

2. Term, Vesting and Forfeiture .

(a) Term . This Option may be exercised only within the Term set forth in the Grant Notice, and may be exercised during such Term only in accordance with the Plan and the terms of this Option Agreement.

(b) Time Vesting . The Option shall vest in one or more installments in accordance with the Vesting Schedule set forth on the Grant Notice, with the vesting of each installment subject to the Optionee’s continued service as a member of the Board through the applicable vesting date, subject to the terms hereof.

(c) Accelerated Vesting . Any Option, or portion thereof, which has not yet vested under subparagraph (b) above shall, upon the occurrence of a Change in Control or the termination of the Optionee’s continued service as a member of the Board, vest or be forfeited in accordance with the provisions of the Plan, and the terms of this Agreement (including Schedule 1 hereto).

(d) Forfeiture of Option . If Optionee’s service as a member of the Board terminates for any reason, Optionee shall forfeit all rights with respect to any portion of the Option that has not yet vested as of the effective date of the termination, except to the extent such Award vests upon such termination under Paragraph 2(c).

3. Exercise of Option .

(a) Right to Exercise . This Option is exercisable during its Term in accordance with the Vesting Schedule set forth in the Grant Notice and the applicable provisions of the Plan and this Option Agreement.


(b) Method of Exercise . This Option is exercisable pursuant to the procedures for exercise provided from time to time by the Company and/or by a third-party vendor selected by the Company. The Option exercise shall require payment of the aggregate exercise price as to all exercised shares. The method of payment of the aggregate exercise price shall be in a form approved by the Company in accordance with Section 7(a)(ii) of the Plan. This Option shall be deemed to be exercised upon receipt and approval by the Company (or the appropriate third party) of all required exercise notices, together with full payment of the exercise price and such additional documents as the Company (or the third-party vendor) may then require. The Company may cause, or authorize its third-party to vendor to cause, the vested portion of this Option to automatically be exercised on the Expiration Date for such Option, to the extent it has not previously been exercised or forfeited.

4. Incorporation of the Plan by Reference; Conflicting Terms . The Option is granted under, and expressly subject to, the terms and provisions of the Plan, which terms and provisions are incorporated herein by reference. Optionee hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof. In the event of any conflict between the terms of the Plan and the terms of this Agreement, the terms and provisions of the Plan shall govern.

5. Non-Transferability of Option . This Option may not be transferred in any manner otherwise than by will or by the laws of descent or distribution and may be exercised during the lifetime of Optionee only by Optionee. The terms of the Plan and this Option Agreement shall be binding upon the executors, administrators, heirs, successors and assigns of Optionee.

6. Stockholder Rights . Optionee shall not have any stockholder rights with respect to the shares of Common Stock granted pursuant to this Option until Optionee shall have exercised the Option in accordance with Section 3 hereof.

7. Adjustments Upon Changes in Capitalization or Corporate Acquisitions . Should any change be made to the Common Stock by reason of any Fundamental Change, divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off or other relevant change, appropriate adjustments shall be made to (a) the total number and/or class of securities subject to this Option, and (b) the Exercise Price Per Share set forth in the Grant Notice in order to reflect such change and thereby preclude a dilution or enlargement of benefits hereunder.

8. Compliance with Laws and Regulations . Notwithstanding anything herein to the contrary, no shares of Common Stock shall be issued pursuant to the exercise of this Option unless such issuance and exercise complies with all relevant provisions of law and the requirements of any stock exchange or quotation service upon which the shares of Common Stock are then listed.

9. Board Discretion . This Option has been granted pursuant to a determination made by the Board and/or one or more committees of the Board (as delegated by the Board). Notwithstanding anything to the contrary herein, and subject to the limitations of the Plan, the Board or its delegated committee(s) shall have plenary authority to: (a) interpret any provision of this Agreement or the Option; (b) make any determinations necessary or advisable for the administration of this Agreement or the Option; (c) make adjustments as it deems appropriate to the aggregate number and type of securities available under this Agreement to appropriately adjust for, and give effect to, any Fundamental Change, divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off or other relevant change; and (d) otherwise modify or amend any provision hereof, or otherwise with respect to the Option, in any manner that does not materially and adversely affect any right granted to Optionee by the express terms hereof, unless required as a matter of law, subject to the limitations stated in the Plan.


10. Tax Withholding . To the extent applicable and required by law, at the time Optionee exercises his or her Option, in whole or in part, the Company shall withhold from Optionee’s compensation any required taxes, including social security and Medicare taxes, and federal, state and local income tax, with respect to the income arising from the exercise of the Option under this Agreement. The Company shall have the right to require the payment of any such taxes before delivering any shares of Common Stock upon the exercise of the Option, or any portion thereof. Optionee may elect to have any such withholding obligations satisfied by: (i) delivering cash; (ii) delivering part or all of the withholding payment in previously owned shares of Common Stock; and/or (iii) irrevocably directing the Company to reduce the number of shares that would otherwise be issued to Optionee upon the exercise of the Option that number of whole shares of Common Stock having a fair market value, determined by the Company, in its sole discretion, equal to the amount of tax required to be withheld, but not to exceed the Company’s required minimum statutory withholding.

11. Electronic Delivery . The Company may choose to deliver certain statutory or regulatory materials relating to the Plan in electronic form, including without limitation securities law disclosure materials. Without limiting the foregoing, by accepting this Option, Optionee hereby agrees that the Company may deliver the Plan prospectus and the Company’s annual report to Optionee in an electronic format. If at any time Optionee would prefer to receive paper copies of any document delivered in electronic form, the Company will provide such paper copies upon written request to the Investor Relations department of the Company.

12. No Right to Continued Service on the Board . Nothing in this Agreement shall be deemed to create any limitation or restriction on or otherwise affect such rights as the Company, the stockholders of the Company, or the Board otherwise would have to remove Optionee from the Board, to exclude Optionee from any slate of nominees for election to the Board, or to otherwise terminate Optionee’s service on the Board at any time for any reason.

13. Entire Agreement . This Agreement, including Schedule 1 hereto, and the Plan contain the entire understanding of the parties with respect to the subject matter hereof and supersede all prior agreements, understandings and negotiations between the parties.

14. Governing Law . To the extent federal law does not otherwise control, this Agreement shall be governed by the laws of Delaware, without giving effect to principles of conflicts of laws.


SCHEDULE 1 TO EXHIBIT A

TERMINATION AND CHANGE IN CONTROL PROVISIONS UNDER THE

EXPRESS SCRIPTS, INC. 2011 LONG-TERM INCENTIVE PLAN

STOCK OPTION GRANT NOTICE

FOR NON-EMPLOYEE DIRECTORS

I. Termination of Service of Non-Employee Director

(A) Generally . Except as provided herein, if Optionee’s service as a member of the Board terminates, then any portion of the Option that has not vested as of the date of such termination shall terminate as of such date, and the unvested portion of the Option shall be forfeited to the Company without payment therefor.

(B) Death. If Optionee’s service as a member of the Board terminates because of his or her death, then the Option, to the extent it has not expired or been terminated, shall vest and become exercisable in full, and may be exercised by the Optionee’s Successor at any time, or from time to time, within one year after the date of Optionee’s death.

(C) Disability . If Optionee’s service as a member of the Board terminates because of Disability, then the Option, to the extent it has not expired or been terminated, shall vest and become exercisable in full, and Optionee or Optionee’s Successor may exercise such Option at any time, or from time to time, within one year after the date of Optionee’s Disability.

(D) Retirement . The termination of Optionee’s service as a member of the Board after attainment of age 65 for any reason other than death or Disability shall be considered a Retirement, subject to the following:

 

  1. Tenured Retirement . After attainment of age 70, Optionee’s Retirement shall be deemed to be a “Tenured Retirement”. Upon a Tenured Retirement, the Option, to the extent it has not expired or been terminated, shall vest and become exercisable in full, and may be exercised by the Optionee, or Optionee’s Successor at any time, or from time to time, up to and including the date the Option expires.

 

  2. Early Retirement . If Optionee has attained the age of 65, but not age 70, and has at least ten years of service on the Board, then Optionee’s Retirement shall be deemed to be an “Early Retirement”. Upon an Early Retirement, the following shall occur:

 

  (a) any portion of the Option which has vested but not yet been exercised as of the date of the Retirement shall remain vested and fully-exercisable by the Optionee, or Optionee’s Successor at any time, or from time to time, up to and until the first to occur of (i) the four-year anniversary of the date of the Retirement, or (ii) the date the Option expires;

 

  (b) for any portion of the Option which has not vested, expired or otherwise been terminated as of date of the Retirement, a pro-rata portion thereof (determined as set forth below) shall remain in effect and vest and become exercisable in accordance with the original vesting schedule, and following such vesting shall be fully-exercisable by the Optionee, or Optionee’s Successor at any time, or from time to time, up to and until the first to occur of (i) the four-year anniversary of the date of the Retirement, or (ii) the date the Option expires;


  (c) the pro-rata portion of the Option that continues to vest under the preceding paragraph shall be a percentage which is equal to (i) the number of full months served by Optionee past age 65, divided by (ii) 60. The remaining portion of the Option that is not eligible for continued vesting under the preceding paragraph shall immediately terminate upon Retirement.

 

  3. Death or Disability While Eligible for Retirement . If Optionee’s service as a member of the Board terminates because of his or her death or Disability and, at the time of such termination of service on the Board Optionee would have been eligible for either a Tenured Retirement or an Early Retirement, Optionee or Optionee’s Successor may elect to have the Option treated as if Optionee’s service had terminated due to such applicable form of Retirement (rather than due to death or Disability, as applicable). Such election shall be made through the delivery of an irrevocable notice indicating such desired treatment to the Company’s General Counsel no less than 60 days after the date of Optionee’s death or Disability (as applicable).

 

  4. Standard Retirement . Any Retirement that is not either a Tenured Retirement or an Early Retirement shall be deemed to be a Standard Retirement.

(E) Reasons other than Death, Disability, Tenured Retirement, Early Retirement or Termination for Cause . If Optionee’s service as a member of the Board terminates due to a Standard Retirement or for any other reason other than death, Disability, Tenured Retirement or Early Retirement, then the Option, to the extent it has not expired or been terminated, shall remain exercisable for one year after termination of Optionee’s service on the Board, but only to the extent that such Option was exercisable immediately prior to Optionee’s termination of service.

(F) Expiration of Term . Any portion of the Option that remains unexercisable upon termination of service as a member of the Board (after taking into account the foregoing paragraphs (A)-(E), and except as specifically provided in the foregoing paragraph (D)(3)) shall terminate immediately upon such termination of service as a member of the Board. Any portion of the Option that is, or becomes, exercisable upon termination of service as a member of the Board (or thereafter pursuant to the foregoing paragraph (D)(3)) which is not exercised within the applicable period set forth in the foregoing paragraphs (A)-(E) shall terminate as of the end of the applicable period described in such paragraphs; provided, however, that the Company may cause, or authorize its third-party to vendor to cause, any remaining vested portion of the Option to automatically be exercised on the last date of the applicable period, to the extent it has not previously been exercised or forfeited. Notwithstanding the foregoing, or any other provision of the Plan, the Stock Option Agreement, the Grant Notice, or this Schedule 1, in no event shall the Option be exercisable after expiration of the Term.

II. Change in Control

(A) Acceleration of Vesting Upon Change in Control After Which No Public Market for Company or Exchange Stock Exists

(i) Acceleration of Vesting . Upon the occurrence of a Change in Control after which there will be no generally recognized U.S. public market for the Company’s Common Stock or any common stock for which the Company’s Common Stock is exchanged, the Option, to the extent it has not expired or been terminated, shall, to the extent not yet exercisable, vest and become exercisable in full.


(ii) Company Payment . Upon the occurrence of a Change in Control transaction after which there will be no generally recognized U.S. public market for the Company’s Common Stock or any common stock for which the Company’s Common Stock is exchanged, on the Change in Control Date the Option shall be automatically cancelled without further action by the Company or the Optionee, and the Company shall provide payment in connection with such cancellation at a per share price equal to the excess (if any) of the Change in Control Price (as defined below) over the exercise price of the Option. The Change in Control Price shall mean the value, expressed in dollars, as of the date of receipt of the per share consideration received by the Company’s stockholders whose stock is acquired in a transaction constituting a Change in Control. In case such all or part of such consideration shall be in a form other than cash, the value of such consideration shall be as determined in good faith by a majority of the Board of Directors based on a written opinion by a nationally recognized investment banking firm, whose determination shall be described in a statement furnished to Participants.

(B) Acceleration of Vesting Upon Other Change in Control Transactions . Upon the occurrence of a Change in Control after which there remains a generally recognized U.S. public market for the Company’s Common Stock or for any common stock for which the Company’s Common Stock is exchanged, the Option, to the extent it has not expired or been terminated, shall vest and become exercisable in full and shall remain exercisable for the remainder of the Term.

(C) Options Not Assumed . Notwithstanding anything herein to the contrary, the Board may provide for such other treatment of the Option as the Board may determine in its sole discretion with respect to the Option if it is not assumed or is cancelled in connection with a Change in Control.

Exhibit 31.1

I, George Paz, certify that:

 

1) I have reviewed this quarterly report on Form 10-Q of Express Scripts Holding Company;

 

2) Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

3) Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

4) The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

  a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

  b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

 

  c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

  d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

5) The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

  a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

  b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

 

Date: August 7, 2012

  /s/George Paz
  George Paz, Chairman, President and
  Chief Executive Officer

Exhibit 31.2

I, Jeffrey Hall, certify that:

 

1) I have reviewed this quarterly report on Form 10-Q of Express Scripts Holding Company;

 

2) Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

3) Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

4) The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

  a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

  b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

 

  c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

  d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

5) The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

  a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

  b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

 

Date: August 7, 2012

  /s/Jeffrey Hall
  Jeffrey Hall, Executive Vice President and
  Chief Financial Officer

Exhibit 32.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AND EXCHANGE ACT RULE 13a-14(b)

In connection with the accompanying Form 10-Q (the “Report”) of Express Scripts Holding Company (the “Company”) for the period ended June 30, 2012, I, George Paz, Chairman, President and Chief Executive Officer of the Company, certify, to the best of my knowledge, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, and Exchange Act Rule 13a-14(b) that:

 

  (1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

 

  (2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

 

BY:    /s/George Paz
  George Paz
  Chairman, President and
  Chief Executive Officer
  Express Scripts Holding Company

Date: August 7, 2012

Exhibit 32.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AND EXCHANGE ACT RULE 13a-14(b)

In connection with the accompanying Form 10-Q (the “Report”) of Express Scripts Holding Company (the “Company”) for the period ended June 30, 2012, I, Jeffrey Hall, Executive Vice President and Chief Financial Officer of the Company, certify, to the best of my knowledge, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, and Exchange Act Rule 13a-14(b) that:

 

  (1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

 

  (2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

 

BY:    /s/Jeffrey Hall
  Jeffrey Hall
  Executive Vice President and Chief Financial Officer
  Express Scripts Holding Company

Date: August 7, 2012