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As filed with the Securities and Exchange Commission on February 5, 2021

Registration No. 333-                

 

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM S-1

REGISTRATION STATEMENT

UNDER

THE SECURITIES ACT OF 1933

 

 

Oscar Health, Inc.

(Exact name of registrant as specified in its charter)

 

Delaware   6324   46-1315570
(State or other jurisdiction of incorporation or organization)   (Primary Standard Industrial Classification Code Number)  

(I.R.S. Employer

Identification No.)

75 Varick Street, 5th Floor

New York, New York 10013

(646) 403-3677

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

 

 

Bruce L. Gottlieb, Esq.

Special Counsel

Oscar Health, Inc.

75 Varick Street, 5th Floor

New York, New York 10013

(646) 403-3677

(Name, address, including zip code, and telephone number, including area code, of agent for service)

 

 

Copies to:

 

Keith L. Halverstam, Esq.
Peter N. Handrinos, Esq.
Latham & Watkins LLP
885 Third Avenue
New York, New York 10022
(212) 906-1200
  Joseph C. Theis, Jr., Esq.
Paul R. Rosie, Esq.
Goodwin Procter LLP
100 Northern Avenue
Boston, Massachusetts 02210
(617) 570-1000

 

 

APPROXIMATE DATE OF COMMENCEMENT OF PROPOSED SALE TO THE PUBLIC: AS SOON AS PRACTICABLE AFTER THIS REGISTRATION STATEMENT IS DECLARED EFFECTIVE.

 

 

If any of the securities being registered on this form are to be offered on a delayed or continuous basis pursuant to Rule 415 under the Securities Act of 1933, check the following box.  

If this form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.  

If this form is a post-effective amendment filed pursuant to Rule 462(c) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.  

If this form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.  

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

 

Large accelerated filer      Accelerated filer  
Non-accelerated filer      Smaller reporting company  
     Emerging growth company  

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 7(a)(2)(B) of the Securities Act.  

 

 

CALCULATION OF REGISTRATION FEE

 

 

Title of each class of securities to be registered  

Proposed

maximum

aggregate
offering price(1)(2)

  Amount of
registration fee

Class A Common Stock, $0.00001 par value per share

  $100,000,000   $10,910

 

 

 

(1)

Estimated solely for the purpose of calculating the registration fee pursuant to Rule 457(o) under the Securities Act of 1933, as amended.

 

(2)

Includes the offering price of shares of Class A common stock that may be sold if the option to purchase additional shares of Class A common stock granted by the Registrant to the underwriters is exercised. See “Underwriting.”

The Registrant hereby amends this Registration Statement on such date or dates as may be necessary to delay its effective date until the Registrant shall file a further amendment which specifically states that this Registration Statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933, as amended, or until the Registration Statement shall become effective on such date as the Securities and Exchange Commission, acting pursuant to said Section 8(a), may determine.

 

 

 


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The information in this preliminary prospectus is not complete and may be changed. These securities may not be sold until the registration statement filed with the Securities and Exchange Commission is effective. This preliminary prospectus is not an offer to sell nor does it seek an offer to buy these securities in any jurisdiction where the offer or sale is not permitted.

 

Subject to Completion. Dated February 5, 2021.

             Shares

 

 

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Oscar Health, Inc.

Class A Common Stock

 

 

This is the initial public offering of shares of Class A common stock of Oscar Health, Inc. We are selling                shares of Class A common stock, and the selling stockholders named in this prospectus are selling              shares of Class A common stock. We will not receive any proceeds from the sale of shares by the selling stockholders.

Prior to this offering, there has been no public market for our Class A common stock. It is currently estimated that the initial public offering price per share of Class A common stock will be between $                 and $                . We intend to apply to list our Class A common stock on the New York Stock Exchange, or the NYSE, under the symbol “OSCR.”

Upon completion of this offering, we will have two classes of common stock: Class A common stock and Class B common stock. The rights of the holders of Class A common stock and Class B common stock will be identical, except with respect to voting, conversion, and transfer rights. Each share of Class A common stock will be entitled to one vote. Each share of Class B common stock will be entitled to 20 votes and will be convertible at any time into one share of Class A common stock and mandatorily convertible upon the occurrence of certain events, as further described in “Description of Capital Stock.” Thrive Capital (as defined herein), which is affiliated with our Co-Founder Joshua Kushner, and Mario Schlosser, our other Co-Founder, will be the only holders of our Class B common stock, and following the completion of this offering, Thrive Capital and our Co-Founders will beneficially own approximately                 % of the voting power of our outstanding capital stock, assuming no exercise of the underwriters’ option to purchase additional shares of our Class A common stock. See “Description of Capital Stock.”

Upon completion of this offering, we will be a “controlled company” as defined under the corporate governance rules of the NYSE.

We are an “emerging growth company,” as defined in Section 2(a) of the Securities Act of 1933, as amended, and, as such, will be subject to reduced public company reporting requirements. See “Prospectus Summary—Implications of Being an Emerging Growth Company.”

 

 

Investing in our Class A common stock involves risks. See “Risk Factors” beginning on page 21 to read about factors you should consider before buying shares of our Class A common stock.

 

 

Neither the Securities and Exchange Commission nor any state securities commission or any other regulatory body has approved or disapproved of these securities or passed upon the accuracy or adequacy of this prospectus. Any representation to the contrary is a criminal offense.

 

 

 

     Per Share      Total  

Initial public offering price

   $                    $                

Underwriting discounts and commissions(1)

   $        $    

Proceeds, before expenses, to us

   $        $    

Proceeds, before expenses, to the selling stockholders

   $        $    

 

(1)

See “Underwriting” for a description of the compensation payable to the underwriters.

At our request, the underwriters have reserved up to three percent of the shares of Class A common stock offered by this prospectus for sale, at the initial public offering price, to certain persons associated with us. See “Underwriting—Directed Share Program.”

We have granted the underwriters an option for a period of 30 days to purchase up to an additional                  shares of Class A common stock from us at the public offering price, less the underwriting discounts and commissions.

 

 

The underwriters expect to deliver the shares against payment in New York, New York on                , 2021.

 

Goldman Sachs & Co. LLC   Morgan Stanley   Allen & Company LLC
Wells Fargo Securities   BofA Securities   Credit Suisse
Cowen                       LionTree                    Ramirez & Co., Inc.   Siebert Williams Shank

 

 

Prospectus dated                 , 2021.


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529,000

 

   47%

 

members 1

  

 

of subscribing members are
monthly active users 2

LOGO    LOGO

 

89%

  

 

68%

 

of subscribing members have
interacted with our digital or
Care Team channels 2

  

 

of surveyed members indicate
that they trust Oscar to advise
them on how and where to get
the health care they need 2

 

 

1 

as of January 31, 2021

2 

as of December 31, 2020


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Letter from Joshua Kushner and Mario Schlosser

Co-Founders

Many founders’ letters, especially in health care, open with a story about a personal experience that led to the founding of the company. We did have those eye-opening events in 2012–a leg injury for Josh and the birth of a first child for Mario–and they did in fact lead us to create Oscar.

But we’d like to start by telling you about our name. Oscar is named for a real person, Josh’s great-grandfather. He was an immigrant to America. His given name was not Oscar. But that’s the name he got at Ellis Island, and he stuck with it.

When it came time to start our business, we wanted to let our members know that we were not a faceless health insurer whose logo lives on a card in their wallets. We wanted to communicate that we could help them navigate the health care landscape like a doctor in the family would. So we chose a real name–of somebody whose life story inspires us–to say that we intend to serve them like a real-life human and not a disembodied corporation.

In our first year, we placed subway ads in New York that said: “Hi, we’re Oscar, a new kind of health insurer.” We love when people tell us that they remember those ads. It tells us that our message got through.

Oscar was also inspired by the doctor who took care of Mario and his family growing up. Mario was born in a small town in Germany. His hometown doctor began his day in the clinic and every afternoon hopped on his bike to visit patients. Seeing patients in their homes let him head off small problems before they became big problems. Being under his care was, in fact, like having a doctor in the family.

When Mario moved to the U.S. as an adult he learned how unusual that experience sounded to American ears. He saw that the reason wasn’t any lack of dedication among American caregivers. It was because of the fee-for-service system–a system that produces worse outcomes than in other countries, and at a higher cost. As a computer scientist, Mario wondered whether technology could deliver the experience of a doctor in the family–but this time at scale.

Oscar today is eight years old. We’ve grown a lot in that time. We signed up 15,000 members in New York in our first year and are proud to serve 529,000 members in 18 states today. We are prouder still that we lead our market category when it comes to members who say they would recommend us to their friends. That tells us that we are living up to our name.

How do we do this? It may sound counterintuitive, but we bring a human touch to health care through the use of technology and data. We were inspired by consumer businesses that use the power of computer science to make complex decisions simple and intuitive for their customers. We believed this approach could transform health care just as it has so many other fields.

We knew from the beginning that this would require building a full-stack platform that we control end-to-end. We understood it would make the challenge of being a startup health insurer even harder. But we believed it was the only way to create a differentiated member experience.

Now, nearly a decade in, we have entered the phase where our technology investment is truly beginning to compound. We still continuously improve our platform with more than 50 code updates each day. But our core systems are now mature and give us a window into nearly every health care interaction our members have. Our technology lets us help members find the right doctor, access virtual care, and powers Care Teams that assist them in navigating the health care system. It also lets us constantly test, re-test, and optimize based on real-time data, like the very best tech companies that inspired us.


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We also embrace the opportunity to be a health insurer. This may seem counterintuitive to many, especially given our own unpleasant experiences with the system. But health insurers are uniquely positioned to improve the lives of individual consumers and the system as a whole. Insurers are the only entities in health care who have the same incentives as consumers–to find quality care at an affordable price–and that are involved in nearly every health care interaction. This gives us unique leverage to help bend the cost curve and improve access to care. Most of our members in the individual market could not have gotten affordable insurance coverage 10 years ago. Serving them is a privilege for all of us at Oscar.

We are sometimes asked whether Oscar is a tech company or a health care company. Our answer is that we use the tools and mindset of a consumer technology company to solve problems in health care. In the beginning it seemed next to impossible to assemble a team that could do both. Today Oscar is powered by over 1,800 employees, including our engineers, doctors, nurses, actuaries, data scientists, and insurance experts. We are grateful for what they have taught us–and each other. After nearly a decade, we truly have one foot in consumer technology and the other in health care, making what was once a challenge now one of our biggest competitive advantages.

As we look to our next decade, we are eager to tackle the opportunities and challenges that lie ahead. U.S. health care continues to individualize, digitize, and move towards value. We believe Oscar can play a significant role in powering that transformation.

What will not change is our mission–to make a healthier life affordable and accessible to all—which will remain inspired by those who led us to begin this journey in the first place.

As we expand to new markets, new geographies, and new product lines, we would be honored to serve you as Oscar members. We are equally honored to welcome you as shareholders into the next chapter of Oscar’s history.

Josh and Mario


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TABLE OF CONTENTS

 

     Page  

About this Prospectus

     i  

Prospectus Summary

     1  

Risk Factors

     21  

Cautionary Note Regarding Forward-Looking Statements

     61  

Use of Proceeds

     63  

Dividend Policy

     64  

Capitalization

     65  

Dilution

     68  

Selected Consolidated Financial Data

     71  

Management’s Discussion and Analysis of Financial Condition and Results of Operations

     72  

Business

     99  

Management

     134  

Executive Compensation

     143  

Principal and Selling Stockholders

     161  

Certain Relationships and Related Party Transactions

     167  

Description of Capital Stock

     172  

Description of Certain Indebtedness

     183  

Shares Eligible for Future Sale

     185  

Material U.S. Federal Income Tax Considerations for Non-U.S. Holders of Class A Common Stock

     189  

Underwriting

     194  

Legal Matters

     204  

Change in Accountants

     205  

Experts

     207  

Where You Can Find More Information

     208  

Index to Consolidated Financial Statements

     F-1  

 

 

Through and including                     , 2021 (the 25th day after the date of this prospectus), all dealers effecting transactions in these securities, whether or not participating in this offering, may be required to deliver a prospectus. This is in addition to a dealer’s obligation to deliver a prospectus when acting as an underwriter and with respect to an unsold allotment or subscription.

You should rely only on the information contained in this prospectus and any free writing prospectus prepared by or on behalf of us that we have referred to you. We, the selling stockholders, and the underwriters have not authorized anyone to provide you with additional or different information. If anyone provides you with additional, different, or inconsistent information, you should not rely on it. Offers to sell, and solicitations of offers to buy, shares of our Class A common stock are being made only in jurisdictions where offers and sales are permitted. The information contained in this prospectus is accurate only as of the date of this prospectus, regardless of the time of delivery of this prospectus or of any sale of shares of our Class A common stock. Our business, financial condition, operating results, and prospects may have changed since such date.

No action is being taken in any jurisdiction outside the United States to permit a public offering of our Class A common stock. Persons who come into possession of this prospectus in jurisdictions outside the United States are required to inform themselves about and to observe any restriction as to this offering and the distribution of this prospectus applicable to those jurisdictions. See “Underwriting.”

 

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ABOUT THIS PROSPECTUS

Certain Definitions

As used in this prospectus, unless the context otherwise requires:

 

   

we,” “us,” “our,” “our business,” the “Company,” “Oscar,” and similar references refer to Oscar Health, Inc., formerly known as Mulberry Health Inc., and its subsidiaries.

 

   

Holdco” refers only to Oscar Health, Inc. and not any of its subsidiaries.

 

   

ACA” refers to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended.

 

   

Annual Election Period” refers to the yearly period when beneficiaries can enroll or disenroll in an Original Medicare or Medicare Advantage health plan. The Annual Election Period starts on October 15 and ends on December 7 of each year.

 

   

APTC” refers to advanced premium tax credits.

 

   

Co-Founders” refers to Joshua Kushner and Mario Schlosser.

 

   

direct policy premium” refers to monthly premiums collected from our members and/or from the federal government during the period indicated, before risk adjustment and reinsurance.

 

   

full stack technology platform” refers to our cloud-based end-to-end technology solution, which powers our differentiated member experience engine. Our platform connects our member-facing features, including our mobile application, which we refer to as our app, website, and virtual care solutions with our back-office tools that span all critical health care insurance and technology domains, including member and provider data, utilization management, claims management, billing, and benefits.

 

   

Health Insurance Marketplaces” refers to the health insurance marketplaces established per the ACA and operated by the federal government for most states and other marketplaces operated by individual states, for individuals and small employers to purchase health insurance coverage in the Individual and Small Group markets that include minimum levels of benefits, restrictions on coverage limitations and premium rates, and APTC.

 

   

health insurance subsidiary” refers to any subsidiary of Oscar Health, Inc. that has applied for or received a license, certification or authorization to sell health plans by any state Department of Insurance, Department of Financial Services, Department of Health, or comparable regulatory authority. As of December 31, 2020, Oscar Health, Inc. had 14 health insurance subsidiaries.

 

   

health plans” refers to the health insurance plans that Oscar sells in the Individual and Small Group markets and the Medicare Advantage Plans that Oscar sells in the Medicare Advantage market. The term includes co-branded health plans sold directly by our health insurance subsidiaries, in the case of our Cleveland Clinic + Oscar, Montefiore + Oscar, and Oscar + Holy Cross + Memorial Health plans, and co-branded plans sold directly by our partner and partially-reinsured by a health insurance subsidiary, in the case of the Cigna + Oscar plan.

 

   

IBNR” refers to health care costs incurred but not yet reported.

 

   

InsuranceCo Administrative Expense Ratio” is defined as provided in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Operating and Non-GAAP Financial Metrics—InsuranceCo Administrative Expense Ratio.”

 

   

InsuranceCo Combined Ratio” is defined as the sum of MLR and InsuranceCo Administrative Expense Ratio.

 

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Medical Loss Ratio” or “MLR” is defined as provided in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Operating and Non-GAAP Financial Metrics—Medical Loss Ratio.”

 

   

member” refers to any individual covered by any of our health plans. A member covered under more than one of our health plans counts as a single member for the purposes of this metric. Our membership is measured as of a particular point in time and may decrease over time as individuals disenroll throughout the year before they become effectuated members.

 

 

   

monthly active users” refers to the total number of members who have logged into our website or app or contacted their Care Teams for the month of December 2020.

 

   

NPS” refers to net promoter score, which can range from a low of negative 100 to a high of positive 100. NPS benchmarks can vary significantly by industry, but a score greater than zero represents a company that has more promoters than detractors. For Oscar, NPS reflects member responses to the following question—“On a scale of zero to ten: How likely is it that you would recommend Oscar to a friend or colleague?” Responses of 9 or 10 are considered “promoters,” responses of 7 or 8 are considered neutral or “passives,” and responses of 6 or less are considered “detractors.” We then subtract the number of respondents who are detractors from the number of respondents who are promoters, divide that number by the total number of respondents, and then multiply the resulting figure by 100. We use this method to calculate an NPS score for each member segment, where a member segment is defined by a region and subsidization level of a member. We then calculate our aggregate NPS by taking a weighted average of the segments, where the weights reflect the actual representation of that segment in our aggregate membership. We do this to adjust for differing survey rates and response rates to our survey in different segments of our membership. Our methodology for calculating NPS reflects responses from our members who choose to respond to the survey question. In particular, our NPS reflects responses given to us between January 1, 2020 and December 31, 2020, and reflects a sample size of 16,651 responses over that period. NPS gives no weight to members who decline to answer the survey question.

 

   

Open Enrollment Period” refers to the yearly period when individuals and families can enroll in a health plan or make changes to an existing health plan. In most states, the 2021 open enrollment period for the Individual market started on November 1, 2020 and ended on December 15, 2020; it ended as late as January 31, 2021 in certain states in which Oscar does business. The Medicare Advantage Open Enrollment Period, which permits switching between Medicare Advantage plans, started on January 1, 2021 and ends on March 31, 2021.

 

   

PMPM” refers to per member per month.

 

   

Special Enrollment Period” refers to a time outside the Open Enrollment Period or Annual Election Period when an eligible person can enroll in a health plan or make changes to an existing health plan. A person is generally eligible for a special enrollment period if certain qualifying life events occur, such as losing certain health coverage, moving, getting married, having a baby, or adopting a child.

 

   

subscribing member” refers to the individual who has been designated the primary member under an Oscar account. Each Oscar account consists of one subscribing member and may include additional covered members, such as the subscribing member’s spouse and children. Numbers quoted for “subscribing members” throughout this prospectus include only subscribers 18 years of age and older.

 

   

Thrive Capital” refers to Thrive Capital Management, LLC, a Delaware limited liability company, and the investment funds affiliated with or advised by Thrive Capital Management, LLC.

 

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Rounding Adjustments

Certain monetary amounts, percentages, and other figures included in this prospectus have been subject to rounding adjustments. Percentage amounts included in this prospectus have not in all cases been calculated on the basis of such rounded figures, but on the basis of such amounts prior to rounding. For this reason, percentage amounts in this prospectus may vary from those obtained by performing the same calculations using the figures in our consolidated financial statements or the figures included elsewhere in this prospectus. Certain other amounts that appear in this prospectus may not sum due to rounding.

 

TRADEMARKS, SERVICE MARKS, AND TRADE NAMES

This prospectus includes our trademarks, service marks, and trade names, including but not limited to Oscar®, Oscar Health®, Oscar CareSM, and our logo, which are protected under applicable intellectual property laws. This prospectus also contains trademarks, service marks, and trade names of other companies, which are the property of their respective owners. We do not intend our use or display of other parties’ trademarks, service marks, or trade names to imply, and such use or display should not be construed to imply, a relationship with, or endorsement or sponsorship of us by, these other parties. Solely for convenience, trademarks, service marks, and trade names referred to in this prospectus may appear without the ®, , or SM symbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent permitted under applicable law, our rights or the right of the applicable licensor to these trademarks, service marks, and trade names.

MARKET AND INDUSTRY DATA

This prospectus includes estimates regarding market and industry data. Unless otherwise indicated, information concerning our industry and the markets in which we operate, including our general expectations, market position, market opportunity, and market size, are based on management’s knowledge and experience in the markets in which we operate, together with currently available information obtained from various sources, including publicly available information, industry reports and other publications, reports from government agencies, surveys, our members and providers, and other contacts in the markets in which we operate. Certain information is based on management estimates, which have been derived from third-party sources, as well as data from our internal research, and are based on certain assumptions that we believe to be reasonable.

In presenting this information, we have made certain assumptions that we believe to be reasonable based on such data and other similar sources and on our knowledge of, and our experience to date in, the markets in which we operate. While we believe the market and industry data included in this prospectus and upon which the management estimates included herein are in part based are generally reliable, such information is inherently uncertain and imprecise, and you are cautioned not to give undue weight to such data or the management estimates based on such data. Market and industry data are subject to change and may be limited by the availability of raw data, the voluntary nature of the data gathering process and other limitations inherent in any statistical survey of such data. Certain of these publications, studies and reports were published before the COVID-19 pandemic and therefore do not reflect any impact of COVID-19 on any specific market or globally. In addition, projections, assumptions, and estimates of the future performance of the markets in which we operate and our future performance are necessarily subject to uncertainty and risk due to a variety of factors, including those described in “Risk Factors,” “Cautionary Note Regarding Forward-Looking Statements,” and “Management’s Discussion and Analysis of Financial Condition and Results of

 

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Operation.” These and other factors could cause results to differ materially from those expressed in the estimates made by third parties and by us. Accordingly, you are cautioned not to place undue reliance on such market and industry data or any other such estimates. The content of, or accessibility through, the sources and websites identified herein, except to the extent specifically set forth in this prospectus, does not constitute a portion of this prospectus and is not incorporated herein, and any websites are an inactive textual reference only. In addition, references to third-party publications and research reports herein are not intended to imply, and should not be construed to imply, a relationship with, or endorsement of us by, the third-party producing any such publication or report.

 

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PROSPECTUS SUMMARY

This summary highlights selected information contained elsewhere in this prospectus. This summary does not contain all of the information that you should consider before deciding to invest in our Class A common stock. You should read the entire prospectus carefully, including the sections entitled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and our consolidated financial statements and the related notes included elsewhere in this prospectus, before making an investment decision. Some of the statements in this prospectus constitute forward-looking statements. See “Cautionary Note Regarding Forward-Looking Statements.”

Overview

At Oscar, we make a healthier life accessible and affordable for all.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar over eight years ago to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family, helping us navigate the health care system in our moments of greatest need. In the years since, we have built a suite of services that permit us to earn our members’ trust, leverage the power of personalized data, and help our members find quality care they can afford. We call this our member engagement engine, and it is powered by a differentiated full stack technology platform that will allow us to continue to innovate like a technology company and not a traditional insurer in the years ahead.

After eight years of selling health insurance, we are proud to have earned industry-leading levels of trust, engagement, and customer satisfaction from the 529,000 members who, as of January 31, 2021, have chosen Oscar. At the same time, we have achieved positive unit economics through a Medical Loss Ratio, or MLR, of 84.7% for the year ended December 31, 2020. We serve 291 counties across 18 states, and our members had over 5 million health care visits in 2020. They include families seeking coverage that works for toddlers and their busy parents, adults with chronic conditions who know their care providers by their first names, and seniors choosing a benefits package that will serve them throughout their retirement years. As we continue to bring the Oscar experience to new members, new states, and new markets, our goal will remain the same: to build engagement, earn trust, and help our members live healthier lives.

Hi, We’re Oscar

We created Oscar because of our own frustrations with U.S. health care. The U.S. health care system is the world’s largest and most expensive—estimated to have cost over $4 trillion in 2020—yet health outcomes are worse than in other advanced economies. Costs are so out of control that medical bills contribute to around 66% of all personal bankruptcies in the United States. It doesn’t have to be this way. According to a report published in the Journal of the American Medical Association in 2019, nearly 25% of health care spending in the U.S. is wasted, the result of a system plagued by misaligned incentives, lack of coordination, and administrative complexities.

Health insurers have substantial influence over the health care ecosystem because they disburse 75 cents of every health care dollar. Despite decades of effort, however, incumbent insurers have made little progress in reigning in health care costs or incentivizing key stakeholders to produce better outcomes. Instead, for far too many consumers, health insurance adds an additional layer of complexity to an already complex system. With an average Net Promoter Score, or NPS, of three, according to Forrester Research, customer satisfaction for health insurers ranks among the lowest of any industry.



 

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We founded Oscar to solve these problems and to provide consumers with access to the affordable, high-quality health care they deserve. We recognized that doing so would require reorienting how customers see their health insurer and what they expect from it. Too often, customers view legacy insurers as entities that merely take in monthly premiums and then pay medical claims. We aimed instead to serve as their guide to a confusing and fragmented system, helping them save money by optimizing their spending. In order to achieve all of this, we would need to earn something that is all too rare in the health insurance industry: member trust. We would need to build a technology platform that provides an intuitive, seamless customer experience, and we would need to leverage the power of personalized data. Though our member experience would begin with trust, engagement, and

the smart use of data, our ultimate goal would be to bend the cost curve by guiding members to the right care at the right time and at the right value.

Our experience to date reaffirms our view that real change in health care can only come from the use of personalized data to drive real-time actionable insights and recommendations, such as guiding members to the right doctor, hospital, or site-of-care through what we call care routing. We know we are on the right track when 68% of surveyed members indicate that they trust Oscar to advise them on how and where to get the health care they need and 75% of subscribing members with a medical visit use our tools to search for a provider. This compares to an industry-wide average of only 45% of surveyed customers who trust their insurer for health care advice, and no comparable or available statistics from our competitors when it comes to care routing. Given the central role that primary care providers, or PCPs, play in managing care, it is especially meaningful that once our members join Oscar nearly half of their first-time PCP visits are to a doctor Oscar has recommended to them. It is the ongoing engagement and trusted relationship we have with our members that drives our NPS score of 30, which is in a different ballpark altogether than the average score of three among other health insurers.

We encourage our members to interact regularly with us through our mobile app and website, which make it easy for them to search for and access their medical history, lab tests, and various care options, as well as to refill prescriptions through our virtual care solution. We also assign each member a dedicated Care Team, typically composed of five Care Guides and a registered nurse known as a Case Manager, who build trust and engagement by providing personalized insights and real-time guidance through the health care system. As of December 31, 2020, 89% of our subscribing members have interacted with our digital or Care Team channels, 81% have a digital profile, almost half have downloaded our app, and our per member app download rate as of December 31, 2020 is approximately nine times higher than for other insurers. Almost half (47%) of our subscribing members are monthly active users.

Additionally, since 2014, all of our members have had 24/7 access to Oscar’s virtual care offerings, in nearly all cases at no additional cost. These include urgent care through our Virtual Urgent Care service and, since January 1, 2021, primary care through our Virtual Primary Care service. Of our subscribing members who have had one or more medical visits, 37% used our in-house virtual offering in 2020. Even before the ongoing COVID-19 pandemic, in the three-month period ended December 31, 2019, the total number of visits through our Oscar virtual program represented nearly one out of five (19%) of the total number of PCP, urgent care, and outpatient emergency room, or ER, visits by our subscribing members. Use of virtual care by our members has further increased during the COVID-19 pandemic.

The combination of our full stack technology platform and member engagement engine allows us to help our members find quality providers, but we understand that value is just as important. Over the next five years, health care costs are expected to grow at 5% to 6% per year, outstripping both inflation



 

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and gross domestic product, or GDP, growth estimates. Whether our members are spending their own out-of-pocket dollars before a deductible is reached or contending with rapid medical cost inflation, we are acutely aware of the need to make sure every consumer health care dollar is well spent. Our fully integrated systems and data infrastructure enable us to efficiently and effectively identify higher quality, lower cost health care providers in our network and our levels of trust and engagement earn us the ability to help our members find the right care.

The value of our proprietary insurance platform has been recognized across the industry as leading health care providers and insurers, including the Cleveland Clinic and Cigna, have chosen to form innovative partnerships with us. While each of these arrangements have unique elements, the common thread is that they are built on our full stack technology platform and member engagement engine. Many partnerships feature co-branding and/or risk-sharing in addition to fee based revenue or value based reimbursement, underscoring the distinctive value that our contributions add. We believe our investment in deeply differentiated technology provides a foundation that will enable us to monetize our platform and diversify our revenue streams over time, if we choose to do so.

We began by offering health plans in the Individual market because we believed it was where our member-first approach would set us apart. When the ACA created new direct-to-consumer channels in 2014, we knew that we would be competing with some of the nation’s largest health insurers. But we also knew we would have a unique window when a new entrant could gain market share rapidly by creating a superior product—one that could ultimately be extended to other insurance markets. After only eight years of selling health insurance in the Individual market, our strategy has proved out. We are the third largest for-profit national insurer in the Individual market in the United States based on publicly reported membership figures for insurers serving the Individual market during plan year 2020, and we expanded to Small Group in 2017 and Medicare Advantage in 2020. Today, we have at least one health plan in 291 counties across 18 states and expect to expand in the years ahead both geographically and with respect to insurance markets.

Since our inception, we have experienced significant member growth while keeping insurance premiums affordable for our members. As of January 31, 2021, we had 529,000 members, up from 82,000 as of January 31, 2017, representing a compound annual growth rate, or CAGR, of 59%, and we had an average individual per member per month, or PMPM, direct policy premium rate of $515 for the month ended January 31, 2021. There can be no assurance that such member growth will continue. For the years ended December 31, 2019 and 2020, after taking into account reinsurance premiums ceded, premiums earned were $468.9 million and $455.0 million, respectively. Our direct policy premiums for the years ended December 31, 2019 and 2020 were $1.3 billion and $2.3 billion, respectively, and we generated net losses of $261.2 million and $406.8 million, respectively.

Health Care Needs to be Reimagined

Though affordability and poor outcomes are the most visible problems with U.S. health care from the consumer perspective, all of the ecosystem’s key stakeholders—consumers, employers, payers, and providers—face serious challenges when it comes to improving the system. As U.S. health care spending approaches 18% of GDP—more than twice the average of other Organization for Economic Co-operation and Development, or OECD, countries—the need for creative solutions from the private sector has never been greater:

 

   

Lack of Consumer-Centric Solutions.    Even though health care decisions are among the most important any consumer will make, it is easier to research the right auto mechanic online



 

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than the right oncologist and more convenient to make a restaurant reservation on a smartphone than to book something as simple as an annual physical. The reason has little to do with what is technologically feasible and everything to do with the skewed incentives created by the U.S. health care system.

 

   

Lack of Coordination and Interoperability.    The health care industry is fragmented and inefficient, with different legacy health insurers, hospital systems, provider groups, and pharmacy networks each possessing distinct incentive structures—some or all of which may diverge from consumers’ interests. Even as consumer demand for greater coordination grows, inflexible and disparate legacy technological systems present a significant barrier to meeting consumers’ wants and needs.

 

   

Lack of Innovation.    As consumers have become more involved in—and financially responsible for—their own health care choices, they seek more personalization, convenience, and value. Consumer demand for new care delivery models—such as virtual, home and mobile—has only accelerated due to the ongoing COVID-19 pandemic. The fee-for-service reimbursement model and fragmented legacy technology systems present serious hurdles for realizing the full benefits that telehealth can bring. We started Oscar to move health care forward and enabling innovative virtual care has been part of our DNA since the beginning.

We Have a Massive Opportunity

The U.S. health care industry is a massive and growing market in the middle of a paradigm shift that creates substantial opportunities for private sector innovation. According to the Centers for Medicare & Medicaid Services, or CMS, health care spending in the U.S. is estimated to have been over $4 trillion in 2020 and is projected to grow to over $6 trillion by 2028. Of the $4 trillion in health care spending, $3 trillion of that amount is estimated to have passed through health insurers in 2020, an amount that is expected to grow to nearly $5 trillion by 2028. Public and private health insurance companies today represent over $1 trillion of enterprise value in the United States alone. The secular shifts toward consumerization, technological innovation, and personalization in health care, along with the accelerating demand for value and accountability, have raised the stakes for health insurers when it comes to providing lasting value to consumers. As the first technology-driven, direct-to-consumer health insurance company, we have built an innovative full stack technology platform that is uniquely positioned to deliver against this challenge.

We currently sell health plans in three markets—Individual, Small Group, and Medicare Advantage—which, in aggregate, serve more than an estimated 50 million Americans and represent an estimated $450 billion in direct policy premiums.

As we scale, our addressable market will continue to expand due to our ability to enable new innovative models of integrated care. Our platform is increasingly modular and able to address large adjacencies within health care technology spend including telemedicine, care concierge, claims management and population health. Our member engagement tools and insurance operations infrastructure have the ability to be deployed alongside other provider and payer networks to enable new risk-based models. Collectively, we estimate these addressable markets represent an additional opportunity of $123 billion, including $40 billion in telemedicine, $20 billion in care concierge, $12 billion in claims management, and $51 billion in population health.

We Are a Differentiated Full Stack Technology Platform

“Full stack” is not a term typically used in the legacy health insurance industry, but it is common in the technology sector, where companies are accustomed to building dynamic technology systems



 

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in-house that can be adjusted on a daily basis to serve the evolving needs of the business on every level. When we launched Oscar, we knew that tackling the challenges of the U.S. health care system would be ambitious. We recognized early on that health care was too broken to fix by simply reconfiguring existing technologies, and we understood that our ability to bend the cost curve would require us to control all of our data and processes before we could empower members with real-time actionable insights. This meant purpose-building a platform from the ground up that we update through code deployments more than 50 times per day. This platform enables us to run nearly 80 automated population health programs, or campaigns, as of December 31, 2020, that allow us to collect data and trigger real-time interventions at scale. We believe we have built our platform to scale and it is broadly applicable across health care and health insurance in the U.S. and abroad. Competitors who lack this member engagement engine will face significant challenges in replicating our consumer experience; we believe our platform thus forms an important structural moat around the innovations we have developed.

Our Strengths

We believe the following strengths will continue to drive our growth in a substantial market opportunity with powerful tailwinds:

 

   

Member-first philosophy.    We founded Oscar with a focus on guiding our members throughout their health care journey. We focus on delivering a better member experience by making health care easier to navigate, more transparent, and more affordable.

 

   

High member engagement and trust drives member satisfaction.    Our member-first philosophy allows us to develop and earn trusted relationships with our members. This deep trust drives higher levels of engagement, allowing us to positively influence how our members make decisions about their health and well-being. This ability to engage members and earn their trust also helps drive our member satisfaction.

 

   

Innovative approach to care.    We offer high-quality and high-value care to our members. Our innovative virtual care model, for example, acts as a front door for members to the health care system either by handling care directly or helping them find the right doctor at the right time. We also include consumer-focused plan design features like our $3 prescription drug tier.

 

   

Differentiated full stack technology platform.    Innovation is core to our DNA. Over the last nine years, we have built a full stack technology platform that combines data science and end-to-end control of the member experience to drive better data, better insights, and better decision-making using a cloud-based platform.

 

   

Powering the broader health care ecosystem.    Our goal is to enable health care’s key stakeholders to deliver better care to consumers in innovative ways using our platform. Our full stack technology platform and member engagement engine have been recognized throughout the industry, allowing us to partner with leading health care companies across the ecosystem, including through co-branded, fee-based, and/or risk-sharing arrangements.

Our Growth Opportunities

We are in the early stages of addressing our market opportunity and reimagining health care in the U.S. The key elements of our growth strategy are to:

 

   

Acquire more members in existing markets and states.    We believe that we have a significant opportunity to expand and grow share within our current footprint of markets and states as we continue to refine our member engagement engine.



 

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Launch new markets and states.    We believe we can substantially grow our member base by launching into new counties and states. Today, we serve members in 291 counties and 18 states in the U.S., and we expect to be able to selectively and strategically expand into new geographies in the future.

 

   

Introduce new products and plans.    Our platform is built to be extensible to new products and plans, and we plan to continue investing and scaling to address the needs of consumers and partners. In 2017, we entered the Small Group market, and in 2020, we expanded our presence in this market with Cigna + Oscar co-branded plans. In 2019, we announced that we would be launching Medicare Advantage, and in 2020, we served our first members in that market.

 

   

Develop new partnerships and evaluate potential acquisitions.    We believe there is substantial opportunity for us to continue partnering with health care’s key stakeholders through innovative fee-based and/or risk-sharing arrangements that reimagine the way health care is delivered. We will also consider growth through acquisition.

 

   

Monetize our platform.    We have made significant investments to build a unique full stack technology platform that enables innovation in the global health care system. We believe we are well-positioned to monetize our platform through risk-sharing partnerships or, even more directly, through fee-based service arrangements. In January 2021, we entered into a services agreement with Health First Shared Services, Inc., for itself and on behalf of certain of its Florida based health plan subsidiaries, or collectively, Health First, pursuant to which we will perform certain administrative functions and services and provide Health First’s individual commercial and Medicare Advantage members with access to our technology platform, largely beginning on January 1, 2022.

Recent Developments

New Revolving Credit Facility

Prior to the completion of this offering or shortly thereafter, we expect to enter into a $200 million revolving credit facility, or the New Revolving Credit Facility, arranged by certain syndicate lenders. Proceeds are expected to be available to us for general corporate purposes, including funding working capital. We have not yet entered into any commitments with respect to such credit facility, and, accordingly, the terms of our financing arrangements have not yet been determined, remain under discussion, and are subject to change, including as a function of market conditions.

Management Team Update

On December 3, 2020, we announced our hiring of R. Scott Blackley as our new Chief Financial Officer, effective March 16, 2021. Mr. Blackley will succeed our current Chief Financial Officer, Siddhartha Sankaran, who is leaving Oscar’s management team to become Chairman and Chief Executive Officer of SiriusPoint, a global reinsurance company. Mr. Sankaran has been appointed as a member of our board of directors, effective February 5, 2021, and will continue to provide transitional services through June 30, 2021.

Mr. Blackley has served as Chief Financial Officer of Capital One Financial Corporation, or Capital One, a Fortune 100 tech-enabled financial services firm, since May 2016. Prior to that, he served as Capital One’s Controller and Principal Accounting Officer for five years. Before joining Capital One, Mr. Blackley held various executive positions at Fannie Mae, the U.S. Securities and Exchange Commission, and KPMG, LLP.



 

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Summary Risk Factors

There are a number of risks that you should understand before making an investment decision regarding this offering. These risks are discussed more fully in the section entitled “Risk Factors” following this prospectus summary. If any of these risks actually occur, our business, financial condition, or results of operations could be materially and adversely affected. In such case, the trading price of our Class A common stock would likely decline, and you may lose all or part of your investment. These risks include, but are not limited to the following:

 

   

failure to retain and expand our member base;

 

   

failure to execute our growth strategy;

 

   

inability to achieve or maintain profitability in the future;

 

   

changes in federal or state laws or regulations, including changes with respect to the ACA and any regulations enacted thereunder;

 

   

failure to accurately estimate our incurred medical expenses or effectively manage our medical costs or related administrative costs;

 

   

failure to comply with ongoing regulatory requirements and applicable performance standards;

 

   

changes or developments in the health insurance markets in the United States, including passage and implementation of a law to create a single-payer or government-run health insurance program;

 

   

failure to comply with applicable privacy, security, and data laws, regulations, and standards;

 

   

incurrence of cyber-attacks or privacy or data breaches;

 

   

inability to arrange for the delivery of quality care and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks;

 

   

unfavorable or otherwise costly outcomes of lawsuits and claims that arise from the extensive laws and regulations to which we are subject; and

 

   

adverse publicity or other adverse consequences related to our dual class structure or “controlled company” status.

Before you invest in our Class A common stock, you should carefully consider all of the information in this prospectus, including matters set forth under the heading “Risk Factors.”

Implications of Being an Emerging Growth Company

We qualify as an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. An emerging growth company may take advantage of certain reduced reporting and other requirements that are otherwise generally applicable to public companies. As a result:

 

   

we are required to have only two years of audited financial statements and only two years of related selected financial data and Management’s Discussion and Analysis of Financial Condition and Results of Operations disclosure;

 



 

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we are exempt from the requirement that critical audit matters be discussed in our independent auditor’s reports on our audited financial statements or any other requirements that may be adopted by the Public Company Accounting Oversight Board, or the PCAOB, unless the SEC determines that the application of such requirements to emerging growth companies is in the public interest;

 

   

we are exempt from the provisions of Section 404(b) of the Sarbanes-Oxley Act of 2002, or the Sarbanes-Oxley Act, requiring that our independent registered public accounting firm provide an attestation report on the effectiveness of its internal control over financial reporting;

 

   

we are exempt from the “say on pay,” “say on frequency,” and “say on golden parachute” advisory vote requirements of the Dodd-Frank Wall Street Reform and Consumer Protection Act, or the Dodd-Frank Act; and

 

   

we are exempt from certain disclosure requirements of the Dodd-Frank Act relating to compensation of our executive officers and are permitted to omit the detailed compensation discussion and analysis from proxy statements and reports filed under the Securities Exchange Act of 1934, as amended, or the Exchange Act.

We may take advantage of these provisions until the last day of our fiscal year following the fifth anniversary of the completion of this offering or such earlier time that we are no longer an emerging growth company. We would cease to be an emerging growth company upon the earliest of: (i) the last day of the first fiscal year in which our annual gross revenues are $1.07 billion or more; (ii) the date on which we have, during the previous three-year period, issued more than $1 billion in non-convertible debt securities; or (iii) the date on which we are deemed to be a “large accelerated filer,” which will occur as of the end of any fiscal year in which we (x) have an aggregate market value of our Class A common stock held by non-affiliates of $700 million or more as of the last business day of our most recently completed second fiscal quarter, (y) have been required to file annual and quarterly reports under the Exchange Act for a period of at least 12 months, and (z) have filed at least one annual report pursuant to the Exchange Act.

We may choose to take advantage of some but not all of these reduced burdens. We have elected to adopt the reduced requirements with respect to our financial statements and the related selected financial data and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” disclosure. As a result, the information that we provide to stockholders may be different from the information you may receive from other public companies in which you hold an investment.

In addition, pursuant to Section 107 of the JOBS Act, as an emerging growth company, we have elected to take advantage of the extended transition period for complying with new or revised accounting standards until those standards would otherwise apply to private companies. As a result, our operating results and financial statements may not be comparable to the operating results and financial statements of other companies who have adopted the new or revised accounting standards. It is possible that some investors will find our Class A common stock less attractive as a result, which may result in a less active trading market for our Class A common stock and higher volatility in our stock price.



 

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Our Corporate Information

Oscar Health, Inc., formerly known as Mulberry Health Inc., is the registrant and the issuer of our Class A common stock in this offering and was incorporated as a Delaware corporation on October 25, 2012. Our corporate headquarters are located at 75 Varick Street, 5th Floor, New York, New York 10013. Our telephone number is (646) 403-3677. On January 4, 2021, we changed our name from “Mulberry Health Inc.” to “Oscar Health, Inc.”

Our principal website address is www.hioscar.com. The information on, or that can be accessed through, our website is deemed not to be incorporated in this prospectus or to be part of this prospectus. You should not consider information contained on our website to be part of this prospectus in deciding whether to purchase shares of our Class A common stock.



 

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THE OFFERING

 

Class A common stock offered by us

                shares.

Class A common stock offered by the selling stockholders

  


             shares.

Underwriters’ option to purchase additional shares of Class A common stock

  


The underwriters have an option to purchase up to              additional shares of Class A common stock from us at the initial public offering price, less underwriting discounts and commissions. The underwriters can exercise this option at any time within 30 days from the date of this prospectus.

Class A common stock to be outstanding upon completion of this offering

  


             shares (or              shares if the underwriters exercise their option to purchase additional shares of Class A common stock in full).

Class B common stock to be outstanding upon completion of this offering

  


             shares.

Class A and Class B common stock to be outstanding upon completion of this offering

  


             shares (or             shares if the underwriters exercise their option to purchase additional shares of Class A common stock in full).

Use of proceeds

  

We estimate that we will receive net proceeds from this offering of approximately $             million (or $             million if the underwriters exercise their option to purchase additional shares of Class A common stock in full), based upon an assumed initial public offering price of $             per share (which is the midpoint of the price range set forth on the cover page of this prospectus) and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us.

 

The principal purposes of this offering are to increase our capitalization and financial flexibility and create a public market for our Class A common stock. We expect to use approximately $             million of the net proceeds of this offering to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility (as defined herein), and the remainder of such net proceeds for general corporate purposes, including to fund our growth (including capital contributions to our health insurance subsidiaries), technology



 

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development, working capital, operating expenses, and capital expenditures. Additionally, we may use a portion of the net proceeds to acquire or invest in products, services, or technologies; however, we do not have agreements or commitments for any material investments at this time. As of the date of this prospectus, other than repayment of indebtedness under our Term Loan Facility, we do not have a specific plan for the net proceeds to us from this offering and, accordingly, we are not able to allocate the net proceeds among any of these potential uses in light of the variety of factors that will impact how such net proceeds are ultimately utilized by us. We will have broad discretion in the way that we use the net proceeds of this offering. We will not receive any proceeds from the sale of shares of Class A common stock by the selling stockholders. See “Use of Proceeds.”

Voting rights

  

Upon completion of this offering, we will have two classes of common stock, Class A common stock and Class B common stock. The rights of holders of Class A common stock and Class B common stock will be identical, except with respect to voting, conversion and transfer rights. Each share of Class A common stock will be entitled to one vote. Each share of Class B common stock will be entitled to 20 votes and will be convertible at any time into one share of Class A common stock and mandatorily convertible upon the occurrence of certain events, as further described in “Description of Capital Stock.”

 

Thrive Capital and our Co-Founders will be the only holders of our Class B common stock, and following the completion of this offering, they will beneficially own             % of our outstanding capital stock and hold             % of the voting power of our outstanding capital stock (            % and             %, respectively, if the underwriters exercise their option to purchase additional shares of our Class A common stock in full). These holders of our outstanding Class B common stock will have the ability to control the outcome of matters submitted to our stockholders for approval, including the election of our directors and the approval of any change of control transaction. See “Principal and Selling Stockholders” and “Description of Capital Stock” for additional information.



 

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Controlled company

   Upon completion of this offering, we will be a “controlled company” within the meaning of the corporate governance rules of the NYSE.

Dividend policy

   We do not expect to pay any dividends on our Class A common stock for the foreseeable future. See “Dividend Policy.”

Directed share program

   At our request, the underwriters have reserved for sale at the initial public offering price up to three percent of the shares of Class A common stock offered by this prospectus, to certain individuals or entities, including our provider and distribution partners, and certain other individuals or entities identified by management, through a directed share program. If purchased by these individuals or entities, these shares will not be subject to a lock-up restriction, except in the case of shares purchased by any director or executive officer. The number of shares of Class A common stock available for sale to the general public will be reduced by the number of reserved shares sold to these individuals or entities. Any reserved shares not purchased by these individuals or entities will be offered by the underwriters to the general public on the same terms as the other shares of Class A common stock offered under this prospectus. See “Certain Relationships and Related Party Transactions” and “Underwriting—Directed Share Program.”

Risk factors

   Investing in our Class A common stock involves risks. See “Risk Factors” beginning on page 21 and other information included in this prospectus for a discussion of factors you should carefully consider before deciding to invest in shares of our Class A common stock.

Listing

   We intend to apply to list our Class A common stock on the NYSE under the symbol “OSCR.”

The number of shares of our Class A common stock and Class B common stock that will be outstanding upon the completion of this offering is based on              shares of our Class A common stock and             shares of our Class B common stock outstanding, in each case, as of December 31, 2020, after giving effect to the Preferred Stock Conversion, the Series B Conversion, the Selling Stockholder Class B Conversion, and the Reclassification described below, and includes             shares of Class A common stock to be issued to certain selling stockholders upon the exercise of options and settlement of restricted stock units, or RSUs, in connection with the sale of such shares in this offering.

The number of shares of our Class A common stock and Class B common stock to be outstanding upon completion of this offering excludes:

 

   

             shares of Class A common stock issuable upon exercise of stock options outstanding as of December 31, 2020 under our Amended and Restated 2012 Stock Plan, or the 2012 Plan, with a weighted average exercise price of $             per share, except for             shares to be issued upon the exercise



 

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of options by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

             shares of Class A common stock issuable upon the exercise of warrants outstanding as of December 31, 2020, with a weighted average exercise price of $             per share;

 

   

            shares of Class A common stock issuable in connection with the vesting and settlement of RSUs outstanding as of December 31, 2020, pursuant to our 2012 Plan, except for              shares to be issued upon settlement of RSUs by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

            shares of our Class A common stock issuable in connection with the vesting of restricted stock units, or RSUs, that were granted under our 2021 Plan, which will become effective in connection with the completion of this offering to our Co-Founders, which we refer to collectively as the Founders Awards (see “Executive and Director Compensation” for additional information regarding the Founders Awards);

 

   

            shares of our Class A common stock, issuable upon the vesting and settlement of RSUs, which we refer to as the IPO RSUs, granted under our 2021 Plan, including to our named executive officers and directors, which awards will become effective in connection with the completion of this offering; and

 

   

             shares of Class A common stock that will become available for future issuance under our new equity compensation plans, consisting of (1)              shares of Class A common stock under our 2021 Incentive Award Plan, or the 2021 Plan (which number includes the Founders Awards and the IPO RSUs) and (2)             shares of Class A common stock under our 2021 Employee Stock Purchase Plan, or the ESPP, each of which will become effective in connection with this offering (and each of which exclude any potential annual evergreen increases pursuant to the terms of the 2021 Plan and the ESPP).

The 2021 Plan and ESPP each provide for annual automatic increases in the number of shares of Class A common stock reserved thereunder, as more fully described in the section titled “Executive Compensation.”

Unless otherwise indicated, all information contained in this prospectus assumes or gives effect to:

 

   

the conversion of             outstanding shares of preferred stock into an aggregate of             shares of Series A common stock, which will occur immediately after the pricing of this offering, or the Preferred Stock Conversion;

 

   

the conversion of             shares of Series B common stock outstanding (excluding those beneficially owned by Thrive Capital and our Co-Founders), into             shares of Series A common stock, which will occur prior to the closing of this offering, or the Series B Conversion;

 

   

the filing and effectiveness of our amended and restated certificate of incorporation, or the Amended Charter, which will occur prior to the closing of this offering and which will, among other things, effect (i) the reclassification of all outstanding shares of our Series A common stock, other than shares of Series A common stock beneficially owned by Thrive Capital, into Class A common stock, (ii) the reclassification of all outstanding shares of our Series B common stock, after giving effect to the Series B Conversion, into Class B common stock (and the subsequent conversion of             shares of Class B common stock into            shares of Class A common stock in connection with the sale of shares in this offering by a selling stockholder, or the Selling Stockholder Class B Conversion), (iii) the reclassification of



 

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shares of Series A common stock beneficially owned by Thrive Capital into Class B common stock, and (iv) a             for one reverse stock split of our capital stock, which are collectively referred to, excluding the Selling Stockholder Class B Conversion, as the Reclassification;

 

   

the adoption of our amended and restated bylaws, or the Amended Bylaws, which will occur immediately prior to the closing of this offering;

 

   

no exercise of the outstanding stock options or warrants, or settlement of RSUs (other than the exercise of options to purchase              shares of our Class A common stock by certain selling stockholders and settlement of              RSUs in order to sell such shares in this offering), described above subsequent to December 31, 2020;

 

   

no exercise by the underwriters of their option to purchase up to              additional shares of Class A common stock;

 

   

an initial public offering price of $             per share of Class A common stock, which is the midpoint of the price range set forth on the cover page of this prospectus; and

 

   

for information regarding shares outstanding upon completion of this offering, the conversion of             shares of Class B common stock into             shares of Class A common stock in connection with the sale of shares in this offering by the selling stockholders.



 

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SUMMARY CONSOLIDATED FINANCIAL AND OTHER DATA

The following tables present the summary consolidated financial and other data for Oscar Health, Inc. and its subsidiaries. We have derived the summary consolidated statements of operations data for the years ended December 31, 2019 and 2020 and the summary consolidated balance sheet data as of December 31, 2020 from our audited consolidated financial statements included elsewhere in this prospectus. You should read this data together with our consolidated financial statements and related notes included elsewhere in this prospectus and the sections titled “Selected Consolidated Financial Data” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Our historical results for any prior period are not necessarily indicative of the results that may be expected in the future.

 

     Year ended
December 31,
 
     2019     2020  
     (in thousands, except share
and per share data)
 

Consolidated Statement of Operations:

    

Revenue:

    

Premiums before ceded reinsurance

   $ 1,041,145     $ 1,672,339  

Reinsurance premiums ceded

     (572,284     (1,217,304
  

 

 

   

 

 

 

Premiums earned

     468,861       455,035  

Investment income and other revenue

     19,327       7,766  
  

 

 

   

 

 

 

Total revenue

     488,188       462,801  

Operating expenses:

    

Claims incurred, net

     408,259       309,353  

Other insurance costs

     167,851       216,534  

General and administrative expenses

     110,682       166,655  

Federal and state assessments

     48,170       81,458  

Health insurance industry fee

     —         19,251  

Premium deficiency reserve expense

     12,615       71,816  
  

 

 

   

 

 

 

Total operating expenses

     747,577       865,067  

Loss from operations

     (259,389     (402,266

Interest expense

     —         3,514  
  

 

 

   

 

 

 

Loss before income tax expense

     (259,389     (405,780

Income tax expense

     1,793       1,045  
  

 

 

   

 

 

 

Net loss

     (261,182     (406,825

Other comprehensive income—net of tax

    

Unrealized gain on investments

     17       906  
  

 

 

   

 

 

 

Comprehensive loss

   $ (261,165   $ (405,919
  

 

 

   

 

 

 

Net loss per share attributable to common stockholders, basic and diluted

   $ (3.02   $ (4.72

Weighted-average common shares outstanding, basic and diluted

     86,439,407       87,790,273  

Pro forma net loss per share attributable to common stockholders, basic and diluted (1)

    

Pro forma weighted-average common shares outstanding, basic and diluted (1)

    

Consolidated Statement of Cash Flows:

    

Net cash (used in)/provided by operating activities

   $ (165,370   $ 222,732  

Net cash provided by/(used in) investing activities

     150,513       (344,714

Net cash (used in)/provided by financing activities

     (2,119     611,707  


 

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     As of December 31, 2020  
     Actual      Pro Forma(2)      Pro Forma
As Adjusted(3)(4)
 
     (in thousands)  

Consolidated Balance Sheet:

        

Cash and cash equivalents

   $ 826,326      $                    $                

Short-term investments

     366,387        

Total assets

     2,272,106        

Total liabilities

     1,823,088        

Convertible preferred stock

     1,744,911        

Total stockholders’ deficit

     1,295,893        

 

     Year ended December 31,  
     2019     2020  

Key Operating and Non-GAAP Financial Metrics:(5)

    

Members

     229,818       402,044  

Direct Policy Premiums (in thousands)

   $ 1,325,760     $ 2,287,319  

Medical Loss Ratio(6)

     87.6     84.7

InsuranceCo Administrative Expense Ratio(7)

     25.5     26.1

InsuranceCo Combined Ratio

     113.1     110.8

Adjusted EBITDA(8) (in thousands)

   $ (222,173   $ (402,447

 

(1)

See note          to our audited consolidated financial statements included elsewhere in this prospectus for an explanation and calculation of earnings per share, basic and diluted.

(2)

The pro forma consolidated balance sheet data as of December, 31, 2020 presents our consolidated balance sheet data to give effect to (i) the Preferred Stock Conversion, (ii) the Series B Conversion, (iii) the Reclassification, and (iv) the filing and effectiveness of our Amended Charter, in each case as if such event had occurred on December 31, 2020.

(3)

The pro forma as adjusted consolidated balance sheet data reflect (i) the items described in footnote (2) above, (ii) our receipt of estimated net proceeds from the sale of shares of Class A common stock that we are offering by this prospectus and the application of the net proceeds from this offering as set forth under “Use of Proceeds,” assuming an initial public offering price of $        per share, which is the midpoint of the price range set forth on the cover page of this prospectus, after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us, (iii) the Selling Stockholder Class B Conversion and (iv) the issuance of             shares of our Class A common stock upon the settlement of RSUs and exercise of options by certain selling stockholders in connection with the sale of shares in this offering, including aggregate proceeds of $         million received by us in connection with the exercise of such options. A $1.00 increase (decrease) in the assumed initial public offering price of $        per share would increase (decrease) each of cash and cash equivalents, total assets and total stockholders’ deficit by $        million, assuming that the number of shares offered by this prospectus, as set forth on the cover page of this prospectus, remains the same, and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us. Similarly, an increase (decrease) of 1.0 million shares in the number of shares offered in this offering would increase (decrease) each of cash and cash equivalents, total assets and total stockholders’ deficit by $         million, assuming the assumed initial public offering price, as set forth on the cover page of this prospectus, remains the same, and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

(4)

The pro forma as adjusted data discussed above are illustrative only and will be adjusted based on the actual initial public offering price and other terms of this offering determined at pricing.



 

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(5)

See “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Operating and Non-GAAP Financial Metrics” for information on how we define these key operating and non-GAAP financial metrics.

 

(6)

MLR is calculated as set forth in the table below. See “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Operating and Non-GAAP Financial Metrics—Medical Loss Ratio” for more information on MLR.

 

     Year ended December 31,  
     2019     2020  
     (in thousands)  

Direct claims incurred before ceded quota share reinsurance(a)

   $ 924,256     $ 1,364,432  

XOL ceded claims(b)

     (13,908     (13,633

State reinsurance(c)

     (6,959     (10,026
  

 

 

   

 

 

 

Net claims before ceded quota share reinsurance(A)

   $ 903,389     $ 1,340,773  
  

 

 

   

 

 

 

Premiums before ceded reinsurance(d)

   $ 1,041,145     $ 1,672,339  

Other non-recurring items(e)

     3,240       (64,538

XOL reinsurance premiums(f)

 

     (13,332     (24,066
  

 

 

   

 

 

 

Net premiums before ceded quota share reinsurance(B)

 

   $ 1,031,053     $ 1,583,735  
  

 

 

   

 

 

 

Medical Loss Ratio (A divided by B)

 

     87.6     84.7
  

 

 

   

 

 

 

 

 

 

  (a)

See footnote 4 to our audited consolidated financial statements included elsewhere in this prospectus for a reconciliation of direct claims incurred to claims incurred, net presented on the face of our audited consolidated income statement.

  (b)

Represents claims ceded to reinsurers pursuant to an excess of loss, or XOL, treaty, for which such reinsurers are financially liable. We use XOL reinsurance to limit the losses on individual claims of our members.

  (c)

Represents payments made by certain state-run reinsurance programs established subject to CMS approval under Section 1332 of the ACA.

  (d)

See footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus for an explanation of premiums before ceded reinsurance.

  (e)

Represents a pre-quota share write-off of a NYDFS receivable in 2019 as described in footnote 2 in the reconciliation presented in footnote 8 below, which is offset by proceeds received from the sale of a portion of our risk corridor recovery in 2019. The amount was settled in 2020 and we received proceeds of $64.5 million of premiums earned offset by $12.1 million of legal fees and federal and state assessments. For additional information refer to footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus.

  (f)

Represents XOL reinsurance premiums paid.

 

(7)

InsuranceCo Administrative Expense Ratio is calculated as set forth in the table below. See “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Operating and Non-GAAP Financial Metrics—InsuranceCo Administrative Expense Ratio” for more information on InsuranceCo Administrative Expense Ratio.



 

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     Year ended December 31,  
     2019     2020  
     (in thousands)  

Other insurance costs

   $ 167,851     $ 216,534  

Ceding commissions

     65,591       126,840  

Other non-recurring items(a)

     —         (12,102

Stock-based compensation expense

     (17,615     (18,299 )

Health insurance industry fee

     —         19,251  

Federal and state assessment of health insurance subsidiaries(b)

     47,019       81,199
  

 

 

   

 

 

 

Health insurance subsidiary adjusted administrative expenses(A)

   $ 262,846     $ 413,423  
  

 

 

   

 

 

 

Premiums before ceded reinsurance(a)

   $ 1,041,145     $ 1,672,339  

Other non-recurring items(a)

     3,240       (64,538

XOL reinsurance premiums(a)

 

     (13,332     (24,066
  

 

 

   

 

 

 

Net premiums before ceded quota share reinsurance(B)

 

   $ 1,031,053     $ 1,583,735  
  

 

 

   

 

 

 

InsuranceCo Administrative Expense Ratio (A divided by B)

 

     25.5     26.1
  

 

 

   

 

 

 

 

 

  (a)

See footnotes (d) through (f) to footnote 6 above for a description of these line items.

  (b)

Represents federal and state assessments of our health insurance subsidiaries.

 

(8)

Adjusted EBITDA is a supplemental measure of our performance that is not required by, or presented in accordance with generally accepted accounting principles in the U.S., or GAAP. Adjusted EBITDA is not a measurement of our financial performance under GAAP and should not be considered as an alternative to net loss or any other performance measure derived in accordance with GAAP, or as an alternative to cash flows from operating activities as a measure of our liquidity.

We define Adjusted EBITDA as net loss for the Company and its consolidated subsidiaries before interest expense, income tax expense, depreciation and amortization as further adjusted for stock-based compensation, warrant contract expense, changes in the fair value of warrant liabilities, and non-operating litigation reserves/settlements as described below.

We caution investors that amounts presented in accordance with our definition of Adjusted EBITDA may not be comparable to similar measures disclosed by our competitors, because not all companies and analysts calculate Adjusted EBITDA in the same manner. We present Adjusted EBITDA because we consider this metric to be an important supplemental measure of our performance and believe it is frequently used by securities analysts, investors, and other interested parties in the evaluation of companies in our industry. Management believes that investors’ understanding of our performance is enhanced by including this non-GAAP financial measure as a reasonable basis for comparing our ongoing results of operations.

Management uses Adjusted EBITDA:

 

   

as a measurement of operating performance because it assists us in comparing the operating performance of our business on a consistent basis, as it removes the impact of items not directly resulting from our core operations;

 

   

for planning purposes, including the preparation of our internal annual operating budget and financial projections;

 

   

to evaluate the performance and effectiveness of our operational strategies; and

 

   

to evaluate our capacity to expand our business.

By providing this non-GAAP financial measure, together with a reconciliation to the most comparable GAAP measure, we believe we are enhancing investors’ understanding of our



 

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business and our results of operations, as well as assisting investors in evaluating how well we are executing our strategic initiatives. Adjusted EBITDA has limitations as an analytical tool, and should not be considered in isolation, or as an alternative to, or a substitute for net loss or other financial statement data presented in our consolidated financial statements as indicators of financial performance. Some of the limitations are:

 

   

such measure does not reflect our cash expenditures, or future requirements for capital expenditures, or contractual commitments;

 

   

such measure does not reflect changes in, or cash requirements for, our working capital needs;

 

   

such measure does not reflect the interest expense, or the cash requirements necessary to service interest or principal payments on our debt;

 

   

such measure does not reflect our tax expense or the cash requirements to pay our taxes;

 

   

although depreciation and amortization are non-cash charges, the assets being depreciated and amortized will often have to be replaced in the future and such measure does not reflect any cash requirements for such replacements; and

 

   

other companies in our industry may calculate such measures differently than we do, limiting their usefulness as comparative measures.

Due to these limitations, Adjusted EBITDA should not be considered as a measure of discretionary cash available to us to invest in the growth of our business. We compensate for these limitations by relying primarily on our GAAP results and using this non-GAAP measure only supplementally. Adjusted EBITDA includes adjustments to exclude the impact of material infrequent items. It is reasonable to expect that these items could occur in future periods. However, we believe these adjustments are appropriate because the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our business, and may complicate comparisons of our internal operating results and operating results of other companies over time. In addition, Adjusted EBITDA includes adjustments for other items that we do not expect to regularly record following this offering. Each of the normal recurring adjustments and other adjustments described in this paragraph and in the reconciliation table below help management with a measure of our core operating performance over time by removing items that are not related to day-to-day operations.

The following table reconciles Adjusted EBITDA to the most directly comparable GAAP financial performance measure, which is net loss:

 

     Year ended December 31,  
     2019     2020  
     (in thousands)  

Net loss

   $ (261,182   $ (406,825

Interest expense

     —         3,514  

Income tax expense

     1,793       1,045  

Depreciation and amortization

     6,899       11,285  

Stock-based compensation/warrant expense(a)

     34,262       40,970  

Other non-recurring items(b)

     (3,945     (52,436
  

 

 

   

 

 

 

Adjusted EBITDA

   $ (222,173   $ (402,447
  

 

 

   

 

 

 

 

  (a)

Represents (i) non-cash expenses related to equity-based compensation programs, which vary from period to period depending on various factors including the timing, number, and



 

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  the valuation of awards, (ii) warrant contract expense, and (iii) changes in the fair value of warrant liabilities.
  (b)

A health insurance subsidiary of the Company had previously recorded a receivable in 2018 of $16,055 from the New York Department of Financial Services, or NYDFS, in connection with the NYDFS’s program to limit federal risk adjustment transfers, which would have allowed us to collect additional funds from the NYDFS that we had previously remitted to CMS. However, this NYDFS program would have resulted in other insurance carriers having to return certain of the funds they received in connection with the federal risk adjustment program to the NYDFS. In 2017, these carriers initiated a lawsuit against the NYDFS to reverse the NYDFS limitations, which was subsequently decided in the carriers’ favor. As a result, we will no longer be entitled to receive the additional funds and we have written off the receivable in 2019. Additionally, the write-off of the receivable in 2019 is offset by proceeds received from the sale of a portion of our risk corridor recovery in 2019. The amount was settled in 2020 and we received proceeds of $64.5 million of premiums earned offset by $12.1 million of legal fees and federal and state assessments. For additional information refer to footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus.



 

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RISK FACTORS

Investing in our Class A common stock involves a high degree of risk. You should carefully consider the risks and uncertainties described below, together with all of the other information in this prospectus, including our audited consolidated financial statements and the related notes, before deciding to invest in our Class A common stock. The occurrence of any of the events described below could harm our business, operating results, financial condition, liquidity, or prospects. In any such event, the market price of our Class A common stock could decline, and you may lose all or part of your investment. Additional risks and uncertainties not presently known to us, or that we currently deem immaterial, may also impair our business. See “Cautionary Note Regarding Forward-Looking Statements.”

Most Material Risks to Us

Our success and ability to grow our business depend in part on retaining and expanding our member base. If we fail to add new members or retain current members, our business, revenue, operating results, and financial condition could be harmed.

We currently derive substantially all of our revenue from direct policy premiums, which is primarily driven by the number of members covered by our health plans. As a result, the size of our member base is critical to our success. We have experienced significant member growth since we commenced operations; however, we may not be able to maintain this growth, and our member base could decrease rapidly or shrink over time.

Attracting new members depends, in large part, on our ability to continue to be perceived as providing a superior member experience, competitive pricing, access to competitive provider networks and quality providers, and competitive insurance coverage relative to other insurers in the same geographic and insurance markets. Some of the health insurers with which we compete have greater financial and other resources, offer a broader scope of products, and may be able to price their products more competitively than ours. Many of them also have relationships with more providers and provider groups than we do, and so are able to offer a larger network and/or obtain better unit cost economics.

Additionally, our ability to attract new members and retain existing members depends in part on the Health Insurance Marketplaces, which we rely on to promote our health plans and increase our membership, and insurance brokers, who help us identify and enroll new members and generally assist with marketing our products and plans.

If we fail to remain competitive on member experience, pricing, and insurance coverage options, our ability to grow our business and generate revenue by attracting and retaining members may be adversely affected. There are many other factors that could negatively affect our ability to grow our member base, including if:

 

   

our competitors or new market entrants mimic our innovative product offerings or our full stack technology platform, causing current and potential members to purchase our competitors’ insurance products instead of ours;

 

   

our digital platform experiences technical or other problems or disruptions that frustrate the member experience;

 

   

we or our partners or other third parties with whom we collaborate sustain a cyber-attack or suffer privacy or data security breaches;

 

   

we experience unfavorable shifts in member perception of our digital platform or other member service channels;

 

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we suffer reputational harm to our brand resulting from negative publicity, whether accurate or inaccurate;

 

   

we are unable to maintain licenses and approvals to offer insurance in our current markets or to expand geographically in an economically sustainable manner;

 

   

we fail to continue to offer new and competitive products;

 

   

our strategic partners terminate or fail to renew our current contracts or we fail to enter into contracts with new strategic partners;

 

   

insurance brokers that we rely on to build our member base are unable to market our insurance products effectively, or if we fail to attract brokers to sell our insurance products, or lose important broker relationships to our competitors or otherwise; or

 

   

our members do not find sufficient value in our virtual care offerings, including primary and urgent care.

Our inability to overcome these challenges could impair our ability to attract new members and retain existing members, and could have a material adverse effect on our business, revenue, operating results, and financial condition.

Our business, financial condition, and results of operations may be harmed if we fail to execute our growth strategy.

Our growth strategy includes, without limitation, the acquisition of additional members in existing and new markets and states, introducing new products and plans, and monetizing our technology.

We are expanding rapidly by entering into new markets and introducing new health plans in the markets in which we currently operate. As of the date of this prospectus, our health insurance subsidiaries operate in 18 states, 15 of which we expanded to since 2017. As our business grows, we may incur significant expenses prior to commencement of operations and the receipt of revenue in new markets or from new plans, including significant time and expense in obtaining the regulatory approvals and licenses necessary to grow our operations. For example, in order to obtain a certificate of authority to market and sell insurance in most jurisdictions, we must establish a provider network and demonstrate our ability to perform or delegate utilization management and other administrative functions. We are also required to contribute capital to fund capital and surplus requirements, escrows, or contingency guaranties, which may, at times, be significant. Even if we are successful in obtaining a certificate of authority, regulators may not approve our proposed benefit designs, provider networks, or premium levels, or may require us to change them in ways that harm our profitability. Further, even if we successfully attract members in sufficient numbers to cover our costs, the new business could fail, which could not only result in financial harm, but also reputational harm to our brand. We may also experience delays in operational start dates. Even if we are successful in establishing a profitable new health plan or entering a new market, increasing membership, revenues and medical costs could trigger increased risk-based capital, or RBC, requirements that could substantially exceed the net income generated by the health plan or in the new market. In such circumstances, we may not be able to fund on a timely basis, or at all, the increased RBC requirements with our available cash resources. As we expand, if competitors seek to retain market share by reducing prices, we may be forced to reduce our prices on similar plan offerings in order to remain competitive, which could impact our financial condition and may require a change in our operating strategies. It is difficult to predict the full effect of pricing changes. Even if we reduce the pricing of our plans, our resulting membership enrollment could be lower than anticipated and our growth could stall. As a result of these factors, entering new markets or introducing new health plans may decrease our profitability. In addition, we are continuously updating and developing new technology for our providers. If our providers do not utilize the technology we deploy to them, we may not be able to efficiently and cost-effectively operate our business.

 

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As we expand our product offerings and enter new markets, we need to establish our reputation and brand with new members, and to the extent we are not successful in creating positive impressions, our business in these newer markets could be adversely affected. There can also be no assurance that we will be able to maintain or enhance our reputation and brand in our existing markets, and failure to do so could materially adversely affect our business, results of operations, and financial condition.

We also pursue opportunistic partnerships and acquisitions to allow us to provide better health care options for our members as well as to augment existing operations, and we may be in discussions with respect to one or more partnerships or acquisitions at any given time. For example, we recently entered into a partnership with Cigna to exclusively provide commercial health plans to small businesses, for which we made a significant investment in financial and other resources. Partnerships or other acquisition opportunities that we enter into may not perform as well as expected, may not achieve timely profitability or expected synergies, may expose us to additional liability, or may limit our ability to offer products in certain insurance markets and geographic regions.

We may also pursue opportunities to monetize our platform, including through platform arrangements, such as our recent arrangement with Health First. We may not be able to perform these platform arrangements as well as expected, and these arrangements may pose operational challenges, may not achieve timely profitability, may expose us to additional liability, or may limit our ability to offer products in certain insurance markets and geographic regions.

We expect that our growth strategy will continue to focus on opportunities in existing and new markets and states for the foreseeable future, which will require significant dedication of management attention and financial resources. If we are unable to effectively execute our growth strategy, our future growth will suffer, and our results of operations could be harmed.

We have a history of losses, and we may not achieve or maintain profitability in the future.

We have not been profitable since our inception in 2012 and had an accumulated deficit of $1,012.9 million and $1,427.1 million as of December 31, 2019 and 2020, respectively. We incurred net losses of $261.2 million and $406.8 million in the years ended December 31, 2019 and 2020, respectively. We expect to make significant investments to further market, develop, and expand our business, including by continuing to develop our full stack technology platform and member engagement engine, acquiring more members, maintaining existing members and investing in partnerships, collaborations and acquisitions. In addition, we expect to continue to increase our headcount in the coming years. As a public company, we will also incur significant legal, accounting, compliance, and other expenses that we did not incur as a private company. The commissions we offer to brokers could also increase significantly as we compete to attract new members. We will continue to make such investments to grow our business. Despite these investments, we may not succeed in increasing our revenue on the timeline that we expect or in an amount sufficient to lower our net loss and ultimately become profitable. Moreover, if our revenue declines, we may not be able to reduce costs in a timely manner because many of our costs are fixed, at least in the short-term. If we are unable to manage our costs effectively, this may limit our ability to optimize our business model, acquire new members, and grow our revenues. Accordingly, despite our best efforts to do so, we may not achieve or maintain profitability, and we may continue to incur significant losses in the future.

Any potential repeal of, changes to, or judicial challenges to the ACA, could materially and adversely affect our business, results of operations, and financial condition.

The enactment of the ACA in March 2010 transformed the U.S. health care delivery system through a series of complex initiatives; however, the ACA continues to face judicial challenges, as well as efforts to repeal or change certain of its significant provisions. For the years ended December 31,

 

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2019 and 2020, approximately 96% and 95%, respectively, of our revenue was derived from sales of health plans subject to regulation under the ACA, primarily comprised of policies directly purchased by individuals and families and secondarily comprised of policies purchased by small employers and provided to their employees as a benefit. Consequently, changes to, or repeal of, portions or the entirety of the ACA, as well as judicial interpretations in response to legal and other constitutional challenges, could materially and adversely affect our business and financial position, results of operations, or cash flows. Even if the ACA is not amended or repealed, elected and appointed officials could continue to propose changes impacting the ACA, which could materially and adversely affect our business, results of operations, and financial condition.

The ACA’s provisions include the establishment of Health Insurance Marketplaces. The ACA also established significant subsidies to support the purchase of health insurance by individuals, in the form of advanced premium tax credits, or APTCs, available through Health Insurance Marketplaces. During the years ended December 31, 2019 and 2020, the direct policy premiums of approximately 43% and 60%, respectively, of our members were subsidized by APTCs. Additionally, the ACA implemented certain requirements for insurers, including changes to Medicare Advantage payments and a minimum MLR provision that requires insurers to pay rebates to consumers when insurers do not meet or exceed specified annual MLR thresholds. The ACA also established anti-discrimination protections on the basis of race, color, national origin, sex, age, and disability, which may impact the manner in which health insurers receiving any form of federal financial assistance design and implement their benefit packages. Further, the ACA imposes significant fees, assessments, and taxes on us and other health insurers, plans and other industry participants. As of December 31, 2020, we offered Individual plans through the Health Insurance Marketplaces in 15 states, which represented approximately 79% of our total membership.

There have been significant efforts to repeal, or limit implementation of, certain provisions of the ACA. Such initiatives include repeal of the individual mandate effective in 2019, as well as easing of the regulatory restrictions placed on short-term limited duration insurance and association health plans, some or all of which may provide fewer benefits than the traditional ACA-mandated insurance benefits. The perceived uncertainty and possible changes in the Health Insurance Marketplaces could result in reduced participation from individuals seeking insurance coverage and possible non-renewal of existing policies. Because we rely on the Health Insurance Marketplaces to promote our Individual and some of our Small Group products and increase membership, reduced participation in such marketplaces could materially and adversely impact our business, financial condition, and results of operations. Also, although individuals would still be able to purchase coverage, possibly through marketplaces that continue to be maintained by certain states or by purchasing coverage directly from an insurer, the elimination of subsidies would make such coverage unaffordable to some individuals and could thereby reduce overall membership. Further, the federal government’s continued refusal to fund cost sharing subsidies and/or withdrawal of APTCs could additionally impact marketplace enrollment, although we may expect some changes to the foregoing with President Joe Biden’s new administration. These market and political dynamics may increase the risk that our Health Insurance Marketplace products will be selected by individuals who have a higher risk profile or utilization rate or lower subsidization rate than we anticipated when we established the pricing for products on Health Insurance Marketplaces, possibly leading to financial losses.

The constitutionality of the ACA itself continues to face judicial challenge. In December 2018, a partial summary judgment ruling by a federal district court in Texas v. United States of America held that the ACA’s individual mandate requirement—which was set to $0 by Congress in 2017—was essential to the ACA, and, without it, the remainder of the ACA was invalid (i.e., that it was not “severable” from the ACA). That decision was appealed to the Fifth Circuit Court of Appeals, which agreed with the district court in December 2019 that the individual mandate was unconstitutional, but remanded the case to the district court for additional analysis on the question of severability of the

 

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remainder of the ACA. In January 2020, both plaintiffs and defendants appealed the Fifth Circuit’s decision to the Supreme Court, which granted a writ of certiorari in March 2020. Oral argument took place on November 10, 2020 in the case now captioned California v. Texas. The Supreme Court’s decision could end the case, or it could result in the case being sent back to the lower courts for continued litigation. The ACA remains in effect until judicial review of the decision is concluded, and the ultimate content, timing, or effect of any outcome of the lawsuit cannot be predicted. In the interim, Congress and President Biden may consider other legislation and/or executive orders to change elements of the ACA, including for example, the January 18, 2021 Executive Order issued by President Biden directing the Secretary of HHS to consider opening a Special Enrollment Period from February 15, 2021 through May 14, 2021 for the Health Insurance Marketplace as well as directing federal agencies to examine all existing regulations, orders, guidance documents, policies and similar agency actions to determine if any such actions are inconsistent with the policy set forth in the Executive Order to protect and strengthen Medicaid and the ACA and make high-quality healthcare accessible and affordable for every American.

These changes to the ACA and other potential changes involving the functioning of the Health Insurance Marketplaces as a result of new legislation, regulation, or executive action, could materially impact our business, results of operations, and financial condition.

Failure to accurately estimate our incurred medical expenses or effectively manage our medical costs or related administrative costs could negatively affect our financial position, results of operations, and cash flows.

Our profitability depends, to a significant degree, on our ability to accurately estimate and effectively manage our medical expenses. Because the premiums are set in advance of the policy year based on a projection of future expenses, our overall financial results are sensitive to changes in our medical expenses. For example, if our medical expenses for the policy year 2020 had been one percentage point higher, this would have resulted in an approximately $13.6 million increase in our net loss after taking into account risk adjustment determinations and reinsurance. Changes in health care regulations and practices, the level of utilization of health care services, hospital and pharmaceutical costs, and to the broader competitive landscape, disasters, the potential effects of climate change, major epidemics, pandemics, or newly emergent viruses (such as COVID-19), continued inequity and racial discrimination in the U.S. health care system, and the resulting physical and mental health costs in broader society, new medical technologies, new pharmaceuticals, increases in provider fraud, and other external factors, including general economic conditions such as inflation and unemployment levels, are generally beyond our control and could reduce our ability to accurately estimate and effectively control the costs of providing health benefits.

Due to the time lag between when services are actually rendered by providers and when we receive, process, and pay a claim for those services, our medical expenses include a provision for claims incurred but not paid. We are continuously enhancing our process for estimating claims liability, which we monitor and refine on a monthly basis as claims receipts, payment information, and inpatient acuity information becomes available. As more complete information becomes available, we adjust the amount of the estimate, and include the changes in estimates in expenses in the period in which the changes are identified. Given the uncertainties inherent in such estimates, there can be no assurance that our claims liability estimate will be adequate, and any adjustments to the estimate may unfavorably impact, potentially in a material way, our reported results of operations and financial condition. Further, our inability to estimate our claims liability may also affect our ability to take timely corrective actions, further exacerbating the extent of any adverse effect on our results.

Additionally, when we expand our product offerings, we have limited information with which to develop our anticipated claims liability. Changes to (or new or revised interpretations of) subregulatory

 

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guidance, regulations, or statutes that govern Health Insurance Marketplaces, including, but not limited to, those governing eligibility criteria, Special Enrollment Periods, and minimum benefits requirements, may pose difficulty in estimating our claims liability.

From time to time in the past, our actual results have varied from those expected, particularly in times of significant changes in the number of our members. If it is determined that our estimates are significantly different than actual results, our results of operations and financial position could be adversely affected.

Risks Related to the Regulatory Framework that Governs Us

Our business activities are subject to ongoing, complex, and evolving regulatory obligations, and to continued regulatory review, which result in significant additional expense and the diversion of our management’s time and efforts. If we fail to comply with regulatory requirements, or are unable to meet performance standards applicable to our business, our operations could be disrupted or we may become subject to significant penalties.

We operate in a highly regulated industry and we must comply with numerous and complex state and federal laws and regulations to operate our business, including requirements to maintain or renew our regulatory approvals or obtain new regulatory approvals to sell insurance and to sell specific health plans. The National Association of Insurance Commissioners, or NAIC, has adopted the Annual Financial Reporting Model Regulation, or the Model Audit Rule, which, where adopted by states, requires expanded governance practices, risk and solvency assessment reporting, and filing of periodic financial and operating reports. Most states have adopted these or similar measures to expand the scope of regulations relating to corporate governance and internal control activities of health maintenance organizations, or HMOs, and insurance companies. We are also required to notify, or obtain approval from, federal and/or state regulatory authorities prior to taking various actions as a business, including making changes to our network, service offerings, and the coverage of our health plans, as well as prior to entering into relationships with certain vendors and health organizations.

In each of the markets in which we operate, we are regulated by the relevant insurance and/or health and/or human services, or other government departments that oversee the activities of insurance and/or health care organizations providing or arranging to provide services to Medicare Advantage members, Health Insurance Marketplace enrollees, or other beneficiaries. For example, our health insurance subsidiaries must comply with minimum statutory capital and other financial solvency requirements, such as deposit and surplus requirements, and related reporting requirements. Our health insurance subsidiaries must also comply with numerous statutes and regulations governing the sale, marketing, and administration of insurance. Additionally, our health insurance subsidiaries may be required to maintain dedicated personnel and physical offices in certain jurisdictions where we operate.

The frequent enactment of, amendments to, or changes in interpretations of laws and regulations could, among other things: require us to restructure our relationships with providers within our network; require us to contract with additional providers at unfavorable terms; require us to cover certain forms of care provided by out-of-network providers at rates or levels indicated by rule or statute; require us to implement changes to our health care services and types of coverage, or prevent us from innovating and evolving; restrict revenue and enrollment growth; increase our sales, marketing, and administrative costs; impose additional capital and surplus requirements; make it more difficult to obtain regulatory approvals to operate our business or maintain existing regulatory approvals; prevent or delay us from entering into new service areas or product lines; and increase or change our liability to members in the event of malpractice by our contracted providers. The evolving regulatory landscape requires a significant investment of time and resources to ensure compliance with new and changing laws and

 

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regulations. In addition, changes in political party legislative majorities or executive branch administrations at the state or federal level in the United States may change the attitude towards health care programs and result in changes to the existing legislative or regulatory environment.

The federal government periodically considers reducing or reallocating the amount of money it spends for Medicare. Furthermore, Medicare remains subject to the automatic spending reductions imposed by the Budget Control Act of 2011 and the American Taxpayer Relief Act of 2012, subject to a 2% cap, which was extended by subsequent legislative amendments through 2030. We anticipate this and any future similar initiatives will require government agencies to find funding alternatives, which may result in reductions in funding for programs, contraction of covered benefits, and limited or no premium rate increases, or premium rate decreases.

Additionally, the taxes and fees that we are required to pay to federal, state, and local governments may increase due to several factors, including: enactment of, changes to, or interpretations of, tax laws and regulations, audits by governmental authorities, and geographic expansions into higher taxing jurisdictions.

The governmental health care programs in which we participate are subject to a myriad of rules, regulations, and subregulatory guidance, as well as third party and publicly administered performance standards. For example, a portion of each Medicare Advantage plan’s reimbursement is tied to the plan’s Star Rating, as published by CMS, with those plans receiving a rating of four (4.0) or more stars eligible for quality-based bonus payments. A plan’s Star Rating affects its image in the market, and plans that perform well are able to offer enhanced benefits and market more effectively. Medicare Advantage plans with Star Ratings of five (5.0) stars are eligible for year-round open enrollment; conversely, plans with lower Star Ratings have more restricted times for enrollment of beneficiaries. Medicare Advantage plans with Star Ratings of less than three (3.0) stars for three consecutive years are denoted as “low performing” plans on the CMS website and in the CMS “Medicare and You” handbook. In addition, in 2019, CMS had its authority reinstated to terminate Medicare Advantage contracts for plans rated below three (3.0) stars for three consecutive years. As a result, Medicare Advantage plans that achieve higher Star Ratings may have competitive advantage over plans with lower Star Ratings. As of December 31, 2020, none of our health plans were eligible to receive Star Ratings because of our recent market entry. The Star Rating system is subject to change annually by CMS, which may make it more difficult to achieve and maintain three (3.0) Star Ratings or greater in the future. Our health insurance subsidiaries’ operating results, premium revenue, and benefit offerings will likely depend significantly on their Star Ratings, and there can be no assurances that we will be successful in achieving favorable Star Ratings or maintaining or improving our Star Ratings once achieved. Similarly, health care accreditation agencies such as the National Committee for Quality Assurance, or NCQA, evaluate health plans based on various criteria, including effectiveness of care and member satisfaction. Health insurers seeking accreditation from NCQA must pass a rigorous, comprehensive review, and must annually report their performance. If we fail to achieve and maintain accreditation from agencies, such as NCQA, we could lose the ability to offer our health plans on Health Insurance Marketplaces, or in certain jurisdictions, which would materially and adversely affect our results of operations, financial position, and cash flows.    

Additionally, there are numerous steps federal and state regulators require for continued implementation of the ACA. If we fail to effectively implement or appropriately adjust our operational and strategic initiatives with respect to the implementation of health care reform, or do not do so as effectively as our competitors, our results of operations may be materially and adversely affected.

Although we strive to comply with all existing regulations and to meet performance standards applicable to our business, failure to meet these requirements could result in financial fines, inability to obtain new regulatory approvals to sell insurance or health plans, inability to obtain regulatory approval

 

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to expand our geographic service area, inability to obtain new regulatory approvals to offer administrative services, revocation of existing licenses to offer insurance or administrative services, other penalties, and reputational harm.

Changes or developments in the health insurance markets in the United States, including passage and implementation of a law to create a single-payer or government-run health insurance program, could materially and adversely harm our business and operating results.

Our business is within the public and private sectors of the U.S. health insurance system, which are evolving quickly and subject to a changing regulatory environment, and our future financial performance will depend in part on growth in the market for private health insurance, as well as our ability to adapt to regulatory developments. Changes and developments in the health insurance system in the United States could reduce demand for our services and harm our business. For example, there has been an ongoing national debate relating to the health insurance system in the United States. Certain elected officials have introduced proposals to expand the Medicare program, ranging from proposals that would create a new single-payer national health insurance program for all United States residents, replacing virtually all other sources of public and private insurance, to more incremental approaches, such as lowering the age of eligibility for the Medicare program, expanding Medicare to a larger population, or creating a new public health insurance option that would compete with private insurers. Additionally, proposals to establish a single-payer or government-run health care system at the state level are regularly introduced in some of our key states, such as New York and California. At the federal level, President Biden and Congress may consider other legislation and/or executive orders to change elements of the ACA. In December 2019, a federal appeals court held that the individual mandate portion of the ACA was unconstitutional and left open the question whether the remaining provisions of the ACA would be valid without the individual mandate. On November 10, 2020, the U.S. Supreme Court heard oral arguments in this matter, and is in the process of reviewing this case. A decision is expected in 2021. On January 28, 2021, President Biden issued an Executive Order that iterates the policy of the Administration to protect and strengthen Medicaid and the ACA, making high-quality healthcare accessible and affordable to all Americans and directs the Secretary of HHS to consider opening a Special Enrollment Period for Americans to seek Individual market coverage through the Health Insurance Marketplace. On the same day in response to the President’s Executive Order, the Secretary of HHS announced a Special Enrollment Period from February 15, 2021 through May 15, 2021, for uninsured and under-insured individuals and families to seek coverage through the Health Insurance Marketplace. The Executive Order also directs federal agencies to examine agency actions to determine whether they are consistent with that the Administration’s commitment regarding the ACA, and begin rulemaking to suspend, revise, or rescind any inconsistent actions. Areas of focus include policies or practices that may reduce affordability of coverage, present unnecessary barriers to coverage, or undermine protections for people with preexisting conditions. We continue to evaluate the effect that the ACA and its possible modifications, repeal and replacement has on our business.

If we fail to comply with applicable privacy, security, and data laws, regulations and standards, including with respect to third-party service providers that utilize sensitive personal information on our behalf, or applicable consumer protection laws, our business, reputation, results of operations, financial position, and cash flows could be materially and adversely affected.

As part of our normal operations, we collect, process, and retain confidential information about individuals. We are subject to various federal and state laws and rules regarding the collection, use, disclosure, storage, transmission, and destruction of confidential information about individuals. For example, we are subject to the Health Insurance Portability and Accountability Act of 1996, or HIPAA, and the Health Information Technology for Economic and Clinical Health Act of 2009, or HITECH, which require us to protect the privacy, security, and confidentiality of medical records and protected

 

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health information, or PHI, that we collect, disseminate, maintain, and use. HIPAA applies national privacy and security standards for PHI to covered entities, including health insurers and certain types of health care providers, and their service providers that access, create, receive, use, or maintain PHI, known as business associates. HIPAA requires covered entities and business associates to maintain policies and procedures governing PHI that is used or disclosed, and to implement administrative, physical, and technical safeguards to protect PHI, including PHI maintained, used, and disclosed in electronic form. These safeguards include employee training, identifying business associates with whom covered entities need to enter into HIPAA-compliant contractual arrangements, and various other measures. Health insurers and other covered entities are also required to report impermissible uses or disclosures of PHI to affected individuals and the U.S. Department of Health and Human Services, or HHS, unless the covered entity demonstrates through a risk assessment that there is low probability the PHI has been compromised, and to notify the media in any states where 500 or more people are impacted by any unauthorized release or use of or access to PHI. Ongoing implementation and oversight of these measures involves significant time, effort, and expense. While we undertake substantial efforts to secure the PHI that we maintain, use, and disclose in electronic form, a cyber-attack or other intrusion that bypasses our information security systems causing an information security breach, loss of PHI, confidential member information, or other data subject to privacy laws or a material disruption of our operational systems could result in a material adverse impact on our business, along with potentially substantial fines and penalties.

HIPAA and HITECH also established new enforcement mechanisms and enhanced penalties for failure to comply with specific standards relating to the privacy, security, and electronic transmission of PHI. If a person knowingly or intentionally obtains or discloses PHI in violation of HIPAA requirements, criminal penalties may also be imposed. HIPAA authorizes state Attorneys General to file suit under HIPAA on behalf of state residents. Courts can award damages, costs, and attorneys’ fees related to violations of HIPAA in such cases. While HIPAA does not create a private right of action allowing individuals to sue us in civil court for HIPAA violations, its standards have been used as the basis for a duty of care in state civil suits such as those for negligence or recklessness in the misuse or breach of PHI. It is possible that Congress may enact additional legislation in the future to increase the amount or application of penalties, and to create a private right of action under HIPAA, which could entitle patients to seek monetary damages for violations of the privacy rules.

State laws may apply to our collection, use, handling, processing, destruction, disclosure, and storage of personal information as well. States have begun enacting more comprehensive privacy laws and regulations addressing consumer rights to data protection or transparency that may affect our privacy and security practices. For example, the California Consumer Privacy Act of 2018, or the CCPA, effective as of January 1, 2020, gives California residents expanded rights to access and require deletion of their personal information, opt out of certain personal information sharing, and receive detailed information about how their personal information is used. The CCPA also provides for civil penalties for violations, as well as a private right of action for data breaches that may increase data breach litigation. Further, a new California privacy law, the California Privacy Rights Act, or CPRA, was passed by California voters on November 3, 2020. The CPRA will create additional obligations with respect to processing and storing personal information that are scheduled to take effect on January 1, 2023 (with certain provisions having retroactive effect to January 1, 2022). The CCPA and CPRA contain exemptions for medical information governed by the California Confidentiality of Medical Information Act, and for PHI collected by a covered entity or business associate governed by the privacy, security, and breach notification rule established pursuant to HIPAA and HITECH, but the precise interpretation and application of this exemption by regulators is not yet clear.

With laws and regulations, such as HIPAA and the CCPA, imposing relatively burdensome obligations, and with substantial uncertainty over the interpretation and application of these and other laws and regulations to our business, we may face challenges in addressing their requirements and

 

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making necessary changes to our policies and practices, and may incur significant costs and expenses in our effort to do so. For example, the increased consumer control over the sharing of personal information under the CCPA may affect members’ ability to share such personal information with us, or may require us to delete or remove member information from our records or data sets, which may create considerable costs or loss of revenue for our organization.

In addition, certain of our businesses are also subject to the Payment Card Industry, or PCI, Data Security Standard, which is a multifaceted security standard that is designed to protect credit card account data as mandated by PCI entities. We rely on vendors to assist us with PCI matters and to ensure PCI compliance. Our business and operations are also subject to federal, state, and local consumer protection laws, including the Telephone Consumer Protection Act, or TCPA, which places restrictions on the use of automated tools and technologies to communicate with wireless telephone subscribers or communications services consumers generally. Despite our compliance efforts, we may become subject to claims that we have violated the PCI Data Security Standard, the TCPA or other telemarketing laws based on past, present, or future business practices, which could have an adverse impact on our business and reputation.

In addition, any failure or perceived failure by us to maintain posted privacy policies which are accurate, comprehensive and fully implemented, and any violation or perceived violation of our privacy-, data protection-, or information security-related obligations to members, users, or other third parties or any of our other legal obligations relating to privacy, data protection, or information security may result in governmental investigations or enforcement actions, litigation, claims, or public statements against us by consumer advocacy groups or others, and could result in significant liability, loss of relationships with key third parties, including telecommunications carriers, social media networks, and other data providers, or cause our consumers to lose trust in us, which could have material impact on our revenue and operations.

Despite our best attempts to maintain adherence to information privacy and security best practices, as well as compliance with applicable laws, rules, and contractual requirements, our facilities and systems, and those of our third-party service providers, may be vulnerable to privacy or security breaches, acts of vandalism or theft, malware, ransomware, or other forms of cyber-attack, misplaced or lost data including paper or electronic media, programming and/or human errors, or other similar events. In the past, we have experienced, and disclosed to applicable regulatory authorities, data breaches resulting in disclosure of confidential or PHI. Although none of these data breaches have resulted in any material financial loss or penalty to date, future data breaches could require us to expend significant resources to remediate any damage, interrupt our operations and damage our reputation, subject us to state or federal agency review and could also result in regulatory enforcement actions, material fines and penalties, litigation or other actions which could have a material adverse effect on our business, reputation and results of operations, financial position, and cash flows.

We are subject to extensive fraud, waste, and abuse laws that may give rise to lawsuits and claims against us, the outcome of which may have a material adverse effect on our business, financial condition, cash flows, or results of operations.

Because we receive payments from federal governmental agencies, we are subject to various laws commonly referred to as “fraud, waste, and abuse” laws, including the federal Anti-Kickback Statute, the federal Physician Self-Referral Law, or Stark Law, and the federal False Claims Act, or FCA. These laws permit the Department of Justice, or DOJ, the HHS Office of Inspector General, or OIG, CMS, and other enforcement authorities to institute a claim, action, investigation, or other proceeding against us for violations and, depending on the facts and circumstances, to seek treble damages, criminal and civil fines, penalties, and assessments. Violations of these laws can also result in exclusion, debarment, temporary or permanent suspension from participation in government health

 

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care programs, the institution of corporate integrity agreements, or CIAs, and/or other heightened monitoring of our operations. Liability under such statutes and regulations may arise, among other things, if we knew, or it is determined that we should have known, that information we provided to form the basis for a claim for government payment was false or fraudulent, or that we were out of compliance with program requirements considered material to the government’s payment decision. Fraud, waste and abuse prohibitions encompass a wide range of activities, including, but not limited to, kickbacks or other inducements for referral of members or for the coverage of products (such as prescription drugs) by a plan, billing for unnecessary medical services by a health care provider, payments made to excluded providers, and improper marketing and beneficiary inducements.

The DOJ and the OIG have continuously increased their scrutiny of health care payers and providers, and Medicare Advantage insurers, under the FCA, in particular, which has led to a number of investigations, prosecutions, convictions, and settlements in the health care industry. We expect this trend to continue, particularly in light of the HHS’s December 4, 2020 announcement regarding the creation of a new False Claims Act Working Group aimed at enhancing HHS’s partnership with the DOJ to combat fraud and abuse. CMS and the OIG also periodically perform risk adjustment data validation, or RADV, audits of selected Medicare Advantage health insurance plans to validate the coding practices of, and supporting documentation maintained by health care providers. Certain of our health plans may be selected for such audits, which could in the future result in retrospective adjustments to payments made to our health plans, fines, corrective action plans, or other adverse action by CMS. On November 24, 2020, CMS issued a final rule that amends the RADV program by: (i) revising the methodology for error rate calculations beginning with the 2019 benefit year; and (ii) changing the way CMS applies RADV results to risk adjustment transfers beginning with the 2020 benefit year. According to CMS, these changes are designed to give insurers more stability and predictability with respect to the RADV program and promote fairness in how health insurers receive adjustments. However, the future impact of these changes remains unclear, and such changes may ultimately increase financial recoveries from the government’s ability to retrospectively claw back or recover funds from health insurers.

In particular, there has recently been increased scrutiny by the government on health insurers’ diagnosis coding and risk adjustment practices, particularly for Medicare Advantage plans. In some proceedings involving Medicare Advantage plans, there have been allegations that certain financial arrangements with providers violate other laws governing fraud and abuse, such as the federal Anti-Kickback Statute. Health insurers are required to maintain compliance programs to prevent, detect and remediate fraud, waste, and abuse, and are often the subject of fraud, waste, and abuse investigations and audits. We perform ongoing monitoring of our compliance with CMS risk adjustment requirements and other applicable laws. We also monitor our provider payment practices and relationships with other third parties whose products and services we reimburse (e.g., pharmaceutical manufacturers) to ensure compliance with applicable laws, including, but not limited to, the federal Anti-Kickback Statute. While we believe our compliance efforts and relationships with providers and other third parties comply with applicable laws, we may be subject to audits, reviews, and investigations of our practices and arrangements by government agencies.

The regulations, contractual requirements, and policies applicable to participants in government health care programs are complex and subject to change. Moreover, many of the laws, rules, and regulations in this area have not been well-interpreted by applicable regulatory agencies or the courts. Additionally, the significant increase in actions brought under the FCA’s “whistleblower” or “qui tam” provisions, which allow private individuals to bring actions on behalf of the government, has caused greater numbers of health care companies to have to defend a false claim action, pay fines, or agree to enter into a CIA to avoid being excluded from Medicare and other state and federal health care programs as a result of an investigation arising out of such action. Health plans and providers often seek to resolve these types of allegations through settlement for significant and material amounts,

 

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even when they do not acknowledge or admit liability, to avoid the uncertainty of treble damages that may be awarded in litigation proceedings. Such settlements often contain additional compliance and reporting requirements as part of a consent decree or settlement agreement, including, for example, CIAs, deferred prosecution agreements, or non-prosecution agreements. If we are subject to liability under qui tam or other actions or settlements, our business, financial condition, cash flows, or results of operations could be adversely affected.

Risks Related to our Business

If we are unable to arrange for the delivery of quality care, and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks, or if we are unable to enter into cost-effective contracts with such providers, our profitability could be adversely affected.

Our profitability depends, in large part, upon our ability to contract at competitive prices with hospitals, physicians, and other health care providers, such that we can provide our members with access to competitive provider networks. Our provider arrangements with primary care physicians, specialists, hospitals, and other health care providers generally may be terminated or not renewed by either party without cause upon prior written notice. We cannot provide any assurance that we will be able to continue to renew our existing contracts or enter into new contracts on a timely basis or under favorable terms enabling us to service our members profitably. Health care providers within our provider networks may not properly manage the costs of services, maintain financial solvency or avoid disputes with other providers or their federal and state regulators. Any of these events could have a material adverse effect on the provision of services to our members and our operations.

In any particular market or geography, physicians and other health care providers could refuse to contract, demand higher payments, demand favorable contract terms, or take other actions that could result in higher medical costs or difficulty in meeting regulatory or accreditation requirements, among other things. In some markets and geographies, certain health care providers, particularly hospitals, physician/hospital organizations, or multi-specialty physician groups, may have significant positions or near monopolies that could result in diminished bargaining power on our part. In addition, accountable care organizations, clinically integrated networks, independent practice associations, practice management companies (which aggregate physician practices for administrative efficiency and marketing leverage), and other organizational structures that physicians, hospitals and other health care providers choose may change the way in which these providers interact with us, and may change the competitive landscape. Such organizations or groups of health care providers may compete directly with us, which could adversely affect our operations, and our results of operations, financial position, and cash flows by impacting our relationships with these providers or affecting the way that we price our products and estimate our costs, which might require us to incur costs to change our operations. Health care providers in our provider networks may consolidate or merge into hospital systems, resulting in a reduction of providers in our network and in the competitive environment. In addition, if these providers refuse to contract with us, use their market position to negotiate contracts unfavorable to us or place us at a competitive disadvantage, our ability to market products or to be profitable in those areas could be materially and adversely affected.

From time to time, health care providers assert, or threaten to assert, claims seeking to terminate provider agreements. If a provider agreement were terminated, such termination could adversely impact the adequacy of our network to service our members, and may put us at risk of non-compliance with applicable federal and state laws. If we are unable to retain our current provider contract terms or enter into new provider contracts timely or on favorable terms, our profitability may be harmed. In addition, from time to time, we may in the future be subject to class action or other lawsuits by health care providers with respect to claims payment procedures, reimbursement policies, network

 

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participation, or similar matters. In addition, regardless of whether any such lawsuits brought against us are successful or have merit, they will be time-consuming and costly, and could have an adverse impact on our reputation. As a result, under such circumstances, we may be unable to operate our business effectively.

Some providers that render services to our members are not contracted with our health insurance subsidiaries. While our health insurance subsidiaries are required to meet various federal and state requirements regarding the size and composition of our participating provider networks, our business model is based, in the Individual and Medicare Advantage markets, and for certain of our Small Group plans, on contracting with selected health care systems and other providers, not all systems and providers in a given area. This allows us to work more closely with high quality health care systems that engage with us using our technology. That approach, however, makes it possible that our members will receive emergency services, or other services which we are required to cover by law or by the terms of our health plans, from providers who are not contracted with our health insurance subsidiaries. This situation is more likely for our members than for members who choose a plan from a competitor of ours with a broader network. In those cases, there is no pre-established understanding between the provider and our health insurance subsidiary about the amount of compensation that is due to the provider. In some states, and under federal law for our Medicare Advantage business, the amount of compensation is defined by law or regulation, but in most instances, it is either not defined or it is established by a standard that is not unambiguously translatable into dollars. In such instances, providers may claim they are underpaid for their services, and may either litigate or arbitrate their dispute with our health insurance subsidiary. Additionally, many states require us to hold our members harmless for these out-of-network costs, which can be significant. It is difficult to predict the amount we may have to pay to out-of-network providers. The uncertainty of the amount to pay to such providers and the possibility of subsequent adjustment of the payment could materially and adversely affect our business, financial condition, cash flows, or results of operations.

Moreover, the insolvency of one of our partners or providers could expose us to material liabilities. For example, a portion of our specialists and hospitals are paid on a capitated basis. We expect to maintain such arrangements or enter into similar arrangements as we expand. Under certain capitation arrangements, we pay a fixed amount PMPM to the provider without regard to the frequency, extent, or nature of the medical services actually furnished, and such provider is responsible for paying other providers in our network out of the capitation amount. Due to insolvency or other circumstances, such delegated providers with a capitation arrangement may be unable or unwilling to pay claims they have incurred with third party providers in connection with referral services provided to our members. The inability or unwillingness of delegated providers to pay referral claims presents us with both immediate financial risk and potential disruption to member care, as well as potential loss of members. Depending on states’ laws, we may be held liable for such unpaid referral claims even though the delegated provider has contractually assumed such risk. Additionally, competitive pressures or practical regulatory considerations may force us to pay such claims even when we have no legal obligation to do so, or we may have already paid claims to a delegated provider and such payments cannot be recouped when the delegated provider becomes insolvent. Such liabilities incurred or losses suffered as a result of provider insolvency or other circumstances could have a material adverse effect on our business, financial condition, cash flows, or results of operations.

The result of risk adjustment programs may impact our revenue, add operational complexity, and introduce additional uncertainties that have a material adverse effect on our results of operations, financial condition, and cash flows.

The Individual, Small Group, and Medicare Advantage markets we serve employ risk adjustment programs that impact the revenue we recognize for our enrolled membership. As a result of the variability of certain factors that go into the development of the risk adjustment we recognize, such as

 

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risk scores, and other market-level factors where applicable, the actual amount of revenue could be materially more or less than our estimates. Consequently, our estimate of our health plans’ risk scores for any period, and any resulting change in our accrual of revenues related thereto, could have a material adverse effect on our results of operations, financial condition, and cash flows. The data provided to CMS to determine the risk score are subject to audit by CMS even several years after the annual settlements occur. If the risk adjustment data we submit are found to incorrectly overstate the health risk of our members, we may be required to refund funds previously received by us and/or be subject to penalties or sanctions, including potential liability under the FCA, which could be significant and would reduce our revenue in the year that repayment or settlement is required. Further, if the data we provide to CMS incorrectly understates the health risk of our members, we might be underpaid for the care that we must provide to our members, which could have a negative impact on our results of operations and financial condition.

Significant delays in our receipt of direct policy premiums, including as a result of regulatory restrictions on policy cancellations and non-renewals, could have a material adverse effect on our business operations, cash flows, or earnings.

We currently derive substantially all of our revenue from direct policy premiums and recognize premium revenue over the period that coverage is effective. For the years ended December 31, 2019 and 2020, approximately 57% and 40% of our direct policy premiums, respectively, were collected directly from our members, and approximately 43% and 60% of our direct policy premiums, respectively, were collected from CMS as part of the APTC program. There can be no assurance that we will receive premiums in advance of or by the end of a given coverage period. Moreover, actions taken by state and federal governments could increase the likelihood of delay in our receipt of premiums. For example, in response to the COVID-19 pandemic, state insurance departments, including in states in which we operate, issued guidelines, recommendations, and moratoria around policy cancellations and non-renewals due to non-payment. In certain states, departments urged insurers to consider actions that included relaxing due dates for premium payments, extending grace periods, waiving late fees and penalties, and allowing premium payment plans to avoid a lapse in coverage. Certain states also prohibited insurers from terminating plans due to non-payment until a specified date. If such guidelines, recommendations, and moratoria were to remain in place for an extended period of time or if similar measures were introduced due to a resurgence of COVID-19 or for other reasons, including unanticipated public health or economic crises, our receipt of premiums, if any, could be significantly delayed, which could have a material adverse effect on our business, operations, cash flows, or earnings.

We make virtual health care services available to our members through Oscar Medical Group, in which we do not own any equity or voting interest, and our virtual care availability may be disrupted if our arrangements with providers like the Oscar Medical Group become subject to legal challenges.

Our corporate entities are not licensed to practice medicine. Pursuant to state corporate practice of medicine laws, many states in which we operate through our subsidiaries limit the practice of medicine to licensed individuals or professional organizations owned by licensed individuals, and business corporations generally may not exercise control over the medical decisions of physicians. Statutes and regulations relating to the corporate practice of medicine, fee-splitting between physicians and referral sources, and similar issues, vary widely from state to state. Mulberry Management Corporation, one of our subsidiaries, has group participation or management services agreements with three physician-owned professional corporations, known collectively as the Oscar Medical Group. Each of the professional corporations comprising the Oscar Medical Group is wholly owned by one physician licensed in California, Florida, and New York who oversees the operation of the Oscar Medical Group in his capacity as President and sole director of each Oscar Medical Group professional corporation.

 

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He also serves as a consultant to Mulberry Management Corporation. Under the terms of the management services agreements between Mulberry Management Corporation and the Oscar Medical Group, the Oscar Medical Group retains sole responsibility for all medical decisions, as well as for hiring and managing physicians and other licensed health care providers, developing operating policies and procedures, and implementing professional standards and controls. We believe that our services operations comply with applicable state statutes and regulations regarding corporate practice of medicine, fee-splitting, and similar issues. However, regulatory authorities and other parties may assert that, despite the management services agreements and other arrangements through which we operate, we are engaged in the prohibited corporate practice of medicine, that our arrangements constitute unlawful fee-splitting, or that other similar issues exist. To that end, many of the laws, rules, and regulations with respect to corporate practice of medicine are ambiguous and have not been well-interpreted by applicable regulatory agencies or the courts. Moreover, we cannot predict whether changes will be made to existing laws, regulations, or interpretations, or whether new ones will be enacted or adopted, which could cause us to be out of compliance with these requirements. If that were to occur, we could be subject to civil and/or criminal penalties, our agreements could be found legally invalid and unenforceable (in whole or in part), or we could be required to restructure our contractual arrangements, any of which could have a material adverse effect on our results of operations, financial position, or cash flows.

Our health insurance subsidiaries have entered into provider participation agreements with the Oscar Medical Group that enable the Oscar Medical Group to participate in Oscar’s provider network. While we expect that our relationship with the Oscar Medical Group will continue, a material change in our relationship with the Oscar Medical Group, whether resulting from a dispute among the entities or the loss of these relationships or contracts with the Oscar Medical Group, may temporarily disrupt our ability to provide virtual health care services to our members and could harm our business.

Our limited operating history makes it difficult to evaluate our current business performance, implementation of our business model, and our future prospects.

We launched our business in 2012 and have a limited operating history. Today, our insurance subsidiaries operate in 18 states, 15 of which we expanded to since 2017. Due to our limited operating history and the rapid growth we have experienced since we began operations, there is greater uncertainty in estimating our operating results, and our historical results may not be indicative of, or comparable to, our future results. In addition, we have limited data to validate key aspects of our business model, including our growth strategy. For example, we recently entered into an exclusive strategic partnership with Cigna to offer differentiated health solutions to small businesses. As a relatively new entrant in this market, we have limited experience and are unable to predict whether we will be able to effectively and consistently provide solutions that are tailored to the budgets of small businesses and to the health needs of their employees. We cannot provide any assurance that the data we collect will provide useful measures for evaluating our business model. Moreover, we cannot provide any assurance that partnerships or joint ventures we enter into in the future will perform as well as historical partnerships or expectations. Our inability to adequately assess our performance and growth could have a material adverse effect on our brand, reputation, business, financial condition, and results of operations.

Our revenue depends on the direct policy premiums we collect from members who obtain health care services from a limited number of in-network providers, and the loss of any of these providers could result in a material reduction of our membership, which would adversely impact our revenue and operating results.

Almost all of our revenue depends on the direct policy premiums we collect from members or from the federal government on behalf of our members who obtain health care services from a limited

 

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number of providers with whom we contract. We generally manage our provider contracts on a state-by-state basis, entering into separate contracts in each state with local affiliates of a particular provider, such that no one local provider contract receives a majority of our allowed medical costs for services rendered to our members. When aggregating the payments we make to each provider through its local affiliates, however, AdventHealth, Tenet Healthcare Corporation, and HCA Healthcare accounted for a total of approximately 11%, 9%, and 7%, respectively, of total allowable medical costs for the year ended December 31, 2020. We believe that a majority of our revenue will continue to be derived from direct policy premiums obtained from members who receive services from a concentrated number of providers. These providers may terminate or seek to terminate their contracts with us in the future. The sudden loss of any of our providers or the renegotiation of any of our provider contracts could adversely impact our reputation or the quality of our provider networks, which could result in a loss of a membership that adversely affects our revenue and operating results. In the ordinary course of business, we engage in active discussions and renegotiations with providers in respect of the terms of our provider contracts. Certain of our providers may seek to renegotiate or terminate their agreements with us for a variety of reasons, including in response to higher-than-expected health care costs and other market dynamics or financial pressures. These discussions could result in reductions to the fees and changes to the scope of services contemplated by our original provider agreements and, consequently, could negatively impact our revenues, business, and prospects.

Unanticipated changes in population morbidity, including those affecting areas where we are geographically concentrated, could significantly increase utilization rates and medical costs.

Large-scale changes in health care utilization or increases in medical costs can take many forms and may be associated with widespread natural disasters, illness, or medical conditions. The states in which we operate that have the largest concentrations of revenues include Florida, California and Texas. Due to the geographic concentration of our business, we are exposed to heightened risks of potential losses resulting from regional factors. For example, natural disasters, such as a major earthquake, wildfire, or hurricane, affecting regions or states in which we operate, could have a significant impact on the health of a large number of our covered members. Other conditions that could impact our members include a virulent influenza season or epidemic or pandemic, newly emergent mosquito-borne illnesses, such as the Zika virus, the West Nile virus, or the Chikungunya virus, or new viruses such as COVID-19. In addition, federal and state law enforcement officials have issued warnings in the past, and may do so in the future, about potential terrorist activity involving biological or other weapons of mass destruction.

All of these conditions, and others, could have a significant impact on the health of the population of wide-spread areas. We seek to ensure our premiums appropriately account for anticipated changes in utilization, including seasonal items, such as the flu. However, if any of the regions or states in which we operate were to experience a large-scale natural disaster, a viral epidemic or pandemic, a significant terrorism attack, or some other large-scale event affecting the health of a large number of our members, utilization rates and our covered medical expenses in such regions or states would rise, which could have a material adverse effect on our business, financial condition, cash flows, or results of operations. Additionally, such natural disasters, epidemics, or pandemics could lead to regulatory changes which may force us to cover health care costs for members for which we would not typically be responsible. For example, states experiencing pandemics or natural disasters such as wildfires and hurricanes may promulgate emergency regulations requiring insurers to relax prior authorization requirements, remove prescription drug refill limitations, and cover out-of-network care.

 

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The ongoing COVID-19 pandemic could significantly increase our costs of operation due to unanticipated changes in law or regulation, population morbidity, or utilization behaviors, adversely impact our operational effectiveness, and heighten the risks we face in our business, including those discussed in this prospectus.

In December 2019, a novel strain of coronavirus, SARS-CoV-2, was identified in Wuhan, China.

Since then, SARS-CoV-2, and the resulting disease, COVID-19, has spread rapidly to almost every country in the world and all 50 states within the United States. The COVID-19 pandemic continues to evolve and the impact of COVID-19, and the actions taken to contain its spread or address its impact, could have a material adverse effect on our operations and financial results.

We seek to ensure our direct policy premiums appropriately account for anticipated changes in utilization. However, our ability to do so accurately is limited by the changing nature of COVID-19 infection rates, the mutation of the COVID-19-causing virus into more infectious strains, the uncertain time frame to widespread availability and adoption of COVID-19 vaccines, the effectiveness of those vaccines against novel virus strains, and the evolving clinical understanding of COVID-19’s post-acute, long-term impacts on health. Governmental authorities have recommended, and in certain cases, required, that elective or other medical appointments be suspended or canceled to avoid non-essential patient exposure to medical environments and potential infection. We have experienced depressed non-COVID-19 related medical costs and, as the pandemic continues to affect the United States and as our members continue to change the way the utilize care, this trend may continue. Some of these costs will likely be incurred at a later date, resulting in increased medical claims expenses in the future. Additionally, as a result of those measures, we may be unable to fully implement clinical initiatives to manage health care costs and chronic conditions of our members and appropriately document their health risks and diagnoses to substantiate payments we may be entitled to under federal and state risk adjustment programs. The reduced demand for certain routine and non-critical medical services has also created financial stress for certain of our providers and could result in providers leaving our network, the insolvency of such providers, increased provider payment disputes, and less favorable payment terms from providers.

Additionally, the long-term health impacts of SARS-CoV-2 infection causing COVID-19 are not yet well known or understood. If a large-scale COVID-19 outbreak resulted in a significant number of our members needing unanticipated ongoing post-acute care, such as regular physical, occupational, or respiratory therapy, additional pharmaceutical intervention, or care for increased frequency of other illness resulting from a COVID-19-weakened immune system, our business could be materially adversely impacted due to an unanticipated increase in covered medical expenses.

State and federal governments have promulgated regulatory changes requiring us to relax premium collection practices, and cover health care costs for members for which we would not typically be responsible. For example, the Families First Coronavirus Response Act (the FFCRA), as amended by the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), requires member health care expenses incurred during a visit to evaluate the need for or obtain COVID-19 diagnostic testing to be borne entirely by us. Certain states, such as New York and New Jersey, require us to cover all costs of members’ receipt of medical care via telemedicine from any in-network provider. New large-scale COVID-19 outbreaks may result in additional regulation in our states of operation, which could limit our ability to collect unpaid premiums. In addition, we have expanded benefit coverage in areas such as COVID-19 care and testing, telemedicine, and pharmacy benefits; offered additional enrollment opportunities to those who previously declined employer-sponsored offerings; extended certain premium payment terms for customers experiencing financial hardship; simplified administrative practices; and accelerated payments to care providers, all with the aim of assisting our customers, providers and members in addressing the impacts of the COVID-19 pandemic. Such measures and any further steps taken by us, could adversely impact our financial results.

 

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The spread and impact of COVID-19, or actions taken to mitigate this spread, could also have a material and adverse effect on our ability to operate effectively, including as a result of the complete or partial closure of facilities or labor shortages. Disruptions in public and private infrastructure, including communications, availability of in-person sales and marketing channels, financial services and supply chains, could materially and adversely disrupt our normal business operations. We have transitioned most of our employee population to a remote work environment in an effort to mitigate the spread of COVID-19, as have a number of our third-party service providers, which may exacerbate certain risks to our business, including increased risk of phishing and other cybersecurity attacks, and increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us or our members or other third-parties.

The outbreak of COVID-19 has also severely impacted global economic activity, which may adversely impact our members, partners and service providers, and caused significant volatility in the financial markets. These developments may adversely affect the timing of member premium or commercial service fee collections and corresponding payments, the ability of third parties to provide services to us, the value of our investment portfolio, and our access to capital.

We are continuing to monitor the spread of COVID-19, changes to our covered services, the ongoing costs and business impacts of dealing with COVID-19, including the potential costs and impacts associated with lifting, or reimposing restrictions on movement and economic activity and related risks. The extent of this impact will depend on future developments, which are highly uncertain and cannot be predicted at this time, including, but not limited to, the transmission rate, introduction of new strains of COVID-19, duration and spread of the outbreak, its severity, the extent and effectiveness of the actions taken to contain the spread of the virus and address its impacts, including vaccine approval, effectiveness, availability and adoption, and how quickly and to what extent normal economic and operating conditions can resume. The ultimate impact of the COVID-19 pandemic on our business, results of operations, financial position, and cash flows is uncertain as the pandemic continues to evolve globally, but such impacts could be material to our business, results of operations, financial position and cash flows.

We utilize quota share reinsurance to reduce our capital and surplus requirements and protect against downside risk on the ceded claims. If regulators do not approve our reinsurance agreements for this purpose, or if we cannot negotiate renewals of our quota share arrangements on acceptable terms, or at all, enter into new agreements with reinsurers, or otherwise obtain capital through debt or equity financings, our capital position would be negatively impacted, and we could fall out of compliance with applicable regulatory requirements.

In 2020, we utilized quota share reinsurance arrangements with two other insurance companies, Axa France Vie and Berkshire Hathaway Specialty Insurance Company, to reduce our capital and surplus requirements, which enables us to more efficiently deploy capital to finance our growth. In connection with our quota share reinsurance arrangements, which generally have terms of two or three years, reinsurers are entitled to a portion of our premiums, but also share financial responsibility for health care costs incurred by our members. All premiums and claims ceded under our quota share arrangements are shared proportionally with our reinsurers, up to a limit specified in each agreement, which varies from 100% to 105% of ceded premiums for the agreements applicable to the years ended December 31, 2019 and 2020. These reinsurers have the unilateral right to extend certain of our arrangements if certain profitability limits are not met. Our decisions on claims payments are binding on the reinsurer with the exception of any payments by us that are not required to be made under the member’s policy. During the years ended December 31, 2019 and 2020, approximately 55% and 77% of our business, respectively, was ceded under quota share reinsurance arrangements, with approximately 33% and 32% of our business, respectively, ceded to Axa France Vie and approximately

 

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22% and 45% of our business, respectively, ceded to Berkshire Hathaway Specialty Insurance Company. We entered into statutory trust agreements with Axa France Vie in compliance with the credit for reinsurance laws and regulations of the state of domicile of each ceding company in connection with reinsurance ceded to an unauthorized reinsurer. Each trust account is funded at 102% of the ceding entity’s health care costs incurred but not yet reported, or IBNR. Acceptable assets deposited into the trust accounts include cash, certificates of deposit, and instruments that are acceptable to the commissioner of the insurance department of the ceding entity’s state of domicile.

Because reinsurers are entitled to a portion of our premiums under our quota share reinsurance arrangements, changes in the amount of business ceded under these arrangements directly impacts our net premium and net income estimates.

We also had XOL reinsurance arrangements for 2020 that covered claims on individuals in excess of $500,000, and anticipate entering into XOL reinsurance arrangements for 2021 to cover claims on individuals in excess of $750,000. We pay approximately 1% of premiums for this coverage to our reinsurer. The amount of business ceded under our reinsurance arrangements can vary significantly from year to year. Further, if our reinsurers consistently and successfully dispute our obligations to make a claim payment under a given policy, if we cannot renegotiate renewals of any of our quota share reinsurance arrangements (all of which are slated for negotiation in 2021) on acceptable terms, if we are unable to enter into such arrangements with additional reinsurers or, if such arrangements are not approved by any of our regulators (or if our regulators take a different view, whether prospectively or retroactively, with respect to the capital treatment of our reinsurance agreements), we may not have sufficient capital and surplus to comply with applicable regulatory requirements, and we would have to enter into a corrective action plan or cease operations in jurisdictions where we could not comply with such requirements.

These arrangements also subject us to various obligations, representations, and warranties with respect to the reinsurers. Reinsurance does not relieve us of liability as an insurer. We remain obligated to pay our members’ health care claims, even if a reinsurer defaults on obligations to us under the reinsurance arrangement. Although we regularly evaluate the financial condition of reinsurers to minimize exposure to significant losses from reinsurer insolvencies, reinsurers may become financially unsound. If a reinsurer fails to meet its obligations under the reinsurance contract or if the liabilities exceed any applicable loss limit, we remain responsible for covering the claims on the reinsured policies.

We also rely on debt and equity to help fund subsidiary surplus requirements, as well as pay our operating expenses and capital expenditures or fund acquisitions. In the event we need access for such purposes, our ability to obtain such capital may be limited and it may come at significant cost.

We are subject to risks associated with outsourcing services and functions to third parties.

We contract with third-party vendors and service providers who provide services to us and our subsidiaries to help with our internal administrative functions, as well as third-party vendors and service providers who help us administer our products and plans. For example, CaremarkPCS Health provides certain prescription benefit management, disease management, and specialty pharmacy services with respect to our health plans. In New Jersey, we contract with QualCare, which provides us with access to its network, which represents a significant portion of our medical network in New Jersey, and various network management services. The partial or complete loss of a vendor or other third-party relationship could cause a material disruption to our business and make it difficult and costly to provide services and products that our regulators and members expect, which could have a material adverse effect on our financial condition, cash flows, and results of operations.

 

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Some of these third-parties have direct access to our systems in order to provide their services to us and operate the majority of our communications, network, and computer hardware and software. For example, we currently offer our products through our website and online app using Amazon Web Services, Inc., or AWS, platforms for cloud computing, a provider of cloud infrastructure services, and the Google Cloud Platform, or GCP. Our operations depend on protecting the virtual cloud infrastructure hosted in AWS and GCP by maintaining its configuration, architecture, and interconnection specifications, as well as the information stored in these cloud platforms and which third-party internet service providers transmit. In the event that either our AWS or GCP service agreement is terminated, or there is a lapse of service, interruption of internet service provider connectivity, or damage to such facilities, we could experience interruptions in meeting key service obligations to our members and business partners, as well as delays and additional expense in arranging new facilities and services, which could harm our business, results of operations, and financial condition.

Other third-parties that have access to our systems and member information, or provide services that help with our administrative functions include Atlassian Corporation Plc, or Atlassian, which provides a reporting and project management tool called Jira for certain of our health insurance subsidiaries to launch and track investigations, make changes to member information, and communicate efficiently with departments within Oscar, and inContact, Inc., or inContact, which provides cloud-based contact center software solutions that we use to engage with members. The Oscar platform also integrates various third-party applications, including Google LLC, or Google, Workplace applications, such as Gmail, Hangouts, Calendar, and Drive.

Our arrangements with third-party vendors and service providers may make our operations vulnerable if those third parties fail to satisfy their obligations to us, including their obligations to maintain and protect the security and confidentiality of our information and data, or the information and data relating to our members or customers. We are also at risk of a data security incident involving a vendor or third party, which could result in a breakdown of such third party’s data protection processes or cyber-attackers gaining access to our infrastructure through the third party. To the extent that a vendor or third party suffers a data security incident that compromises its operations, we could incur significant costs and possible service interruption. In addition, we may have disagreements with our third-party vendors or service providers regarding relative responsibilities for any such failures or incidents under applicable business associate agreements or other applicable outsourcing agreements. Any contractual remedies and/or indemnification obligations we may have for vendor or service provider failures or incidents may not be adequate to fully compensate us for any losses suffered as a result of any vendor’s failure to satisfy its obligations to us or under applicable law. Our vendor and service provider arrangements could be adversely impacted by changes in vendors’ or service providers’ operations or financial condition, or other matters outside of our control. Violations of, or noncompliance with, laws and/or regulations governing our business or noncompliance with contract terms by third-party vendors and service providers could increase our exposure to liability to our members, providers, or other third parties, or could result in sanctions and/or fines from the regulators that oversee our business. In turn, this could increase the costs associated with the operation of our business or have an adverse impact on our business and reputation. Moreover, if these vendor and service provider relationships were terminated for any reason, we may not be able to find alternative partners in a timely manner or on acceptable financial terms, and may incur significant costs and/or experience significant disruption to our operations in connection with any such vendor or service provider transition. As a result, we may not be able to meet the full demands of our members or customers and, in turn, our business, financial condition, and results of operations may be harmed. In addition, we may not fully realize the anticipated economic and other benefits from our outsourcing projects or other relationships we enter into with third-party vendors and service providers, as a result of unanticipated delays in transitioning our operations to the third-party vendor or service provider, such third-party vendor or service provider’s noncompliance with contract terms, unanticipated costs or

 

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expenses, or violations of laws and/or regulations, or otherwise. This could result in substantial costs or other operational or financial problems that could have a material adverse effect on our business, financial condition, cash flows, or results of operations.

Adverse market conditions may result in our investment portfolio suffering losses or reduce our ability to meet our financing needs, which could materially and adversely affect our results of operations or liquidity.

We maintain a significant investment portfolio of cash equivalents and primarily short-term investments in a variety of securities, which are subject to general credit, liquidity, market, and interest rate risks and will decline in value if interest rates increase or one of the issuers’ credit ratings is reduced. As a result, we may experience a reduction in value or loss of our investments, which could have a materially adverse effect on our results of operations, liquidity, and financial condition.

In addition, during periods of increased volatility, adverse securities and credit markets may exert downward pressure on the availability of liquidity and credit capacity for certain issuers. We need liquidity to pay our operating expenses, make payments on our indebtedness and pay capital expenditures. The principal sources of our cash receipts are premiums, administrative fees, investment income, proceeds from borrowings and proceeds from the issuance of capital stock. Our access to additional financing will depend on a variety of factors such as market conditions, the general availability of credit, the volume of trading activities, the availability of credit to our industry, our credit ratings and credit capacity, as well as the possibility that customers or lenders could develop a negative perception of our long- or short-term financial prospects. Similarly, our access to funds may be impaired if regulatory authorities or rating agencies take negative actions against us. If one or a combination of these factors were to occur, our internal sources of liquidity may prove to be insufficient and, in such case, we may not be able to successfully obtain additional financing on favorable terms, or at all.

If state regulators do not approve payments of dividends and distributions by our subsidiaries to us, we may not have sufficient funds to implement our business strategy.

As we operate as one or more holding companies and we principally generate revenue through our health insurance subsidiaries, we are regulated under state insurance holding company laws. Although most of our subsidiaries are not currently profitable, in the future, if they become profitable or if our current levels of reserves and capital become excessive, we may make requests for dividends and distributions from our subsidiaries to fund our operations. In addition to state corporate law limitations, these subsidiaries are subject to more stringent laws and regulations that may restrict the ability to pay or limit the amount of dividends and distributions that can be paid to us without prior approval of, or notification to, state regulators, including mandatory statutory capital and surplus requirements. As we become profitable, we may increasingly rely on distributions from our subsidiaries, and if regulators were to deny our subsidiaries’ requests to pay dividends, the funds available to us would be limited, which could harm our ability to implement our business strategy.

If we are unable to integrate and manage our information systems effectively, our operations could be disrupted.

Our operations depend significantly on effective information systems. The information gathered and processed by our information systems, assists us in, among other things, monitoring utilization and other cost factors, processing provider claims, and providing data to our regulators. Our health care providers also depend upon our information systems for membership verifications, claims status, and other information. We partner with third parties, including Amazon, Atlassian, inContact, and Google, to support our information technology systems. Our information systems and applications require

 

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continual maintenance, upgrading, and enhancement to meet our current and expected operational needs and regulatory requirements. If we underestimate the need to expand or experience difficulties with the transition to or from information systems or do not appropriately plan, integrate, maintain, enhance, or expand our information systems, we could suffer, among other things, operational disruptions, loss of existing members and difficulty in attracting new members, regulatory enforcement, and increases in administrative expenses. In addition, our ability to integrate and manage our information systems may be impaired as the result of events outside our control, including acts of nature, such as earthquakes or fires, or acts of terrorists. Also, we may from time to time obtain significant portions of our systems-related or other services or facilities from independent third parties, which may make our operations vulnerable if such third parties discontinue such services or fail to perform adequately.

From time to time, we may become involved in costly and time-consuming litigation and regulatory actions, which require significant attention from our management.

From time to time, we are a defendant in lawsuits and the subject of regulatory actions, and are subject to audits and investigations relating to our business, including, without limitation, claims by members alleging failure to pay for or authorize payment for health care, claims related to non-payment or insufficient payments for out-of-network services by providers, claims of trademark and other intellectual property infringement, claims alleging bad faith, inquiries regarding our submission of risk adjustment data, enforcement actions by state regulatory bodies alleging non-compliance with state law, and claims related to the imposition of new taxes, including, but not limited to, claims that may have retroactive application. We also may receive subpoenas and other requests for information from various federal and state agencies, regulatory authorities, state Attorneys General, committees, subcommittees, and members of the U.S. Congress and other state, federal, and international governmental authorities. Due to the inherent uncertainties of litigation and regulatory proceedings, we cannot accurately predict the ultimate outcome of any such proceedings. An unfavorable outcome could have a material adverse impact on our business and financial position, results of operations, and/or cash flows, and may affect our reputation and brand. In addition, regardless of the outcome of any litigation or regulatory proceedings, investigations, audits, or reviews, responding to such matters is costly and time consuming, and requires significant attention from our management, and could, therefore, harm our business and financial position, results of operations or cash flows. Insurance may not cover such claims, may not provide sufficient payments to cover all of the costs to resolve one or more such claims, and may result in our having to pay significant fines, judgments, or settlements, which, if uninsured, or if the fines, judgments, and settlements exceed insured levels, could adversely affect our results of operations and cash flows, thereby harming our business. See “Business—Legal Proceedings.”

The regulations and contractual requirements applicable to us and other market participants are complex and subject to change, making it necessary for us to invest significant resources in complying with our regulatory and contractual requirements. Ongoing vigorous legal enforcement and the highly technical regulatory scheme mean that our compliance efforts in this area will continue to require significant resources, and we may not always be successful in ensuring appropriate compliance by our Company, employees, consultants, or vendors, for whose compliance or lack thereof we may be held responsible and liable. Regulatory audits, investigations, and reviews could result in changes to our business practices, and also could result in significant or material premium refunds, fines, penalties, civil liabilities, criminal liabilities, or other sanctions, including marketing and enrollment sanctions, suspension or exclusion from participation in government programs, imposition of heightened monitoring by our federal or state regulators, and suspension or loss of licensure if we are determined to be in violation of applicable laws or regulations. Any of these audits, reviews, or investigations could have a material adverse effect on our financial position, results of operations, or business, or could result in significant liabilities and negative publicity for our Company.

 

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We rely on the experience and expertise of our Co-Founders, senior management team, highly-specialized technology and insurance experts, key technical employees, and other highly skilled personnel.

Our success depends upon the continued service of Mario Schlosser, our Co-Founder, Chief Executive Officer and a member of our board of directors, and Joshua Kushner, our Co-Founder, Vice Chairman and a member of our board of directors, the members of our senior management team, highly-specialized insurance experts, and key technical employees, as well as our ability to continue to attract and retain additional highly qualified personnel. Our future success depends on our continuing ability to identify, hire, develop, motivate, retain, and integrate highly skilled personnel for all areas of our business. If we are unable to attract the requisite personnel, our business, and prospects may be adversely affected. Each of our Co-Founders, members of our senior management team, specialized technology and insurance experts, key technical personnel, and other employees could terminate their relationship with us at any time. The loss of our Co-Founders or any other member of our senior management team, specialized technology and insurance experts, or key personnel might significantly delay or prevent the achievement of our strategic business objectives and could harm our business. In addition, much of our essential technology and infrastructure are custom-made for our business by our personnel. The loss of key technology personnel, including members of management, as well as our engineering and product development personnel, could disrupt our operations and harm our business. We also rely on a small number of highly-specialized insurance experts, the loss of any one of whom could have a disproportionate impact on our business. Competition in our industry for qualified employees is intense. Our compensation arrangements, such as our equity award programs, may not always be successful in attracting new employees, and retaining and motivating our existing employees. Moreover, if and when the stock options or other equity awards are substantially vested, employees under such equity arrangements may be more likely to leave, particularly when the underlying shares have seen a value appreciation.

We face significant competition for personnel, particularly in New York, where our headquarters is located. To attract top talent, we have to offer, and believe we will need to continue to offer, competitive compensation and benefits packages. We may also need to increase our employee compensation levels in response to competitor actions. If we are unable to hire new employees quickly enough to meet our needs, or otherwise fail to effectively manage our hiring needs or successfully integrate new hires, including our recently hired management team members, our efficiency, ability to meet forecasts and our employee morale, productivity, and retention could suffer, which in turn could have an adverse effect on our business, results of operations, and financial condition.

If we or our partners or other third parties with whom we collaborate sustain a cyber-attack or suffer privacy or data security breaches that disrupt our information systems or operations, or result in the dissemination of sensitive personal or confidential information, we could suffer increased costs, exposure to significant liability, adverse regulatory consequences, reputational harm, loss of business, and other serious negative consequences.

As part of our normal operations, we and our partners and other third parties with whom we collaborate routinely collect, process, store, and transmit large amounts of data, including PHI subject to HIPAA, as well as proprietary or confidential information relating to our business or third parties, including our members, providers, and vendors. Information security risks have generally increased in recent years because of the proliferation of new technologies and the increased sophistication and activities of perpetrators of cyber-attacks, as well as a result of an increase in work-from-home arrangements due to the COVID-19 pandemic. Hackers and data thieves are increasingly sophisticated and operating large-scale and complex automated attacks. As cyber threats continue to evolve, we may be required to expend additional resources to further enhance our information security measures, develop additional protocols and/or investigate and remediate any information security vulnerabilities.

 

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Our information technology systems and safety control systems are subject to a growing number of threats from computer programmers, hackers, and other adversaries that may be able to penetrate our network security and misappropriate our confidential information or that of third parties, create system disruptions, or cause damage, security issues, or shutdowns. They also may be able to develop and deploy viruses, worms, and other malicious software programs that attack our systems or otherwise exploit security vulnerabilities. Because the techniques used to circumvent, gain access to, or sabotage security systems, can be highly sophisticated and change frequently, they often are not recognized until launched against a target, and may originate from less regulated and remote areas around the world. We may be unable to anticipate these techniques or implement adequate preventive measures, resulting in potential data loss and damage to our systems. Our systems are also subject to compromise from internal threats such as improper action by employees, including malicious insiders, or by vendors, counterparties, and other third parties with otherwise legitimate access to our systems. Our policies, employee training (including phishing prevention training), procedures, and technical safeguards may not prevent all improper access to our network or proprietary or confidential information by employees, vendors, counterparties, or other third parties. Our facilities may also be vulnerable to security incidents or security attacks, acts of vandalism or theft, misplaced or lost data, human errors, or other similar events that could negatively affect our systems, and our and our members’, data. Additionally, our third-party service providers who process information on our behalf may cause security breaches for which we are responsible.

Moreover, we face the ongoing challenge of managing access controls in a complex environment. The process of enhancing our protective measures can itself create a risk of systems disruptions and security issues. Given the breadth of our operations and the increasing sophistication of cyber-attacks, a particular incident could occur and persist for an extended period of time before being detected. The extent of a particular cyber-attack and the steps that we may need to take to investigate the attack may take a significant amount of time before such an investigation could be completed and full and reliable information about the incident is known. During such time, the extent of any harm or how best to remediate it might not be known, which could further increase the risks, costs, and consequences of a data security incident. In addition, our systems must be routinely updated, patched, and upgraded to protect against known vulnerabilities. The volume of new software vulnerabilities has increased substantially, as has the importance of patches and other remedial measures. In addition to remediating newly identified vulnerabilities, previously identified vulnerabilities must also be updated. We are at risk that cyber-attackers exploit these known vulnerabilities before they have been addressed. The complexity of our systems and platforms, the increased frequency at which vendors are issuing security patches to their products, our need to test patches, and, in some instances, coordinate with third-parties before they can be deployed, all could further increase our risks.

Any compromise or perceived compromise of the security of our systems or the systems of one or more of our vendors or service providers could damage our reputation and brand, cause the termination of relationships with our members, result in disruption or interruption to our business operations, marketing partners and carriers, reduce demand for our services, and subject us to significant liability and expense, as well as regulatory action and lawsuits, which would harm our business, operating results, and financial condition. The CCPA, in particular, includes a private right of action for California consumers whose CCPA-covered personal information is impacted by a data security incident resulting from a company’s failure to maintain reasonable security procedures and, hence, may result in civil litigation in the event of a data breach impacting such information. Although we maintain insurance covering certain security and privacy damages and claim expenses, we may not carry insurance or maintain coverage sufficient to compensate for all liability and, in any event, insurance coverage would not address the reputational damage that could result from a security incident or any regulatory actions or litigation that may result. In addition, in the event that additional data security laws are implemented, we may not be able to timely comply with such requirements, or such requirements may not be compatible with our current processes.

 

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Real or perceived errors, failures or bugs in our systems, website, or app could impair our operations, damage our reputation and brand, and harm our business and operating results.

Our continued success is dependent on our systems, applications, and software continuing to operate and to meet the changing needs of our members and users. We rely on our technology and engineering staff and vendors to successfully implement changes to, and maintain, our systems and services in an efficient and secure manner. Like all information systems and technology, our website and online app may contain material errors, failures, vulnerabilities, or bugs, particularly when new features or capabilities are released, any of which could lead to interruptions, delays, or website or online app shutdowns, or could cause loss of critical data, or the unauthorized disclosure, access, acquisition, alteration or use of personal or other confidential information.

A significant impact on the performance, reliability, security, and availability of our systems, software, or services may harm our reputation and brand, impair our ability to operate, retain existing members, or attract new members, and expose us to legal claims and government action, each of which could have a material adverse impact on our financial condition, results of operations, and growth prospects.

We may not be able to utilize our net operating loss carryforwards, or NOLs, to offset future taxable income for U.S. federal income tax purposes, which could adversely affect our cash flows.

As of December 31, 2020, we had federal income tax NOLs of $1.05 billion available to offset our future taxable income, if any, prior to consideration of annual limitations that may be imposed under Section 382 of the U.S. Internal Revenue Code of 1986, as amended, or the Code, or otherwise. Of our NOLs, approximately $792.1 million of losses will expire between 2032 and 2039, and $253.9 million of losses can be carried forward indefinitely.

We may be unable to use our NOLs, as we do not have a history of positive earnings. In addition, under Section 382 of the Code, if a corporation undergoes an “ownership change” (very generally defined as a greater than 50% change, by value, in the corporation’s equity ownership by certain shareholders or groups of shareholders over a rolling three-year period), the corporation’s ability to use its pre-ownership change NOLs to offset its post-ownership change income may be limited. We completed an analysis under Section 382, and determined that our NOLs are subject to limitations based on changes in ownership that occurred in 2016, and we may experience ownership changes in the future as a result of subsequent shifts in our stock ownership, including this offering, some of which may be outside of our control. If we undergo another ownership change, we may incur additional limitations on our ability to utilize our NOLs existing at the time of the ownership change prior to their expiration. Future regulatory changes could also limit our ability to utilize our NOLs. To the extent we are not able to offset future taxable income with our NOLs, our cash flows may be adversely affected.

Failure to secure, protect, or enforce our intellectual property rights could harm our business, results of operations, and financial condition.

Our commercial success is dependent in part on protecting our core technologies, intellectual property assets, and proprietary rights (such as source code, information, data, processes, and other forms of information, know-how, and technology). We rely on a combination of copyrights, trademarks, service marks, trade secret laws, and contractual restrictions to establish and protect our intellectual property. However, there are steps that we have not yet taken to protect our intellectual property on a global basis. For example, we do not have any patents, which limits our ability to deter patent infringement claims by competitors and other third parties who may hold or obtain patents. Additionally, the steps that we have already taken to protect our intellectual property may not be sufficient or

 

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effective, and our confidentiality, non-disclosure, or invention assignment agreements with employees, consultants, partners, or other parties may be breached and may otherwise not be effective in establishing our rights in intellectual property and in controlling access to our proprietary information. Even if we do detect violations, we may need to engage in litigation to enforce our rights.

We currently hold various domain names relating to our brand, including HiOscar.com. We also engage a third-party vendor to monitor fictitious sites that may purport to be us. Failure to protect our domain names could adversely affect our reputation and brand, and make it more difficult for users to find our website and our online app. We may be unable, without significant cost or at all, to prevent third parties from diverting traffic from or acquiring domain names that are similar to, infringe upon, or otherwise decrease the value of our trademarks and other proprietary rights.

While we take precautions designed to protect our intellectual property, it may still be possible for competitors and other unauthorized third parties to copy our technology and use our proprietary brand, content, and information to create or enhance competing solutions and products, which could adversely affect our competitive position in our rapidly evolving and highly competitive industry. Some license provisions that protect against unauthorized use, copying, decompiling, transfer, and disclosure of our technology may be unenforceable under the laws of certain jurisdictions and foreign countries, and the remedies for such events may not be sufficient to compensate for such breaches. We enter into confidentiality and invention assignment agreements with our employees and consultants, and enter into confidentiality agreements with our third-party providers and strategic partners. We cannot assure you that these agreements will be effective in controlling access to, and use and distribution of, our platform and proprietary information. Further, these agreements do not prevent our competitors from independently developing technologies that are substantially equivalent or superior to our offerings. Such arrangements may limit our ability to protect, maintain, enforce, or commercialize such intellectual property rights. If we are unable to prevent the unauthorized use or exploitation of our intellectual property, the value of our brand, content, and other intangible assets may be diminished, competitors may be able to more effectively mimic our service and methods of operations, the perception of our business and service to members, and potential members, may become confused, and our ability to attract customers may be adversely affected. Any inability or failure to protect our intellectual property could adversely impact our business, results of operations, and financial condition.

We have filed, and may continue in the future to file, applications to protect certain of our innovations and intellectual property. We do not know whether any of our applications will result in the issuance of a patent, trademark, or copyright, as applicable, or whether the examination process will require us to narrow our claims. In addition, we may not receive competitive advantages from the rights granted under our intellectual property. Our existing intellectual property, and any intellectual property granted to us, or that we otherwise acquire in the future, may be contested, circumvented, or invalidated, and we may not be able to detect or prevent third parties from infringing our rights to our intellectual property. Therefore, the exact effect of the protection of this intellectual property cannot be predicted with certainty. In addition, given the costs, effort, and risks of obtaining patent protection, including the requirement to ultimately disclose the invention to the public, we may choose not to seek patent protection for certain innovations. Any failure to adequately obtain such patent protection, or other intellectual property protection, could later prove to adversely impact our business.

We may be required to spend significant resources in order to monitor, protect, and defend our intellectual property rights, and some violations may be difficult or impossible to detect. Litigation to protect and enforce our intellectual property rights could be costly, time-consuming, and distracting to management, and could result in the impairment or loss of portions of our intellectual property. Our efforts to enforce our intellectual property rights may be met with defenses, counterclaims, and countersuits attacking the validity and enforceability of our intellectual property rights. Our inability to protect our proprietary technology against unauthorized copying or use, as well as any costly litigation

 

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or diversion of our management’s attention and resources, could impair the functionality of our platform, delay introductions of enhancements to our platform, result in our substituting inferior or more costly technologies into our platform, or harm our reputation or brand. In addition, we may be required to license additional technology from third parties to develop and market new offerings or platform features, which may not be on commercially reasonable terms, or at all, and could adversely affect our ability to compete or require us to rebrand or otherwise modify our offerings, which could further exhaust our resources. Furthermore, we may also be obligated to indemnify our members or business partners in connection with any such litigation and to obtain licenses.

Risks Related to our Indebtedness

Our debt obligations contain restrictions that impact our business and expose us to risks that could materially adversely affect our liquidity and financial condition.

As of December 31, 2020, on a pro forma basis, after giving effect to the application of the net proceeds of this offering as described in “Use of Proceeds,” we would have had outstanding indebtedness of approximately $                . We may incur additional indebtedness in the future, including borrowings under the New Revolving Credit Facility, which we plan to enter into as described in “Prospectus Summary—Recent Developments—New Revolving Credit Facility.” Our indebtedness could have significant effects on our business, such as:

 

   

limiting our ability to borrow additional amounts to fund capital expenditures, acquisitions, debt service requirements, execution of our growth strategy and other purposes;

 

   

limiting our ability to make investments, including acquisitions, loans and advances, and to sell, transfer or otherwise dispose of assets;

 

   

requiring us to dedicate a substantial portion of our cash flow from operations to pay principal and interest on our borrowings, which would reduce availability of our cash flow to fund working capital, capital expenditures, acquisitions, execution of our growth strategy and other general corporate purposes;

 

   

making us more vulnerable to adverse changes in general economic, industry and competitive conditions, in government regulation and in our business by limiting our ability to plan for and react to changing conditions;

 

   

placing us at a competitive disadvantage compared with our competitors that have less debt; and

 

   

exposing us to risks inherent in interest rate fluctuations because our borrowings are at variable rates of interest, which could result in higher interest expense in the event of increases in interest rates.

In addition, we may not be able to generate sufficient cash flow from our operations to repay our indebtedness when it becomes due and to meet our other cash needs. If we are not able to pay our borrowings as they become due, we will be required to pursue one or more alternative strategies, such as selling assets, refinancing or restructuring our indebtedness or selling additional debt or equity securities. We may not be able to refinance our debt or sell additional debt or equity securities or our assets on favorable terms, if at all, and if we must sell our assets, it may negatively affect our business, financial condition and results of operations. In addition, we may be subject to prepayment penalties depending on when we repay our indebtedness, which amounts could be material.

 

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Restrictions imposed by our Term Loan Facility may materially limit our ability to operate our business and finance our future operations or capital needs.

The terms of our Term Loan Facility, which we intend to repay in full using the proceeds of this offering, may restrict us and our restricted subsidiaries from engaging in specified types of transactions. We expect our New Revolving Credit Facility to have similar terms. These covenants, subject to certain limitations and exceptions, restrict our ability, and that of our subsidiaries, to, among other things:

 

   

incur indebtedness;

 

   

incur certain liens;

 

   

enter into sale and lease-back transactions;

 

   

make investments, loans, advances, guarantees and acquisitions;

 

   

consolidate, merge or sell or otherwise dispose of assets;

 

   

pay dividends or make other distributions on equity interests, or redeem, repurchase or retire equity interests;

 

   

enter into transactions with affiliates;

 

   

alter the business conducted by us and our subsidiaries; and

 

   

change their fiscal year.

A breach of any of these covenants, or any other covenant in the documents governing our Term Loan Facility, could result in a default or event of default under our Term Loan Facility. We anticipate the Revolving Credit Facility will also include defaults or events of defaults for, among other things, payment defaults, breaches of representations and warranties, covenant defaults, certain cross-defaults and cross-accelerations to other indebtedness, certain events of bankruptcy and insolvency, certain judgments and changes of control. In the event of any event of default under our Term Loan Facility, the applicable lenders or agents could elect to terminate borrowing commitments and declare all borrowings and loans outstanding thereunder, together with accrued and unpaid interest and any fees and other obligations, to be immediately due and payable. In addition, or in the alternative, the applicable lenders or agents could exercise their rights under the security documents entered into in connection with our Term Loan Facility. We have pledged substantially all of our assets as collateral securing our Term Loan Facility and any such exercise of remedies on any material portion of such collateral would likely materially adversely affect our business, financial condition or results of operations.

If we were unable to repay or otherwise refinance these borrowings and loans when due, and the applicable lenders proceeded against the collateral granted to them to secure that indebtedness, we may be forced into bankruptcy or liquidation. In the event the applicable lenders accelerate the repayment of our borrowings, we may not have sufficient assets to repay that indebtedness. Any acceleration of amounts due under our Term Loan Facility or other outstanding indebtedness would also likely have a material adverse effect on us.

Pursuant to our Credit Agreement, we are required to comply with certain financial covenants to maintain a minimum dollar threshold of gross premiums (as defined in the Credit Agreement), a minimum combined ratio (as defined in the Credit Agreement) and minimum liquidity (as defined in the Credit Agreement) as further described in “Description of Certain Indebtedness.” Our ability to borrow under our Credit Agreement depends on our compliance with these financial covenants. We expect will have to comply with certain financial covenants in the New Revolving Credit Facility as well. Events beyond our control, including changes in general economic and business conditions, may affect our ability to satisfy the financial covenants. We cannot assure you that we will satisfy the financial covenants in the future, or that our lenders will waive any failure to satisfy the financial covenants.

 

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Changes in the method pursuant to which the London Interbank Offered Rate, or LIBOR, is determined and the transition to other benchmarks may adversely affect our results of operations.

LIBOR and certain other “benchmarks” have been the subject of continuing national, international, and other regulatory guidance and proposals for reform. These reforms may cause such benchmarks to perform differently than in the past or have other consequences which cannot be predicted. In July 2017, the United Kingdom’s Financial Conduct Authority, which regulates LIBOR, publicly announced that it intends to stop persuading or compelling banks to submit LIBOR rates after 2021. To identify a successor rate for U.S. dollar LIBOR, the Alternative Reference Rates Committee or ARRC, a U.S. based group convened by the Federal Reserve Board and the Federal Reserve Bank of New York, was formed. The ARRC is comprised of a diverse set of private sector entities and a wide array of official-sector entities, banking regulators, and other financial sector regulators. The ARRC has identified the Secured Overnight Financing Rate, or SOFR, as its preferred alternative rate for LIBOR. SOFR is a measure of the cost of borrowing cash overnight, collateralized by U.S. Treasury securities, and is based on directly observable U.S. Treasury-backed repurchase transactions. Financial regulators in the United Kingdom, the European Union, Japan, and Switzerland also have formed working groups with the aim of recommending alternatives to LIBOR denominated in their local currencies. Although SOFR appears to be the preferred replacement rate for U.S. dollar LIBOR, it is unclear if other benchmarks may emerge or if other rates will be adopted outside of the United States.

The Term Loan Facility has interest rate payments determined directly or indirectly based on LIBOR. We also expect that our New Revolving Credit Facility to have interest rate payments determined directly or indirectly based on LIBOR. Uncertainty regarding the continued use and reliability of LIBOR as a benchmark interest rate could adversely affect the performance of LIBOR relative to its historic values. The Term Loan Facility contains “hardwired” benchmark replacement provisions with “early opt-in” triggers that permit the replacement of LIBOR prior to the phasing out of published LIBOR rates. The benchmark replacement language contemplates the use of an alternative benchmark rate to be selected by the Administrative Agent, which may include Term SOFR. Even if financial instruments are transitioned to alternative benchmarks, such as SOFR, successfully, the new benchmarks are likely to differ from LIBOR, and our interest expense associated with our outstanding indebtedness or any future indebtedness we incur may increase. Further, transitioning to an alternative benchmark rate, such as SOFR, may result in us incurring significant expense and legal risks, as renegotiation and changes to documentation may be required in effecting the transition. Any alternative benchmark rate may be calculated differently than LIBOR and may increase the interest expense associated with our existing or future indebtedness.

Any of these occurrences could materially and adversely affect our borrowing costs, financial condition, and results of operations.

Risks Related to this Offering and Ownership of Our Class A Common Stock

Our management team will have immediate and broad discretion over the use of the net proceeds from this offering and may not use them effectively.

The principal purposes of this offering are to increase our capitalization and financial flexibility and create a public market for our Class A common stock. We expect to use approximately $             million of the net proceeds of this offering to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility and the remainder of such net proceeds for general corporate purposes, including to fund our growth (including capital contributions to our health insurance subsidiaries), technology development, working capital, operating expenses, and capital expenditures. Additionally, we may use a portion of the net proceeds to acquire or invest in products, services, or technologies; however, we do not have agreements or commitments for any material investments at

 

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this time. See “Use of Proceeds.” As of the date of this prospectus, other than repayment of indebtedness under our Term Loan Facility, we do not have a specific plan for the net proceeds to us from this offering and, accordingly, we are not able to allocate the net proceeds among any of these potential uses in light of the variety of factors that will impact how such net proceeds are ultimately utilized by us. Our management will have broad discretion in the application of the net proceeds. Our stockholders may not agree with the manner in which our management chooses to allocate the net proceeds from this offering. The failure by our management to apply these funds effectively could have a material adverse effect on our business, financial condition, and results of operation. Pending their use, we may invest the net proceeds from this offering in a manner that does not produce income. The decisions made by our management may not result in positive returns on your investment and you will not have an opportunity to evaluate the economic, financial, or other information upon which our management bases its decisions.

Our Class A common stock price may be volatile or may decline regardless of our operating performance, and you may not be able to resell your shares at or above the initial public offering price.

Prior to this offering, there has not been a public trading market for shares of our Class A common stock. It is possible that after this offering an active trading market will not develop or continue or, if developed, that any market will be sustained, which could make it difficult for you to sell your shares of Class A common stock at an attractive price or at all. The initial public offering price of our Class A common stock will be determined by negotiations between us and the representatives of the underwriters based upon a number of factors and may not be indicative of prices that will prevail in the open market following the consummation of this offering. See “Underwriting.” Consequently, you may not be able to sell shares of our Class A common stock at prices equal to or greater than the price you paid in this offering.

Many factors, some of which are outside our control, may cause the market price of our Class A common stock to fluctuate significantly, including those described elsewhere in this “Risk Factors” section and this prospectus, as well as the following:

 

   

our operating and financial performance and prospects;

 

   

our quarterly or annual earnings, or those of other companies in our industry, compared to market expectations;

 

   

conditions that impact demand for our offerings and platform, including demand in our industry generally and the performance of the third parties through whom we conduct significant parts of our business;

 

   

future announcements concerning our business or our competitors’ businesses;

 

   

the public’s reaction to our press releases, other public announcements, and filings with the SEC;

 

   

the market’s reaction to our reduced disclosure and other requirements as a result of being treated as an “emerging growth company” under the JOBS Act;

 

   

coverage by or changes in financial estimates by securities analysts or failure to meet their expectations;

 

   

market and industry perception of our success, or lack thereof, in pursuing our growth strategy;

 

   

strategic actions by us or our competitors, such as acquisitions or restructurings;

 

   

changes in laws or regulations which adversely affect our industry or us;

 

 

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changes in accounting standards, policies, guidance, interpretations, or principles;

 

   

changes in our board of directors, senior management, or key personnel;

 

   

issuances, exchanges or sales, or expected issuances, exchanges, or sales of our capital stock;

 

   

changes in our dividend policy;

 

   

adverse resolution of new or pending litigation, or other claims against us; and

 

   

changes in general market, economic, and political conditions in the United States and global economies or financial markets, including those resulting from natural disasters, terrorist attacks, global pandemics, acts of war, and responses to such events.

As a result, volatility in the market price of our Class A common stock may prevent investors from being able to sell their Class A common stock at or above the initial public offering price, or at all. These broad market and industry factors may materially reduce the market price of our Class A common stock, regardless of our operating performance. In addition, price volatility may be greater if the public float and trading volume of our Class A common stock is low. As a result, you may suffer a loss on your investment.

The dual class structure of our common stock will have the effect of concentrating voting control with Thrive Capital and our Co-Founders for the foreseeable future, which will limit the ability of our other investors to influence corporate matters, including the election of directors and the approval of any change of control transaction.

Upon completion of this offering, our Class B common stock will have 20 votes per share, and our Class A common stock will have one vote per share. Following this offering, and without giving effect to any purchases that may be made through our directed share program or otherwise in this offering, the holders of our outstanding Class B common stock, which consist of Thrive Capital and our Co-Founders, will beneficially own     % of our outstanding capital stock and hold     % of the voting power of our outstanding capital stock (or     % and     %, respectively, if the underwriters exercise their option to purchase additional shares of our Class A common stock in full). Thrive Capital and Joshua Kushner (as the sole managing member of the Thrive General Partners), in particular, will beneficially own     % of our outstanding capital stock and hold     % of the voting power of our outstanding capital stock immediately following this offering (or     % and     %, respectively, if the underwriters exercise their option to purchase additional shares of our Class A common stock in full). Because of the 20-to-one voting ratio between our Class B common stock and Class A common stock, the holders of Class B common stock, in particular Thrive Capital and Joshua Kushner (as the sole managing member of the Thrive General Partners), collectively will control over a majority of the combined voting power of all of our Class A common stock and Class B common stock and therefore will be able to control all matters submitted to our stockholders for approval until a significant portion of such shares of outstanding Class B common stock have been converted to shares of Class A common stock as further described in “Description of Capital Stock.” This concentrated control will limit or preclude the ability of our other investors to influence corporate matters for the foreseeable future. For example, Thrive Capital and our Co-Founders will have sufficient voting power to determine the outcome with respect to elections of directors, amendments to our certificate of incorporation, amendments to our bylaws that are subject to a shareholder vote, increases to the number of shares available for issuance under our equity incentive plans or adoption of new equity incentive plans, and approval of any merger, consolidation, sale of all or substantially all of our assets or other major corporate transaction requiring stockholder approval for the foreseeable future. In addition, this concentrated control may also prevent or discourage unsolicited acquisition proposals or offers for our capital stock that you may feel are in your best interest as one of our stockholders. This control may also adversely affect the market price of our Class A common stock.

 

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Because Thrive Capital’s and our Co-Founders’ interests may differ from those of our other stockholders, actions that Thrive Capital and our Co-Founders take with respect to us, as significant stockholders, may not be favorable to our other stockholders, including holders of our Class A common stock.

Thrive Capital and its affiliates engage in a broad spectrum of activities. In the ordinary course of its business activities, Thrive Capital and its affiliates may engage in activities where their interests conflict with our interests or those of our other stockholders. Thrive Capital or one of its affiliates may also pursue acquisition opportunities that may be complementary to our business, and, as a result, those acquisition opportunities may not be available to us. In addition, Thrive Capital may have an interest in us pursuing acquisitions, divestitures and other transactions that, in its judgment, could enhance its investment, even though such transactions might involve risks to you. See “Description of

Capital Stock—Corporate Opportunities.”

Future transfers by holders of Class B common stock will generally result in those shares converting to Class A common stock, subject to limited exceptions. As among the individual holders of Class B common stock, the conversion of Class B common stock to Class A common stock will have the effect, over time, of increasing the relative voting power of those holders of Class B common stock who retain their shares in the long term (and decreasing the relative voting power of those holders of Class B common stock who transfer their shares). See “Description of Capital Stock—Anti-Takeover Provisions” for additional information.

We cannot predict the effect our dual class structure may have on the market of our Class A common stock.

We cannot predict whether our dual class structure will result in a lower or more volatile market price of our Class A common stock, in adverse publicity, or in other adverse consequences. For example, certain index providers, such as S&P Dow Jones, have announced restrictions on including companies with multiple-class share structures in certain of their indices, including the S&P 500. Accordingly, our dual class share structure would make us ineligible for inclusion in certain indices and, as a result, mutual funds, exchange-traded funds, and other investment vehicles that attempt to passively track those indices may not invest in our Class A common stock. These policies are relatively new and it is unclear what effect, if any, they will have on the valuations of publicly-traded companies excluded from such indices, but it is possible that they may depress valuations, as compared to similar companies that are included. Because of the dual class structure of our common stock, we will likely be excluded from certain indices and we cannot assure that other stock indices will not take similar actions. Given the sustained flow of investment funds into passive strategies that seek to track certain indices, exclusion from certain stock indices would likely preclude investment by many of these funds and could make our Class A common stock less attractive to other investors. As a result, the market price of our Class A common stock could be adversely affected.

We will be a “controlled company” within the meaning of the rules of NYSE and, as a result, will qualify for, and intend to rely on, exemptions from certain corporate governance requirements. You will not have the same protections afforded to stockholders of companies that are subject to such requirements.

Upon completion of this offering, Thrive Capital and Joshua Kushner (as the sole managing member of the Thrive General Partners) will control approximately     % of the combined voting power of our outstanding capital stock (or     % if the underwriters exercise their option to purchase additional shares in full). As a result, we will be a “controlled company” within the meaning of the corporate

 

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governance standards of the NYSE. Under these rules, a listed company of which more than 50% of the voting power is held by an individual, group or another company is a “controlled company” and may elect not to comply with certain corporate governance requirements, including:

 

   

the requirement that a majority of the board of directors consist of independent directors;

 

   

the requirement that our nominating and corporate governance committee be composed entirely of independent directors with a written charter addressing the committee’s purpose and responsibilities;

 

   

the requirement that our compensation committee be composed entirely of independent directors with a written charter addressing the committee’s purpose and responsibilities; and

 

   

the requirement for an annual performance evaluation of our nominating and corporate governance and compensation committees.

Following this offering, we do not intend to rely on these exemptions, except for the exemption from the requirement that our nominating and corporate governance committee be composed entirely of independent directors. However, as long as we remain a “controlled company,” we may elect in the future to take advantage of any of these other exemptions. As a result of any such election, our board of directors may not have a majority of independent directors, our compensation committee may not consist entirely of independent directors, and our directors may not be nominated or selected by independent directors. Accordingly, you will not have the same protections afforded to stockholders of companies that are subject to all of the corporate governance requirements of the NYSE.

We do not intend to pay dividends on our Class A common stock for the foreseeable future.

We currently intend to retain all available funds and any future earnings to fund the development and growth of our business. As a result, we do not anticipate declaring or paying any cash dividends on our Class A common stock in the foreseeable future. Any decision to declare and pay dividends in the future will be made at the discretion of our board of directors, subject to applicable laws, and will depend on, among other things, our business prospects, results of operations, financial condition, cash requirements and availability, industry trends, and other factors that our board of directors may deem relevant. Any such decision also will be subject to compliance with contractual restrictions and covenants in the agreements governing our current indebtedness. In addition, our ability to pay dividends in the future depends on the earnings and distributions of funds from our health insurance subsidiaries. Applicable state insurance laws restrict the ability of such health insurance subsidiaries to declare stockholder dividends and require our health insurance subsidiaries to maintain specified levels of statutory capital and surplus. We expect our New Revolving Credit Facility will contain restrictions on our ability to pay dividends. Moreover, we may incur additional indebtedness, the terms of which may further restrict or prevent us from paying dividends on our Class A common stock. As a result, you may have to sell some or all of your Class A common stock after price appreciation in order to generate cash flow from your investment, which you may not be able to do. Our inability or decision not to pay dividends could also adversely affect the market price of our Class A common stock.

We may issue shares of preferred stock in the future, which could make it difficult for another company to acquire us or could otherwise adversely affect holders of our Class A common stock, which could depress the price of our Class A common stock.

Our Amended Charter will authorize us to issue one or more series of preferred stock. Our board of directors will have the authority to determine the powers, designations, preferences, and relative, participating, optional or other special rights, and the qualifications, limitations, or restrictions thereof, of the shares of preferred stock and to fix the number of shares constituting any series, without any further vote or action by our stockholders. Our preferred stock could be issued with voting, liquidation, dividend, and other rights superior to the rights of our Class A common stock. The potential issuance of

 

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preferred stock may delay or prevent a change in control of us, discouraging bids for our Class A common stock at a premium to the market price, and may materially and adversely affect the market price and the voting and other rights of the holders of our Class A common stock.

Future sales and issuances of our Class A common stock or rights to purchase our Class A common stock, including pursuant to our equity incentive plans, or other equity securities or securities convertible into our Class A common stock, could result in additional dilution of the percentage ownership of our stockholders and could cause the stock price of our Class A common stock to decline.

In connection with this offering, we intend to file a registration statement with the SEC on Form S-8 providing for the registration of shares of our Class A common stock issued or reserved for issuance under the 2012 Plan, 2021 Plan, and ESPP. Subject to the satisfaction of vesting conditions and the expiration of lock-up agreements, shares issued pursuant to or registered under the registration statement on Form S-8 will be available for resale immediately in the public market without restriction. From time to time in the future, we may also issue additional shares of our Class A common stock, Class B common stock or securities convertible into Class A common stock pursuant to a variety of transactions, including acquisitions. The issuance by us of additional shares of our Class A common stock or securities convertible into our Class A common stock would dilute your ownership of us, and the sale of a significant amount of such shares in the public market could adversely affect prevailing market prices of our Class A common stock.

Future sales, or the perception of future sales, by us or our existing stockholders in the public market following this offering could cause the market price for our Class A common stock to decline.

The sale of substantial amounts of shares of our Class A common stock in the public market, or the perception that such sales could occur, could harm the prevailing market price of shares of our Class A common stock. These sales, or the possibility that these sales may occur, also might make it more difficult for us to sell equity securities in the future at a time and at a price that we deem appropriate. Upon completion of this offering, based on the shares outstanding as of December 31, 2020, we will have a total of                  shares of our Class A common stock outstanding (or                  shares if the underwriters exercise their over-allotment option in full) and                  shares of Class B common stock outstanding.

All of the shares of Class A common stock sold in this offering will be freely tradable without restriction or further registration under the Securities Act, except that any shares held by our affiliates,

as that term is defined under Rule 144 of the Securities Act, or Rule 144, may be sold only in compliance with the limitations described in “Shares Eligible for Future Sale.” The remaining outstanding shares of Class A common stock held by our existing owners after this offering will be subject to certain restrictions on resale.

We, our executive officers, directors, and the holders of substantially all of our outstanding stock will sign lock-up agreements with the underwriters that will, subject to certain exceptions, restrict the sale of the shares of our Class A common stock and certain other securities held by them until the earlier of 180 days following the date of this prospectus and the opening of trading on the second trading day immediately following our public release of earnings for the second quarter following the most recent period for which financial statements are included in this prospectus, as further described in “Shares Eligible for Future Sale.” Notwithstanding the foregoing, as further described in the section titled “Shares Eligible for Future Sale,” (A) up to              million shares of our Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock held by Employee Stockholders (as defined in the section titled “Shares Eligible for

 

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Future Sale”) may be sold for a 7-trading day period beginning at the commencement of trading on the first trading day on which our Class A common stock is traded on the NYSE, and (B) up to              million shares of our outstanding Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock held by Employee Stockholders, plus any shares eligible for sale during the window described in clause (A) above that were not previously sold, may be sold beginning at the opening of trading on the second trading day immediately following our public release of earnings for the first quarter following the most recent period for which financial statements are included in this prospectus, provided that the closing price of our Class A common stock on NYSE is at least 33% greater than the initial public offering price per share set forth on the cover page of this prospectus for the periods described in the section titled “Underwriting.”

Upon the expiration of the lock-up agreements described above, all such shares will be eligible for resale in the public market, subject, in the case of shares held by our affiliates, to volume, manner of sale, and other limitations described in “Shares Eligible for Future Sale.” Goldman Sachs & Co. LLC may, in its sole discretion and at any time without notice, release all or any portion of the shares or securities subject to any such lock-up agreements. See “Underwriting” for a description of these lock-up agreements.

As restrictions on resale end, the market price of our shares of Class A common stock could drop significantly if the holders of such restricted shares sell them or are perceived by the market as intending to sell them. These factors could also make it more difficult for us to raise additional funds through future offerings of our shares of Class A common stock or other securities.

The JOBS Act will allow us to postpone the date by which we must comply with certain laws and regulations intended to protect investors, and to reduce the amount of information we provide in our reports filed with the SEC. We cannot be certain if this reduced disclosure will make our Class A common stock less attractive to investors.

The JOBS Act is intended to reduce the regulatory burden on “emerging growth companies.” As defined in the JOBS Act, a public company whose initial public offering of common equity securities occurs after December 8, 2011, and whose annual net revenues are less than $1.07 billion will, in general, qualify as an “emerging growth company” until the earliest of:

 

   

the last day of its fiscal year following the fifth anniversary of the date of its initial public offering of common equity securities;

 

   

the last day of its fiscal year in which it has annual gross revenue of $1.07 billion or more;

 

   

the date on which it has, during the previous three-year period, issued more than $1.07 billion in nonconvertible debt; and

 

   

the date on which it is deemed to be a “large accelerated filer,” which will occur at such time as the company (1) has an aggregate worldwide market value of common equity securities held by non-affiliates of $700 million or more as of the last business day of its most recently completed second fiscal quarter, (2) has been required to file annual and quarterly reports under the Exchange Act for a period of at least 12 months, and (3) has filed at least one annual report pursuant to the Exchange Act.

Under this definition, we will be an “emerging growth company” upon completion of this offering and could remain an “emerging growth company” until as late as the fifth anniversary of the completion of this offering. For so long as we are an “emerging growth company,” we will, among other things:

 

   

not be required to comply with the auditor attestation requirements of Section 404(b) of the Sarbanes-Oxley Act, or Section 404(b);

 

 

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not be required to hold a nonbinding advisory stockholder vote on executive compensation pursuant to Section 14A(a) of the Exchange Act;

 

   

not be required to seek stockholder approval of any golden parachute payments not previously approved pursuant to Section 14A(b) of the Exchange Act;

 

   

be exempt from the requirement of the PCAOB regarding the communication of critical audit matters in the auditor’s report on the financial statements; and

 

   

be subject to reduced disclosure obligations regarding executive compensation in our periodic reports and proxy statements.

In addition, Section 107 of the JOBS Act provides that an emerging growth company can use the extended transition period provided in Section 7(a)(2)(B) of the Securities Act for complying with new or revised accounting standards. This permits an emerging growth company to delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. We have elected to use this extended transition period and, as a result, our consolidated financial statements may not be comparable to the financial statements of issuers who are required to comply with the effective dates for new or revised accounting standards that are applicable to public companies. We cannot predict if investors will find our Class A common stock less attractive as a result of our decision to take advantage of some or all of the reduced disclosure requirements above. If some investors find our Class A common stock less attractive as a result, there may be a less active trading market for our Class A common stock and our stock price may be more volatile.

The obligations associated with being a public company require significant resources and management attention, and we have and will continue to incur increased costs as a result of becoming a public company.

After completion of this offering, as a public company, we will face increased legal, accounting, administrative, and other costs and expenses that we did not incur as a private company, and which have not been reflected in our historical consolidated financial statements included elsewhere in this prospectus. We have already started to incur, and expect to continue to incur, significant costs related to operating as a public company. Upon the completion of this offering, we will be subject to the Exchange Act, the rules and regulations implemented by the SEC, the Sarbanes-Oxley Act, the Dodd-Frank Act, the PCAOB, and the rules and standards of the NYSE, each of which imposes additional reporting and other obligations on public companies. As a public company, we will be required to, among others:

 

   

prepare, file, and distribute annual, quarterly, and current reports with respect to our business and financial condition;

 

   

prepare, file, and distribute proxy statements and other stockholder communications;

 

   

expand the roles and duties of our Board and committees thereof, and management;

 

   

hire additional financial and accounting personnel and other experienced accounting and finance staff with the expertise to address complex accounting matters applicable to public companies;

 

   

institute more comprehensive financial reporting and disclosure compliance procedures;

 

   

involve and retain to a greater degree outside counsel and accountants to assist us with the activities listed above;

 

   

enhance our investor relations function;

 

   

establish new internal policies, including those relating to trading in our securities and disclosure controls and procedures;

 

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comply with our exchange’s listing standards; and

 

   

comply with the Sarbanes-Oxley Act.

These rules and regulations and changes in laws, regulations, and standards relating to corporate governance and public disclosure, which have created uncertainty for public companies, have and will continue to increase our legal and financial compliance costs and make some activities more time consuming and costly. These laws, regulations, and standards are subject to varying interpretations, in many cases due to their lack of specificity and, as a result, their application in practice may evolve over time as new guidance is provided by regulatory and governing bodies. This could result in continuing uncertainty regarding compliance matters and higher costs necessitated by ongoing revisions to disclosure and governance practices. Our investment in compliance with existing and evolving regulatory requirements has and will continue to result in increased administrative expenses and a diversion of management’s time and attention from revenue-generating activities to compliance activities, which could have a material adverse effect on our business, financial condition, and results of operations.

In addition, the need to establish the corporate infrastructure demanded of a public company may also divert management’s attention from implementing our business strategy, which could prevent us from improving our business, financial condition, and results of operations. If we do not continue to develop and implement the right processes and tools to manage our changing enterprise and maintain our culture, our ability to compete successfully and achieve our business objectives could be impaired, which could negatively impact our business, financial condition, and results of operations. In addition, we cannot predict or estimate the amount of additional costs we may incur to comply with these requirements. We anticipate that these costs will materially increase our general and administrative expenses.

We also expect that being a public company and complying with applicable rules and regulations will make it more difficult and more expensive for us to obtain director and officer liability insurance, and we may be required to accept reduced policy limits and coverage, or incur substantially higher costs to obtain the same or similar coverage. As a result, it may be more difficult for us to attract and retain qualified people to serve on our board of directors, our board committees, or as executive officers.

As a public reporting company, we will be subject to rules and regulations established from time to time by the SEC regarding our internal control over financial reporting. If we fail to establish and maintain effective internal control over financial reporting and disclosure controls and procedures, we may not be able to accurately report our financial results, or report them in a timely manner.

Upon consummation of this offering, we will become a public reporting company subject to the rules and regulations established from time to time by the SEC and the NYSE. These rules and regulations will require, among other things, that we establish and periodically evaluate procedures with respect to our internal control over financial reporting. Reporting obligations as a public company are likely to place a considerable strain on our financial and management systems, processes, and controls, as well as on our personnel.

In addition, as a public company, we will be required to document and test our internal control over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act so that our management can certify as to the effectiveness of our internal control over financial reporting. Section 404(a) of the Sarbanes-Oxley Act, or Section 404(a), requires that, beginning with our second annual report following our initial public offering, management assess and report annually on the effectiveness of our

 

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internal control over financial reporting, and identify any material weaknesses in our internal control over financial reporting. Although Section 404(b) requires our independent registered public accounting firm to issue an annual report that addresses the effectiveness of our internal control over financial reporting, we have opted to rely on the exemptions provided in the JOBS Act and, consequently, will not be required to comply with SEC rules that implement Section 404(b) until such time as we are no longer treated as an “emerging growth company.” We could potentially qualify as an “emerging growth company” until as late as the fifth anniversary of the completion of this offering.

If our senior management is unable to conclude that we have effective internal control over financial reporting, or to certify the effectiveness of such controls, and our independent registered public accounting firm cannot render an unqualified opinion on management’s assessment and the effectiveness of our internal control over financial reporting at such time as it is required to do so, and material weaknesses in our internal control over financial reporting are identified, we could be subject to regulatory scrutiny, a loss of public and investor confidence, and to litigation from investors and stockholders, which could have a material adverse effect on our business and our stock price. In addition, if we do not maintain adequate financial and management personnel, processes, and controls, we may not be able to manage our business effectively or accurately report our financial performance on a timely basis, which could cause a decline in our Class A common stock price and adversely affect our business, financial condition, and results of operations. Failure to comply with the Sarbanes-Oxley Act could potentially subject us to sanctions or investigations by the SEC, the exchange upon which our securities are listed or other regulatory authorities, which would require additional financial and management resources.

Anti-takeover provisions in our governing documents and under Delaware law could make an acquisition of our company more difficult, limit attempts by our stockholders to replace or remove our current management, and depress the market price of our Class A common stock.

Our Amended Charter, Amended Bylaws, and Delaware law contain, or will contain, provisions that could have the effect of rendering more difficult, delaying or preventing an acquisition deemed undesirable by our board of directors. Among others, our Amended Charter and Amended Bylaws will include the following provisions:

 

   

a dual class structure that provides our holders of Class B common stock with the ability to control the outcome of matters requiring stockholder approval;

 

   

limitations on convening special stockholder meetings, which could make it difficult for our stockholders to adopt desired governance changes;

 

   

advance notice procedures, which apply for stockholders to nominate candidates for election as directors or to bring matters before an annual meeting of stockholders;

 

   

a prohibition on stockholder action by written consent, which means that our stockholders will only be able to take action at a meeting of stockholders;

 

   

a forum selection clause, which means certain litigation can only be brought in Delaware;

 

   

no authorization of cumulative voting, which limits the ability of minority stockholders to elect director candidates;

 

   

certain amendments to our certificate of incorporation will require the approval of two-thirds of the then outstanding voting power of our capital stock, voting as a single class;

 

   

amendments to our bylaws by our stockholders will require the approval of two-thirds of the then outstanding voting power of our capital stock, voting as a single class;

 

   

the authorization of undesignated or “blank check” preferred stock, the terms of which may be established and shares of which may be issued without further action by our stockholders and which may be used to create a “poison pill”;

 

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newly created directorships are filled by a majority of directors; and

 

   

the approval of two-thirds of the then outstanding voting power of our capital stock, voting as a single class, is required to remove a director.

These provisions, alone or together, could delay or prevent hostile takeovers and changes in control or changes in our management. As a Delaware corporation, we are also subject to provisions of Delaware law, including Section 203 of the Delaware General Corporation Law, or the DGCL, which prevents interested stockholders, such as certain stockholders holding more than 15% of our outstanding common stock from engaging in certain business combinations for a period of 3 years following the time that such stockholder became an interested stockholder, unless (i) prior to the time such stockholder became an interested stockholder, the board approved the transaction that resulted in such stockholder becoming an interested stockholder, (ii) upon consummation of the transaction that resulted in such stockholder becoming an interested stockholder, the interested stockholder owned 85% of the voting stock of the Company outstanding at the time the transaction commenced (excluding certain shares) or (iii) following board approval, the business combination receives the approval of the holders of at least two-thirds of our outstanding common stock not owned by such interested stockholder.

The insurance laws in most states requires regulatory review and approval of a change in control of our domestic insurers. “Control” generally means the possession, direct or indirect, of the power to direct, or cause the direction of, the management and policies of an insurer, whether through the ownership of voting securities, by contract, or otherwise. The state statutes usually presume that control exists if a person or company, directly or indirectly, owns, controls, or holds with the power to vote ten percent (10%) or more of the voting securities of an insurer or a parent company, but some states may presume control at a lower percentage. This presumption can then be rebutted by a showing that control does not exist. Accordingly, a change in control could trigger regulatory review and approval in one or more states in which we operate.

Any provision of our Amended Charter, Amended Bylaws, Delaware law, or applicable state insurance law that has the effect of delaying, preventing, or deterring a change in control could limit the opportunity for our stockholders to receive a premium for their shares of our Class A common stock, and could also affect the price that some investors are willing to pay for our Class A common stock.

Our Amended Charter will provide that the Court of Chancery of the State of Delaware will be the sole and exclusive forum for substantially all disputes between us and our stockholders, and federal district courts will be the sole and exclusive forum for Securities Act claims, which could limit our stockholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers, or employees.

Our Amended Charter will provide that, unless we consent to the selection of an alternative forum, the Court of Chancery of the State of Delaware is the sole and exclusive forum for: (a) any derivative action, suit, or proceeding brought on our behalf; (b) any action, suit, or proceeding asserting a claim of breach of fiduciary duty owed by any of our current or former directors, officers or other employees or stockholders to us or to our stockholders, creditors, or other constituents; (c) any action, suit, or proceeding asserting a claim arising pursuant to the DGCL, our Amended Charter or Amended Bylaws, or as to which the DGCL confers exclusive jurisdiction on the Court of Chancery of the State of Delaware; or (d) any action, suit, or proceeding asserting a claim governed by the internal affairs doctrine; provided that the exclusive forum provisions will not apply to suits brought to enforce any liability or duty created by the Exchange Act, or to any claim for which the federal courts have exclusive jurisdiction.

Our Amended Charter will further provide that, unless we consent in writing to the selection of an alternative forum, the federal district courts are the exclusive forum for the resolution of any complaint asserting a cause of action arising under the Securities Act. We note that investors cannot waive

 

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compliance with the federal securities laws and the rules and regulations thereunder. Section 22 of the Securities Act creates concurrent jurisdiction for federal and state courts over all suits brought to enforce any duty or liability created by the Securities Act or the rules and regulations thereunder. The choice of forum provisions may limit a stockholder’s ability to bring a claim in a judicial forum that it finds favorable for disputes with us or our current or former directors, officers, or other employees or stockholders, which may discourage such lawsuits against us and our current or former directors, officers, and other employees or stockholders. Alternatively, if a court were to find the choice of forum provisions contained in our Amended Charter to be inapplicable or unenforceable in an action, we may incur additional costs associated with resolving such action in other jurisdictions, which could harm our business, financial condition, and results of operations.

An active trading market for our Class A common stock may never develop or be sustained.

Although we intend to apply to have our Class A common stock listed on the NYSE, an active trading market for our Class A common stock may not develop on that exchange or elsewhere or, if developed, that market may not be sustained. If an active trading market for our Class A common stock does not develop or is not maintained, the liquidity of our Class A common stock, your ability to sell your shares of our Class A common stock when desired, and the prices that you may obtain for your shares of Class A common stock will be adversely affected.

If securities analysts do not publish research or reports about our company, or if they issue unfavorable commentary about us or our industry or downgrade our Class A common stock, the price of our Class A common stock could decline.

The trading market for our Class A common stock will depend in part on the research and reports that third-party securities analysts publish about our company and our industry. We may be unable to attract research coverage, and if one or more analysts cease coverage of our company, we could lose visibility in the market. In addition, one or more of these analysts could downgrade our Class A common stock or issue other negative commentary about our company or our industry. As a result of one or more of these factors, the trading price of our Class A common stock could decline.

If our operating and financial performance in any given period does not meet the guidance that we provide to the public, the market price of our Class A common stock may decline.

We may, but are not obligated to, provide public guidance on our expected operating and financial results for future periods. Any such guidance will be comprised of forward-looking statements subject to the risks and uncertainties described in this prospectus, and in our other public filings and public statements. Our actual results may not always be in line with or exceed any guidance we have provided, especially in times of economic uncertainty. If, in the future, our operating or financial results for a particular period do not meet any guidance we provide or the expectations of investment analysts, or if we reduce our guidance for future periods, the market price of our Class A common stock may decline. Even if we do issue public guidance, there can be no assurance that we will continue to do so in the future.

Investors in this offering will experience immediate and substantial dilution of $        per share.

Based on an assumed initial public offering price of $        per share (the midpoint of the range set forth on the cover of this prospectus), purchasers of our Class A common stock in this offering will experience immediate and substantial dilution of $        per share in the as adjusted net tangible book value per share of Class A common stock from the initial public offering price, and our as adjusted net tangible book value as of December 31, 2020 after giving effect to this offering would be $        per share. This dilution is due in large part to earlier investors having paid substantially less than the initial public offering price when they purchased their shares. See “Dilution.”

 

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CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

This prospectus contains forward-looking statements. All statements other than statements of historical facts contained in this prospectus may be forward-looking statements. Statements regarding our future results of operations and financial position, business strategy, and plans and objectives of management for future operations, including, among others, statements regarding the offering, expected growth, future capital expenditures, and entry into the New Revolving Credit Facility are forward-looking statements. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” or “continue” or the negative of these terms or other similar expressions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions, and uncertainties that are difficult to predict. Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, actual results may prove to be materially different from the results expressed or implied by the forward-looking statements.

There are or will be important factors that could cause our actual results to differ materially from those indicated in these forward-looking statements, including, but not limited to, the following:

 

   

the impact of COVID-19 on global markets, economic conditions, the healthcare industry and our results of operations, and the response by governments and other third parties;

 

   

failure to retain and expand our member base;

 

   

failure to execute our growth strategy;

 

   

failure to maintain or enter into new partnerships or collaborations with healthcare industry participants;

 

   

negative publicity, unfavorable shifts in member perception of our digital platform or other member service channels;

 

   

inability to achieve or maintain profitability in the future;

 

   

changes in federal or state laws or regulations, including changes with respect to the ACA and any regulations enacted thereunder;

 

   

failure to accurately estimate our incurred claims expenses or effectively manage our claims costs or related administrative costs, including as a result of fluctuations in medical utilization rates due to the impact of COVID-19;

 

   

failure to comply with ongoing regulatory requirements and applicable performance standards, including as a result of our participation in government-sponsored programs, such as Medicare;

 

   

changes or developments in the health insurance markets in the United States, including passage and implementation of a law to create a single-payer or government-run health insurance program;

 

   

failure to comply with applicable privacy, security, and data laws, regulations, and standards;

 

   

loss of key in-network providers or an inability to maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks, or to arrange for the delivery of quality care;

 

   

unfavorable or otherwise costly outcomes of lawsuits and claims that arise from the extensive laws and regulations to which we are subject;

 

   

unanticipated results of risk adjustment programs;

 

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delays in our receipt of premiums;

 

   

disruptions or challenges to our relationship with the Oscar Medical Group;

 

   

cyber-security breaches of our and our partners’ information and technology systems;

 

   

unanticipated changes in population morbidity and large-scale changes in health care utilization; and

 

   

the other factors set forth under “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”

The foregoing factors should not be construed as exhaustive and should be read together with the other cautionary statements included in this prospectus. If one or more events related to these or other risks or uncertainties materialize, or if our underlying assumptions prove to be incorrect, actual results may differ materially from what we anticipate. Many of the important factors that will determine these results are beyond our ability to control or predict. Accordingly, you should not place undue reliance on any such forward-looking statements. Any forward-looking statement speaks only as of the date on which it is made, and, except as otherwise required by law, we do not undertake any obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise. New factors emerge from time to time, and it is not possible for us to predict which will arise. In addition, we cannot assess the impact of each factor on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements.

In addition, statements that “we believe” and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based upon information available to us as of the date of this prospectus, and while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. These statements are inherently uncertain and investors are cautioned not to unduly rely upon these statements.

You should read this prospectus and the documents that we reference in this prospectus and have filed as exhibits to the registration statement of which this prospectus forms a part with the understanding that our actual future results, levels of activity, performance, and achievements may be materially different from what we expect.

 

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USE OF PROCEEDS

We estimate that we will receive net proceeds from this offering of approximately $                 million (or approximately $                 million if the underwriters exercise their option to purchase additional shares of Class A common stock in full), based upon an assumed initial public offering price of $                 per share (which is the midpoint of the price range set forth on the cover page of this prospectus) and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us. We will not receive any proceeds from the sale of shares of our Class A common stock by the selling stockholders.

The principal purposes of this offering are to increase our capitalization and financial flexibility and create a public market for our Class A common stock. We expect to use approximately $                 million of the net proceeds of this offering to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility, under which $                 million in principal amount was outstanding and which had an interest rate of     % as of                 , 2021, and the remainder of such net proceeds for general corporate purposes, including to fund our growth (including capital contributions to our health insurance subsidiaries), technology development, working capital, operating expenses, and capital expenditures. Additionally, we may use a portion of the net proceeds to acquire or invest in products, services, or technologies; however, we do not have agreements or commitments for any material investments at this time. As of the date of this prospectus, other than repayment of indebtedness under our Term Loan Facility, we do not have a specific plan for the net proceeds to us from this offering and, accordingly, we are not able to allocate the net proceeds among any of these potential uses in light of the variety of factors that will impact how such net proceeds are ultimately utilized by us. We will have broad discretion in the way that we use the net proceeds of this offering. See “Risk Factors—Risks Related to this Offering and Ownership of Our Class A Common Stock—Our management team will have immediate and broad discretion over the use of the net proceeds from this offering and may not use them effectively” for additional information.”

Each $1.00 increase (decrease) in the assumed initial public offering price of $                per share (which is the midpoint of the price range set forth on the cover page of this prospectus) would increase (decrease) the net proceeds to us from this offering by approximately $                 million, assuming the number of shares offered, as set forth on the cover page of this prospectus, remains the same, and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us.

Each 1,000,000 share increase (decrease) in the number of shares offered in this offering would increase (decrease) the net proceeds to us from this offering by approximately $                 million, assuming that the price per share for the offering remains at $                 (which is the midpoint of the price range set forth on the cover page of this prospectus), and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

 

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DIVIDEND POLICY

We have never declared or paid any cash dividends on our capital stock. We currently intend to retain any future earnings and do not expect to pay any dividends in the foreseeable future. Any future determination to declare cash dividends will be made at the discretion of our board of directors, subject to applicable laws, and will depend on a number of factors, including our financial condition, results of operations, capital and surplus requirements, contractual restrictions, general business conditions, and other factors that our board of directors may deem relevant.

Additionally, we are a holding company that transacts a majority of our business through operating subsidiaries. Consequently, our ability to pay dividends to stockholders is largely dependent on receipt of dividends and other distributions from our subsidiaries. Applicable insurance laws restrict the ability of our health insurance subsidiaries to declare stockholder dividends and require our health insurance subsidiaries to maintain specified levels of statutory capital and surplus. Regulators have broad powers to prevent reduction of statutory surplus to inadequate levels, and there is no assurance that dividends of the maximum amounts calculated under any applicable formula would be permitted. State insurance regulatory authorities that have jurisdiction over the payment of dividends by our health insurance subsidiaries may in the future adopt statutory provisions more restrictive than those currently in effect. See “Business—Government Regulation—State Regulation of Insurance Companies and HMOs.” In addition, some of our health insurance subsidiaries may have entered into specific commitments not to pay dividends.

Our ability to pay dividends may also be restricted by the terms of the Credit Agreement, any future credit agreement or any future debt, or preferred equity securities of us or our subsidiaries. See “Risk Factors—Risks Related to this Offering and Ownership of Our Class A Common Stock—We do not intend to pay dividends on our Class A common stock for the foreseeable future.”

 

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CAPITALIZATION

The following table sets forth our cash, cash equivalents and short-term investments and capitalization as of December 31, 2020 on:

 

   

an actual basis;

 

   

a pro forma basis to give effect to (i) the Preferred Stock Conversion, (ii) the Series B Conversion, (iii) the Reclassification, and (iv) the filing and effectiveness of our Amended Charter, in each case as if such event had occurred on December 31, 2020; and

 

   

a pro forma as adjusted basis to give effect to (i) the pro forma adjustments described in the preceding clause, (ii) the issuance and sale of Class A common stock in this offering at an assumed initial public offering price of $                per share (which is the midpoint of the price range set forth on the cover page of this prospectus), after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us, (iii) the application of the net proceeds therefrom as described under “Use of Proceeds,” (iv) Selling Stockholder Class B Conversion and (v) the issuance of                shares of our Class A common stock upon the settlement of RSUs and exercise of options by certain selling stockholders in connection with the sale of shares in this offering, including aggregate proceeds of $                million received by us in connection with the exercise of such options.

The pro forma and pro forma as adjusted information set forth in the table below is illustrative only and will be adjusted based on the actual initial public offering price and other terms of this offering determined at pricing. You should read this information in conjunction with our consolidated financial statements and the related notes included elsewhere in this prospectus and the “Management’s Discussion and Analysis of Financial Condition and Results of Operations” section and other financial information contained in this prospectus.

 

    As of December 31, 2020  
    Actual     Pro forma     Pro forma
as
adjusted(1)
 
    (in thousands, except share and
per share data)
 

Cash and cash equivalents

  $ 826,326   $                   $                
 

 

 

   

 

 

   

 

 

 

Indebtedness(2)

     

Term Loan Facility(3)

  $ 142,487      

Convertible preferred stock, par value $0.00001; 407,156,831 shares authorized, actual and 400,904,302 shares issued and outstanding, actual; no shares authorized, pro forma and no shares issued and outstanding, pro forma; no shares authorized, pro forma as adjusted and no shares issued and outstanding, pro forma as adjusted

    1,744,911      

Total (deficit) equity:

     

Stockholders’ (deficit) equity:

     

Preferred stock, par value $0.00001; no shares authorized, actual and no shares issued and outstanding, actual; shares authorized, pro forma and no shares issued and outstanding, pro forma; shares authorized, pro forma as adjusted and no shares issued and outstanding, pro forma as adjusted

         

Class A Common stock, $0.00001 par value; no shares authorized, actual and no shares issued and outstanding, actual;                shares authorized, pro forma and                 shares issued and outstanding, pro forma;                shares authorized, pro forma as adjusted and                shares issued and outstanding, pro forma as adjusted

         

Class B Common stock, $0.00001 par value; no shares authorized, actual and no shares issued and outstanding, actual; shares authorized, pro forma and shares issued and outstanding, pro forma; shares authorized, pro forma as adjusted and shares issued and outstanding, pro forma as adjusted

         

 

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    As of December 31, 2020  
    Actual     Pro forma     Pro forma
as
adjusted(1)
 
    (in thousands, except share and
per share data)
 

Series A common stock, $0.00001 par value; 680,000,000 shares authorized, actual and 24,875,753 shares issued and outstanding, actual; no shares authorized, pro forma and no shares issued and outstanding, pro forma; no shares authorized, pro forma as adjusted and no shares issued and outstanding, pro forma as adjusted

    1      

Series B common stock, $0.00001 par value; 69,487,963 shares authorized, actual and 69,487,963 shares issued and outstanding, actual; no shares authorized, pro forma and no shares issued and outstanding, pro forma; no shares authorized, pro forma as adjusted and no shares issued and outstanding, pro forma as adjusted

    1      

Series C common stock, $0.00001 par value; 10,000,000 shares authorized, actual and no shares issued and outstanding, actual; no shares authorized, pro forma and no shares issued and outstanding, pro forma; no shares authorized, pro forma as adjusted and no shares issued and outstanding, pro forma as adjusted

    —        

Treasury stock

    (2,923    

Additional paid-in capital

    133,255      

Accumulated deficit

    (1,427,106    

Accumulated other comprehensive loss

    879      
 

 

 

   

 

 

   

 

 

 

Total stockholders’ (deficit) equity

    (1,295,893    
 

 

 

   

 

 

   

 

 

 

Total capitalization

    $591,505     $       $    
 

 

 

   

 

 

   

 

 

 

 

(1)

Each $1.00 increase or decrease in the assumed initial public offering price of $                per share (which is the midpoint of the price range set forth on the cover page of this prospectus) would increase or decrease each of cash, cash equivalents and short-term investments, additional paid-in capital, total stockholders’ (deficit) equity and total capitalization on a pro forma as adjusted basis by approximately $                million, assuming the number of shares offered, as set forth on the cover page of this prospectus, remains the same, and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

Each 1,000,000 share increase or decrease in the number of shares offered in this offering would increase or decrease each of cash, cash equivalents and short-term investments, additional paid-in capital, total stockholders’ (deficit) equity and total capitalization on a pro forma as adjusted basis by approximately $                 million, assuming that the price per share for the offering remains at $                  (which is the midpoint of the price range set forth on the cover page of this prospectus), and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

 

(2)

Prior to the completion of this offering or shortly thereafter, we expect to enter into the New Revolving Credit Facility arranged by certain syndicate lenders. Proceeds are expected to be available to us for general corporate purposes, including funding working capital. See “Prospectus Summary—Recent Developments—New Revolving Credit Facility.”

 

(3)

Net of $7.5 million of original discount and debt issuance costs. We expect to use approximately $                 of the net proceeds of this offering to repay in full outstanding borrowings, including fees and expenses, under the Term Loan Facility. See “Description of Certain Indebtedness” for a description of our Term Loan Facility.

The number of shares of our Class A common stock and Class B common stock that will be outstanding upon the completion of this offering is based on                shares of our Class A common stock and                shares of our Class B common stock outstanding, in each case, as of December 31, 2020, after giving effect to the Preferred Stock Conversion, the Series B Conversion, the Selling Stockholder Class B Conversion, and the Reclassification described below, and includes the shares of Class A common stock to be issued to the selling stockholders upon the exercise of options and settlement of RSUs in connection with the sale of such shares in this offering.

The number of shares of our Class A common stock and Class B common stock to be outstanding upon completion of this offering excludes:

 

   

                shares of Class A common stock issuable upon exercise of stock options outstanding as of December 31, 2020 under the 2012 Plan, with a weighted average

 

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exercise price of $                 per share, except for                shares to be issued upon the exercise of options by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

                shares of Class A common stock issuable upon the exercise of warrants outstanding as of December 31, 2020, with a weighted average exercise price of $                 per share;

 

   

                shares of Class A common stock issuable in connection with the vesting and settlement of RSUs outstanding as of December 31, 2020, pursuant to the 2012 Plan, except for shares to be issued upon settlement of RSUs by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

                 shares of our Class A common stock issuable in connection with the vesting of the Founders Awards granted under the 2021 Plan;

 

   

                shares of Class A common stock issuable upon the vesting and settlement of the IPO RSUs granted under the 2021 Plan; and

 

   

                shares of Class A common stock that will become available for future issuance under our new equity compensation plans, consisting of (1)                 shares of Class A common stock under the 2021 Plan (which number includes the Founders Awards and the IPO RSUs) and (2)                 shares of Class A common stock under the ESPP, each of which will become effective in connection with this offering (and each of which exclude any potential annual evergreen increases pursuant to the terms of the 2021 Plan and the ESPP).

 

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DILUTION

If you invest in our Class A common stock in this offering, your ownership interest will be immediately diluted to the extent of the difference between the initial public offering price per share of our Class A common stock and the pro forma as adjusted net tangible book value per share of our Class A common stock immediately after this offering. Dilution in pro forma as adjusted net tangible book value per share to new investors represents the difference between the amount per share paid by purchasers of shares of our Class A common stock in this offering and the pro forma as adjusted net tangible book value per share of our Class A common stock immediately after completion of this offering.

As of December 31, 2020, our historical net tangible book value (deficit) was $                million, or $                per share of common stock. Historical net tangible book value (deficit) per share represents our total tangible assets less total liabilities and redeemable convertible preferred stock, divided by the number of shares of common stock outstanding as of December 31, 2020.

As of December 31, 2020, our pro forma net tangible book value (deficit) was $                million, or $                 per share. Pro forma net tangible book value per share represents the amount of our total tangible assets reduced by the amount of our total liabilities and divided by the total number of shares of our Class A common stock and Class B common stock outstanding as of December 31, 2020 after giving effect to (i) the Preferred Stock Conversion, (ii) the Series B Conversion, (iii) the Reclassification, and (iv) the filing and effectiveness of our Amended Charter, in each case as if such event occurred on December 31, 2020.

After giving further effect to (i) the sale by us of                  shares of our Class A common stock in this offering at the assumed initial public offering price of $                 per share, which is the midpoint of the price range set forth on the cover page of this prospectus, and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us and the application of the net proceeds of this offering as set forth under “Use of Proceeds” and (ii) the issuance of                shares of our Class A common stock upon the settlement of RSUs and exercise of options by certain selling stockholders in connection with the sale of shares in this offering, including aggregate proceeds of $                million received by us in connection with the exercise of such options, our pro forma as adjusted net tangible book value as of December 31, 2020, would have been $                 million, or $                 per share. This represents an immediate increase in pro forma as adjusted net tangible book value of $                 per share to our existing stockholders and an immediate dilution in pro forma as adjusted net tangible book value of $                 per share to investors purchasing shares of our Class A common stock in this offering. The following table illustrates this dilution:

 

Assumed initial public offering price per share of Class A common stock

      $              

Historical net tangible book value (deficit) per share as of December 31, 2020

   $                 

Pro forma increase in net tangible book value (deficit) per share

     

Pro forma net tangible book value (deficit) per share as of December 31, 2020

     

Increase in pro forma net tangible book value per share attributable to new investors purchasing shares of Class A common stock in this offering and the settlement of RSUs and exercise of options by certain selling stockholders in connection with this offering

     
  

 

 

    

Pro forma as adjusted net tangible book value per share immediately after this offering

     
     

 

 

 

Dilution in pro forma as adjusted net tangible book value per share to new Class A common stock investors in this offering

      $    
     

 

 

 

 

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Each $1.00 increase (decrease) in the assumed initial offering price of $                 per share, which is the midpoint of the price range set forth on the cover page of this prospectus, would increase (decrease) our pro forma as adjusted net tangible book value after this offering by approximately $                 million, or $                 per share, and would increase (decrease) the dilution per share to new investors purchasing our Class A common stock in this offering by $                 per share, assuming that the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same, and after deducting underwriting discounts and commissions, and estimated offering expenses payable by us. Each increase (decrease) of 1.0 million shares in the number of shares sold in this offering, as set forth on the cover page of this prospectus, would increase (decrease) our pro forma as adjusted net tangible book value after this offering by approximately $                 million, or $                 per share, and would increase (decrease) the dilution per share to new investors by $                 per share, assuming that the assumed initial public offering price of $                 per share, which is the midpoint of the price range set forth on the cover page of this prospectus, remains the same, and after deducting underwriting discounts and commissions, and estimated offering expenses payable by us.

The following table presents, on a pro forma as adjusted basis as of December 31, 2020, after giving effect to the pro forma adjustments described above, the difference between the existing stockholders and the investors purchasing shares of our Class A common stock in this offering with respect to the number of shares of our Class A common stock purchased from us, the total consideration paid or to be paid to us, and the average price per share paid or to be paid to us, before deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us:

 

     Shares Purchased     Total Consideration        
     Number      Percent     Amount      Percent     Average
price per
Share
 

Existing stockholders

                                        $                                     $                

New investors

            
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

 

Total

        100   $          100   $    
  

 

 

    

 

 

   

 

 

    

 

 

   

 

 

 

Each $1.00 increase (decrease) in the assumed initial offering price of $                 per share, which is the midpoint of the price range set forth on the cover page of this prospectus, would increase (decrease) the total consideration paid by new investors, total consideration paid by all stockholders and average price per share paid by all stockholders by $                , $                 and $                 per share, respectively, assuming that the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same, and after deducting underwriting discounts and commissions, and estimated offering expenses payable by us. Each increase (decrease) of 1.0 million shares in the number of shares sold in this offering, as set forth on the cover page of this prospectus, would increase (decrease) the total consideration paid by new investors, total consideration paid by all stockholders and average price per share paid by all stockholders by $                , $                 and $                 per share, respectively, assuming that the assumed initial public offering price of $                 per share, which is the midpoint of the price range set forth on the cover page of this prospectus, remains the same, and after deducting underwriting discounts and commissions and estimated offering expenses payable by us.

If the underwriters exercise in full their option to purchase                  additional shares of our Class A common stock in this offering, the pro forma as adjusted net tangible book value (deficit) per share after this offering would be $                 per share and the dilution to new investors in this offering would be $                 per share. If the underwriters exercise such option in full, the number of shares held by new investors will increase to approximately                  shares of our Class A common stock, or approximately                 % of the total number of shares of our Class A common stock outstanding after this offering.

 

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The number of shares of our Class A common stock and Class B common stock that will be outstanding upon the completion of this offering is based on                  shares of our Class A common stock and                  shares of our Class B common stock outstanding, in each case, as of December 31, 2020, after giving effect to the Preferred Stock Conversion, the Series B Conversion, the Selling Stockholder Class B Conversion, and the Reclassification described below, and includes the                shares of Class A common stock to be issued to the selling stockholders upon the exercise of options and settlement of RSUs in connection with the sale of such shares in this offering.

The number of shares of our Class A common stock and Class B common stock to be outstanding upon completion of this offering excludes:

 

   

                 shares of Class A common stock issuable upon exercise of stock options outstanding as of December 31, 2020 under the 2012 Plan, with a weighted average exercise price of $                 per share, except for                shares to be issued upon the exercise of options by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

                 shares of Class A common stock issuable upon the exercise of warrants outstanding as of December 31, 2020, with a weighted average exercise price of $                 per share;

 

   

                 shares of Class A common stock issuable in connection with the vesting and settlement of RSUs outstanding as of December 31, 2020, pursuant to the 2012 Plan, except for shares to be issued upon settlement of RSUs by certain selling stockholders in connection with the sale of such shares in this offering;

 

   

                shares of our Class A common stock issuable in connection with the vesting of the Founders Awards granted under the 2021 Plan;

 

   

                shares of Class A common stock issuable upon the vesting and settlement of the IPO RSUs granted under the 2021 Plan; and

 

   

                 shares of Class A common stock that will become available for future issuance under our new equity compensation plans, consisting of (1)                 shares of Class A common stock under the 2021 Plan, which number includes the Founders Awards and the IPO RSUs and (2)                shares of Class A common stock under the ESPP, each of which will become effective in connection with this offering (and each of which exclude any potential annual evergreen increases pursuant to the terms of the 2021 Plan and the ESPP).

To the extent any options, warrants or RSUs are granted and exercised in the future, there may be additional economic dilution to new investors.

In addition, we may choose to raise additional capital due to market conditions or strategic considerations, even if we believe we have sufficient funds for our current or future operating plans. To the extent that we raise additional capital through the sale of equity, as Class A common stock, or other securities that are convertible into our Class A common stock, such as convertible debt securities, the issuance of these securities could result in further dilution to our stockholders.

 

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SELECTED CONSOLIDATED FINANCIAL DATA

The following tables present the selected consolidated financial data for Oscar Health, Inc. and its subsidiaries. We have derived the selected consolidated statements of operations data for the years ended December 31, 2019 and 2020 and the selected consolidated balance sheet data as of December 31, 2019 and 2020 from our audited consolidated financial statements included elsewhere in this prospectus. You should read this data together with our consolidated financial statements and related notes included elsewhere in this prospectus and the section titled “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Our historical results for any prior period are not necessarily indicative of the results that may be expected in the future.

 

     Year ended December 31,  
               2019                         2020            
     (in thousands, except share
and per share data)
 

Consolidated Statement of Operations:

    

Revenue:

    

Premiums before ceded reinsurance

   $ 1,041,145     $ 1,672,339  

Reinsurance premiums ceded

     (572,284     (1,217,304
  

 

 

   

 

 

 

Premiums earned

     468,861       455,035  

Investment income and other revenue

     19,327       7,766  
  

 

 

   

 

 

 

Total revenue

     488,188       462,801  

Operating expenses:

    

Claims incurred, net

     408,259       309,353  

Other insurance costs

     167,851       216,534  

General and administrative expenses

     110,682       166,655  

Federal and state assessments

     48,170       81,458  

Health insurance industry fee

     —         19,251  

Premium deficiency reserve expense

     12,615       71,816  
  

 

 

   

 

 

 

Total operating expenses

     747,577       865,067  

Loss from operations

     (259,389     (402,266

Interest expense

     —         3,514  
  

 

 

   

 

 

 

Loss before income tax expense

     (259,389     (405,780

Income tax expense

     1,793       1,045  
  

 

 

   

 

 

 

Net loss

     (261,182     (406,825

Other comprehensive income—net of tax

    

Unrealized gain on investments

     17       906  
  

 

 

   

 

 

 

Comprehensive loss

   $ (261,165   $ (405,919
  

 

 

   

 

 

 

Net loss per share attributable to common stockholders, basic and diluted

   $ (3.02   $ (4.72

Weighted-average common shares outstanding, basic and diluted

     86,439,407       87,790,273  

Consolidated Balance Sheet:

    

Cash and cash equivalents

   $ 336,644     $ 826,326  

Short-term investments

     333,753       366,387  

Total assets

     1,346,914       2,272,106  

Total liabilities

     996,308       1,823,088  

Convertible preferred stock

     1,295,744       1,744,911  

Total stockholders’ (deficit) equity

     (945,138     (1,295,893

 

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS

You should read the following discussion and analysis of our financial condition and results of operations in conjunction with the section entitled “Selected Consolidated Financial Data” and our consolidated financial statements and the related notes included elsewhere in this prospectus. This discussion contains forward-looking statements that involve risks and uncertainties about our business and operations. Our actual results and the timing of selected events may differ materially from those anticipated in these forward-looking statements as a result of various factors, including those we describe under “Risk Factors” and elsewhere in this prospectus. See “Cautionary Note Regarding Forward-Looking Statements.” Additionally, our historical results are not necessarily indicative of the results that may be expected for any period in the future.

Overview

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar over eight years ago to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family, helping us navigate the health care system in our moments of greatest need. In the years since, we have built a suite of services that permit us to earn our members’ trust, leverage the power of personalized data, and help our members find quality care they can afford. We call this our member engagement engine, and it is powered by a differentiated full stack technology platform that will allow us to continue to innovate like a technology company and not a traditional insurer in the years ahead. As we continue to bring the Oscar experience to new members, new states, and new markets, our goal will remain the same: to build engagement, earn trust, and help our members live healthier lives.

Our experience over the past few years tells us that our strategy is working and that there is substantial demand for the member-first experience that Oscar was founded to create. We have grown our membership to 529,000 members as of January 31, 2021, representing a CAGR of 59% since 2017, while keeping insurance premiums affordable for our members and maintaining industry-leading engagement, trust, and member satisfaction metrics. Our use of quota share reinsurance arrangements has helped us grow in a sustainable and capital-efficient manner. We have achieved approximately 10% market share based upon membership across the counties we serve in the Individual market. Simultaneously, we have extended our offerings into new insurance markets, including Small Group and Medicare Advantage. In parallel, we have been able to meaningfully lower our MLR by 12 points from the year ended December 31, 2017 to the year ended December 31, 2020, to a healthy and economically sustainable level of 84.7%. We have also been able to drive our InsuranceCo Administrative Expense Ratio lower, from over 50% in 2017 to 26.1% in 2020, with increased scale and technological efficiencies. Throughout this period, we have continued to enhance our members’ experience by consistently deploying new features that help simplify and improve their health care journey. As a result, some of the most sophisticated participants in the health care ecosystem have recognized the power of our full stack technology platform and have formed innovative partnerships with us.

For the years ended December 31, 2019 and 2020, after taking into account reinsurance premiums ceded, premiums earned were $468.9 million and $455.0 million, respectively. Additionally, our members generated $1,325.8 million and $2,287.3 million of direct policy premiums for the years ended December 31, 2019 and 2020, respectively, an increase from $390.7 million for the year ended December 31, 2017, representing a CAGR of 80% between 2017 and 2020. There can be no assurance that such premium growth will continue. In 2020, we achieved an MLR of 84.7%, as compared to an MLR of 87.6% in 2019. For the years ended December 31, 2019 and 2020, due to our continued investment in our technology, product

 

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development, and market expansion, we generated a net loss of $261.2 million and $406.8 million, respectively, and Adjusted EBITDA losses of $222.2 million and $402.4 million, respectively. See “Prospectus Summary—Summary Consolidated Financial and Other Data” for more information and for a reconciliation of non-GAAP metrics to the most directly comparable financial measure calculated and presented in accordance with GAAP.

Our Business Model

Our business model is built around our member engagement engine and full stack technology platform, which drive high engagement and trust among our members, collect and integrate data to produce real-time personalized insights, and help our members find high quality care options, including innovative virtual care solutions that we develop in partnership with the Oscar Medical Group. We believe the investments we have made to date lead to better outcomes and a better experience for our members, and that our competitors will not be able to replicate our differentiated suite of services without access to a full stack technology platform such as ours. As we continue to invest in our technology, we expect the following impact:

 

  1.

Continued Membership Growth:     We believe our member engagement engine will attract and retain members across our existing and new products over time. Additionally, our members who engage more frequently with their dedicated Care Teams have higher retention rates than our non-engaged members, which should drive increasing retention rates over time. We have a significant opportunity to expand our offerings beyond our current geographic and insurance market footprint as well as grow share in our existing offerings. We have a proven track record of success in growing our membership. Out of the 15 states we served as of December 31, 2020, we expanded to 12 of those states in the preceding three years. The following tables set forth our members by state and insurance market as of December 31, 2019 and 2020.

Member by State

 

     As of
December 31,
 
     2019      2020  

Arizona

     1,775        4,344  

California

     55,914        103,834  

Colorado

     —          1,221  

Florida

     29,667        115,171  

Georgia

     —          426  

Kansas

     —          327  

Michigan

     592        2,059  

Missouri

     —          934  

New Jersey

     14,862        12,936  

New York

     51,296        39,275  

Ohio

     14,723        16,238  

Pennsylvania

     —          3,283  

Tennessee

     9,805        8,126  

Texas

     51,184        93,164  

Virginia

     —          706  
  

 

 

    

 

 

 

Total

     229,818        402,044  
  

 

 

    

 

 

 

 

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Member by Offering

 

     As of
December 31,
 
     2019      2020  

Individual and Small Group

     229,818        400,120  

Medicare Advantage

     —          1,924  
  

 

 

    

 

 

 

Total

     229,818        402,044  
  

 

 

    

 

 

 

Our membership increased 75% to 402,044 as of December 31, 2020 compared to 229,818 as of December 31, 2019. There are a number of drivers that caused our membership to increase by 75% over this period, including (i) geographic expansion within our existing states, (ii) geographic expansion to new states, and (iii) improvement in our competitive position within our existing markets. Specifically, we grew our geographic presence in Florida and Texas between 2019 and 2020 to offer Individual plans in more counties, which drove increased membership in those states. This growth in geographic presence included expansion into large metropolitan areas like Miami in Florida and Dallas and Houston in Texas. Additionally, we entered six new states in 2020: Colorado, Georgia, Kansas, Missouri, Pennsylvania, and Virginia. Finally, in California, our competitive position improved in key geographies between 2019 and 2020, which drove more individuals to buy our plans in Southern California. Separately, we entered the Medicare Advantage market in 2020 and had 1,924 members in this market as of December 31, 2020.

From time to time, our membership in particular states may contract. For example, our membership in New Jersey, New York, and Tennessee decreased as of December 31, 2020, as compared to our membership levels in those states as of December 31, 2019. Whether we experience membership growth or contraction in a given state depends on numerous factors, including our premium rates as compared to those of our competitors, in each case, as approved by state regulators, and other factors, such as plan design and provider network changes that impact the desirability of our health plans to consumers. We expect our overall geographic expansion in new and existing states as well as improvements in our competitive position within existing markets to continue to offset limited declines in membership in certain states.

 

  2.

Improved Unit Economics:     Our technology investments and scale have helped us meaningfully reduce our MLR and administrative expense ratios over the past several years and we expect they will continue to do so. Specifically, we expect many elements of our member engagement engine and full stack technology platform, including our real-time interventions and virtual care will help us achieve a better MLR over time. We also expect other elements of our platform, including our modern claims system, will drive administrative efficiencies over time. Finally, we expect to achieve increased operating leverage as we scale our fixed costs over a growing membership base.

 

  3.

Increased Platform Opportunities:     Recognition of our innovative model has already enabled partnerships with other payers and providers in which health plans and products are powered by our platform. The attractive economics of these deals often include both risk-sharing and/or fee-based compensation for use of our innovative technology. In the future, we may continue to pursue such deals, including through fee-based licensing arrangements involving our integrated platform and engine or modules thereof. We believe the health care of the future is consumer-oriented, digitally-enabled, data-driven, and value-conscious and that we are well-positioned to power stakeholders in that future.

Our revenue largely consists of premiums that we receive from our members, which we receive as a fixed amount PMPM. In each of the three insurance markets we serve—Individual, Small Group,

 

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and Medicare Advantage—we establish our PMPM premium rates on either an annual or quarterly basis through a process of actuarial estimation and regulatory approval from state and/or federal agencies. Our estimates reflect a variety of factors, including our members’ expected utilization of medical services, expected member risk acuity, and expected non-benefit administrative expenses including distribution and personnel costs. Other revenue consists primarily of investment income. In the future, we may also derive fee-based as well as risk-sharing revenue from partnerships with other entities in the health care ecosystem.

Our use of reinsurance enables us to scale rapidly in a sustainable and capital-efficient manner and offers greater predictability in earnings in the event of unexpected significant fluctuations in our MLR. We cede a specified percent of our premiums and claims to our third-party reinsurers under a quota share reinsurance arrangement. In return, the reinsurers must meet the risk and capital requirements associated with the premiums we cede to them. Under our 2020 XOL reinsurance contracts, the reinsurer is paid to cover claims related losses over a $500,000 attachment point, which mitigates catastrophic risk.

Our claims incurred consists of costs of care for the health services incurred by our members including inpatient, outpatient, physician and pharmacy costs. These may also include amounts under risk-sharing agreements with some of our provider partners. The amount of these costs are impacted by our contracted unit costs and members’ utilization of such services. We believe our differentiated member engagement engine and full stack technology platform, including care routing, Care Team interventions, our evolving virtual care solutions, and our innovative plan designs should help lower these costs over time for us and our members. Our other insurance costs are comprised of fixed and variable costs associated with running our insurance subsidiaries. The operating costs of our subsidiaries consist of distribution and marketing costs to sell our plans, vendor costs, compensation and benefits, and taxes and fees. Our general and administrative expenses include development costs associated with building our technology and certain other administrative expenses. Our development costs are largely made up of employees in our product and engineering teams that are focused on extending the capabilities of our full stack technology platform.

Insurance Premiums

We generate a substantial majority of our total revenue from premiums we receive from serving members in the geographies in which we operate. Direct policy premiums are received on a PMPM basis from our members. For the years ended December 31, 2019 and 2020, 57% and 40% of our direct policy premiums, respectively, were collected directly from our members, while the rest were collected from the CMS as part of the APTC program, collectively referred to as direct policy premiums. We recognize premiums before ceded reinsurance revenue over the period that coverage is effective and bill our members on a monthly basis, with billings due at the beginning of the service period. CMS engages in a monthly reconciliation and payment process for its portion of direct policy premiums.

Individual and Small Group

The Individual market primarily consists of policies purchased by individuals and families through Health Insurance Marketplaces. The Small Group market consists of employees of companies with up to 50 full-time workers in most states and up to 100 full-time workers in California, Colorado, New York, and Vermont.

In the Individual market, our PMPM premium rates become applicable at the beginning of a calendar year and are developed during the prior year based on our estimates of a variety of factors, including our members’ utilization of medical services, the unit cost for such services, estimated member risk acuity, and non-benefit administrative expenses including distribution and personnel

 

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costs. In the Small Group market, the process is substantially similar except that in some states we may file rates on a quarterly basis. We offer health plans in the Individual market on exchange and off-exchange under the five “metal” plan categories—Catastrophic, Bronze, Silver, Gold, and Platinum. These differ based on the size of the monthly premium and the level of sharing of medical costs between Oscar and our members, with the Catastrophic and Bronze plans having the highest level of sharing. Both Individual and Small Group PMPM premium rates are required to be approved by applicable state and federal regulatory agencies in accordance with the ACA, as well as any premium rate changes by age, geography, and plan design, amongst others. Additionally, various federal and state laws have minimum MLR requirements. We elect to participate in a given Individual or Small Group market on an annual basis. In substantially all cases, our base premiums are subject to a risk adjustment based on the health status of our members relative to the overall health status of all individuals in a given state or market.

Medicare Advantage

We began providing plans in the Medicare Advantage program in 2020 to adults who are age 65 and older and eligible for traditional Medicare but who instead select coverage through a private market plan.

We enter into contracts with CMS under the Medicare Advantage program to provide health care benefits to Medicare beneficiaries. In exchange, we receive a fixed PMPM premium that varies based on a variety of factors, including the CMS Star ratings of our health plans as well as member geographic location, demographics, and health status. CMS also uses a risk adjustment system to adjust the premiums paid to Medicare Advantage plans that reflects the predicted health care costs of their members compared to an “average” beneficiary based on health status and other factors. Medicare Advantage premiums paid to us under our CMS contracts are subject to annual review by CMS as well as federal government reviews and audits. We elect to participate in a given Medicare geographic region on an annual basis.

 

 

LOGO

Innovative Partnerships

As we have built our full stack technology platform, we have started to monetize the platform we have built through co-branded partnerships with leading providers, payers and other innovators. Our co-branded partnerships, which grew to four in 2020 from one in 2019, are proof points of our

 

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ability to deploy our technology to support innovative health care use cases and create value by enabling other payers and providers to leverage the strength of our full stack technology platform to power health plans. We currently have co-branded partnerships with (1) the Cleveland Clinic in the Individual market, which launched in 2018, (2) Montefiore in the Medicare Advantage market, which launched in 2020, and (3) Cigna in the Small Group market, which launched in 2020. We also announced a co-branded plan with Holy Cross and Memorial in the Medicare Advantage market, which began selling in 2020 for enrollment in 2021. Our platform helps power the plans of each of these co-branded partnerships. In addition, in January 2021, we entered into a new partnership with Health First, where we will provide certain administrative services and provide their individual commercial and Medicare Advantage members with access to our full stack technology platform largely beginning on January 1, 2022. While the economics of a partnership may vary, we often monetize through a risk-sharing or fee-based arrangement, depending on the services we are performing.

Reinsurance

We believe our reinsurance agreements help us achieve important goals for our business, including risk management, capital efficiency, and greater predictability in our earnings in the event of unexpected significant fluctuations in MLR. Specifically, reinsurance is a financial arrangement under which one insurer, which we refer to as the “primary insurer,” enters into a reinsurance contract with a reinsurance company, which covers a portion of the medical claims or ceded claims of the primary insurer in return for a portion of their premium, or premiums ceded. Some reinsurance agreements include a ceding commission payment from the reinsurer to the primary insurer to cover administrative costs. We currently use quota share agreements with certain partners to reduce our capital and surplus requirements, which enables us to grow in a capital-efficient manner and better manage risk. For the years ended December 31, 2019 and 2020, approximately 55% and 77% of our business, respectively, was ceded under quota share reinsurance arrangements, with approximately 33% and 32% of our business, respectively, ceded to Axa France Vie and approximately 22% and 45% of our business, respectively, ceded to Berkshire Hathaway Specialty Insurance Company. We entered into statutory trust agreements with Axa France Vie in compliance with the credit for reinsurance laws and regulations of the state of domicile of each ceding company in connection with reinsurance ceded to an unauthorized reinsurer. Each trust account is funded at 102% of the ceding entity’s IBNR. Acceptable assets deposited into the trust accounts include cash, certificates of deposit, and instruments that are acceptable to the commissioner of the insurance department of the ceding entity’s state of domicile. Because reinsurers are entitled to a portion of our premiums under our quota share reinsurance arrangements, increases in the amount of premiums ceded under these arrangements reduce our revenue. Premiums for quota share insurance are based on a percentage of premiums earned before ceded reinsurance. Claims ceded under these quota share arrangements are limited to an amount specified in each agreement proportional to the MLR of ceded business and subject to a maximum MLR, which varies from 100% to 105% of ceded premiums for the agreements applicable to the years ended December 31, 2019 and 2020. To the extent ceded premiums exceed ceded claims and commissions, we typically receive an experience refund. Reinsurance recoveries are recorded as a reduction to claims incurred, net. We also use XOL reinsurance to limit our exposure to large catastrophic risk from individual claims of members. Reinsurance premiums are based on enrollment calculated on a PMPM basis. Our quota share and XOL reinsurance treaties do not relieve us of our primary medical claims incurred obligations.

Key Operating and Non-GAAP Financial Metrics

We regularly review a number of metrics, including the following key operating and non-GAAP financial metrics, to evaluate our business, measure our performance, identify trends in our business, prepare financial projections, and make strategic decisions. We believe these operational and financial

 

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measures are useful in evaluating our performance, in addition to our financial results prepared in accordance with GAAP.

 

     Year ended December 31,  
             2019                     2020          

Members

     229,818       402,044  

Direct Policy Premiums (in thousands)

   $ 1,325,760     $ 2,287,319  

Medical Loss Ratio

     87.6     84.7

InsuranceCo Administrative Expense Ratio

     25.5     26.1

InsuranceCo Combined Ratio

     113.1     110.8

Adjusted EBITDA(1) (in thousands)

   $ (222,173   $ (402,447

 

(1)

Adjusted EBITDA is a non-GAAP measure. See “Prospectus Summary—Summary Consolidated Financial and Other Data” for information regarding our use of Adjusted EBITDA.

Members

Members are defined as any individual covered by one of our health plans. We view the number of members enrolled in our health plans as an important metric to help evaluate and estimate revenue and market share. Additionally, the more members we enroll, the more data we have which allows us to improve the functionality of our platform.

Membership increased 75% to 402,044 as of December 31, 2020 compared to 229,818 as of December 31, 2019. The increase is primarily attributable to growth in key existing states, especially in California and Florida due to as well as intra-state and new state expansion, new plan offerings, and the introduction of Medicare Advantage plans.

Direct Policy Premiums

Direct policy premiums are defined as the premiums collected from our members or from the federal government during the period indicated, before risk adjustments and reinsurance. These premiums include APTC, or premium subsidies, which are available to individuals and families with annual income between 100% and 600% of the federal poverty level in California and 100% and 400% of the federal poverty level in all other states under the ACA. We believe direct policy premiums are an important metric to assess our growth. We expect direct policy premiums will increase over time as we increase membership and continue to diversify our member mix more towards higher value metal tiers like Silver and across our lines of business.

Direct policy premiums increased 73% to $2,287.3 million for the year ended December 31, 2020 compared to $1,325.8 million for the year ended December 31, 2019. The increase is primarily attributable to the significant growth in our membership in existing and new states, as described above, and further increased by changes in membership mix towards higher value plans.

Medical Loss Ratio

Medical loss ratio is calculated as set forth in the table below. Medical claims are total medical expenses incurred by members in order to utilize health care services less any member cost sharing. These services include inpatient, outpatient, pharmacy, and physician costs. Medical claims also include risk sharing arrangements with certain of our providers. The impact of the federal risk adjustment program is included in the denominator of our MLR. We believe MLR is an important metric to demonstrate the loss ratio of our costs to pay for health care of our members to the premiums before ceded reinsurance. We believe our member engagement engine and full stack technology platform will allow us to more efficiently manage total claims incurred. MLRs in our existing products

 

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are subject to various federal and state minimum requirements. Below is a calculation of our MLR for the periods indicated.

 

     Year ended December 31,  
             2019                     2020          
     (in thousands)  

Direct claims incurred before ceded quota share reinsurance(1)

   $ 924,256     $ 1,364,432  

XOL ceded claims(2)

     (13,908     (13,633

State reinsurance(3)

     (6,959     (10,026
  

 

 

   

 

 

 

Net claims before ceded quota share reinsurance(A)

   $ 903,389     $ 1,340,773  
  

 

 

   

 

 

 

Premiums before ceded reinsurance(4)

   $ 1,041,145     $ 1,672,339  

Other non-recurring items(5)

     3,240       (64,538

XOL reinsurance premiums(6)

     (13,332     (24,066
  

 

 

   

 

 

 

Net premiums before ceded quota share reinsurance(B)

   $ 1,031,053     $ 1,583,735  
  

 

 

   

 

 

 

Medical Loss Ratio (A divided by B)

     87.6     84.7
  

 

 

   

 

 

 

 

(1)

See footnote 4 to our audited consolidated financial statements included elsewhere in this prospectus for a reconciliation of direct claims incurred to claims incurred, net appearing on the face of our audited consolidated income statement.

(2)

Represents claims ceded to reinsurers pursuant to an XOL treaty, for which such reinsurers are financially liable. We use XOL reinsurance to limit the losses on individual claims of our members.

(3)

Represents payments made by certain state-run reinsurance programs established subject to CMS approval under Section 1332 of the ACA.

(4)

See footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus for an explanation of premiums before ceded reinsurance.

(5)

Represents a pre-quota share write-off of a NYDFS receivable in 2019 as described in footnote 2 in the reconciliation presented in the section titled “—Adjusted EBITDA” below, which is offset by proceeds received from the sale of a portion of our risk corridor recovery in 2019. The amount was settled in 2020 and we received proceeds of $64.5 million of premiums earned offset by $12.1 million of legal fees and federal and state assessments. For additional information, refer to footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus.

(6)

Represents XOL reinsurance premiums paid.

MLR decreased to 84.7% for the year ended December 31, 2020 compared to 87.6% for the year ended December 31, 2019. The decrease is primarily attributable to the impact of COVID-19 as elective or other medical appointments that were deferred, suspended or canceled to avoid non-essential patient exposure to medical environments. Some favorability was also driven in part by pricing margin improvements, operational improvements, and product enhancements. These benefits were partially offset by negative prior period development and reserve estimates reflecting uncertainty around COVID-19.

InsuranceCo Administrative Expense Ratio

InsuranceCo Administrative Expense Ratio is calculated as set forth in the table below. The ratio reflects the costs associated with running our combined insurance companies. We believe InsuranceCo Administrative Expense Ratio is useful to evaluate our ability to lower our expenses as a percentage of premiums before ceded quota share reinsurance. Expenses necessary to run the insurance company are included in other insurance costs and federal and state assessments. These expenses include variable expenses paid to vendors and distribution partners, premium taxes and exchange fees, employee-related compensation, benefits, marketing costs, and other administrative

 

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expenses. We believe that the combination of our technology and scale will allow us to achieve efficiencies in our variable costs as well as increased operating leverage over time. Below is a calculation of our InsuranceCo Administrative Expense Ratio for the periods indicated.

 

     Year ended December 31,  
             2019                     2020          
     (in thousands)  

Other insurance costs

   $ 167,851     $ 216,534  

Ceding commissions

     65,591       126,840  

Other non-recurring items(2)

     —         (12,102

Stock-based compensation expense

     (17,615     (18,299

Health insurance industry fee

     —         19,251  

Federal and state assessment of health insurance subsidiaries(1)

     47,019       81,199  
  

 

 

   

 

 

 

Health insurance subsidiary adjusted administrative expenses (A)

   $ 262,846     $ 413,423  
  

 

 

   

 

 

 

Premiums before ceded reinsurance(2)

   $ 1,041,145     $ 1,672,339  

Other non-recurring items(2)

     3,240       (64,538

XOL reinsurance premiums(2)

     (13,332     (24,066
  

 

 

   

 

 

 

Net premiums before ceded quota share reinsurance(B)

   $ 1,031,053     $ 1,583,735  
  

 

 

   

 

 

 

InsuranceCo Administrative Expense Ratio (A divided by B)

     25.5     26.1
  

 

 

   

 

 

 

 

(1)

Represents federal and state assessments of our health insurance subsidiaries.

(2)

See footnotes 4 through 6 to the calculation presented in the section titled “—Medical Loss Ratio” above for a description of these line items.

The Administrative Expense Ratio increased to 26.1% for the year ended December 31, 2020 compared to 25.5% for the year ended December 31, 2019. The increase is mostly attributable to the health insurance industry fee of $19.3 million as well as expansion investments to launch our Medicare Advantage and our Cigna + Oscar offering. These were partially offset by operational efficiencies and scale benefits.

InsuranceCo Combined Ratio

InsuranceCo Combined Ratio is defined as the sum of MLR and InsuranceCo Administrative Expense Ratio. We believe this ratio best represents the current overall performance of our insurance business for activities that can be compared to peers.

InsuranceCo Combined Ratio decreased to 110.8% for the year ended December 31, 2020 compared to 113.1% for the year ended December 31, 2019. The improvement in the InsuranceCo Combined Ratio was driven by the same factors that drove our MLR and InsuranceCo Administrative Expense Ratio; including deferred care from COVID-19, medical and administrative operational improvements, and scale. These improvements were partially offset by prior year development and the health insurance industry fee.

Adjusted EBITDA

Adjusted EBITDA is defined as net loss for the Company and its consolidated subsidiaries before interest expense, income tax expense, depreciation and amortization as further adjusted for stock-based compensation, warrant contract expense, changes in the fair value of warrant liabilities, and non-operating litigation reserves/settlements as described below. We present Adjusted EBITDA because we consider it to be an important supplemental measure of our performance and believe it is frequently used by securities analysts, investors, and other interested parties in the evaluation of companies in our industry. Adjusted EBITDA is a non-GAAP measure. See “Prospectus Summary—Summary Consolidated Financial and Other Data” for information regarding our use of Adjusted EBITDA.

 

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     Year ended December 31,  
             2019                     2020          
     (in thousands)  

Net loss

   $ (261,182   $ (406,825

Interest expense

     —         3,514  

Income tax expense

     1,793       1,045  

Depreciation and amortization

     6,899       11,285  

Stock-based compensation/warrant expense(1)

     34,262       40,970  

Other nonrecurring items(2)

     (3,945     (52,436
  

 

 

   

 

 

 

Adjusted EBITDA

   $ (222,173   $ (402,447
  

 

 

   

 

 

 

 

(1)

Represents (i) non-cash expenses related to equity-based compensation programs, which vary from period to period depending on various factors including the timing, number, and the valuation of awards, (ii) warrant contract expense, and (iii) changes in the fair value of warrant liabilities.

(2)

A health insurance subsidiary of the Company had previously recorded a receivable in 2018 of $16,055 from the New York Department of Financial Services, or NYDFS, in connection with the NYDFS’s program to limit federal risk adjustment transfers, which would have allowed us to collect additional funds from the NYDFS that we had previously remitted to CMS. However, this NYDFS program would have resulted in other insurance carriers having to return certain of the funds they received in connection with the federal risk adjustment program to the NYDFS. In 2017, these carriers initiated a lawsuit against the NYDFS to reverse the NYDFS limitations, which was subsequently decided in the carriers’ favor. As a result, we will no longer be entitled to receive the additional funds and we have written off the receivable in 2019. The write-off of the receivable is offset by proceeds received from the sale of a portion of our risk corridor recovery in 2019. The amount was settled in 2020 and we received proceeds of $64.5 million of premiums earned offset by $12.1 million of legal fees and federal and state assessments. For additional information, refer to footnote 3 to our audited consolidated financial statements included elsewhere in this prospectus.

Adjusted EBITDA losses increased to $402.4 million for the year ended December 31, 2020 compared to $222.2 million for year ended December 31, 2019. The increase in losses was driven primarily by an increase in our premium deficiency reserve and the cost of the health insurance industry fee levied in 2020. We increased our premium deficiency reserve expense to account for growth in 2021 membership as we invest in markets and products. We expect this premium deficiency reserve will be released into earnings over the course of 2021 as we incur the related contract losses. The health insurance industry fee increased year over year as it was suspended for 2019 but resumed in 2020. The fee was eliminated for 2021.

In addition, general and administrative expenses increased as we made investments to enhance our technology platform, launch our Medicare Advantage plans and our Cigna + Oscar offering, and incurred costs to support requirements to operate as a public company. Increased losses were partially offset by improvement in our net underwriting margin due to higher reinsurance experience refunds and lower claims incurred, which was primarily driven by the impact of COVID-19 as elective or other medical appointments that were deferred, suspended or canceled to avoid non-essential patient exposure to medical environments. In addition, net underwriting margin benefited from pricing margin improvements, operational improvements, and product mix enhancements.

 

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Key Factors Affecting Performance

Our financial condition and results of operations have been, and will continue to be, affected by a number of factors including the following:

Our Ability to Acquire New Members and Retain Existing Members

Our long-term growth depends in large part on our continued ability to acquire new members and retain existing members. We believe that we have significant opportunity to expand and grow market share within our current geographic footprint. We typically enter new counties with a 7% to 8% average market share in year one and are typically able to grow our penetration over time. Today, we estimate our market share in the Individual market has grown to approximately 15% in counties where we have been operating for three years or more, based on membership within the market. Our ability to continue acquiring members in existing markets and states is driven by our combination of innovative plan design and data-driven pricing. Members find value in the differentiated offerings in our health plans, such as virtual care at no additional cost, wellness incentives, and dedicated Care Teams.

We believe our member engagement engine is the start of how we retain members. On average, our members who engage more frequently with their dedicated Care Teams have higher retention rates than members who are less engaged. Our increased engagement allows us to provide our members with even better guidance through the health care system, creating a virtuous cycle that benefits our members, our partners and increases the value of our platform. Our ability to retain our members is also driven by our ability to competitively price our products each year. We have developed a digital platform and in-depth approach to pricing that takes a balanced view of growth, profitability, and risk that allows us to remain affordable and competitive within our markets. We believe it would be difficult for incumbent insurance providers to emulate this model without access to a full stack technology platform such as ours.

Our Ability to Expand into New Geographies

Our continued success also depends on our ability to expand into new geographies. Our existing geographic footprint today represents a fraction of our addressable market opportunity. Today, we serve members in 291 counties and 18 states in the U.S. Based upon our experience, we believe our innovative care model can scale nationally. We therefore expect to be able to selectively and strategically expand into new geographies.

In order to expand into a new market or state, we start planning 10 to 18 months prior to target launch date, depending on the insurance market and whether we are operating through a partnership or not. Our goal in selecting markets is to maximize return on investment over the long term. We typically enter into markets with Individual plans and offer our health plans in limited geographic areas. Over time, we seek to expand into other insurance products, plans, and coverage areas. We believe that the scalable economics of the Individual plans alone make it likely that we will have a positive return on investment. As we continue our expansion, our success will depend on the competitive dynamics in our new markets, and our ability to attract members and deploy our care model in those markets.

Our Ability to Enter into New Partnerships and Offer New Products and Plans

Our growth depends on our ability to enter into new partnerships and offer new products and plans that attract new members. We currently operate in the Individual, Small Group, and Medicare Advantage markets, and our modernized approach has been designed with flexibility to more easily add new plans and end markets. As we further scale our business, we will be able to leverage our existing regulatory infrastructure, strong brand name, and full stack technology platform into developing

 

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new plans for existing markets and growing membership through enhanced plan designs. Our continued success is dependent on our ability to maintain our competitive position as a technology-driven, direct-to-consumer health insurance company.

We plan to continue to invest in and scale our offerings to address the needs of consumers and our partners. We believe opportunities exist to expand in commercial, government, and other ancillary benefits markets, amongst others. Our expansion into new products and plans may come through partnerships with other health insurers or providers. These innovative partnerships, which often feature risk-sharing economic arrangements, allow us to leverage the strengths of legacy health care stakeholders while reimagining the way health care is delivered.

Our Ability to Manage Our Medical Expenses

Our business performance and growth depends, in large part, on our ability to accurately estimate and effectively manage our MLR. Historically, our MLR has fluctuated substantially, and has also varied across our state health plans. Over the last four years, we have improved our MLR from 96.8% for the year ended December 31, 2017 to 84.7% for the year ended December 31, 2020 by focusing on improving our plan design and pricing, our risk adjustment operations, and other operational efficiencies. We believe our differentiated member engagement engine and full stack technology platform, tools including care routing, Care Team interventions, our evolving virtual care solutions, and our innovative plan designs and our claims engine should help lower these costs over time for us and our members.

Our Ability to Achieve Efficiencies in our Other Insurance Costs and General and Administrative Expenses

Our results depend on our ability to manage our other insurance costs along with general and administrative expenses. While we expect other insurance costs and general and administrative expenses to increase as we grow the business and incur additional expenses of being a public company, we do not expect our expenses to grow at the same pace as our direct policy premiums because we do not require a proportional increase in the size of our headcount or technology infrastructure to support our growth. We are focused on leveraging the operational efficiencies created by our innovative cloud-based platform, which is scalable, flexible, and purpose-built, spanning all critical health care insurance and technology domains, including member and provider data, utilization management, claims management, billing, and benefits. Our existing full stack technology platform will help us run our operations efficiently at scale, delivering better outcomes, and cost savings for our members.

We use our technology to drive efficiency across all functions, including underwriting, plan administration, and claims. We are beginning to realize operating efficiencies as we scale against our fixed expense base. We believe that as we continue to scale, we will be able to achieve efficiencies in our other insurance costs and general and administrative expenses to drive profitability. Our administrative infrastructure has significant expansion capacity, allowing us to integrate new members from expansion within existing markets and to enter new markets at lower incremental cost.

Our Ability to Grow in a Capital-Efficient Manner

Each of our health insurance subsidiaries that is operated by the Company is subject to laws and regulations that, among other things, require the maintenance of a minimum amount of statutory capital. Our ability to continue to grow depends on effective balance sheet management. We utilize quota share reinsurance and XOL reinsurance to help improve capital efficiency of the balance sheet and to protect potential tail risk exposures, respectively. The structure of our reinsurance contracts is consistent with our long-term risk strategy, which is designed to (1) optimize capital efficiency, (2) provide a buffer from adverse deviations in claims, and (3) allow us to grow sustainably and profitably.

 

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We must comply with regulatory constraints on our minimum capital position and have entered into a number of parental guarantees with our health insurance subsidiaries as part of the certificate of authority application process in various states. Actual capital levels are monitored on a regular basis, and we believe we will have access to sufficient capital and liquidity sources to satisfy future regulatory requirements. We believe our investment strategy is conservative given our growth trajectory and short-term liabilities.

Seasonality

Our business is generally affected by the seasonal patterns of our enrollment and medical expenses and, to a lesser extent, marketing spend in advance of an Open Enrollment Period or Annual Election Period. Direct policy premiums earned are historically highest in the first quarter primarily due to the annual enrollment cycles and the enrollment of our members.

Members

In the Small Group market, approximately 40% of membership is acquired between December 1 and January 1; with the remaining members acquired throughout the balance of the year. For Individual and Medicare Advantage products, the majority of our member growth occurs in connection with the annual Open Enrollment Period and Annual Election Period. We also add members throughout the year, including during Special Enrollment Periods when certain eligible individuals can enroll.

Claims Incurred

Our medical expenses are generally expected to be highest in the fourth quarter of the year and are impacted by seasonal effects of medical costs such as the flu season, the utilization of deductibles and out-of-pocket maximums over the course of the policy year which shifts more costs to us in the fourth quarter as we pay a higher proportion of claims. As a result, we typically have higher levels of medical costs in the third and fourth quarters of a calendar year. Our medical costs can also vary according to the number of days and holidays in a given period.

Impact of COVID-19

In December 2019, a novel strain of coronavirus, SARS-CoV-2, was identified in Wuhan, China. Since then, SARS-CoV-2, and the resulting disease, COVID-19, has spread rapidly to almost every country in the world and all 50 states within the United States. Global health concerns relating to the outbreak of COVID-19 have been weighing on the macroeconomic environment, and the outbreak has significantly increased economic uncertainty. The outbreak has resulted in authorities implementing numerous measures to try to contain the virus, such as travel bans and restrictions, quarantines, shelter-in-place orders, and business shutdowns.

In particular for our business, governmental authorities have also recommended, and in certain cases, required, that elective or other medical appointments be suspended or canceled to avoid non-essential patient exposure to medical environments and potential infection. These and other measures have meant that our MLR has improved as members have fewer medical expenses and providers make fewer claims against members’ health insurance.

To date, we have experienced or expect to experience the following impacts on our business

model due to COVID-19:

 

   

Virtual Care. The utilization of telehealth in primary care visits for Oscar’s subscribing members increased by more than 50%, from 21% of total primary episodes in 2019 to 33% in 2020. We

 

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intend to continue to offer our members flexible options when seeking care, including our Oscar virtual care solutions. In 2021, we launched innovative virtual primary care plan designs in three key states for a more convenient, efficient, and cost-effective doctor experience.

 

   

Medical Loss Ratio. Because of the suspension of many elective medical appointments and procedures due to COVID-19, we have experienced a decrease in our MLR from 2019 as compared to 2020. We also have experienced and may continue to experience depressed non-COVID-19 related medical costs, as the pandemic continues to affect the United States, and our members have changed the way they utilize care. Some of these costs will likely be incurred at a later date, resulting in increased medical claims expenses in the future. We cannot accurately estimate the future net potential impact, positive or negative, to our medical claims expenses at this time.

 

   

Work From Home Arrangements. We have taken significant steps to support our employees to protect their health and safety, while also ensuring that our business can continue to operate and that services continue without disruption. We have implemented our business continuity plans and have taken actions to support our workforce. We have transitioned the vast majority of our employees to work from home, allowing us to continue to operate at close to full capacity, while continuing to maintain our internal control focus. As a result, we have experienced and expect continued incremental costs due to investments and actions we have already taken and continued efforts to protect our members and employees and the communities we serve.

 

   

Member Solutions. We have expanded benefit coverage in areas such as COVID-19 care and testing, telemedicine, and pharmacy benefits; offered additional enrollment opportunities to those who previously declined employer-sponsored offerings; extended certain premium payment terms for customers experiencing financial hardship; simplified administrative practices; and accelerated payments to care providers, all with the aim of assisting our customers, providers and members in addressing the impacts of the COVID-19 pandemic.

Overall measures to contain the COVID-19 outbreak may remain in place for a significant period of time, as certain geographic regions have experienced a resurgence of COVID-19 infections and new strains of COVID-19 that appear to be more transmissible have developed. The duration and severity of this pandemic is unknown and the extent of the business disruption and financial impact depends on

factors beyond our knowledge and control.

Components of our Results of Operations

Premiums Before Ceded Reinsurance

Premiums before ceded reinsurance primarily consist of premiums received, or to be received, directly from our members or from CMS as part of the APTC program, net of the impact of our risk adjustment payable. Premiums before ceded reinsurance are generally impacted by the amount of risk sharing adjustments, our ability to acquire new members and retain existing members, and average size and premium rate of policies.

Reinsurance Premiums Ceded

Reinsurance premiums ceded represent the amount of premiums written that are ceded to reinsurers either through quota share or XOL reinsurance. We enter into reinsurance agreements, in part, to limit our exposure to potential losses as well as to provide additional capacity for growth. Reinsurance premiums ceded are recognized over the reinsurance contract period in proportion to the period of risk covered. The volume of our reinsurance premiums ceded is impacted by the level of our premiums earned and any decision we make to increase or decrease limits, retention levels, and co-participations.

 

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Investment Income and Other Revenue

Investment income and other revenue primarily includes interest earned and gains on investments in U.S. Treasury and agency securities, corporate notes, certificates of deposit, and commercial paper.

Claims Incurred, Net

Claims incurred, net primarily consists of both paid and unpaid medical expenses incurred to provide medical services and products to our members. Medical claims include fee-for-service claims, pharmacy benefits, capitation payments to providers, and various other medical-related costs. Under fee-for-service claims arrangements with providers, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of hospital and physician services. Medical claims are recognized in the period health care services are provided. Unpaid medical expenses include claims reported and in the process of being settled, but that have not yet been paid, as well as health care costs incurred but not yet reported to us, which are collectively referred to as benefits payable or claim reserves. The development of the claim reserve estimate is based on actuarial methodologies that consider underlying claim payment patterns, medical cost inflation, historical developments, such as claim inventory levels and claim receipt patterns, and other relevant factors. The methods for making such estimates and for establishing the resulting liability are continuously reviewed and any adjustments are reflected in the period determined. Claims incurred, net also reflects the net impact of our ceded reinsurance claims.

Other Insurance Costs

Other insurance costs primarily include wages, benefits, marketing, rent, costs of software and hardware, distribution costs, unallocated claims adjustment expenses, and administrative costs associated with functions that are necessary to support our health insurance business and are net of ceding commissions we receive from our reinsurance partners. Such functions include, but are not limited to, information systems, legal, finance, compliance, concierge, and claims processing. Other insurance costs will increase over time as we support a larger membership base but we expect our ability to leverage our technology and member engagement will decrease the magnitude of the increase in costs.

General and Administrative Expenses

General and administrative expenses primarily include wages, benefits, research and development, costs of software and hardware, and administrative costs for our corporate and technology functions. Such functions include, but are not limited to information systems, executive management, legal, and finance. Research and development expenses include expenses related to developing our platform. General and administrative expenses will increase over time following the closing of this offering due to the additional legal, accounting, insurance, investor relations, and other costs that we will incur as a public company.

Federal and State Assessments

Federal and state assessments represent non-income tax charges from federal and state governments, including but not limited to Exchange user fees, premium taxes, franchise taxes, and other state and local non-premium related taxes.

 

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Health Insurance Industry Fee

The ACA includes an annual, nondeductible insurance industry tax that is levied proportionally across the insurance industry for risk-based health insurance products, which we are subject to. It is calculated based on a ratio of our applicable net premiums written, compared to the total U.S. health insurance industry applicable net premiums written during the previous calendar year. We record the health insurance industry fee, or HIF, liability in accounts payable and accrued liabilities at the beginning of the calendar year. A corresponding deferred cost is recorded in receivables and other assets that is amortized to HIF in the consolidated statement of operations and comprehensive loss using a straight-line method of allocation over the calendar year. There was a one year suspension of HIF for 2019, but HIF resumed in 2020. The HIF has been permanently repealed for calendar years beginning in 2021.

Premium Deficiency Reserve Expense

Premium deficiency reserve expense is the year over year change in the premium deficiency reserve liability. Premium deficiency reserve liabilities are established when it is probable that expected future claims and maintenance expenses will exceed future premium and reinsurance recoveries on existing medical insurance contracts without consideration of investment income. For purposes of determining premium deficiency losses, contracts are grouped consistent with the Company’s method of acquiring, servicing, and measuring the profitability of such contracts which is generally on a line of business basis.

Income Tax Expense

Income tax expense consists primarily of changes to our current and deferred federal and state tax assets and liabilities. Income taxes are recorded as deferred tax assets and deferred tax liabilities based on differences between the book and tax bases of assets and liabilities. Our deferred tax assets and liabilities are calculated by applying the current tax rates and laws to taxable years in which such differences are expected to reverse.

We continually review the need for, and the adequacy of, valuation allowances, and recognize benefits from our deferred tax assets only when an analysis of both positive and negative factors indicates that it is more likely than not such benefits will be realized.

 

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Results of Operations

Year Ended December 31, 2020 compared to the Year Ended December 31, 2019

The following table sets forth our results of operations for the years indicated:

 

     For the years ended December 31,     % change  
(in thousands)    2019     2020     $ Change  

Premiums before ceded reinsurance

   $ 1,041,145     $ 1,672,339     $ 631,194       60.6

Reinsurance premiums ceded

     (572,284     (1,217,304     (645,020     112.7
  

 

 

   

 

 

   

 

 

   

 

 

 

Premiums earned

     468,861       455,035       (13,826     (2.9 )% 

Investment income and other revenue

     19,327       7,766       (11,561     (59.8 )% 
  

 

 

   

 

 

   

 

 

   

 

 

 

Total revenue

     488,188       462,801       (25,387     (5.2 )% 

Operating Expenses:

        

Claims incurred, net

     408,259       309,353       (98,906     (24.2 )% 

Other insurance costs

     167,851       216,534       48,683       29.0

General and administrative expenses

     110,682       166,655       55,973       50.6

Federal and state assessments

     48,170       81,458       33,288       69.1

Health insurance industry fee

           19,251       19,251       NM  

Premium deficiency reserve expense

     12,615       71,816       59,201       469.3
  

 

 

   

 

 

   

 

 

   

 

 

 

Total operating expenses

     747,577       865,067       117,490       15.7
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss from operations

     (259,389     (402,266     (142,877     55.1

Interest expense

           3,514       3,514       NM  
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss before income tax expense

     (259,389     (405,780     (146,391     56.4

Income tax expense

     1,793       1,045       (748     (41.7 )% 
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss

   $ (261,182   $ (406,825   $ (145,643     55.8
  

 

 

   

 

 

   

 

 

   

 

 

 

Premiums Before Ceded Reinsurance

Premiums before ceded reinsurance increased $631.2 million or 61% to $1.7 billion for the year ended December 31, 2020, from $1.0 billion for the year ended December 31, 2019, which was primarily driven by higher membership in existing markets as well as expansion into six new states and the introduction of Medicare Advantage. Additionally, we benefited from the one-time ACA risk corridor settlement of $64.5 million in 2020. These amounts were partially offset by an increase of $330.2 million in risk adjustment payments required to be made under the ACA driven primarily by our increase in membership that have healthier risk profiles within respective geographies where we operate.

Reinsurance Premiums Ceded

Reinsurance premiums ceded increased $645.0 million or 113% to $1,217.3 million for the year ended December 31, 2020 from $572.3 million for the year ended December 31, 2019, which was primarily attributable to an increase in the amount the Company ceded through its quota share contracts due to an increase in cession rates from 55% in 2019 to 77% in 2020 and an increase in premiums subject to reinsurance.

Investment Income and Other Revenue

Investment income and other revenue decreased $11.6 million or 60% to $7.8 million for the year ended December 31, 2020 from $19.3 million for the year ended December 31, 2019, which was primarily attributable to lower interest rates.

 

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Claims Incurred, Net

Claims incurred, net decreased $98.9 million or 24% to $309.4 million for the year ended December 31, 2020 from $408.3 million for the year ended December 31, 2019, which was primarily driven by an increase in average quota share cession rates and decreased utilization of medical benefits by our members due to COVID-19, which was partially offset by higher claim volume due to increased members. Reinsurance losses ceded was 77% of claims as compared to only 55% in 2019.

Other Insurance Costs

Other insurance costs increased $48.7 million or 29% to $216.5 million for the year ended December 31, 2020 from $167.9 million for the year ended December 31, 2019. The increase of insurance related costs, net of ceding commissions, supported our growth and retention efforts in existing markets, expansion into the Medicare Advantage market and launch of new Small Group offerings. Additionally, increased member-driven administrative costs included claims processing, variable compensation and benefits, premium taxes, and network administrative costs. For our new Medicare Advantage and Small Group product launches, we invested in our marketing and outreach efforts. Additionally, we incurred $10.5 million in class-action legal counsel fees related to the one-time ACA risk corridor settlement.

General and Administrative Expenses

General and administrative expenses increased $56.0 million or 51% to $166.7 million for the year ended December 31, 2020 from $110.7 million for the year ended December 31, 2019. The increase is due to higher compensation and benefits expense to grow our technology teams to support strategic partnerships, platform technologies, and our member experience. Additionally, accounting, legal, and other professional fees increased in order to support requirements to operate as a public company.

Federal and State Assessments

Federal and state assessments increased $33.3 million or 69% to $81.5 million for the year ended December 31, 2020 from $48.2 million for the year ended December 31, 2019, which was primarily attributable to higher exchange fees due to an increase in membership.

Health Insurance Industry Fee

HIF was $19.3 million for the year ended December 31, 2020, which has been repealed effective 2021.

Premium Deficiency Reserve Expense

Premium deficiency reserve expense increased $59.2 million or 469% to $71.8 million for the year ended December 31, 2020 from $12.6 million for the year ended December 31, 2019, which was attributable to higher expected future losses in certain states for 2021.

Income Tax Expense

Income tax expense decreased $0.7 million or 42% to $1.0 million for the year ended December 31, 2020 from $1.8 million for the year ended December 31, 2019, which was primarily attributable to one profitable subsidiary which had an increase in pretax income and is not included in the consolidated federal tax return.

 

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Liquidity and Capital Resources

Overview

We maintain liquidity at two levels of our corporate structure, through our health insurance subsidiaries and through Holdco.

The majority of the assets held by our health insurance subsidiaries is in the form of cash and cash equivalents and investments. For the years ended December 31, 2019 and 2020, cash and cash equivalents and investments of the health insurance subsidiaries were $504.0 million and $1,271.3 million, respectively, of which $15.4 million and $16.8 million, respectively, was on deposit with regulators as required for statutory licensing purposes and is classified as restricted deposits on the balance sheet.

Our health insurance subsidiaries’ states of domicile have statutory minimum capital and surplus requirements which are intended to measure capital adequacy, taking into account the risk characteristics of an insurer’s investments and products. The combined statutory capital and surplus of our health insurance subsidiaries was $135.7 million and $199.1 million at December 31, 2019 and 2020, respectively, which was in compliance with and in excess of the minimum capital and surplus requirements for each period. The health insurance subsidiaries historically have required capital contributions from Holdco to maintain minimum levels. Our health insurance subsidiaries also utilize quota share reinsurance arrangements to reduce our minimum capital and surplus requirements, which enables us to more efficiently deploy capital to fund our growth. For the years ended December 31, 2019 and 2020, Holdco made $73.5 million and $366.2 million of capital contributions, respectively, to the health insurance subsidiaries. See “Risk Factors—Risks Related to Our Business—If state regulators do not approve payments of dividends and distributions by our subsidiaries to us, we may not have sufficient funds to implement our business strategy.”

The majority of the assets held by Holdco are in the form of cash and cash equivalents and investments. Cash and cash equivalents and investments of Holdco for the years ended December 31, 2019 and 2020, were $177.8 million and $264.4 million, respectively, of which $6.5 million were restricted for each year. Since inception, Holdco has financed its operations primarily through private sales of equity securities. For the year ended December 31, 2019, Holdco also had access to a revolving credit facility, which terminated by its terms in July 2019. No borrowings were drawn under this facility for the year ended December 31, 2019. In October 2020, we entered into a Term Loan Facility, as further described below, which we intend to repay using a portion of the proceeds of this offering. As of December 31, 2020, $142.5 million, net of unamortized discount and debt issuances costs was outstanding.

Our cash flows used in operations may differ substantially from our net loss due to non-cash charges or due to changes in balance sheet accounts. The timing of our cash flows from operating activities can also vary among periods due to the timing of payments made or received. Some of our payments and receipts, including risk adjustment and subsequent reinsurance receipts, can be significant. Therefore, their timing can influence cash flows from operating activities in any given period which would have a negative impact on our operating cash flows.

Prior to the completion of this offering or shortly thereafter, we expect to enter into the New Revolving Credit Facility arranged by certain syndicate lenders. See “Prospectus Summary—Recent Developments—Revolving Credit Facility” for additional information. We may be required to seek additional equity or debt financing. Our future capital requirements will depend on many factors, including the pace of new member growth. In the event that additional financing is required from outside sources, we may not be able to raise it on terms acceptable to us or at all. If we are unable to raise additional capital when desired, our business, financial condition, and results of operations would be harmed.

 

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Term Loan Facility

On October 30, 2020, we entered into the Credit Agreement with HPS Investment Partners, LLC, as administrative agent, and certain other lenders for the Term Loan Facility, in the aggregate principal amount of $150.0 million. The Term Loan Facility is guaranteed by Mulberry Management Corporation and all of our future direct and indirect subsidiaries (subject to certain permitted exceptions, including exceptions guarantees that would require material governmental consents or in respect of joint venture). The Term Loan Facility is secured by a lien on substantially all of our and the guarantors’ assets (subject to certain exceptions).

The Term Loan Facility matures on October 30, 2024; provided that upon the invalidation of certain provisions of the ACA by the Supreme Court of the United States or any other federal courts that could reasonably be likely to result in a material adverse effect, upon the election of the majority lenders, the maturity of the Term Loan Facility will be 12 months from such election, which is referred to as the “Springing Maturity Date.” Notwithstanding the Springing Maturity Date, upon certain events (including the consummation of this initial public offering), the maturity date of the Term Loan Facility will revert to October 30, 2024.

The Term Loan Facility requires us to comply with certain restrictive covenants, including but not limited to covenants relating to limitations on indebtedness, liens, investments, loans and advances, restricted payments and restrictive agreements, mergers, consolidations, sale of assets and acquisitions, sale and leaseback transactions, affiliate transactions, and certain specified financial covenants. The Term Loan Facility contains other customary covenants, representations, and events of default. As of December 31, 2020, we were in compliance with the loan covenants.

In connection with this offering, we expect to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility.

See “Description of Certain Indebtedness” for further information about the terms of the Term Loan Facility.

Investments

We generally invest cash of our health insurance subsidiaries in investment-grade, marketable debt securities to improve our overall investment return. We primarily invest cash of the Company in U.S. Treasury and agency securities. These investments are purchased pursuant to board approved investment policies which conform to applicable state laws and regulations.

Our investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets, all in a manner consistent with state requirements that prescribe the types of instruments in which our subsidiaries may invest. These investment policies require that our investments have final maturities of a maximum of three years from the settlement date. Professional portfolio managers operating under documented guidelines manage our investments and a portion of our cash equivalents. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels.

Our restricted investments are invested principally in cash and cash equivalents and U.S. Treasury securities; we have the ability to hold such restricted investments until maturity. The Company maintains cash and cash equivalents and investments on deposit or pledged to various state agencies as a condition for licensure. We classify our restricted assets as long-term given the requirement to maintain such assets on deposit with regulators.

 

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Summary of Cash Flows

Our cash flows used in operations may differ substantially from our net loss due to non-cash charges or due to changes in balance sheet accounts.

The timing of our cash flows from operating activities can also vary among periods due to the timing of payments made or received. Some of our payments and receipts, including loss settlements and subsequent reinsurance receipts, can be significant. Therefore, their timing can influence cash flows from operating activities in any given period. The potential for a large claim under an insurance or reinsurance contract means that our health insurance subsidiaries may need to make substantial payments within relatively short periods of time, which would have a negative impact on our operating cash flows.

The following table shows summary cash flows information for the periods indicated:

 

     Year ended December 31,        
             2019                     2020             Change  
     (in thousands)        

Net cash (used in)/provided by operating activities

   $ (165,370   $ 222,732     $ 388,102  

Net cash provided by/(used in) investing activities

     150,513       (344,714     (495,227

Net cash (used in)/provided by financing activities

     (2,119     611,707       613,826  
  

 

 

   

 

 

   

 

 

 

Net (decrease)/increase in cash and cash equivalents and restricted cash equivalents

   $ (16,976   $ 489,725     $ 506,701  

Operating Activities

Net cash provided by operating activities increased $388.1 million to $222.7 million for the year ended December 31, 2020 compared to $(165.4) million for the year ended December 31, 2019, primarily due to membership growth driving the change in receivables due from reinsurance programs and benefits payable. Our risk adjustment transfer payable significantly increased as our members continue to have lower than average risk scores. In addition, we received $52.4 million in net proceeds in 2020 due to the risk corridor claims settlement.

Investing Activities

Net cash used in investing activities decreased $495.2 million to $344.7 million for the year ended December 31, 2020 compared to $150.5 million for the year ended December 31, 2019. The decrease was primarily attributable to the growth of the investment portfolio, as purchases more than offset sales and maturity of investments in 2020.

Financing Activities

Net cash provided by financing activities increased $613.8 million to $611.7 million for the year ended December 31, 2020 compared to $(2.1) million for the year ended December 31, 2019. The increase was primarily attributable to the issuances of preferred stock in 2020, $210.9 million of Series A11 Preferred Stock and $151.2 million of Series A12 Preferred Stock, and net proceeds from the Term Loan Facility of $142.2 million. In addition, $87.0 million and $19.3 million of convertible preferred stock warrants and stock options, respectively, were exercised.

 

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Contractual Obligations and Commitments

The following table sets forth our contractual obligations and commitments as of December 31, 2020:

 

     Payments Due by Period  
     Total      Less
than
1 Year
     1 to 3
Years
     4 to 5
Years
     More
than
5 Years
 
     (in thousands)  

Term loan facility(1)

     152,417        —          152,417        —          —    

Interest on long-term debt(1)

     87,811        19,949        67,862        —          —    

Operating lease obligations(2)

     116,462        12,863        40,950        24,938        37,711  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ 356,690      $ 32,812      $ 261,229      $ 24,938      $ 37,711  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

 

(1)

Relates to borrowings under the Term Loan Facility and assumes quarterly interest payments of which 50% will be paid-in-kind through stated maturity of the Term Loan Facility by applying the interest rate of 12.75% in effect as of December 31, 2020 under our Term Loan Facility. Payments herein are subject to change, as payments for variable rate debt have been estimated. As of December 31, 2020, the total principal amount of debt outstanding under our Term Loan Facility, excluding unamortized debt discount and deferred issuance costs, was $142.5 million. The Term Loan Facility matures on October 30, 2024; provided that upon the invalidation of certain provisions of the ACA by the Supreme Court of the United States or any other federal courts that could reasonably be likely to result in a material adverse effect, upon the election of the majority lenders, the maturity of the Term Loan Facility will be 12 months from such election, which is referred to as the “Springing Maturity Date.” Notwithstanding the Springing Maturity Date, upon certain events (including the consummation of this initial public offering), the maturity date of the Term Loan Facility will revert to October 30, 2024. In connection with this offering, we expect to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility. See “Description of Certain Indebtedness.”

(2)

We lease office space under operating leases that are non-cancellable and expire on various dates through 2032.

Prior to the completion of this offering or shortly thereafter, we expect to enter into the New Revolving Credit Facility as described in the subsection titled “—Liquidity and Capital Resources—New Revolving Credit Facility.” Obligations under this facility are not included in the table above.

Off-Balance Sheet Arrangements

We do not have any off-balance sheet arrangements, as defined by applicable regulations of the SEC, that are reasonably likely to have a current or future material effect on our financial condition, results of operations, liquidity, capital expenditures, or capital resources.

Critical Accounting Policies and Estimates

The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of revenues, expenses, assets, and liabilities and disclosure of contingent assets and liabilities in our financial statements. We regularly assess these estimates; however, actual amounts could differ from those estimates. The most significant items involving management’s estimates include estimates of benefits payable, reinsurance, premium deficiency reserve, risk adjustment, stock-based compensation, and income taxes. The impact of changes in estimates is recorded in the period in which they become known.

 

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An accounting policy is considered to be critical if the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change, and the effect of the estimates and assumptions on financial condition, or operating performance. The accounting policies we believe to reflect our more significant estimates, judgments and assumptions that are most critical to understanding and evaluating our reported financial results are: benefits payable, reinsurance, premium deficiency reserve, risk adjustment, stock-based compensation, and income taxes.

Benefits Payable

Benefits payable includes estimates of our obligations for health care services that have been rendered on behalf of members, but for which claims have either not yet been received or processed. Depending on the health care professional and type of service, the typical billing lag for services can be up to 90 days from the date of service. Approximately 90% of claims related to health care services are known and settled within 90 days from the date of service and substantially all within 12 months from the accepted claims submission.

In each reporting period, our operating results include the effects of more completely developed benefits payable estimates associated with previously reported periods. If the revised estimate of prior period health care claims is less than the previous estimate, we will decrease reported health care claims in the current period (favorable development). If the revised estimate of prior period health care claims is more than the previous estimate, we will increase reported health care costs in the current period (unfavorable development). Health care costs in the years ended December 31, 2019 and 2020 included favorable health care claim development related to prior years of $10.3 million (net of reinsurance) and unfavorable development of $1.0 million (net of reinsurance), respectively.

In developing our benefits payable estimates, we apply different estimation methods depending on the month for which incurred claims are being estimated. For example, in recent months, we estimate claim costs incurred by applying assumed medical cost trends to the PMPM medical costs incurred in prior months for which more complete claim data is available, supplemented by a review of near-term completion factors. Additional consideration is also given to settled claims that may reopen as a result of provider disputes.

Completion Factors

A completion factor is an actuarial estimate, based upon historical experience and analysis of current trends, of the percentage of incurred claims during a given period that have been adjudicated by us at the date of estimation. Completion factors are the most significant factors we use in developing our benefits payable estimates. For periods prior to the three most recent months, completion factors include judgments related to claim submissions such as the time from date of service to claim receipt, claim levels, and processing cycles, as well as other factors. If actual claims submission rates from providers (which can be influenced by a number of factors, including provider mix and electronic versus manual submissions) or our claim processing patterns are different than estimated, our reserve estimates may be significantly impacted. For the most recent three months, the completion factors are informed primarily from forecasted per member per month claims projections developed from our historical experience and adjusted by emerging experience data in the preceding months which may include adjustments for known changes in estimates of recent hospital and drug utilization data, provider contracting changes, changes in benefit levels, changes in member cost sharing, changes in medical management processes, product mix, and workday seasonality.

 

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The following table illustrates the sensitivity of the estimated potential impact on our benefits payable estimates gross of reinsurance, for those periods as of December 31, 2020 to an increase (decrease) in the underlying completion factors:

 

Changes in Estimates

   Increase
(Decrease) in
Benefits Payable

(in thousands)
 

(1.00)%

   $ 27,673  

(0.75)%

     20,702  

(0.50)%

     13,767  

(0.25)%

     6,866  

0.25%

     (6,832

0.50%

     (13,630

0.75%

     (20,394

1.00%

     (27,125

Management believes the amount of benefits payable is reasonable and adequate to cover our liability for unpaid claims as of December 31, 2020; however, actual claim payments may differ from established estimates as discussed above. Assuming a hypothetical 1% difference between our December 31, 2020 estimates of benefits payable and actual benefits payable, excluding any potential offsetting impact from premium rebates, net earnings for the year ended December 31, 2020 would have increased or decreased by approximately $3.0 million.

For more detail related to our medical claims expenses, see note 2 of the audited consolidated financial statements included elsewhere in this prospectus.

Reinsurance

The Company is party to quota share reinsurance agreements with two reinsurers under which the reinsurers assume an agreed percentage of the underlying policies. During the years ended December 31, 2019 and 2020, approximately 33% and 32% of our business, respectively, was ceded under quota share reinsurance arrangements to Axa France Vie and approximately 22% and 45% of our business, respectively, was ceded to Berkshire Hathaway Specialty Insurance Company. All premiums and claims ceded under our quota share contracts are shared proportionally with our reinsurers up to a limit specified in each agreement, which varies from 100% to 105% of ceded premiums for the agreements applicable to the years ended December 31, 2019 and 2020. We are entitled to experience refunds for premiums for quota share insurance if our MLR is below certain specified thresholds. We also receive a ceding commission, which is reflected in other insurance costs. Reinsurance recoveries are recorded as a reduction to claims incurred, net. We entered into statutory trust agreements with Axa France Vie in compliance with the credit for reinsurance laws and regulations of the state of domicile of each ceding company in connection with reinsurance ceded to an unauthorized reinsurer. Each trust account is funded at 102% of the ceding entity’s IBNR. Acceptable assets deposited into the trust accounts include cash, certificates of deposit, and instruments that are acceptable to the commissioner of the insurance department of the ceding entity’s state of domicile. The Company also has a reinsurance assumed agreement, which is included as an addition to premiums earned in the accompanying consolidated statement of operations and comprehensive loss. The Company stopped assuming reinsurance on the Tennessee Small Group market for contracts written in 2018. These contracts have since ended and any activity is related to the adjudication of claims which may follow the policy for up to four years.

The Company regularly evaluates the financial condition of its reinsurers to minimize exposure to significant credit losses. For our unauthorized reinsurers, the Company strives to maintain sufficient qualifying assets of the reinsurer in trusts or collateral, mostly in excess of net reinsurance recoverables.

 

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The Company has other reinsurance agreements to limit its losses on individual claims of enrolled members. Premiums for these reinsurance agreements are based on enrollment calculated on a per member, per month basis. Reinsurance recoveries are recorded as reductions to claims incurred, net. The reinsurance coverage does not relieve the Company of its primary obligations. Our 2020 reinsurers had ratings from A++ to AA-.

Premium Deficiency Reserve

Premium deficiencies are recognized when it is probable that expected future claims and administrative expenses will exceed future premium and reinsurance recoveries on existing medical insurance contracts. Administrative expenses are inclusive of maintenance costs to operate the business (e.g. claim processing costs, and salaries, among others.) For purposes of determining premium deficiency expenses, contracts are grouped consistent with the Company’s method of acquiring, servicing, and measuring the profitability of such contracts which is generally on a state and product basis. Anticipated investment income is not considered in the calculation of premium deficiency reserve expense.

Risk Adjustment

The risk adjustment programs in the Individual, Small Group, and Medicare Advantage markets we serve are designed to mitigate the potential impact of adverse selection and provide stability for health insurers. Under the Individual and Small Group risk adjustment program, each plan is assigned a risk score based upon demographic information and current year claims information related to its members. Plans with lower than average risk scores will generally pay into the pool, while plans with higher than average risk scores will generally receive distributions. This amount is calculated based on the risk score of the Company’s members. The Company refines its estimate as new information becomes available and the Company receives the final report from CMS in August of the following year. In the Medicare Advantage risk adjustment program, each member is assigned a risk score that reflects the member’s predicted health costs compared to an average member. Plans receive higher payments for members with higher risk scores than members with lower risk scores.

Stock-Based Compensation

The Company accounts for stock-based awards to employees in accordance with the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 718, Compensation - Stock Compensation (“ASC 718”). Employee options are valued on the date of grant and are expensed on a straight-line basis over the related service period (generally the vesting period) of the award. We estimate the fair value of each stock option grant using the Black-Scholes-Merton option-pricing model, which uses the underlying fair value of our Class A common stock as the most critical input for the estimate. Both option and stock awards, generally vest over a period of four years and are exercisable up to 10 years from the date of grant. The Company modified certain awards in conjunction with employee terminations. The modifications provided for the extension of the post-employment exercise period. For the years ended December 31, 2019 and December 31, 2020, the modifications resulted in $8.7 million and $6.4 million of stock-based compensation expenses, respectively, of which $3.5 million and $3.3 million was recognized in general and administrative expenses, respectively, and $5.2 million and $3.1 million was recognized in other insurance costs, respectively.

Income Taxes

The Company records deferred tax assets, or DTAs, and deferred tax liabilities or DTLs, based on differences between the book and tax bases of assets and liabilities. The deferred tax assets and liabilities are calculated by applying enacted tax rates and laws to taxable years in which such differences are expected to reverse.

 

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The Company evaluates the need for a valuation allowance considering all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies and the Company’s recent operating results. The Company established a valuation allowance of $296.9 million because it does not consider it more likely than not that these deferred tax assets will be recovered, as the Company does not have a history of positive earnings.

The Company files a consolidated federal income tax return on behalf of itself and substantially all of its various operating subsidiaries. The Company’s Ohio entity is considered outside of the US Consolidated group and files tax returns separately. The Company files as part of a unitary group in various states. Often, application of tax rules within the various jurisdictions is subject to differing interpretation. An analysis is performed of the amount at which each tax position meets a “more likely than not” standard for sustainability upon examination by taxing authorities. Only tax benefit or provision amounts meeting or exceeding this standard will be reflected in the tax expense and deferred tax balances. At present, the Company has not recorded any tax amounts which fail to meet this standard. Any differences between the amounts of tax benefits reported on tax returns and tax benefits reported in the financial statements will be recorded as a liability for unrecognized tax benefits. Any liability for unrecognized tax benefits would be reported separately from deferred tax assets and liabilities. For additional information, see note 17 of the audited consolidated financial statements included elsewhere in this prospectus.

Quantitative and Qualitative Disclosures of Market Risk

Market risk represents the risk of loss that may impact our financial position due to adverse changes in financial market prices and rates. Our market risk exposure is primarily a result of exposure due to potential changes in interest rates and/or inflation and the resulting impact on investment income and interest expense. We do not hold financial instruments for trading purposes.

Interest Rate Risk

We are subject to interest rate risk in connection with the fair value of our investment portfolio, which consists of U.S. Treasury and agency securities, corporate notes, certificates of deposit, and commercial paper. Our primary market risk exposure is changes to prime rate-based interest rates. Interest rate risk is highly sensitive due to many factors, including U.S. monetary and tax policies, U.S. and international economic factors, and other factors beyond our control. Assuming a hypothetical and immediate 1% increase in interest rates at December 31, 2020, the fair value of our investments would decrease by approximately $5.7 million. Any declines in interest rates over time would reduce our investment income.

Inflation Risk

Inflationary factors such as increases in health care costs may adversely affect our operating results. While it is difficult to accurately measure the impact of inflation due to the imprecise nature of the estimates required, we believe the effects of inflation, if any, on our historical results of operations and financial condition have been immaterial. We cannot assure you, however, that our results of operations and financial condition will not be materially impacted by inflation in the future.

Recent Accounting Pronouncements

For a discussion of new accounting pronouncements recently adopted and not yet adopted, see note 2 to the audited consolidated financial statements included elsewhere in this prospectus.

 

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JOBS Act

We qualify as an “emerging growth company,” as defined in the JOBS Act. Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until such time as those standards apply to private companies. We have elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that we (i) are no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, our financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates.

We are in the process of evaluating the benefits of relying on other exemptions and reduced reporting requirements provided by the JOBS Act. Subject to certain conditions set forth in the JOBS Act, if as an emerging growth company we choose to rely on such exemptions, we may not be required to, among other things, (1) provide an auditor’s attestation report on our systems of internal controls over financial reporting pursuant to Section 404, (2) provide all of the compensation disclosure that may be required of non-emerging growth public companies under the Dodd-Frank Act, (3) comply with the requirement of the PCAOB regarding the communication of critical audit matters in the auditor’s report on the financial statements, and (4) disclose certain executive compensation related items, such as the correlation between executive compensation and performance and comparisons of the Chief Executive Officer’s compensation to median employee compensation. These exemptions will apply until we no longer meet the requirements of being an emerging growth company. We will remain an emerging growth company until the earlier of (a) the last day of the fiscal year (i) following the fifth anniversary of the completion of our initial public offering, (ii) in which we have total annual gross revenue of at least $1.07 billion, or (iii) in which we are deemed to be a large accelerated filer, which means the market value of our Class A common stock that is held by non-affiliates exceeds $700.0 million as of the last business day of our prior second fiscal quarter, and (b) the date on which we have issued more than $1 billion in non-convertible debt during the prior three-year period.

 

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BUSINESS

Our Purpose

At Oscar, we make a healthier life accessible and affordable for all.

Our Business

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar over eight years ago to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family, helping us navigate the health care system in our moments of greatest need. In the years since, we have built a suite of services that permit us to earn our members’ trust, leverage the power of personalized data, and help our members find quality care they can afford. We call this our member engagement engine, and it is powered by a differentiated full stack technology platform that will allow us to continue to innovate like a technology company and not a traditional insurer in the years ahead.

After eight years of selling health insurance, we are proud to have earned industry-leading levels of trust, engagement, and customer satisfaction from the 529,000 members who, as of January 31, 2021, have chosen Oscar. At the same time, we have achieved positive unit economics through an MLR of 84.7% for the year ended December 31, 2020. We serve 291 counties across 18 states, and our members had over 5 million health care visits in 2020. They include families seeking coverage that works for toddlers and their busy parents, adults with chronic conditions who know their care providers by their first names, and seniors choosing a benefits package that will serve them throughout their retirement years. As we continue to bring the Oscar experience to new members, new states, and new markets, our goal will remain the same: to build engagement, earn trust, and help our members live healthier lives.

Hi, We’re Oscar

The Problem

We created Oscar because of our own frustrations with U.S. health care. The U.S. health care system is the world’s largest and most expensive—estimated to have cost over $4 trillion in 2020—yet health outcomes are worse than in other advanced economies. Costs are so out of control that medical bills contribute to around 66% of all personal bankruptcies in the United States. It doesn’t have to be this way. According to a report published in the Journal of the American Medical Association in 2019, nearly 25% of health care spending in the U.S. is wasted, the result of a system plagued by misaligned incentives, lack of coordination, and administrative complexities.

Health insurers have substantial influence over the health care ecosystem because they disburse 75 cents of every health care dollar. Despite decades of effort, however, incumbent insurers have made little progress in reigning in health care costs or incentivizing key stakeholders to produce better outcomes. According to the Harris Poll, U.S. consumers give health insurers the lowest rating of any sector of the health care system when it comes to making a positive difference. Instead, for far too many consumers, health insurance adds an additional layer of complexity to an already complex system. According to another survey, fewer than 4% of Americans could accurately define the four basic health insurance terms: Deductible, Co-Insurance, Co-Pay, and Out-of-Pocket Maximum. With an average NPS of three, according to Forrester Research, customer satisfaction for health insurers ranks among the lowest of any industry.

 

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Our Solution

We founded Oscar to solve these problems and to provide consumers with access to the affordable, high-quality health care they deserve. We recognized that doing so would require reorienting how customers see their health insurer and what they expect from it. Too often, customers view legacy insurers as entities that merely take in monthly premiums and then pay medical claims. We aimed instead to serve as their guide to a confusing and fragmented system, helping them save money by optimizing their spending. In order to achieve all of this, we would need to earn something that is all too rare in the health insurance industry: member trust. We would need to build a technology platform that provides an intuitive, seamless customer experience, and we would need to leverage the power of personalized data. Though our member experience would begin with trust, engagement, and the smart use of data, our ultimate goal would be to bend the cost curve by guiding members to the right care at the right time and at the right value.

Our experience to date reaffirms our view that real change in health care can only come from the use of personalized data to drive real-time actionable insights and recommendations, such as guiding members to the right doctor, hospital, or site-of-care through what we call care routing. We know we are on the right track when 68% of surveyed members indicate that they trust Oscar to advise them on how and where to get the health care they need and 75% of subscribing members with a medical visit use our tools to search for a provider. This compares to an industry-wide average of only 45% of surveyed customers who trust their insurer for health care advice, and no comparable or available statistics from our competitors when it comes to care routing. Given the central role that primary care providers, or PCPs, play in managing care, it is especially meaningful that once our members join Oscar nearly half of their first-time PCP visits are to a doctor Oscar has recommended to them. It is the ongoing engagement and trusted relationship we have with our members that drives our NPS score of 30, which is in a different ballpark altogether than the average score of three among other health insurers.

Our Differentiated Full Stack Technology Platform

From the outset, we recognized the importance of building a full stack technology platform for three reasons. First, existing health care administration technologies were too fractured and antiquated to simply reconfigure them for the 21st century consumer. Second, if we wanted to create a modern member-first health insurance company, we would need access to the right data at the right time for all of our members. Third, change would not come in one fell swoop but through daily iteration and trial and error on multiple fronts, which is difficult or impossible on legacy systems. To overcome these limitations, we would need to own the entire insurance operations infrastructure and build our own full stack technology platform. This led us to create our own policies and procedures around claims and service, which allowed us to make faster decisions and deliver better member service. It also led us to build our own cloud-based technology platform, which allows for greater scalability and flexibility, and spans all critical health care insurance and technology domains, including member and provider data, utilization management, claims management, billing, and benefits. The resulting technology platform, which we update through code deployments more than 50 times per day, makes it easier for providers to work with us, accelerates our ability to identify patterns in our members’ data, improves payment accuracy to reduce frustration across the system, and streamlines regulatory reporting. We believe we have built our platform to scale and it is broadly applicable across health care and health insurance in the U.S. and abroad. Competitors who lack this member engagement engine will face significant challenges in replicating our consumer experience; we believe our platform thus forms an important structural moat around the innovations we have developed.

 

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Our Member Engagement Engine

In addition to a digital platform, we knew that we would need to develop a simple and intuitive consumer experience that would enable our members to take control of their health care decisions. That experience begins with trust and engagement, which we earn by providing our members with features that help them navigate the many disconnected elements of the health care ecosystem. When our members adopt these tools, we not only streamline their day-to-day interactions with the health care system and improve member satisfaction, we also obtain valuable data that lets us better understand their unique health care needs. Trust, engagement, and personalized data allow us to help route our members to the providers that can give them the right care, including virtual care, at the right time and right cost. Our full stack technology platform also permits us to offer personalized insights and benefits. It is the combination of all these factors—trust, engagement, care routing, and personalized insights—that allows us to help our members find quality care at rates they can afford. Our ability to deliver a high-value product, in turn, engenders more trust, engagement, and ability on our part to provide personalized, data-driven insights. We refer to this virtuous cycle as our member engagement engine.

 

 

LOGO

An important aspect of our approach to building trust and engaging members is to engage with them through whatever channel is most comfortable for them. Whether it is a secure in-app message to answer coverage and benefit questions, a consultation with a board-certified doctor in the middle of the night through our $0 virtual care solution, or finding the right in-network provider and scheduling an in-person appointment through our app or website, we are there for our members when they need us most. In this way, we are building a product experience more similar to what consumers experience from a best-in-class technology or consumer products company than from a traditional health care organization.

We also maintain a consistent focus on bringing our brand to life for our members through materials, communications, and interactions. We want every experience that our members have with us to reinforce our values and approach to health care. From the first touchpoint we have with a new member, we emphasize our commitment to delivering a differentiated experience that focuses on them as the end user. We strive to simplify the often complex language used in health care and insurance so

 

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that our members feel comfortable accessing their care. We carefully adjust the language we use through A/B testing to increase engagement and utilization.

Our new members begin their Oscar journey with a welcome kit delivered in the mail to explain their benefits and highlight important plan features. Our new members also receive a message from their personalized Care Team to welcome them to Oscar. Each Care Team is typically composed of five Care Guides and a registered nurse known as a Case Manager, supported by a regional team of additional nurses and social workers. Care Teams serve as our members’ guides throughout their health care journey and have access to a broad array of personalized data, allowing them to provide real-time guidance in English or Spanish.

 

 

LOGO

We encourage our members to interact regularly with us through our mobile app and website, which make it easy for them to search for and access their medical history, lab tests, and various care options, as well as to refill prescriptions through our virtual care solution. We also assign each member a dedicated Care Team, typically composed of five Care Guides and a registered nurse known as a Case Manager,

 

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who build trust and engagement by providing personalized insights and real-time guidance through the health care system. As of December 31, 2020, 89% of our subscribing members have interacted with our digital or Care Team channels, 81% have a digital profile, almost half have downloaded our app, and our per member app download rate as of December 31, 2020 is approximately nine times higher than for other insurers. Almost half (47%) of our subscribing members are monthly active users.

Additionally, since 2014, all of our members have had 24/7 access to our Oscar virtual care offerings, in nearly all cases at no additional cost. These include urgent care through our Virtual Urgent Care service, and since January 1, 2021, primary care through our Virtual Primary Care service. Of our subscribing members who have had one or more medical visits, 37% used our in-house virtual offering in 2020. Even before the ongoing COVID-19 pandemic, in the three-month period ended December 31, 2019, the total number of visits through our Oscar virtual program represented nearly one out of five (19%) of the total number of PCP, urgent care, and outpatient ER visits by our subscribing members. Use of virtual care by our members has further increased during the COVID-19 pandemic.

Saving Money on Health Care

The combination of our full stack technology platform and member engagement engine allows us to help our members find quality providers, but we understand that value is just as important. Over the next five years, health care costs are expected to grow at 5% to 6% per year, outstripping both inflation and GDP growth estimates. Whether our members are spending their own out-of-pocket dollars before a deductible is reached or contending with rapid medical cost inflation, we are acutely aware of the need to make sure every consumer health care dollar is well spent. Our fully integrated systems and data infrastructure enable us to efficiently and effectively identify higher quality, lower cost health care providers in our network, and our levels of trust and engagement earn us the ability to help our members find the right care.

During the year ended December 31, 2020, 46% of our first-time doctor visits as a member to major specialties—Family Medicine, Pediatricians, OBGYNs, Cardiologists, Dermatologists, and Psychologists—were guided by an Oscar recommendation from our app or a member’s Care Team. This care routing resulted in estimated median member savings of approximately 7% during the year ended December 31, 2020, for members who accepted our top recommendations and member satisfaction levels of 92%.

Cost savings estimates are based on allowed visit costs for major specialties (Primary Care, OBGYN, Pediatrics, Dermatology, Cardiology, and Psychology), compared to the allowed visit costs for the same services in the same region for our members that do not use our care routing technology or accept our recommendations. Our popular $0 virtual care options also help our members avoid unnecessary and costly in-person visits to the doctor. We have also created a $3 prescription drug tier made up of approximately 300 drugs that treat our members’ most common conditions. Our ability to better manage the cost for members is evidenced by our improving MLR over time.

Our Growing Plan Portfolio

When we started Oscar, we were the first standalone, for-profit health insurer in 25 years to enter the Individual market in New York. We began by offering health plans in the Individual market because we believed it was where our member-first approach would set us apart. When the ACA created new direct-to-consumer channels in 2014, we knew that we would be competing with some of the nation’s largest health insurers. But we also knew we would have a unique window when a new entrant could gain market share rapidly by creating a superior product—one that could ultimately be extended to other insurance markets. After only eight years of selling health insurance in the Individual market, our strategy has proved out. We are the third largest for-profit national insurer in the Individual market in the United States based on publicly reported membership figures for insurers serving the Individual market during plan year 2020, and we expanded to Small Group in 2017 and Medicare Advantage in 2020.

 

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Today, we have at least one health plan in 291 counties across 18 states and expect to expand in the years ahead both geographically and with respect to insurance markets.

Our Innovative Partnerships

The value of our proprietary insurance platform has been recognized across the industry as leading health care providers and insurers, including the Cleveland Clinic and Cigna, have chosen to form innovative partnerships with us. While each of these arrangements have unique elements, the common thread is that they are built on our full stack technology platform and member engagement engine. Many of our partnerships feature co-branding and/or risk-sharing in addition to fee based revenue or value based reimbursement, underscoring the distinctive value that our contributions add. In some of our partnership arrangements, our partners have the option to purchase 50% of the equity of the relevant Oscar health plan entity. We believe our investment in deeply differentiated technology provides a foundation that will enable us to monetize our platform and diversify our revenue streams over time, if we choose to do so.

 

   

Cleveland Clinic + Oscar.    In 2018, we launched a groundbreaking partnership with Cleveland Clinic to merge our consumer interface with their world-renowned provider network. Today, every Cleveland Clinic + Oscar plan member has access to the prestigious Cleveland Clinic provider network in combination with the powerful member engagement tools of Oscar.

 

   

Montefiore + Oscar.    In 2019, we announced a partnership in Medicare Advantage with Montefiore Health System to offer the first co-branded plan in New York. Members of the Montefiore + Oscar plan get access to high quality affordable doctors from Montefiore’s first-class team through our platform when and where it’s convenient.

 

   

Oscar + Holy Cross + Memorial Health.    In 2020, we expanded our presence in Medicare Advantage by announcing a co-branded health plan with Holy Cross Health and Memorial Healthcare System in Florida, where our platform powers an Oscar + Holy Cross + Memorial Health product that combines our platform with our partners’ extensive physician networks.

 

   

Cigna + Oscar.    In 2020, we also announced a Cigna + Oscar partnership with Cigna to exclusively serve the Small Group employer market, which includes approximately 15 million consumers. Our partnership unites Oscar’s highly-differentiated member experience with Cigna’s broad provider networks.

 

   

Health First.    In 2021, Health First, a Florida-based insurer, announced that Oscar would provide administrative services to its individual and Medicare Advantage members, largely beginning on January 1, 2022. The partnership will give Health First members access to Oscar’s member engagement platform along with the same high quality care they are used to.

Our Financials

Since our inception, we have experienced significant member growth while keeping insurance premiums affordable for our members. We have also achieved high levels of member satisfaction while still managing to keep premiums at a level our members can afford. By 2020, our seventh year of serving members in the Individual market, we had achieved an estimated 10% of market share based on membership within the market, and an MLR of 84.7%. As of January 31, 2021, we had 529,000 members, up from 82,000 as of January 31, 2017, representing a compound annual growth rate, or CAGR, of 59%, and we had a PMPM, direct policy premium rate of $515 for the month ended January 31, 2021. There can be no assurance that such member growth will continue. For the years ended December 31, 2019 and 2020, after taking into account reinsurance premiums ceded, premiums earned were $468.9 million and $455.0 million, respectively. Our direct policy premiums for the years ended December 31, 2019 and 2020 were $1.3 billion and $2.3 billion, respectively. Due to our

 

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continued investment in our technology, product development, and market expansion, for the years ended December 31, 2019 and 2020, we generated net losses of $261.2 million and $406.8 million, respectively, and Adjusted EBITDA losses of $222.2 million and $402.4 million, respectively. See “Prospectus Summary—Summary Consolidated Financial and Other Data” for more information and for a reconciliation of non-GAAP metrics to the most directly comparable financial measure calculated and presented in accordance with GAAP.

Health Care Needs to be Reimagined

Though affordability and poor outcomes are the most visible problems with U.S. health care from the consumer perspective, all of the ecosystem’s key stakeholders—consumers, employers, payers, and providers—face serious challenges when it comes to improving the system. As U.S. health care spending approaches 18% of GDP—more than twice the average of other OECD countries—the need for creative solutions from the private sector has never been greater.

Lack of Consumer-Centric Solutions

Even though health care decisions are among the most important any consumer will make, it is easier to research the right auto mechanic online than the right oncologist and more convenient to make a restaurant reservation on a smartphone than to book something as simple as an annual physical. The reason has little to do with what is technologically feasible and everything to do with the skewed incentives created by the U.S. health care system. The tax treatment of employer-sponsored health insurance that ties coverage to employment, the fee-for-service payment structure that incentivizes providers to focus on episodic and reactive care, and a web of archaic regulations that were not designed with modern technology in mind all have traditionally conspired to make the largest and arguably most important sector of the economy the least responsive to consumer demands. In recent years, as health care costs continue to skyrocket, the burden has gradually but significantly shifted to the consumer. According to the Kaiser Family Foundation, the average employee premium contribution for family health insurance coverage for 2020 was over $5,500, an increase of approximately 40% in the last decade, while the average annual deductible among covered employees rose by approximately 80% to $1,644 in the last decade. In most sectors of the economy, this would lead to enhanced competition that benefits consumers. Yet in health care, even as consumers have become more financially responsible for their decisions, they still lack access to basic data—such as price and quality—that would enable them to make informed choices. As a result, many consumers have lost trust in the U.S. health care system. According to the American Board of Internal Medicine, confidence in the medical system fell from 80% in 1975 to 38% in 2019—the most dramatic decline for any American institution in the same period.

Lack of Coordination and Interoperability

The health care industry is fragmented and inefficient, with different legacy health insurers, hospital systems, provider groups, and pharmacy networks each possessing distinct incentive structures—some or all of which may diverge from consumers’ interests. It is no wonder individual consumers feel lost or overlooked within this system. To make matters worse, each of these industry actors have traditionally maintained separate, often antiquated, technological systems with rigid architecture and siloed data. Even as consumer demand for greater coordination grows, inflexible and disparate legacy technological systems present a significant barrier to meeting consumers’ wants and needs.

Lack of Innovation

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care delivery models—such as virtual, home and mobile—has only accelerated due to the ongoing COVID-19 pandemic. According to a McKinsey & Company report, only 11% of consumers used telehealth in 2019, whereas 46% of consumers used telehealth to replace cancelled health care visits in April 2020 (for Oscar members, 57% of primary care visits in April 2020 were conducted virtually). Consumer adoption of telehealth has clearly been accelerated by COVID-19, with 76% of consumers indicating they are likely to use telehealth where available going forward. Despite the surge in consumer demand, however, the existing fee-for-service reimbursement model and fragmented legacy technology systems present serious hurdles for telehealth when it comes to addressing anything other than the most basic health issues. Only entities who are incentivized to lower total cost of care and who have access to end-to-end platforms that incorporate real-time, personalized patient data will be able to realize the full potential of this potentially transformative technology. We built Oscar to move health care forward and enabling innovative virtual care has been part of our DNA since the beginning.

We Have a Massive Opportunity

The U.S. health care industry is a massive and growing market in the middle of a paradigm shift that creates substantial opportunities for private sector innovation. According to CMS, health care spending in the U.S. is estimated to have been over $4 trillion in 2020 and is projected to grow to over $6 trillion by 2028. Of the $4 trillion in health care spending, $3 trillion of that amount is estimated to have passed through health insurers in 2020, an amount that is expected to grow to nearly $5 trillion by 2028. Public and private health insurance companies today represent over $1 trillion of enterprise value in the United States alone. The secular shifts toward consumerization, technological innovation, and personalization in health care, along with the accelerating demand for value and accountability, have raised the stakes for health insurers when it comes to providing lasting value to their consumers. As the first technology-driven, direct-to-consumer health insurance company, we have built an innovative full stack technology platform that is uniquely positioned to deliver against this challenge. Our member experience begins with trust, engagement, and the smart use of data, but our ultimate goal is to bend the cost curve by guiding members to the right care at the right time and at the right value.

We currently sell health plans in three markets—Individual, Small Group, and Medicare Advantage—which, in aggregate, serve more than an estimated 50 million Americans and represent an estimated $450 billion in direct policy premiums.

 

   

The Individual market primarily consists of policies purchased by individuals and families through the Health Insurance Marketplaces. These marketplaces, established in 2014, grew rapidly, following the 2010 enactment of ACA provisions that today, require health insurance companies not to discriminate against pre-existing medical conditions in coverage decisions and provide for premium subsidies for middle and low-income Americans through tax credits. Rules enacted in 2019 provide for Individual Coverage Health Reimbursement Arrangements, or ICHRAs, which enable employers to make tax-favored contributions towards their employees’ purchase of Individual plans. The Departments of Labor, Treasury, and HHS estimate that approximately 800,000 employers will use ICHRAs to pay for insurance for more than 11 million employees and family members in the Individual market. We expect employers will embrace this trend for the same reasons they have shifted away from pensions to 401(k) accounts and agree with the many experts who believe that the decoupling of health insurance from employment would be socially beneficial. On January 28, 2021, President Biden issued an Executive Order which led CMS to establish a Special Enrollment Period for the Individual market from February 15, 2021 to May 15, 2021. New Jersey and California have announced similar Special Enrollment periods for their state-based exchanges.

 

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The Small Group market consists of employees of companies with up to 50 full-time workers in most states and up to 100 full-time workers in California, Colorado, New York, and Vermont. Small businesses are not required to provide health insurance coverage, but those that do are interested in attracting and retaining talented employees and conferring a benefit that is subject to significant tax incentives. Small Group represented a market size of $76 billion of premiums in 2019, and is a part of the broader employer-based insurance market that accounted for an estimated $1.2 trillion of premiums in 2020 and is expected to grow at a 4% CAGR to approximately $1.7 trillion by 2028.

 

   

Medicare Advantage plans are a type of Medicare health plan offered by private companies that contract with the federal government to provide benefits to consumers over 65 years old, giving them the option between traditional Medicare or low- or zero-cost federally-subsidized Medicare Advantage plans. As of December 31, 2020, there were approximately 25 million Medicare Advantage enrollees, and they are estimated to spend approximately $290 billion in annual premiums according to HHS. By 2025, Medicare Advantage enrollment could represent approximately 38 million members, according to LEK Consulting.

While we will continue to focus on bringing the Oscar platform to new members within our existing markets, we also expect to expand into new insurance markets where our member-first approach will add value. These may include the U.S. self-funded employer and international markets.

Our platform partnerships with payers and providers show that we can provide technology solutions to a variety of sophisticated stakeholders across the health care system. As we scale, our addressable market will continue to expand due to our ability to enable new innovative models of integrated care. Our platform is increasingly modular and able to address large adjacencies within health care technology spend including telemedicine, care concierge, claims management and population health. Our member engagement tools and insurance operations infrastructure have the ability to be deployed alongside other provider and payer networks to enable new risk-based models. Collectively, we estimate these addressable markets represent an additional opportunity of $123 billion, including $40 billion in telemedicine, $20 billion in care concierge, $12 billion in claims management, and $51 billion in population health.

We Are a Differentiated Full Stack Technology Platform

When we launched Oscar as a technology-driven, full stack, direct-to-consumer health insurance company, we knew that tackling the challenges of the U.S. health care system would be ambitious. It would take collaboration with players across the system, investment in the resources needed to develop our own infrastructure, and the ability to convince people that their insurer could do more for their health than just pay medical claims. We recognized early on that health care was too broken to fix by simply reconfiguring existing technologies, and we understood that our ability to bend the cost curve would require us to control all of our data and processes before we could empower members with real-time actionable insights. This meant purpose-building a platform from the ground up that we update through code deployments more than 50 times per day. This platform enables us to run nearly 80 automated population health programs, or campaigns, as of December 31, 2020, that allow us to collect data and trigger real-time interventions at scale. We believe we have built our platform to scale and it is broadly applicable across health care and health insurance in the U.S. and abroad. Competitors who lack this member engagement engine will face significant challenges in replicating our consumer experience; we believe our platform thus forms an important structural moat around the innovations we have developed.

 

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We Intervene in Real-Time

Our Care Teams are a critical entry point for our members in navigating and accessing care through Oscar. Through our member engagement, we are able to form a relationship with our members over time that allows us to recommend and ultimately shift members to better and more affordable care. Members are paired with their own Care Team of five dedicated Care Guides and a registered nurse known as a Case Manager, supported by a regional team of licensed nurses and social workers. This team acts as a consistent resource to build a long-term relationship and continuity with a member. A member’s Care Team can answer questions about benefits, upcoming care, prescriptions, and much more, as well as help them find high quality providers. When a Care Guide is unable to answer a member’s question, instead of transferring that member to another department, the Care Guide will take on the responsibility of tracking down the answer and delivering it personally to the member. We believe our Care Team approach is one of the core reasons our member satisfaction is so high.

 

 

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Not only do our members get a dedicated Care Team, they get a Care Team that understands their particular needs and situation. Our proprietary algorithm uses location, predicted Care Team engagement, language preference, and plan type to assign members automatically to the right Care Team. This enables our Care Guides to better understand the needs of our members’ in each of their respective communities—which may vary in terms of housing, income, education, and other social indicators—while becoming experts in the health care landscape of a given market. We also have dedicated teams to assist members with specialized medical needs, including those in need of a transplant, behavioral health treatment, or other forms of complex care management.

Our Care Teams can also offer personalized guidance because of their access to all of our members’ longitudinal data on our full stack technology platform. It is our differentiated platform that makes it possible for us to train and enable our Care Guides to be efficient and effective as they provide customized insights to our members and serve as our first line of response for intervening in real-time in members’ care events. Our Care Teams have a bird’s-eye view of a member’s journey through the health care system, including claims and authorization history, past appointments, and in some cases, appointments scheduled in the future. Our proprietary clinical segmentation model prompts Care Guides and nurses to reach out to members with more complex health needs to make sure they are getting the care they need, particularly if we notice events such as the member being

 

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admitted to the hospital, or a lapse in medication adherence. During the COVID-19 pandemic, for example, our Care Teams were able to identify members who were at special risk or had delayed important care and to intercept them before their health worsened. After we reached out to members taking maintenance medications or using durable medical equipment, or DME, for conditions highlighted by CDC as higher risk for COVID-19, 70% of survey respondents indicated that they refilled or renewed their prescriptions or DME after receiving Oscar’s messages. Members in this category who engaged with their Care Teams on this issue had 127% higher conversion to prescription delivery or delivery-by-mail than those who did not.

When our platform detects that members are seeking information about emergency care, we can put them in immediate touch with doctors on our virtual platform, showing a relative reduction in ER visits of 13% between our target and control groups. When members are admitted into certain ERs, our platform notifies their Care Teams in real-time to enable follow-up as needed to help arrange discharge to an appropriate facility or to ensure home health care. With access to member data on our platform, Care Teams are also able to proactively reach out to schedule follow-ups, help with prescriptions, or connect our members with necessary virtual care. As of December 31, 2020, we are running nearly 80 campaigns simultaneously that allow us to collect data and trigger real-time interventions at scale. All of this is made feasible and cost-efficient by our full stack technology platform that allows us to make full use of available data, has the machine learning to interpret and drive actionable insights from that data, and then empowers members to make better decisions through our easy-to-use front end.

 

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In this illustrative example, Cristina is a woman in her late 40s who lives in Los Angeles. She suffers from asthma and has experienced mild symptoms. Recently, her symptoms seem to be getting more serious and shes running low on her inhaler. How it works How Oscar is Different H I O S C A R . C O M Our Member Cristina At Oscar, we use technology to make healthcare more accessible and affordable for our members while still reducing total cost of care. The difference between Oscar and a typical insurer is exemplified by our efforts to reduce avoidable ER visits, or trips to the emergency room for a condition that can be treated by a primary care provider. Some studies estimate these account for up to two-thirds of total ER visits or $32 billion in total avoidable health care costs each year. 1 2 If Cristina had a typical insurer, she would likely search for a nearby doctor and may end up at the ER to see someone closeby for her increasingly urgent symptoms. There, based on median ER wait times, she may wait up to 5 1/2 hours to see a physician. This visit would cost her around $1,000 in out-of-pocket costs and cost her insurance company around an additional $1,000. 3 Cristinas experience with Oscar is very different. When she searches in our app for an ER, our data-driven platform will recognize patterns in her search and pull in information about her asthma diagnosis from her claims history. 4 Our tech platform will send Cristina an automated message from the nurse on her Care Team, asking her if she would like to speak to a doctor virtually, at no additional cost. If she opts to do so, the doctor will typically call her back within 15 minutes. 5 If, during the consultation, the doctor and Cristina decide that an in-person visit is unnecessary, the refill for Cristinas inhaler can be handled virtually. Cristina can even use our app to have the inhaler delivered to her door that day at no additional cost. 6 With the Oscar experience, Cristina avoids a trip to the ER and pharmacy and saves around $1,000 in out-of-pocket costs and Oscar saves around $1,000, reducing the total cost of care by approximately $2,000. 7 Our full stack technology platform allows us to use A/B testing to understand the effects of specific campaigns and programs, including this one. As a result, we know that this approach reduces emergency room visits by 13% for those in the campaign compared to a control group. This is just one example of how our investment in a full stack technology platform, and all the steps in our member engagement engine, translate into concrete benefits for our members as well as allow us to bend the overall cost curve in health care. Oscar

 

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As of December 31, 2020, 71% of Oscar subscribing members have turned to their Care Team for help in navigating the health care system, making it a core piece of our member experience that we believe increases retention and serves as a primary avenue for influencing health care spend. Strong engagement with our Care Team also extends across the spectrum of our members’ health care needs. Over 90% of our subscribing members with a chronic disease have interacted with their Care Team as of December 31, 2020. When members do have acute needs, the Care Team relationship amplifies our ability to use traditional case management techniques to drive results. For Oscar members who are engaged with their Care Teams through our case management program, our 30-day hospital readmission rate is 6.2%—a 55.4% reduction relative to the industry average of 13.9% as estimated by the Agency for Healthcare Research and Quality.

We Help our Members Find the Right Doctor

Finding the right care at the right time can be complicated. While many consumers turn to their friends and families for provider recommendations, these and similar channels lack a data-informed view on cost and quality. At Oscar, we want to serve as our members’ first point of contact as they navigate the health care system. Our ranking algorithm uses artificial intelligence to match members to the best doctors for them, driven by sophisticated cost and quality algorithms. This technology saves both Oscar and members money by routing care to “high value” providers, which we define as providers who, based primarily on Oscar’s proprietary cost estimate tool, historical claims data, provider location information, and survey data from Oscar members following an appointment with a provider, have lower costs and higher rated reviews from our members, in each case relative to the other providers on our network, and meet certain widely accepted performance benchmarks, such as the Healthcare Effectiveness Data and Information Set, or HEDIS.

Members can search directly on the Oscar app or website, or if they prefer, in consultation with their Care Team, for the right provider. Approximately three out of four of our subscribing members who have a medical visit use our care routing tools to search for a provider each year. Among care router users, over two-thirds end up visiting one of the top five providers recommended through the care router and 92% have a positive review for the doctors they find through Oscar. Members who use our care routing technology and accept our care router suggestions experience median cost savings of approximately 7%. Cost savings estimates are based on allowed visit costs for major specialties (Primary Care, OBGYN, Pediatrics, Dermatology, Cardiology, and Psychology), compared to the allowed visit costs for the same services in the same region for our members that do not use our care routing technology or accept our recommendations.

 

 

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We Help our Members Get Virtual Care

At Oscar, facilitating virtual care delivery is a continuation of our commitment to personalized solutions that meet the unique health care needs of each of our members. We offer flexible options when our members seek care through a broad platform tailored to solving specific member needs, whether through Virtual Urgent Care or Virtual Primary Care, staffed by the Oscar Medical Group, which was founded in 2017. Since 2014, all of our members have had access to telemedicine 24/7.

Of our subscribing members who have had one or more medical visits, 37% have used our virtual offering. We are taking a virtual-first approach to reimagine the way care is delivered and have built a proprietary infrastructure integrated with Oscar claims and data management systems focused on the consumer. With Virtual Urgent Care, members can talk to or message a provider and get a diagnosis, a new prescription, or a last-minute refill in as little as 15 minutes. Our proprietary infrastructure ensures that data is appropriately shared between Care Teams, virtual urgent care providers, and members.

 

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Oscar Virtual Primary Care provides simple, convenient and free primary care to our members, at no additional cost, delivered by a doctor they choose from the cloud. Members simply login to their account and can book an appointment to talk to a provider via their phone or mobile app. They can follow up with this same provider as many times as they need to, just like with a traditional PCP. Oscar Virtual Primary Care was rolled out for plan year 2021. We believe that the addition of primary care to our suite of virtual services - which today includes urgent and related forms of care - will allow us to maximize the potential of telemedicine for our members. Because we are an insurer, our incentive is to deliver quality care at a cost our members can afford. This is distinct from the incentives of fee-for-service providers, who earn more as costs increase. As an insurer with a full stack technology platform, we also are involved with every interaction our members have with the health care system and can use that data to help them make the informed health care decisions. Compared to providers of virtual care point solutions, or to insurers with legacy technology systems, we thus have a broader array of levers to help our members optimize their overall use of health care. This is an advantage that we can use to benefit both members and the Oscar business model alike. Our end-to-end control of our full-stack technology platform allows us to roll out innovative features like this very quickly. We were able to configure our systems in a matter of months to roll out this feature to provide our members in Houston and Dallas with early access to the offering in 2020. To date, nearly 50% of the members who used the offering have a diagnosis for a chronic condition. Members love the program, as demonstrated by an NPS score of 78 for the limited offering, based on survey responses provided by participating members since September 2020. H I O S C A R . C O M Virtual Primary Care To explain how this offering works in concrete terms, lets consider the illustrative example of Louis, a 45-year-old Oscar member who lives in Dallas. In searching for a new doctor, he found Virtual Primary Care in the Oscar Care Router. After some research about the available providers, Louis chose a provider from Oscar Medical Group that had an appointment the following week. How it works 1 2 Based on a real-time analysis of Louiss health data in the Oscar platform, an automated message from the Care Team was sent to confirm his mailing address to ship him an at-home vitals kit for no additional cost. Because the analysis identified that Louis has claims related to a diabetes diagnosis and high blood pressure, the vitals kit included a thermometer and cellularly-connected blood pressure cuff. 3 Louis provider was able to review his full claims history, patient-reported information, and medication adherence charts in the Oscar electronic health record prior to his visit. The review also pulled in data that highlighted gaps in care and identified that the patient was overdue (relative to care standards from CMS) for an eye exam. Based on this review, the provider offered diabetes education and developed a treatment plan to get Louis diabetes under control. The provider also ordered a $0 in-home blood draw to be scheduled at a time that was convenient for Louis. She also shared with Louis that his blood sugar was unmanaged, based on lab data in the EHR, and gave him a new prescription for insulin. The provider also suggested that she see Louis in-person so that she could conduct a foot exam and eye exam, again for $0. 4 During the in-person visit, the Oscar Virtual Primary Care provider suggested that Louis see an endocrinologist within the next 7 days and gave Louis a cost estimate for his first visit with the specialist based on the information provided by Oscar. In the consultation notes emailed to him after, Louis receives a list of high-value, in-network specialists near him. 5 All of this is made possible because of the con_gurability of our claims system and Oscars full stack technology platform on which it was built. We are using this highly nimble system to enable the dynamic incentives which are intended to bring more a_ordable care to our members. When an Oscar Virtual Primary Care doctor prescribes certain things through our care delivery tooling, we are able to waive cost shares for the member in real-time. We believe that Oscar is the only insurer currently positioned to deliver this level of quality care and cost-savings to its members. oscar

 

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We expanded our virtual platform in 2020 by launching plans, effective as of January 1, 2021, offering virtual primary care for a more convenient and efficient provider experience. Through Oscar Virtual Primary Care, primary care from select providers—as well as downstream care in some instances—is included at no cost and is unlimited to our members. Virtual Primary Care unlocks new ways to improve clinical outcomes and member experience while reducing cost.

We Have Built an End-to-End Platform

Product features such as Care Teams, care routing, and virtual care are our way of building the trust, engagement, and relationship that gives us the ability to help members bend the cost curve in health care. Owning the technologies that power our business from end-to-end lets us pioneer new ways of addressing frictions in the health care system and is the foundation for Oscar’s vision to make a healthier life accessible and affordable for all. Using artificial intelligence throughout our platform, we have built a predictive and user friendly back end. An example is our fully-built claims system. This is the underlying technology that insurers use to process member care events for eligibility and payment. We recognized that rebuilding this part of the stack would be critical to our long-term success and scalability, so at the beginning of 2017 we began the process of building our own claims system. Today, this platform provides the foundation for our personalized data insight and analysis as well as our critical cost structure savings. For example, in 2020, 92% of our claims below $30,000 were auto-adjudicated without human intervention. Our claims system and other internal tools also power our cost estimates tool: when a member contacts our Care Team for an estimate of what a particular service or item will cost, the result is calculated in real-time by our claims engine. Unlike most cost estimates within the industry, which reflect average cost for an average provider, our estimates reflect the rate of an actual provider for an actual procedure and also the member’s personalized plan details, such as their deductible and out-of-pocket spending for the year. This functionality is also available to members directly on the web.

 

 

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Further, as noted above, many of our most sophisticated population health tools are closely integrated with our claims system, so that when a particular claim indicates a member is facing a significant health issue, our Care Teams can reach out proactively to help.

 

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Our platform is built to scale and its integration and configurability will enable us, in the years ahead, to make previously impossible things simple. These include features such as paying providers immediately through real-time claims adjudication, providing real-time prior-authorizations for Oscar members, automating the application of dynamic incentives for members and providers based on actions they take, and making health care more transparent for consumers through even more personalized and accurate cost estimates. Our powerful full stack technology enables us to be differentiated in what we offer members and we believe that over time it will continue to allow us to be innovative in ways our competitors cannot match.

 

 

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What We Offer Our Members

Our technology gives us the flexibility to launch new features, enter new geographic and product markets, and enter into innovative partnerships in ways traditional insurers cannot. Today, we offer health plans in three insurance markets: Individual, Small Group, and Medicare Advantage, across 291 counties and 18 states.

 

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Our Health Plans

We began Oscar by offering health plans within the Individual market, one of the few direct-to-consumer insurance markets in health care. The Individual market is built for those who do not have access to employer-sponsored or government-sponsored insurance. As part of the Individual market, health plans are named after metal tiers—for example, Catastrophic, Bronze, Silver, Gold, and Platinum—to make it easy for consumers to compare options. Each health plan offers a different level of coverage and suits members’ needs depending on their circumstances.

For our products and plans in the Small Group market, our digital platform and member engagement engine allow us to add new dimensions to traditional plan offerings that have struggled to keep up with the demands of an increasingly consumer-focused market. In January 2020, we announced our Cigna + Oscar partnership to exclusively deliver a Small Group plan offering in certain markets that combines the strengths of both our organizations. Through Cigna + Oscar, we provide business owners and their employees with access to member-first health care coverage and physician networks that provide personalized care.

We also operate in the Medicare Advantage market, which provides a private-sector alternative to traditional fee-for-service Medicare by allowing individuals 65 and older to apply their Medicare entitlement to obtain free or low-cost health plans that offer richer benefits and lower out-of-pocket expenses than the public alternative. This high growth market is forecast to grow from approximately 25 million enrollees as of December 31, 2020 to approximately 38 million enrollees in 2025, reflecting a CAGR of approximately 8.7%. In Medicare Advantage, CMS pays health insurers a PMPM premium to manage the health care and associated expenses of a participating member. Health insurers are

 

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therefore incentivized to manage the care of a given member with a focus on improving health outcomes and quality of care while lowering costs. We believe our singular focus on the consumer and the technology platform we have built uniquely position us in this important and growing consumer-focused market.

Our Members

With 529,000 members as of January 31, 2021 across 18 states and 291 counties, our membership base reflects the diversity of the broad range of geographies that we serve. As of December 31, 2020, we had more members who were between 56- to 64-years-old than between 27- to 35-years-old, and 31% of our members were part of families with dependents on their plans. The counties we serve range from ones with high median household incomes such as Orange County in California ($90,234) and New York County in New York ($86,553), to much lower income ones such as Marion County in Florida ($45,371) and El Paso County in Texas ($46,871). 16% of our subscribing members as of December 31, 2020 spoke Spanish as their first language, which is higher than the U.S. population as a whole, and these Spanish-speaking members’ NPS scores were over 25 points higher than our average.

 

 

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Not only do our members reflect the diversity of the geographies we serve, but engagement with our technology platform and customer satisfaction remains high, relative to industry average, across different cohorts such as age. For example, Oscar subscribing members who are over 55 years old engage with our digital or Care Team channels at roughly the same rate as our average subscribing member. When it comes to NPS, our scores are actually highest among our members who are 55 years and older, and the group with the next highest NPS is those 18- to 26-years-old. This is one reason why we believe that our product is a good fit for the rapidly-growing Medicare Advantage market.

 

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Our Network

Our health plans include access to a network of high-quality physicians and hospitals, as well as a personalized Care Team that supports members every step of the way, from finding a doctor to navigating costs. We believe the era in which broad, overbuilt provider networks are the principal option is over. To reduce health care costs, certain individuals and employers may move away from broad, national networks to localized program designs. In broad networks, where every hospital and doctor is part of every insurer’s network, there is limited direct competition on cost and quality between hospitals. The result is widely diverging prices in the same markets, with little to no correlation with quality.

As portions of the health care system increasingly shift towards offering more selective networks, we believe the insurers that will thrive are those that can consistently deliver a high-quality experience by engaging their members and routing care to in-network facilities and physicians that offer quality

 

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care at affordable rates. Oscar has EPO or similar networks in all of our markets for our Individual and Medicare Advantage products. The Cigna + Oscar Small Group products use Cigna’s network to offer PPO and EPO plans. We selectively work with technology-forward, high brand-recognition health systems and are proud to say that 9 of the 10 largest health systems in the U.S. are a part of our network (HCA Healthcare, Ascension, Tenet Healthcare Corporation, Community Health Systems, Trinity Health Corporation, Catholic Health Initiatives, Providence Health and Services, Dignity Health, and Prime Healthcare Services).

We optimize our networks for quality and cost by building algorithmically and our proprietary model is able to score the quality and completeness of a network in real-time, based on contract inputs and what we know about the region’s member base.

Our Growth Opportunities

We are in the early stages of addressing our market opportunity and reimagining health care in the U.S. We are focused on a clear strategy with multiple levers of growth:

Acquire more members in existing markets and states

We believe that we have a significant opportunity to expand and grow share within our current footprint of markets and states. We typically enter new counties with a 7% to 8% average share in year one and are typically able to grow our penetration over time. Today, we estimate our market share in the Individual market has grown to approximately 15% in counties where we have been operating for three years or more, based on membership within the market. Our ability to continue acquiring members in existing markets and states is driven by our combination of innovative plan design and data-driven pricing, as well as growing brand recognition through word of mouth from satisfied members. Our member base has continued to evolve as we have invested in our plan design and pricing. Members find value in the differentiated offerings in our health plans, such as virtual care at no additional cost, wellness incentives, and dedicated Care Teams.

We have also established an in-depth approach to the pricing process with a balanced view of growth, profitability, and risk amidst the competitive backdrop. Since launch, we have continued to refine our data-driven pricing process which allows us to assemble deep market-level insights that we enhance over time.

Launch new markets and states

We believe we can substantially grow our member base by launching into new counties and states. Today, we serve members in 291 counties and 18 states in the U.S. We will focus on markets where we can offer competitively priced premiums over the long term and thus drive consistent member retention. Our platform allows us to expand into new counties and states efficiently with limited incremental spend. We have a unique opportunity to leverage our technology to rapidly and seamlessly reach consumers in new geographies.

Introduce new products and plans

Our platform is built to be extensible to new products and plans, and we plan to continue investing and scaling to address the needs of consumers and partners. In 2017, we entered the Small Group market, and in 2020, we expanded our presence in this market with Cigna + Oscar co-branded plans. In 2019, we announced that we would be launching Medicare Advantage, and in 2020, we served our first members in that market. We will continue to evaluate opportunities to bring Oscar’s mission of making a healthier life accessible and affordable to all to health insurance markets such as the expanded Individual market through ICHRA, the U.S. employer self-funded market, and international markets.

 

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In our existing insurance markets, innovative plan designs enable us to acquire new members and grow our market share. In 2020, we announced that as part of our Oscar health plans in select markets, we would offer members Virtual Primary Care (including downstream care in some instances) at $0 for unlimited virtual primary care visits from select providers. We will continue to develop new plan designs that meet the evolving needs of our members and the health care ecosystem.

Our ability to evaluate opportunities, to leverage our existing regulatory framework, technology and brand, and to launch efficiently will continue to create value for us. We anticipate that our ability to quickly expand into new products and plans will help contribute to our growth in the future.

Develop new partnerships and evaluate potential acquisitions

We believe there is substantial opportunity for us to continue partnering with the health care industry’s key stakeholders through innovative fee-based and/or risk-sharing arrangements that reimagine the way health care is delivered. We will also consider growth through acquisition. Our Cigna + Oscar exclusive partnership in Small Group; Montefiore + Oscar partnership in Medicare Advantage; and Cleveland Clinic + Oscar partnership in Individual are proof points of our ability to deploy our technology to support innovative, value-oriented approaches to health care.

In addition to continued partnerships both regionally and nationally across our several product lines, we may selectively pursue acquisitions. These acquisitions may include new geographies and insurance offerings as well as complementary capabilities we can integrate into our existing product offerings to better engage members, improve health outcomes, and lower costs.

Monetize our platform

We have made significant investments to build a unique full stack technology platform that enables innovation in the global health care system. The fact that leading health care organizations in both the payer and provider sectors want to share risk, co-brand with us, and offer attractive economics—speaks volumes about market perception of the potential of our platform. As a result, we believe we are well-positioned to monetize our platform through risk-sharing partnerships, where we take risk for provider claims on behalf of our members, or, even more directly, through fee-based service arrangements where we charge a fee per member or other fee structure. As consumers take increasing control of their health care, we believe our differentiated member engagement and end-to-end member experience can and will create value in multiple sectors of the health care ecosystem. As care shifts towards virtual delivery, we also believe there are more opportunities to deploy our digital, telehealth capabilities to enable other innovative care models.

Our platform today also has the ability to deliver solutions that represent multi-billion dollar industries, such as telemedicine, benefits management, claims processing and health care data and analytics. By leveraging our technology in areas such as machine learning, predictive analytics, and multimodal communication, we have built technology that is both member-first and helps lower costs. We believe that we have the ability to power these adjacent industries with our member engagement engine and full stack technology platform.

Our People, Vision, and Values

As of December 31, 2020, we had 1,839 employees, 617 of whom were based in our New York headquarters, 1,032 based in Tempe, Arizona, 75 based in Los Angeles, California, and the remaining 115 based in smaller regional offices or working remotely. We compete to hire and retain highly-talented and diverse individuals, and we offer our employees competitive compensation packages that typically include base salary, performance bonus, and equity components. Our employees have backgrounds as engineers, doctors, nurses, actuaries, data scientists, and insurance experts.

 

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Oscar attracts employees because we are a mission-driven company. We view it as a privilege and a responsibility to serve our 529,000 members—and we take the responsibility very seriously. We also see it as our responsibility to fundamentally change the industry in which we are operating. As such, Oscar engenders a culture of discovery, analysis, collaboration, and perseverance. This is reflected in our vision and values.

Our Vision.    We refactor health care to make good care cost less.

Refactor is a term used in software engineering that means to improve the design, structure, and implementation of the software, while preserving its functionality. At Oscar, we take this definition a step further. We improve our members’ experience by building trust through deep engagement, personalized guidance, and rapid iteration.

Our Values.    We live by the following seven precepts:

 

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What we do is a big deal.    We’re solving problems that change lives. Respect the rules, but fight for better ones.

 

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Powered by people.    Members above all else. Machines augment us; they don’t replace us. Differences strengthen us. Developing and growing others is what raises the bar.

 

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Seek the truth but never assume you’ve found it. Be scientific. Don’t simply believe what you’re told. Conventional wisdom is always conventional, but not always wise.

 

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No genius without grit.    Be relentless. Be scrappy. Trying and failing beats not trying and changing nothing.

 

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Inspire and provoke.    Develop and display leadership at all levels. Never stop being an individual contributor. Lead others by inspiring with your craft.

 

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Be transparent.    Give and ask for direct feedback. Be grateful for and excited by the help of others. Don’t talk about people behind their backs. Publish, even when it hurts.

 

  7.

Make it right.    Admit your mistakes. Then, learn from them. Teach us what you’ve learned. Use what you make. Never build alone.

Competitive Conditions and Environment

We operate in a highly competitive environment in an industry subject to significant and ongoing changes, including business consolidations, new strategic alliances, market pressures, scientific and technological advances in medical care and therapeutics, and regulatory and legislative challenges and reform both at the federal and state level. This reform includes, but is not limited to, the federal and state health care reform legislation described under “—Government Regulation.” In addition, changes to the political environment may drive additional shifts in the competitive landscape.

We compete to enroll and retain new members and employer groups, as we currently derive substantially all of our revenue from direct policy premiums, which is primarily driven by the number of members covered by our health plans. Employer groups choosing a health plan for their employees and individuals who wish to enroll in a health plan or to change health plans typically choose a plan based on price, the quality of care and services offered, ease of access to services, a specific provider being part of the network, the availability of supplemental benefits, and the reputation or name-recognition of the health plan. We believe that the principal competitive features affecting our ability to retain and increase membership include the range and prices of health plans offered, diversity of coverage, benefits and wellness programs, breadth and quality of provider network, quality of service and member experience, responsiveness to member demands, financial stability, comprehensiveness of coverage, market presence, and reputation.

 

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As attracting new members depends in part on our ability to provide access to competitive provider networks, we compete in establishing such provider networks. We believe that the factors providers consider in deciding whether to contract with a health insurer include existing and potential member volume, reimbursement rates, timeliness and accuracy of claims payment and administrative service capabilities. While our health insurance subsidiaries are required to meet various federal and state requirements regarding the size and composition of our participating provider networks, our business model is based on contracting with selected health care systems and other providers, not all systems and providers in a given area. This allows us to work more closely with high quality health care systems that engage with us using our technology and to receive more favorable reimbursement rates from these health care systems. For additional information on risks associated with the competitive environment in which we operate and a list of factors that could negatively affect our ability to grow our member base, see “Risk Factors—Most Material Risks to Us—Our success and ability to grow our business depend in part on retaining and expanding our member base. If we fail to add new members or retain current members, our business, revenue, operating results and financial condition could be harmed” and “Risk Factors—Risks Related to our Business—If we are unable to arrange for the delivery of quality care, and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks, or if we are unable to enter into cost-effective contracts with such providers, our profitability could be adversely affected.”

The relative importance of each of the competitive factors mentioned in the above paragraphs and the identity of our principal competitors for members, employer groups, and providers varies by market and geography. In the Small Group market, for example, our principal competitors include plans offered by national carriers and local Blue Cross plans, while our principal competitors in the Individual market primarily consist of plans offered by national carriers, regional carriers, Medicaid-focused insurers offering Health Insurance Marketplace products, local Blue Cross plans, and start-up carriers. In the Medicare Advantage market, our principal competitors include Original Medicare fee-for-service plans managed by the federal government and Medicare Advantage plans offered by national, regional, and local managed care organizations and insurance companies, and accountable care organizations.

Additionally, we face significant competition for personnel, particularly in New York, where our headquarters is located. We rely on a small number of highly-specialized insurance experts, and competition in our industry for qualified employees is intense. Our compensation arrangements, such as our equity award programs, may not always be successful in attracting new employees and retaining and motivating our existing employees.

Sales and Marketing

Our marketing and sales initiatives focus on member growth through four primary avenues: acquiring members through Health Insurance Marketplaces, acquiring members through brokers, acquiring members directly through our digital platform and internal sales team, and signing agreements with small businesses that provide employee coverage as part of their benefits packages. We use marketing and sales strategies and various channels, including the internet, which we use on a selected basis to promote our advertisements through social and other media platforms, to reach consumers as well as enterprise benefits leaders. Enterprise marketing and sales strategies also include account-based marketing, business development initiatives, and client service teams focused on member acquisition, employee enrollment, and member engagement. We also use the data generated in member support interactions to constantly refine and improve our marketing campaign.

 

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Reinsurance

We enter into reinsurance agreements to help us achieve important goals for our business, including capital efficiency and greater predictability in our earnings in the event of unexpected significant fluctuations in MLR. Our reinsurance is contracted under two different types of arrangements: quota share reinsurance contracts and XOL reinsurance contracts. In quota share reinsurance, the reinsurer agrees to assume a specified percentage of the ceding company’s losses arising out of a defined class of business in exchange for a corresponding percentage of premiums (in some cases, net of a ceding commission). In XOL reinsurance, the reinsurer agrees to assume all or a portion of the ceding company’s losses in excess of a specified amount. Under XOL reinsurance, the premium payable to the reinsurer is negotiated by the parties based on losses on an individual member in a given calendar year and their assessment of the amount of risk being ceded to the reinsurer because the reinsurer does not share proportionately in the ceding company’s losses.

Our reinsurance contracts generally have a duration of one to three years, and we review them in advance of the contract’s expiration to negotiate terms for new reinsurance contracts. During each renewal cycle, there are a number of factors we consider when determining our reinsurance coverage, including (1) plans to change the underlying insurance coverage we offer, (2) trends in loss activity, (3) the level of our capital and surplus, (4) changes in our risk appetite, and (5) the cost and availability of reinsurance coverage. There can be no assurance that we will be able to renew our reinsurance contracts on similar or attractive terms, or at all, and no assurance that we will be able to negotiate reinsurance coverage with another reinsurance carrier if we are unable to renew our existing reinsurance contracts.

Certain Contracts

Provider Contracts

We contract with hospitals, physicians, and other health care providers in order to provide our members with access to provider networks. While we generally have a standard set of terms that we propose for our provider contracting relationships, each health market in which we operate is unique, and therefore our negotiated contract terms are specific to each market and health provider. For instance, the fee structures for these contracts vary, and can include fee for service arrangements, value based incentives and payment structures, or payments on a capitation basis. Our provider arrangements also generally may be terminated or not renewed by either party without cause upon prior written notice (the specific terms of which will vary). Some of our provider contracts may also contain exclusivity provisions, which either restrict our ability to contract with certain providers, permit the provider to terminate the contract or raise the compensation paid if we contract with certain other providers, and/or restrict our ability to offer certain benefits and plans. However, in all instances we maintain the right to contract with health systems that are necessary in order to meet federal and state requirements for network adequacy. For information on risks associated with our provider contracts, see “Risk Factors—Risks Related to our Business—If we are unable to arrange for the delivery of quality care, and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks, or if we are unable to enter into cost- effective contracts with such providers, our profitability could be adversely affected” and “Risk Factors—Risks Related to our Business—From time to time, we may become involved in costly and time-consuming litigation and regulatory actions, which require significant attention from our management.”

Contract with Health First

On January 21, 2021, through a subsidiary, we entered into a services agreement with Health First, pursuant to which we will provide certain administrative functions and services to Health First’s

 

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individual commercial and Medicare Advantage health plans in Florida. As of December 31, 2020, Health First had approximately 38,207 members in its Medicare Advantage plan and approximately 17,730 members in its individual commercial plans. The primary services to be provided under the contract will commence on January 1, 2022, which includes providing Health First’s members with access to Oscar’s platform, claims management services, concierge services and utilization review services. We will provide some limited services in 2021, including risk adjustment services and support for open enrollment. The services agreement has an initial five year term, with automatic extensions for successive three year terms unless such successive terms are terminated earlier. The services agreement (i) may be terminated at any time upon mutual written consent of the parties or if either party fails to perform or is in breach of its material obligations and (ii) contains other customary termination rights, representations, covenants and indemnification obligations.

Intellectual Property

We believe that our intellectual property rights are important to our business, and our commercial success depends, in part, on our ability to protect our core technologies and other intellectual property assets. We rely on a combination of copyrights, trademarks, service marks, trade secret laws, technical know-how, confidentiality procedures, and other contractual restrictions to establish and protect our intellectual property. As of December 31, 2020, we exclusively owned two registered trademarks in the United States, the Oscar and Oscar Health marks. While trademark registrations in the United States have terms of limited duration, there is no limit on the number of times that the registrations may be renewed if they remain in use in commerce and if all required filings and payments are made with the United States Patent and Trademark Office. Further, even if a federal registration of a trademark in the United States is not renewed, the owner of the trademark may retain its common law trademark rights thereafter, for as long as the mark remains in use in commerce in the applicable state or states. In addition, we have registered domain names for websites that we use or may use in our business. As of December 31, 2020, we had no issued patents and no pending patent applications anywhere in the world, and therefore, we do not have patent protection for any of our proprietary technology, including our full stack technology platform, proprietary software, mobile app, or web portal. However, our software and other proprietary information are protected by copyright on creation. Copyright registrations, which have so far not been necessary, may be sought on an as-needed basis.

We seek to control access to and distribution of our proprietary information, including our algorithms, source and object code, designs, and business processes, through security measures and contractual restrictions. We seek to limit access to our confidential and proprietary information to a “need to know” basis and enter into confidentiality and nondisclosure agreements with our employees, consultants, members, and vendors that may receive or otherwise have access to any confidential or proprietary information. We also obtain written invention assignment agreements from our employees and consultants that assign to us all right, interest, and title to inventions and work product developed during their employment or service engagement, respectively, with us. In the ordinary course of business, we provide our intellectual property to external third parties through licensing or restricted use agreements. For information on risks associated with our intellectual property rights, see “Risk Factors—Risks Related to our Business—Failure to secure, protect, or enforce our intellectual property rights could harm our business, results of operations, and financial condition” and “Risk Factors—Risks Related to our Business—If we are unable to integrate and manage our information systems effectively, our operations could be disrupted.”

 

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Information Technology

Our business is dependent on effective, resilient, and secure information systems that assist us in, among other things, monitoring utilization, and other cost factors, processing provider claims, providing data to our regulators, and implementing our data security measures. Our members also depend upon our information systems for enrollment, primary care and specialist physician roster access and other information, while our providers depend upon our information systems for eligibility verifications, claims status, and other information.

We partner with third parties, including Amazon, Atlassian, inContact, and Google, to support our information technology systems. This makes our operations vulnerable to adverse effects if such third parties fail to perform adequately. We have entered into agreements with third-party vendors who manage certain of our information technology infrastructure services including, among other things, our information technology operations, end-user services, and platforms for cloud computing. As a result of such agreements, we have been able to reduce our administrative expenses over time, while improving the reliability of our information technology functions, and maintain targeted levels of service and operating performance. A segment of the infrastructure services is managed within our cloud platform, while other portions of the infrastructure services are managed externally by vendors. Our use of cloud service providers in particular is intentionally and inherently resilient, with platform level redundancy in networking and computer hardware. As an example, we distribute our AWS services across multiple availability zones to reduce the likelihood of infrastructure failure.

We have established a program of security measures to help protect our computer systems from security breaches and malicious activity and have implemented controls designed to protect the confidentiality, integrity, and availability of data, including PHI, and the systems that store and transmit such data. We have employed various technology and process-based methods, such as network isolation, intrusion detection systems, vulnerability assessments, penetration testing, use of threat intelligence, content filtering, endpoint security (including anti-malware and detection response capabilities), email security mechanisms, and access control mechanisms. We also use encryption techniques for data at rest and in transit.

Our information systems and applications require continual maintenance, upgrading, and enhancement to meet our current and expected operational needs and regulatory requirements. We regularly upgrade and expand our information systems’ capabilities. For information on risks associated with our information technology systems, see “Risk Factors—Risks Related to our Business—If we are unable to integrate and manage our information systems effectively, our operations could be disrupted” and “Risk Factors—Risks Related to our Business—If we or our partners or other third parties with whom we collaborate sustain a cyber-attack or suffer privacy or data security breaches that disrupt our information systems or operations, or result in the dissemination of sensitive personal or confidential information, we could suffer increased costs, exposure to significant liability, adverse regulatory consequences, reputational harm, loss of business, and other serious negative consequences.”

Government Regulation

General

Our operations are subject to comprehensive and detailed federal, state, and local laws and regulations throughout the jurisdictions in which we do business. These laws and regulations, which can vary significantly from jurisdiction to jurisdiction, restrict how we conduct our businesses and result in additional burdens and costs to us. Further, federal, state, and local laws and regulations are subject to amendments and changing interpretations in each jurisdiction. The application of these myriad, detailed legal and regulatory requirements to the complex operation of our businesses creates areas of

 

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uncertainty. In addition, there are numerous proposed health care laws and regulations at the federal, state, and local levels, some of which could materially adversely affect our businesses if they were to be enacted. See “Risk Factors—Risks Related to the Regulatory Framework that Governs Us—Changes or developments in the health insurance markets in the United States, including passage and implementation of a law to create a single-payer or government-run health insurance program, could materially and adversely harm our business and operating results.”

Supervisory agencies, including federal and state regulatory and enforcement authorities, have broad authority to:

 

   

grant, suspend, deny, and revoke certificates of authority to transact insurance;

 

   

regulate our products and services;

 

   

regulate, limit, or suspend our ability to market products, including the exclusion of our products from Health Insurance Marketplaces;

 

   

approve premium rates;

 

   

monitor our solvency and reserve adequacy;

 

   

scrutinize our investment activities on the basis of quality, diversification, and other quantitative criteria; and

 

   

impose criminal, civil, or administrative monetary penalties, and other sanctions for non-compliance with regulatory requirements.

In particular, we are subject to comprehensive oversight from CMS related to our Medicare Advantage plans. CMS regulates the Medicare Advantage payments made to us and the submission of information relating to the health status of members for purposes of determining the amounts of those payments. Additional CMS regulations govern Medicare Advantage benefit design, eligibility, enrollment and disenrollment processes, call center performance, plan marketing, record-keeping and record retention, quality assurance, timeliness of claims payment, network adequacy, and certain aspects of our relationships with and compensation of providers.

To carry out the above tasks, CMS and other agencies periodically examine our current and past business practices, accounts and other books and records, operations and performance of our health plans, compliance with contracts, adherence to governing rules and regulations, and the quality of care we provide to our members. This information and these practices may be subject to routine surveys, mandatory data reporting and disclosure requirements, regular and special investigations and audits, and from time to time, we may receive subpoenas and other requests for information from government entities. For example, CMS currently conducts RADV audits of a subset of Medicare Advantage contracts for each contract year. The RADV program audits diagnosis codes submitted in support of enhanced payments by Medicare Advantage organizations to ensure such diagnosis codes are valid and supported by medical record documentation. In addition, the OIG also audits risk adjustment of companies offering Medicare Advantage plans, and we anticipate this remaining a focus of government investigations in the next few years.

The health insurance business also may be adversely impacted by court decisions that expand or invalidate the interpretations of existing statutes and regulations. It is uncertain whether we can recoup, through higher premiums or other measures, the increased costs caused by potential legislation, regulation, or court rulings.

State Regulation of Insurance Companies and HMOs

Our insurance and HMO subsidiaries must obtain and maintain regulatory approvals to sell specific health plans in the jurisdictions in which they conduct business. The nature and extent of state

 

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regulation varies by jurisdiction, and state insurance regulators generally have broad administrative authority with respect to all aspects of the insurance business. The Model Audit Rule, where adopted by states, requires expanded governance practices, risk and solvency assessment reporting and the filing of periodic financial and operating reports. Most states have adopted these or similar measures to expand the scope of regulations relating to corporate governance and internal control activities of HMOs and insurance companies. Health insurers and HMOs are subject to state examination and periodic regulatory approval renewal proceedings. Some of our business activity is subject to other health care-related regulations and requirements, including utilization review, pharmacy service, or provider-related regulations and regulatory approval requirements. These requirements differ from state to state and may contain network, contracting, product and rate, licensing and financial and reporting requirements. There are laws and regulations that set specific standards for delivery of services, appeals, grievances, and payment of claims, adequacy of health care professional networks, fraud prevention, protection of consumer health information, pricing and underwriting practices, and covered benefits and services.

In addition, we are regulated as an insurance holding company and are subject to the insurance holding company laws of the states in which our health insurance subsidiaries are domiciled. These laws and other laws that govern operations of insurance companies and HMOs contain certain reporting requirements, as well as restrictions on transactions between an insurer or HMO and its affiliates, and may restrict the ability of our health insurance subsidiaries to pay dividends to our holding companies. Under New York law, for example, Oscar Insurance Corporation, or OIC, our New York-domiciled insurance subsidiary, may not declare or distribute a dividend to shareholders except out of earned surplus (as defined under New York law). Additionally, absent prior approval of the Superintendent of the Department of Financial Services, or the Superintendent, OIC may not declare or distribute any dividend to shareholders which, together with all dividends declared or distributed by us during the preceding 12 months, exceeds the lesser of (a) ten percent of OIC’s surplus to policyholders as shown by its last statement on file with the Superintendent, or (b) one hundred percent of adjusted net investment income (as defined under New York law) during such period. Holding company laws and regulations generally require registration with applicable state departments of insurance and the filing of reports describing capital structure, ownership, financial condition, certain intercompany transactions, enterprise risks, corporate governance, and general business operations. In addition, state insurance holding company laws and regulations generally require notice or prior regulatory approval of certain transactions including acquisitions, material intercompany transfers of assets, and guarantees and other transactions between the regulated companies and their affiliates, including parent holding companies. Applicable state insurance holding company acts also restrict the ability of any person to obtain control of an insurance company or HMO without prior regulatory approval. These acts generally define “control” as the direct or indirect power to direct or cause the direction of the management and policies of a person and is presumed to exist if a person directly or indirectly owns or controls 10% or more of the voting securities of another person. Some state laws have different definitions or applications of this standard. Dispositions of control generally are also regulated under applicable state insurance holding company laws.

The states of domicile of our health insurance subsidiaries have statutory RBC requirements for insurance companies and HMOs based on the Risk-Based Capital For Health Organizations Model Act. These RBC requirements are intended to assess the capital adequacy of life and health insurers and HMOs, taking into account the risk characteristics of a company’s investments and products. In general, under these laws, an insurance company or HMO must submit a report of its RBC level to the insurance regulator of its state of domicile each calendar year. These laws typically require increasing degrees of regulatory oversight and intervention if a company’s RBC declines below certain thresholds. As of December 31, 2020, the RBC levels of our insurance and HMO subsidiaries met or exceeded all applicable mandatory RBC requirements. For more information on RBC capital and additional liquidity

 

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and capital requirements, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources—Overview.”

Further, almost all states require insurers and HMOs to comply with the standards set forth in the Model Audit Rule, which imposes financial reporting, independent audit, and corporate governance requirements. Additionally, as a company that directly or indirectly controls insurers, we have an obligation to adopt a formal enterprise risk management, or ERM, function and file enterprise risk reports on an annual basis. The ERM function and reports must address any activity, circumstance, event, or series of events involving the insurer that, if not remedied promptly, is likely to have a material adverse effect upon the financial condition or liquidity of the insurer, including anything that would cause the insurer’s RBC to fall below certain threshold levels or that would cause further transaction of business to be hazardous to policyholders or creditors, or the public. Similarly, in accordance with NAIC’s Risk Management and Own Risk Solvency Assessment Model Act, we must complete an annual “own risk and solvency assessment,” which is an internal assessment, appropriate to the nature, scale, and complexity of our company, of the material and relevant risks associated with the current business plan, and of the sufficiency of capital resources to support those risks.

Ongoing Requirements and Changes Stemming from the ACA

The ACA significantly changed the United States health care system. While we anticipate continued changes with respect to the ACA, either through Congress, court challenges, executive actions, or administrative action, we expect the major portions of the ACA to remain in place and continue to significantly impact our business operations and results of operations, including pricing, minimum MLRs, and the geographies in which our products are available.

The ACA prohibits annual and lifetime limits on essential health benefits, member cost-sharing on specified preventive benefits, and pre-existing condition exclusions. Further, the ACA implemented certain requirements for insurers, including changes to Medicare Advantage payments and the minimum MLR provision that requires insurers to pay rebates to members when insurers do not meet or exceed the specified annual MLR thresholds. In addition, the ACA required a number of other changes with significant effects on both federal and state health insurance markets, including strict rules on how health insurance is rated, what benefits must be offered, the assessment of new taxes and fees (including annual fees on health insurance companies), the creation of public Health Insurance Marketplaces for Individuals and Small employer group health insurance and the availability of premium subsidies for qualified individuals. The ACA allows individual states to choose to enact additional state-specific requirements that extend ACA mandates and some of the states where we operate have implemented higher MLR percentage requirements, lower tobacco user rating ratios, and different age curve variations. Changes to our business environment are likely to continue as elected officials at the national and state levels continue to enact, and both elected officials and candidates for election continue to propose, significant modifications to existing laws and regulations, including changes to taxes and fees. Also, legal challenges regarding the ACA could have a material adverse effect on our business, cash flows, financial condition, and results of operations. See “Risk Factors—Most Material Risks to Us—Any potential repeal of, changes to, or judicial challenges to the ACA, could materially and adversely affect our business, results of operations, and financial condition.”

In general, the individual market risk pool that includes public Health Insurance Marketplaces has become less healthy since its inception in 2014 and continues to exhibit risk volatility. Based on our experience in public Health Insurance Marketplaces to date, we have made adjustments to our premium rates and participation footprint, and we will continue to evaluate the performance of such products going forward. In addition, insurers have faced uncertainties related to federal government funding for various ACA programs. These factors may have a material adverse effect on our results of

 

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operations if premiums are not adequate or do not appropriately reflect the acuity of our member population. Any variation from our expectations regarding acuity, enrollment levels, adverse selection, or other assumptions utilized in setting premium rates could have a material adverse effect on our results of operations, financial position, and cash flows.

Further, implementation of the ACA brings with it significant oversight responsibilities by health insurers that may result in increased governmental audits, increased assertions of alleged FCA liability, and an increased risk of other litigation.

Federal regulatory agencies continue to modify regulations and guidance related to the ACA and markets more broadly. Some of the more significant ACA rules are described below:

 

   

The minimum MLR thresholds by market, as defined by HHS, are as follows:

 

    

 

 

Small Group

     80

Individual

     80

 

   

Certain states require us to meet more restrictive MLR thresholds. For example, New York state law requires an 82% MLR for both Small Group and Individual products and plans.

 

   

The minimum MLR thresholds disclosed above are based on definitions of an MLR calculation provided by HHS, or specific states, as applicable, and differ from our calculation of “benefit expense ratio” based on premium revenue and benefit expense as reported in accordance with GAAP. Definitions under applicable MLR regulations also impact insurers differently depending upon their organizational structure or tax status, which could result in a competitive advantage to some insurance providers that may not be available to us, resulting in an uneven playing field in the industry. Failure to meet the minimum MLR thresholds triggers an obligation to issue premium rebates to members.

 

   

The ACA also imposed a separate minimum MLR threshold of 85% for Medicare Advantage plans. Medicare Advantage plans that do not meet this threshold will have to pay a member MLR rebate. If a plan’s MLR is below 85% for three consecutive years, enrollment will be restricted and the plan will be prohibited from accepting new members. A Medicare Advantage plan contract will be terminated if the plan’s MLR is below 85% for five consecutive years.

 

   

All of our premium revenue and medical membership was subject to the minimum MLR regulations as of and for the year ended December 31, 2020.

 

   

The ACA created an incentive payment program for Medicare Advantage plans. CMS has developed the Medicare Advantage Star Ratings system, which awards between 1.0 and 5.0 stars to Medicare Advantage plans based on performance in several categories, including quality of care and customer service. The Star Ratings are used by CMS to award quality-based bonus payments to plans that receive a rating of 4.0 stars or higher. The methodology and measures included in the Star Ratings system can be modified by CMS annually. As of December 31, 2020, none of our Medicare Advantage plans were eligible to receive Star Ratings because of our recent market entry. We expect to have Star Ratings for our New York plan for performance year 2020.

 

   

Further, the ACA directed the HHS Secretary to develop a system that rates qualified health plans, or QHPs, certified by the Health Insurance Marketplace based on relative quality and price. As a QHP issuer, we must submit quality rating information in accordance with CMS guidelines as a condition of certification and participation in the Health Insurance Marketplaces. Our overall ratings, represented on a scale of 1.0 to 5.0 stars, are based on three categories: member experience, medical care, and plan administration. As of 2020, quality rating information for QHPs is publicly displayed and accessible to consumers on all Health Insurance Marketplaces.

 

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Federal regulations require premium rate increases to be reviewed for Small Group and Individual products above specified thresholds that may be adjusted from time to time. The regulations provide for state insurance regulators to conduct the reviews, except in cases where a state lacks the resources or authority to conduct the required rate reviews, in which cases HHS will conduct the reviews.

 

   

Prior to the implementation of the ACA, health insurers were permitted to use differential pricing based on factors such as health status, gender, and age. The ACA prohibits health insurers selling ACA-regulated plans in the Individual and Small Group markets from using health status and gender in the determination of the insurance premium. In addition, age rating under the ACA is limited to a 3:1 ratio for adults age 21 and older, and tobacco use rating is limited to a 1.5:1 ratio. States also may choose to enact more restrictive rules than the federal minimum standards.

 

   

Medicare Advantage reimbursement rates will not increase as much as they would have, absent the ACA, due to the payment formula promulgated by the ACA that continues to impact reimbursements. We also expect further and ongoing regulatory guidance on a number of issues related to Medicare Advantage, including evolving methodologies for ratings and quality bonus payments. CMS also recently finalized various technical proposed changes to the methodology and processes applied as part of its RADV program. While the changes to the RADV program are in part intended to provide health insurers with greater stability and predictability, and promote fairness in the RADV program’s administration, such changes may ultimately increase the government’s ability to retrospectively claw back or recover funds from health insurers.

 

   

On January 28, 2021, President Biden issued an Executive Order expressing the Administration’s commitment to protecting and strengthening Medicaid and the ACA. Federal agencies must examine agency actions to determine whether they are consistent with that commitment, and begin rulemaking to suspend, revise, or rescind any inconsistent actions. Areas of focus include policies or practices that may reduce affordability of coverage, present unnecessary barriers to coverage, or undermine protections for people with preexisting conditions. The Executive Order also led CMS to establish a Special Enrollment Period for the Individual market from February 15, 2021 to May 15, 2021.

Privacy, Confidentiality and Data Standards Regulation

HIPAA and the administrative simplification provisions of HIPAA impose a number of requirements on covered entities (including health insurers, HMOs, group health plans, providers, and clearinghouses) and their business associates relating to the use, disclosure and safeguarding of PHI. These requirements include uniform standards of common electronic health care transactions and privacy and security regulations; and unique identifier rules for employers, health plans, and providers.

In addition, HITECH and corresponding implementing regulations have imposed additional requirements on the use and disclosure of PHI such as additional breach notification and reporting requirements, contracting requirements for HIPAA business associate agreements, and strengthened enforcement mechanisms and increased penalties for HIPAA violations. Federal consumer protection laws may also apply in some instances to our privacy and security practices related to personally identifiable information. We maintain an internal HIPAA compliance program, which we believe complies with HIPAA privacy and security regulations, and have dedicated resources to monitor compliance with this program.

In addition, Health Insurance Marketplaces are required to adhere to privacy and security standards with respect to personally identifiable information and to impose privacy and security standards that are at least as protective as those the marketplaces must follow. These standards may differ from, and be more stringent than, HIPAA.

 

 

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The use and disclosure of certain data that we collect or process about or from individuals are also regulated in some instances by other federal laws, including the Gramm-Leach-Bliley Act, or GLBA, and state statutes implementing GLBA, in connection with insurance transactions in the states where we operate. Additionally, in response to the growing threat of cyber-attacks in the insurance industry, certain jurisdictions, including New York, have begun to consider new cybersecurity measures, including the adoption of cybersecurity regulations. In March 2017, the NYDFS promulgated Cybersecurity Requirements for Financial Services Companies, which require covered financial institutions to establish and maintain a cybersecurity program and implement and maintain cybersecurity policies and procedures that meet specific requirements.

There are also numerous state and federal laws and regulations related to the privacy and security of health information. Laws in all 50 states require businesses to provide notices to affected individuals whose personal information has been disclosed as a result of a data breach, and certain states require notifications for data breaches involving individually identifiable health information. Most states require holders of personal information to maintain safeguards and take certain actions in response to a data breach, such as maintaining reasonable security measures and providing prompt notification of the breach to affected individuals and the state’s attorney general. For further discussion, see “Risk Factors—Risks Related to the Regulatory Framework that Governs Us.”

Furthermore, states have begun enacting more comprehensive privacy laws and regulations addressing consumer rights to data protection or transparency that may affect our privacy and security practices. This includes, for example, the CCPA, which governs the collection, use, handling, processing, destruction, disclosure, storage, and protection of California residents’ data and imposes additional breach notification requirements. The CCPA requires new disclosures, imposes new rules, and affords California residents new abilities to seek access and deletion of their non-PHI personal information in portions of our business not regulated by the GLBA and state law equivalents. State consumer protection laws may also apply to our privacy and security practices related to personally identifiable information, including information related to consumers and care providers. Complying with conflicting cybersecurity regulations and varying enforcement philosophies, which may differ from state to state, requires significant resources and may materially and adversely affect our ability to standardize our products and services across state lines.

New federal regulations requiring additional transparency could also materially impact our operations. These regulations include federal regulation on data interoperability requiring member data to be made available to third parties unaffiliated with Oscar, as well as federal regulations requiring hospitals and insurers to publish negotiated prices for services as well as the most accurate out-of-pocket cost estimate possible based on an individual’s health plan for procedures, drugs, durable medical equipment, and other items or services.

In addition, certain of our businesses are also subject to the PCI Data Security Standard, which is a multifaceted security standard that is designed to protect credit card account data as mandated by PCI entities. We rely on vendors to assist us with PCI matters and to ensure PCI compliance. Our business and operations are also subject to federal, state, and local consumer protection laws governing the use of email and telephone marketing.

Fraud, Waste and Abuse Laws and the False Claims Act

Because we receive payments from federal governmental agencies, we are subject to various laws commonly referred to as “fraud, waste, and abuse” laws, including the federal Anti-Kickback Statute, the Stark Law, and the FCA. These laws permit the DOJ, the OIG, CMS, and other enforcement authorities to institute a claim, action, investigation, or other proceeding against us for violations and, depending on the facts and circumstances, to seek treble damages, criminal, civil, or

 

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administrative fines, penalties, and assessments. Violations of these laws can also result in exclusion, debarment, temporary or permanent suspension from participation in government health care programs, the institution of corporate integrity agreements, or CIAs, and/or other heightened monitoring of our operations. Liability under such statutes and regulations may arise if, among other things, we knew, or it is determined that we should have known, that information we provided to form the basis for a claim for government payment was false or fraudulent, or that we were out of compliance with program requirements considered material to the government’s payment decision. Companies who receive funds from federal and state governmental agencies are required to maintain compliance programs to detect and deter fraud, waste, and abuse. Although our compliance program is designed to meet all statutory and regulatory requirements, our policies and procedures are frequently under review and subject to updates, and our training and education programs continue to evolve.

Fraud, waste, and abuse prohibitions encompass a wide range of activities, including, but not limited to, kickbacks or other inducements for referral of members or for the coverage of products (such as prescription drugs) by a plan, billing for unnecessary medical services by a health care provider, payments made to excluded providers, and improper marketing and beneficiary inducements. In particular, there has recently been increased scrutiny by the DOJ on health plans’ diagnosis coding and risk adjustment practices, particularly for Medicare Advantage plans. The regulations, contractual requirements, and policies applicable to participants in government health care programs are complex and subject to change. Health insurers are required to maintain compliance programs to prevent, detect, and remediate fraud, waste, and abuse, and are often the subject of fraud, waste, and abuse investigations and audits. We perform ongoing monitoring of our compliance with CMS risk adjustment requirements and other applicable laws. We also monitor our provider payment practices and relationships with other third parties whose products and services we reimburse (e.g. pharmaceutical manufacturers) to ensure compliance with applicable laws, including, but not limited to, the federal Anti-Kickback Statute.

In addition to the FCA, under the federal Civil Monetary Penalties Law, the OIG has the authority to impose civil penalties against any person who, among other things, knowingly presents, or causes to be presented, certain false or otherwise improper claims. There also is FCA liability for knowingly or improperly avoiding repayment of an overpayment received from the government and/or failing to promptly report and return such overpayment. Qui tam actions can be brought by private individuals (for example, a “whistleblower,” such as a disgruntled current or former competitor, member, or employee) on behalf of the government alleging that a company has defrauded the government, and the FCA permits the private individual to share in any settlement of, or judgment entered in, the lawsuit. Qui tam actions have increased significantly in recent years, causing greater numbers of health care companies to have to defend a false claim action, pay substantial settlement amounts, and/or enter into a CIA and/or other heightened monitoring arrangements to avoid exclusion from government health care programs as a result of an investigation arising out of such action. See “Risk Factors—Risks Related to the Regulatory Framework that Governs Us—We are subject to extensive fraud, waste, and abuse laws that may give rise to lawsuits and claims against us, the outcome of which may have a material adverse effect on our business, financial condition, cash flows, or results of operations.”

Guaranty Fund Assessments

Under certain state insolvency or guaranty association laws, insurance companies, and HMOs can be assessed for amounts paid by guaranty funds for policyholder losses incurred when an insurance company or HMO becomes insolvent. Most state insolvency or guaranty association laws currently provide for assessments based upon the amount of premiums received on insurance underwritten within such state (with a minimum amount payable even if no premium is received). Under

 

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many of these guaranty association laws, assessments are made or adjusted retrospectively. Some states permit insurers or HMOs to recover assessments paid through full or partial premium tax offsets, or through future policyholder surcharges. The amount and timing of any future assessments cannot be predicted with certainty; however, future assessments are likely to occur.

Facilities

Our corporate headquarters are located in New York, New York, where we lease and sublease office space. We lease additional office space in New York and also lease offices in Dallas, Texas, Los Angeles, California, and Tempe, Arizona. We believe that our corporate headquarters and other offices are adequate for our immediate needs and that we will be able to obtain additional or substitute space, as needed, on commercially reasonable terms.

Geographic Scope of the Business

As of the date of this prospectus, our health insurance subsidiaries operate in the following 18 states in the United States: Arizona, California, Colorado, Florida, Georgia, Iowa, Kansas, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, and Virginia. We expanded to 15 of these states between 2017 and the date of this prospectus.

Legal Proceedings

Our current and past business practices are subject to review or other investigations by various state insurance and health care regulatory authorities and other state and federal regulatory authorities. These authorities regularly scrutinize the business practices of health insurance companies. These reviews focus on numerous facets of our business, including claims payment practices, statutory capital requirements, provider contracting, risk adjustment, competitive practices, commission payments, privacy issues, utilization management practices, pharmacy benefits, access to care, and sales practices, among others. Some of these reviews have historically resulted in fines imposed on us and some have required changes to certain of our practices. We continue to be subject to these reviews, which could result in additional fines or other sanctions being imposed on us or additional changes to certain of our practices.

We are also currently involved in, and may in the future from time to time become involved in, legal proceedings and claims in the ordinary course of our business, including with our members, providers, employees, and other parties. These matters can relate to various employment claims, disputes regarding reinsurance arrangements and class action lawsuits, or other claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups, and others, including, but not limited to, the alleged failure to properly pay in-network and out-of-network claims and challenges to the manner in which we process claims, and claims alleging that we have engaged in unfair business practices. Although the results of these reviews, legal proceedings and claims cannot be predicted with certainty, we do not believe that the final outcome of any matters that we are currently involved in are reasonably likely to have a material adverse effect on our business, financial condition, or results of operations. Regardless of final outcomes, however, any such reviews, proceedings, and claims may nonetheless impose a significant burden on management and employees and be costly to defend, with unfavorable preliminary or interim rulings.

 

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MANAGEMENT

The following table sets forth information regarding our executive officers and members of our board of directors, including their ages as of the date of this prospectus.

 

Name

  

Age

  

Position(s)

Executive Officers

     

Mario Schlosser

   42   

Co-Founder, Chief Executive Officer, and Director

Joshua Kushner

   35   

Co-Founder, Vice Chairman of the Board and Director

Siddhartha Sankaran

   43   

Chief Financial Officer and Director

Meghan Joyce

   36   

Chief Operating Officer and Executive Vice President of Platform

Joel Klein

   74   

Chief Policy and Strategy Officer

Dennis Weaver, M.D.

   60   

Chief Clinical Officer

Directors

     

Jeffery H. Boyd

   64   

Chairman of the Board

Joel Cutler

   62   

Director

Teri List-Stoll

   57   

Director

Charles E. Phillips, Jr.

   61   

Director

David Plouffe

   53   

Director

Elbert O. Robinson, Jr. (“Robbie”)

   43   

Director

Vanessa A. Wittman

   53   

Director

Executive Officers

Mario Schlosser co-founded Oscar in October 2012 and has served as Chief Executive Officer and as a member of our board of directors since December 2012. Prior to co-founding Oscar in 2012, Mr. Schlosser co-founded Vostu, Ltd., a social gaming company in Latin America, where he led the company’s analytics and game design practices from August 2006 to November 2012. From August 2007 to March 2010, Mr. Schlosser served as a Senior Investment Associate at Bridgewater Associates, where he developed analytical trading models. Prior to joining Bridgewater Associates, Mr. Schlosser worked as a consultant for McKinsey & Company in Europe, the United States, and Brazil from November 2002 to May 2007. Mr. Schlosser holds a degree in computer science with highest distinction from the University of Hannover and a Master of Business Administration from Harvard Business School. As a visiting scholar at Stanford University, Mr. Schlosser wrote and co-authored 10 computer science publications. We believe Mr. Schlosser’s perspective and experience from serving as a Co-Founder and Chief Executive Officer of various companies, including Oscar, as well as his technical acumen, make him particularly qualified to serve as a member of our board of directors.

Joshua Kushner co-founded Oscar in October 2012 and has served as Vice Chairman of our board of directors since February 2021. Mr. Kushner is the Managing Director of Thrive Capital Management, LLC, a New York-based venture capital firm. Mr. Kushner holds a Bachelor of Arts degree, majoring in Government, from Harvard College and a Master of Business Administration from Harvard Business School. We believe Mr. Kushner’s experience as an investor in innovative technology companies, including Oscar, makes him particularly qualified to serve as a member of our board of directors.

Siddhartha Sankaran has served as our Chief Financial Officer since March 2019 and as a member of our board of directors since February 2021. Mr. Sankaran will continue to serve as our Chief Financial Officer until March 15, 2021, and will provide transitional services through June 30,

 

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2021. Prior to joining Oscar, Mr. Sankaran served as Executive Vice President and Chief Financial Officer of American International Group, Inc., or AIG, from February 2016 to December 2018. Prior to that, he served as Executive Vice President and Chief Risk Officer at AIG from November 2010 to February 2016. Mr. Sankaran has been a member of the board of directors of Third Point Reinsurance Ltd., a holding company that provides property and casualty reinsurance products through its reinsurance subsidiaries, since August 2019, and has served as its Chairman since August 2020. Mr. Sankaran holds a Bachelor of Mathematics degree, majoring in actuarial science, with distinction from the University of Waterloo. We believe Mr. Sankaran’s extensive leadership and financial and risk-management experience makes him particularly qualified to serve as a member of our board of directors.

Meghan Joyce has served as our Chief Operating Officer since September 2019 and as our Executive Vice President of Platform since January 2021. Prior to joining Oscar, Ms. Joyce served in several leadership roles at Uber Technologies, Inc. from April 2013 to April 2019, most recently as Regional General Manager of the United States and Canada, responsible for business outcomes and rider and driver experience in cities across the United States and Canada. Prior to that, she served as Senior Policy Advisor at the U.S. Treasury from May 2011 to August 2012, where she managed special projects in financial fiscal policy for the Deputy Secretary of the U.S. Treasury, Under Secretary of Domestic Finance, and Assistant Secretary of Capital Markets. Ms. Joyce has served as a member of the board of directors of The Boston Beer Company, Inc., an alcoholic beverage company, since March 2019. Ms. Joyce holds a Bachelor of Arts degree with highest honors, majoring in the history of science, from Harvard College and a Master of Business Administration from Harvard Business School.

Joel Klein has served as our Chief Policy and Strategy Officer since January 2016. Prior to joining Oscar, Mr. Klein served as the Executive Vice President, Office of the Chairman at News Corporation from June 2013 to December 2015, where he was also a member of the board of directors from June 2013 through November 2020. From January 2011 to September 2015, he served as the Chief Executive Officer at Amplify Education, Inc., an educational technology teaching firm. From 2002 to 2010, he served as the Chancellor of the New York City public school system, and before then, as the U.S. Chairman and Chief Executive Officer of Bertelsmann, Inc. and Chief U.S. Liaison Officer to Bertelsmann AG from 2001 to 2002. Mr. Klein also served with the Clinton administration in a number of roles, including Assistant U.S. Attorney General in charge of the Antitrust Division of the U.S. Department of Justice from 1997 until 2000 and Deputy White House Counsel to President Clinton from 1993 to 1995. Mr. Klein has served as a member of the board of directors of Boston Properties, Inc. since January 2013 and as such board of directors’ Chairman since May 2018. Mr. Klein holds a Bachelor of Arts degree, majoring in economics and political science, from Columbia College and a Juris Doctor from Harvard Law School.

Dennis Weaver, M.D., has served as our Chief Clinical Officer since August 2017. Prior to joining Oscar, Dr. Weaver served as the Executive Vice President and Chief Medical Officer at The Advisory Board Company from April 2011 to August 2017. Dr. Weaver holds a Bachelor of Science degree, majoring in Basic Sciences, from the United States Air Force Academy, an M.D. from the University of Iowa, and a Master of Business Administration from Washington University in St. Louis.

Directors

Jeffery H. Boyd has served as Chairman of our board of directors since February 2021. Mr. Boyd served as Chief Executive Officer and President of Booking Holdings Inc. (formerly known as The Priceline Group, Inc.), an online travel company, from November 2002 to December 2013, as interim Chief Executive Officer in 2016, and as Chairman of the Board from 2014 to 2020. Mr. Boyd

 

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also served as Booking’s President and Co-Chief Executive Officer from August 2002 to November 2002, its Chief Operating Officer from November 2000 to August 2002, and its Executive Vice President, General Counsel, and Secretary from January 2000 to October 2000. Prior to joining Booking, Mr. Boyd served as Executive Vice President, General Counsel, and Secretary of Oxford Health Plans, Inc., a U.S. health care company, from 1995 to 1999, Mr. Boyd has also served as a member of the board of directors of The Home Depot, Inc. since 2016. Mr. Boyd holds a Bachelor of Arts degree from St. Lawrence University and a Juris Doctor from Cornell Law School. We believe Mr. Boyd’s extensive experience in health care, e-commerce, sales, and digital marketing, as well as proven leadership, corporate governance, and strategic management skills, makes him particularly qualified to serve as a member of our board of directors.

Joel Cutler has served as a member of our board of directors since February 2015. Mr. Cutler is the Co-Founder and Managing Director of General Catalyst, a venture capital firm he started in April 2000. Mr. Cutler has served as a member of the board of directors of Lemonade, Inc., a home, renters, and pet health insurance company, since November 2016, and serves as a member of the board of directors of several private companies, including Warby Parker, an eyewear company. Mr. Cutler holds a Bachelor of Arts degree in Government and Economics from Colby College and a Juris Doctor from Boston College Law School. We believe Mr. Cutler’s experience in a wide range of industries, including the insurance industry, his leadership at a venture capital firm, and his service as a director at numerous companies make him particularly qualified to serve as a member of our board of directors.

Teri List-Stoll has served as a member of our board of directors since February 2021. Ms. List-Stoll served as Executive Vice President and Chief Financial Officer of The Gap, Inc., or Gap, a global apparel retailer, from January 2017 to March 2020. Prior to joining Gap, Ms. List-Stoll served as Executive Vice President and Chief Financial Officer of Dick’s Sporting Goods, Inc., a sporting goods retailer, from August 2015 to August 2016, and with Kraft Foods Group, Inc., a food and beverage company, as Advisor from March 2015 to May 2015, as Executive Vice President and Chief Financial Officer from December 2013 to February 2015, and as Senior Vice President of Finance from September 2013 to December 2013. From 1994 to September 2013, Ms. List-Stoll served in various positions of increasing authority at Procter & Gamble Co., a consumer goods company, most recently as Senior Vice President and Treasurer from January 2009 to September 2013. Prior to joining Procter & Gamble Co., Ms. List-Stoll was employed by the accounting firm of Deloitte & Touche LLP for almost ten years. Ms. List-Stoll has served as a member of the board of directors of Microsoft Corporation, a technology company, since October 2014, and Danaher Corporation, a science and technology company, since September 2011. Ms. List-Stoll holds a Bachelor of Arts degree, majoring in Business Administration, from Northern Michigan University and is a Certified Public Accountant. We believe Ms. List-Stoll’s leadership experience and experience dealing with complex finance and accounting matters for large, global corporations, make her particularly qualified to serve as a member of our board of directors.

Charles E. Phillips, Jr. has served as a member of our board of directors since February 2021. Mr. Phillips is the Co-Founder and a Managing Partner of Recognize, a technology investing and transformation company. Prior to Recognize, Mr. Phillips served as Chairman of Infor, Inc., an enterprise software company, from August 2019 to March 2020, and as Chief Executive Officer of Infor, Inc. from October 2010 to August 2019. Before Infor, Inc., Mr. Phillips served as President of Oracle Corporation, a computer technology company, from 2003 to 2010, serving as a member of its board of directors and executive management committee from May 2004 to August 2010. Prior to Oracle, Mr. Phillips was a managing director at Morgan Stanley & Co. LLC in the Technology Group and served on its board of directors. Mr. Phillips has served as a member of the board of directors of American Express, a financial services company, since December 2020, Compass, Inc., a

real estate technology company, since September 2020, ViacomCBS Inc., a media and entertainment company, since December 2019, and, prior to that, on the board of directors of Viacom from

 

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January 2006 to December 2019. He is the Chairman of the Apollo Theater and is the Co-Chair and Co-Founder of the Black Economic Alliance. Mr. Phillips also served on President Obama’s Economic Recovery Board, led by Paul Volcker, and is a member of the Council on Foreign Relations. Mr. Phillips holds a Bachelor of Science degree, majoring in Computer Science, from the U.S. Air Force Academy, a Master of Business Administration from Hampton University, and a Juris Doctor from New York Law School. We believe Mr. Phillips’ extensive experience as a senior executive in a large, multinational corporation, financial, analytical, and technological expertise, and significant public company and corporate governance experience, make him particularly qualified to serve as a member of our board of directors.

David Plouffe has served as a member of our board of directors since February 2021. Mr. Plouffe served as President, Policy and Advocacy of the Chan Zuckerberg Initiative, or CZI, a charitable organization established by Priscilla Chan and Facebook founder Mark Zuckerberg, from January 2017 to November 2019. Prior to joining CZI, Mr. Plouffe served as Senior Vice President of Policy and Strategy of Uber Technologies, Inc., or Uber, a technology-driven transportation company, from August 2014 to January 2017. Before Uber, Mr. Plouffe served in The White House as Senior Advisor to U.S. President Barack Obama from January 2011 to January 2013 and as Campaign Manager for President Obama’s historic campaign victory in 2008. Prior to the Obama White House years, Mr. Plouffe managed and served as the strategist in election efforts of U.S. senators, governors, members of congress, and mayors, and served as the Deputy Chief of Staff to the House Democratic leader on Capitol Hill. Mr. Plouffe has served as a member of the board of directors of the Obama Foundation, a nonprofit organization founded by First Lady Michelle Obama and President Barack Obama, since January 2014, and currently serves on the boards of directors of a number of other nonprofit organizations. Mr. Plouffe holds a Bachelor of Arts degree, majoring in Political Science and Government, from the University of Delaware. We believe Mr. Plouffe’s extensive experience in public policy and advocacy makes him particularly qualified to serve as a member of our board of directors.

Elbert O. Robinson, Jr. (“Robbie”) has served as a member of our board of directors since February 2021. Mr. Robinson is the Founder and Chief Executive Officer of Pendulum Holdings LLC, or Pendulum, an inclusive and strategic growth investing and advisory platform he founded in 2019. Prior to founding Pendulum, Mr. Robinson served as a Partner of BDT & Company, or BDT, a merchant bank he joined in May 2009. Mr. Robinson began his career with Goldman, Sachs & Co., where he spent several years working in various investment, advisory, and financing capacities. Mr. Robinson serves on the boards of a number of nonprofit organizations, including, since 2020, the National Museum of African American History and Culture. Mr. Robinson holds a Bachelor of Arts degree, majoring in Political Science, from Morehouse College. We believe Mr. Robinson’s extensive leadership and investment experience makes him particularly qualified to serve as a member of our board of directors.

Vanessa A. Wittman has served as a member of our board of directors since February 2021. Ms. Wittman is the Chief Financial Officer of Glossier, Inc., an online beauty product company she joined in April 2019. Prior to Glossier, Inc., Ms. Wittman served as Chief Financial Officer of Oath Inc., a digital media company, from January 2018 to January 2019. Ms. Wittman served as Chief Financial Officer of Dropbox, Inc., a cloud storage and collaboration company, from February 2015 to October 2016, and as Chief Financial Officer of Motorola Mobility Holdings, Inc., a consumer electronics and telecommunications company, from March 2012 to February 2015. From October 2008 to March 2012, Ms. Wittman served as Executive Vice President and Chief Financial Officer of Marsh & McLennan Companies, a global professional services company. Prior to Marsh & McLennan Companies, Ms. Wittman held a number of other senior finance roles during her career. Ms. Wittman has served on the boards of directors of Booking since June 2019 and Impossible Foods Inc., a sustainable foods company, since March 2019. From June 2014 to March 2019, Ms. Wittman was a member of the

 

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board of directors of Ulta Beauty, Inc., a cosmetics and beauty supply company. She also served as a member of the board of directors of Sirius XM Holdings Inc., an audio entertainment company, from April 2011 to June 2018. Ms. Wittman holds a Bachelor of Arts degree, majoring in Business Administration, from the University of North Carolina at Chapel Hill, and a Master of Business Administration from the University of Virginia. We believe Ms. Wittman’s extensive financial and executive experience, including as Chief Financial Officer of global technology companies, makes her particularly qualified to serve as a member of our board of directors.

Family Relationships

There are no family relationships among any of our directors or executive officers.

Composition of our Board of Directors

Upon completion of this offering, our board of directors will consist of 10 directors. Each director’s term will continue until the annual meeting of the stockholders next held after his or her election and the election and qualification of his or her successor, or his or her earlier death, disqualification, resignation, or removal.

When considering whether directors have the experience, qualifications, attributes, or skills, taken as a whole, to enable our board of directors to satisfy its oversight responsibilities effectively in light of our business and structure, the board of directors focuses primarily on each person’s background and experience as reflected in the information discussed in each of the directors’ individual biographies set forth above. We believe that our directors provide an appropriate mix of experience and skills relevant to the size and nature of our business.

Director Independence

We will be a “controlled company” under the rules of the NYSE. The rules of the NYSE define a “controlled company” as a company of which more than 50% of the voting power for the election of directors is held by an individual, a group, or another company. Upon completion of this offering, Thrive Capital and Joshua Kushner (as the sole managing member of the Thrive General Partners) will beneficially own approximately     % of the combined voting power of our outstanding capital stock (or     % if the underwriters exercise their option to purchase additional shares of Class A common stock in full). As a result, we qualify for exemptions from, and have elected not to comply with, certain corporate governance requirements under the NYSE rules. Even though we will be a controlled company, we are required to comply with the rules of the SEC and the NYSE relating to the membership, qualifications and operations of the audit committee, as discussed below.

If we cease to be a controlled company and our Class A common stock continues to be listed on the NYSE, we will be required to comply with these requirements by the date our status as a controlled company changes or within specified transition periods applicable to certain provisions, as the case may be.

Prior to the consummation of this offering, our board of directors undertook a review of the independence of our directors and considered whether any director has a material relationship with us, either directly or as an officer, partner, or stockholder of a company that has a relationship with us. Our board of directors has affirmatively determined that Jeffery H. Boyd, Joel Cutler, Teri List-Stoll, Charles E. Phillips, Jr., David Plouffe, Robbie Robinson, and Vanessa A. Wittman are each an “independent director,” as defined under the rules of the NYSE. In making these determinations, our

 

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board of directors considered the current and prior relationships that each director has with our Company and all other facts and circumstances our board of directors deemed relevant in determining their independence, including the beneficial ownership of our capital stock by each director, and the transactions involving them described in the section titled “Certain Relationships and Related Party Transactions.”

Committees of Our Board of Directors

Our board of directors directs the management of our business and affairs, as provided by Delaware law, and conducts its business through actions of the board of directors and standing committees. We will have a standing audit committee, nominating and corporate governance committee, compensation committee, and finance, risk & investment committee. In addition, from time to time, special committees may be established under the direction of the board of directors when necessary to address specific issues.

Each of the audit committee, nominating and corporate governance committee, compensation committee, and finance, risk & investment committee will operate under a written charter that will be approved by our board of directors in connection with this offering. A copy of each of the audit committee, nominating and corporate governance committee, compensation committee, and finance, risk & investment committee charters will be available on our principal corporate website at www.hioscar.com substantially concurrently with the consummation of this offering. The information on, or that can be accessed through, any of our websites is deemed not to be incorporated in this prospectus or to be part of this prospectus.

Audit Committee

Our audit committee will be responsible for, among other things:

 

   

appointing, compensating, retaining, evaluating, terminating, and overseeing our independent registered public accounting firm;

 

   

discussing with our independent registered public accounting firm their independence from management;

 

   

reviewing with our independent registered public accounting firm the scope and results of their audit;

 

   

approving all audit and permissible non-audit services to be performed by our independent registered public accounting firm;

 

   

overseeing the financial reporting process and discussing with management and our independent registered public accounting firm the quarterly and annual financial statements that we file with the SEC;

 

   

overseeing our financial and accounting controls and compliance with legal and regulatory requirements;

 

   

reviewing our policies on risk assessment and risk management;

 

   

reviewing related person transactions; and

 

   

establishing procedures for the confidential anonymous submission of concerns regarding questionable accounting, internal controls, or auditing matters.

Upon the consummation of this offering, our audit committee will consist of Teri List-Stoll, Robbie Robinson, and David Plouffe, with Teri List-Stoll serving as chair. Jeffery H. Boyd will be a non-voting ex officio member of our audit committee. Rule 10A-3 of the Exchange Act and the NYSE require that

 

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our audit committee have at least one independent member upon the listing of our Class A common stock, have a majority of independent members within 90 days of the listing of our Class A common stock and be composed entirely of independent members within one year of the listing of our Class A common stock. Our board of directors has affirmatively determined that Teri List-Stoll, Robbie Robinson, and David Plouffe each meet the definition of “independent director” for purposes of serving on the audit committee under Rule 10A-3 of the Exchange Act and the NYSE rules. In addition, our board of directors has determined that each member of our audit committee meets the financial literacy requirements of the NYSE listing standards and that Teri List-Stoll, Robbie Robinson, and David Plouffe will each qualify as an “audit committee financial expert,” as such term is defined in Item 407(d)(5) of Regulation S-K.

Nominating and Corporate Governance Committee

Our nominating and corporate governance committee will be responsible for, among other things:

 

   

identifying individuals qualified to become members of our board of directors, consistent with criteria approved by our board of directors;

 

   

periodically reviewing our board of directors’ leadership structure and recommending any proposed changes to our board of directors, including recommending to our board of directors the nominees for election to our board of directors at annual meetings of our stockholders;

 

   

overseeing an annual evaluation of the effectiveness of our board of directors and its committees; and

 

   

developing and recommending to our board of directors a set of corporate governance guidelines.

Upon the consummation of this offering, our nominating and corporate governance committee will consist of Joshua Kushner, Charles E. Phillips, Jr. and David Plouffe with Joshua Kushner serving as chair. Jeffery H. Boyd will be a non-voting ex officio member of our nominating and corporate governance committee. We intend to avail ourselves of the “controlled company” exception under the NYSE rules, which exempts us from the requirement that we have a nominating and corporate governance committee composed entirely of independent directors. Joshua Kushner does not qualify as an “independent director” under the NYSE rules. Our board of directors has affirmatively determined that Charles E. Phillips, Jr. and David Plouffe each meet the definition of “independent director” under the NYSE rules.

Compensation Committee

Our compensation committee will be responsible for, among other things:

 

   

reviewing and approving the corporate goals and objectives, evaluating the performance of and reviewing and approving (either alone, or if directed by the board of directors, in connection with a majority of the independent members of the board of directors) the compensation of our Chief Executive Officer;

 

   

reviewing and setting or making recommendations to our board of directors regarding the compensation of our other executive officers;

 

   

reviewing and approving or making recommendations to our board of directors regarding our incentive compensation and equity-based plans and arrangements;

 

   

making recommendations to our board of directors regarding the compensation of our directors; and

 

   

appointing and overseeing any compensation consultants.

 

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Upon the consummation of this offering, our compensation committee will consist of Joel Cutler, Charles E. Phillips, Jr. and Vanessa A. Wittman, with Joel Cutler serving as chair. We intend to avail ourselves of the “controlled company” exception under the NYSE rules, which exempts us from the requirement that we have a compensation committee composed entirely of independent directors. Vanessa A. Wittman does not qualify as an “independent director” under the NYSE rules. Jeffery H. Boyd will be a non-voting ex officio member of our compensation committee. Our board of directors has determined that Joel Cutler and Charles E. Phillips, Jr. meet the definition of “independent director” for purposes of serving on the compensation committee under the NYSE rules, including the heightened independence standards for members of a compensation committee, and are “non-employee directors” as defined in Rule 16b-3 of the Exchange Act.

Finance, Risk & Investment Committee

Our finance, risk & investment committee will be responsible for, among other things:

 

   

reviewing and providing guidance to management and our board of directors with respect to our capital and liquidity risk management processes and strategies, financial risk management strategies, capital structure and capital expenditures strategy;

 

   

overseeing our investment policies and strategies; and

 

   

reviewing and evaluating our policies with respect to enterprise risk assessment and enterprise risk management, including our financial and cybersecurity risks.

Upon the consummation of this offering, our finance, risk & investment committee will consist of Siddhartha Sankaran, Robbie Robinson, and Vanessa A. Wittman, with Siddhartha Sankaran serving as chair. Jeffery H. Boyd will be a non-voting ex officio member of our finance, risk & investment committee.

Risk Oversight

Our board of directors is responsible for overseeing our risk management process. Our board of directors focuses on our general risk management strategy, the most significant risks facing us, and oversees the implementation of risk mitigation strategies by management and for overseeing management of regulatory risks. Our finance, risk & investment committee is responsible for managing risks associated with our capital structure, credit, liquidity and operations, as well as financial and cybersecurity risks, and oversees our enterprise risk management framework. Our audit committee is also responsible for discussing our policies with respect to risk assessment and risk management. Our board of directors does not believe that its role in the oversight of our risks affects the board of directors’ leadership structure.

Compensation Committee Interlocks and Insider Participation

None of our executive officers serves as a member of the board of directors or compensation committee (or other committee performing equivalent functions) of any entity that has one or more executive officers serving on our board of directors or compensation committee.

Board Diversity

Our nominating and corporate governance committee will be responsible for reviewing with the board of directors, on an annual basis, the appropriate characteristics, skills, and experience required for the board of directors as a whole and its individual members. Although our board of directors does not have a formal written diversity policy with respect to the evaluation of director candidates, in its evaluation of director candidates, our nominating and corporate governance committee will consider factors including, without limitation, issues of character, personal and professional integrity, ethics and

 

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values, experience in corporate management, finance and other experience relevant to our industry, relevant social policy concerns, judgment, potential conflicts of interest, other commitments, practical and mature business judgment, including the ability to make independent analytical inquiries, and such factors as age, sex, race, place of residence and specialized experience and any other relevant qualifications, attributes or skills.

Code of Business Conduct and Ethics

Prior to the completion of this offering, we will adopt a written code of business conduct and ethics that applies to our directors, officers, and employees, including our principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions. A copy of the code will be posted on our website, www.hioscar.com. In addition, we intend to post on our website all disclosures that are required by law or the NYSE listing standards concerning any amendments to, or waivers from, any provision of the code. The information on, or that can be accessed through, any of our websites is deemed not to be incorporated in this prospectus or to be part of this prospectus.

 

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EXECUTIVE COMPENSATION

This section discusses the material components of the executive compensation program for our executive officers who are named in the “2020 Summary Compensation Table” below. In 2020, our chief executive officer and our two other highest-paid executive officers, or our named executive officers, and their positions were as follows:

 

   

Mario Schlosser, Chief Executive Officer;

 

   

Meghan Joyce, Chief Operating Officer and EVP of Platform (effective January 2021); and

 

   

Joel Klein, Chief Policy and Strategy Officer.

This discussion may contain forward-looking statements that are based on our current plans, considerations, expectations, and determinations regarding future compensation programs. Actual compensation programs that we adopt following the completion of this offering may differ materially from the currently planned programs summarized in this discussion.

We will continue to update, in accordance with the rules and regulations of the SEC, information in this section regarding the compensation of our named executive officers.

2020 Summary Compensation Table

The following table sets forth information concerning the compensation of our named executive officers for the year ended December 31, 2020:

 

Name and Principal Position

   Salary ($)     Bonus
($)
     Option
Awards ($)
     Non-Equity
Incentive Plan
Compensation ($)
     All Other
Compensation
($)
    Total ($)  

Mario Schlosser

     493,750 (1)      —          —          —          65,000 (2)      558,750  

Chief Executive Officer

               

Meghan Joyce

     600,000       —          1,597,952        —          13,651 (3)      2,211,603  

Chief Operating Officer and EVP of Platform

               

Joel Klein

     575,000       —          512,753        —          —         1,087,753  

Chief Policy and Strategy Officer

               

 

(1)

Mr. Schlosser’s base salary was reduced from $600,000 to $430,000 on May 16, 2020.

(2)

This amount represents a cash stipend for healthcare coverage.

(3)

The Company reimburses Ms. Joyce for healthcare coverage.

Narrative to Summary Compensation Table

2020 Salaries

The named executive officers receive a base salary to compensate them for services rendered to our company. The base salary payable to each named executive officer is intended to provide a fixed component of compensation reflecting the executive’s skill set, experience, role and responsibilities. The base salaries for Mr. Schlosser, Ms. Joyce and Mr. Klein for 2020 were $430,000, $600,000 and $575,000, respectively. Mr. Schlosser’s base salary was reduced from $600,000 to $430,000 on May 16, 2020.

2020 Bonuses

The named executive officers were eligible to earn a cash incentive bonus based upon the achievement of pre-determined performance goals of the Company for 2020, including goals related to

 

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EBITDA achievement, as well as other financial, operational and strategic goals. Under the 2020 bonus program, participants were eligible to receive up to 130% of the participant’s target bonus opportunity.

For 2020, the target bonuses for Mr. Schlosser, Ms. Joyce and Mr. Klein were 30% of each officer’s annual base salary. However, in April 2020, each of the named executive officers agreed to forgo the ability to earn an award under our 2020 bonus program.

Equity Compensation

Equity Compensation Plans

We currently maintain the Amended and Restated 2012 Stock Plan, or the 2012 Plan, in order to provide our service providers the opportunity to acquire a proprietary interest in our success. We offer stock options and RSUs to our service providers, including our named executive officers, although typically have granted stock options. For additional information about the 2012 Plan, please see the section titled “2012 Stock Plan” below. As mentioned below, in connection with the completion of this offering, no further awards will be granted under the 2012 Plan.

In connection with this offering, our board of directors adopted, and our stockholders approved, the 2021 Incentive Award Plan, referred to below as the 2021 Plan, in order to facilitate the grant of cash and equity incentives to directors, employees (including our named executive officers) and consultants of our company and certain of our affiliates and to enable us to obtain and retain services of these individuals, which is essential to our long-term success. For additional information about the 2021 Plan, please see the section titled “2021 Incentive Award Plan” below.

2020 Equity Grants

The following table sets forth the stock options granted to our named executive officers in the 2020 fiscal year.

 

Named Executive Officer

   2020 Options Granted  

Meghan Joyce

     1,000,000  

Joel Klein

     330,000  

The stock options we awarded to Ms. Joyce vest based on a combination of Ms. Joyce’s continued service and the achievement of certain milestones related to our initial public offering, and the stock options we awarded to Mr. Klein vest based on Mr. Klein’s continued service over a four-year period following the vesting commencement date, each as further described in the footnotes to the Outstanding Equity Awards at Fiscal Year-End table below.

2021 Equity Grants

In January 2021 we awarded 176,000 RSUs to Ms. Joyce, of which 46,994 were vested upon grant. The remaining RSUs are scheduled to continue to vest (A) with respect to 9,398 RSUs on the last day of each calendar month from January 2021 to June 2021 and (B) with respect to 72,618 RSUs upon our achievement of certain milestones in relation to our initial public offering.

 

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Founders Awards

In February 2021, a special committee comprised of independent members of our board of directors approved the grant of long-term performance-based restricted stock unit awards (“PSUs”) to our Co-Founders, which we refer to as the Founders Awards. The Founders Awards held by Messrs. Schlosser and Kushner cover 12,689,560 and 6,344,780 shares of Class A common stock, respectively, and will be effective upon the completion of this offering. Each Founders Award will be eligible to vest based on the achievement of pre-determined stock price goals over a seven-year period following the closing of this offering.

The Founders Awards are intended to retain and incentivize the Co-Founders to lead our company to sustained, long-term superior financial and operational performance. We believe the Founders Awards further align the Co-Founders’ interests with those of our long-term stockholders because the vesting, in addition to the value the Founders may realize from the Founders Awards, if any, will depend on the creation of significantly enhanced stockholder value over the seven years following the date of this offering. We expect the Founders Awards to replace the equity and long-term incentive compensation, if any, that we otherwise would have awarded to the Co-Founders during the seven years following this offering.

Half of each Founders Award will become earned based on the achievement of stock price goals (measured as a volume-weighted average stock price over 180 days) at any time between the second and seventh anniversaries of the closing of this offering, as set forth in the following table:

 

Vesting Tranche

   Price Per
Share Goal
     Number of Earned
PSUs

(Schlosser/Kushner)
 

First Vesting Tranche

   $              1,268,956 / 634,478  

Second Vesting Tranche

   $          1,268,956 /634,478  

Third Vesting Tranche

   $          1,268,956 /634,478  

Fourth Vesting Tranche

   $          1,268,956 /634,478  

Fifth Vesting Tranche

   $          1,268,956 /634,478  

The remaining half of each Founders Award also will become earned based on achieving the same stock price goals, but the period for measuring the achievement of those goals will be scaled as set forth in the following table:

 

Vesting Tranche

  

Measurement Period

   Price Per
Share Goal
     Number of
Earned PSUs
(Schlosser/Kushner)
 

First Vesting Tranche

   Second - seventh anniversaries of the closing of this offering    $              1,268,956 / 634,478  

Second Vesting Tranche

   Third - seventh anniversaries of the closing of this offering    $          1,268,956 /634,478  

Third Vesting Tranche

   Fourth - seventh anniversaries of the closing of this offering    $          1,268,956 /634,478  

Fourth Vesting Tranche

   Fifth - seventh anniversaries of the closing of this offering    $          1,268,956 /634,478  

Fifth Vesting Tranche

   Sixth - seventh anniversaries of the closing of this offering    $          1,268,956 /634,478  

 

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Any PSUs that become earned PSUs will vest on the applicable vesting date described in the following table or, if later, the date on which the applicable stock price goal is achieved, subject to the Co-Founder’s continued service:

 

Earned PSUs’ Vesting Tranche

  

Vesting Date

First Vesting Tranche    Third anniversary of the closing of this offering
Second Vesting Tranche    Fourth anniversary of the closing of this offering
Third Vesting Tranche    Fifth anniversary of the closing of this offering
Fourth Vesting Tranche    Sixth anniversary of the closing of this offering
Fifth Vesting Tranche    Seventh anniversary of the closing of this offering

Additionally, if the stock price (measured as the 180-day volume-weighted average price per share) as of the seventh anniversary of the closing of this offering, which we refer to as the expiration date, falls between two stock price goals, then additional PSUs will vest on a pro-rated basis based on straight-line interpolation between the two goals. PSUs that remain unvested as of the expiration date automatically will be terminated without consideration.

Upon a termination of a Co-Founder’s service by us without cause or by the Co-Founder for good reason, subject to the Co-Founder’s timely execution and non-revocation of a general release of claims, or due to a Co-Founder’s death or disability, the PSUs will be treated as follows:

 

   

Any previously earned PSUs will vest, and

 

   

Any remaining PSUs will remain outstanding and eligible to vest for up to two years upon achievement of performance goals during that period.

In the event our company incurs a change in control, then any previously-earned PSUs will vest and any remaining PSUs will vest based on the price per share received by or payable with respect to the Company’s Class A common stockholders in connection with the transaction, pro-rated to reflect a price per share that falls between two stock price goals.

IPO-Related Equity Awards

Our board of directors expects to approve the grant of 50 RSUs pursuant to the 2021 Plan to each of our employees, including our named executive officers, that will become effective on the completion of this offering. Each RSU award will vest upon the expiration of the underwriter-mandated lock-up period associated with this offering, subject to the grantee’s continued employment.

Other Elements of Compensation

Retirement Plans

We currently maintain a 401(k) retirement savings plan for our employees, including our named executive officers, who satisfy certain eligibility requirements. Our named executive officers are eligible to participate in the 401(k) plan on the same terms as other full-time employees. The Code allows eligible employees to defer a portion of their compensation, within prescribed limits, on a pre-tax basis through contributions to the 401(k) plan. Currently, we match contributions made by participants in the 401(k) plan up to a specified percentage of the employee contributions, and these matching contributions are fully vested as of the date on which the contribution is made. We believe that providing a vehicle for tax-deferred retirement savings though our 401(k) plan, and making fully vested matching contributions, adds to the overall desirability of our executive compensation package and further incentivizes our employees, including our named executive officers, in accordance with our compensation policies.

 

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Employee Benefits

All of our full-time employees, including our named executive officers, are eligible to participate in our health and welfare plans, including:

 

   

medical, dental and vision benefits;

 

   

medical and dependent care flexible spending accounts;

 

   

short-term and long-term disability insurance and accidental death and dismemberment insurance; and

 

   

life insurance.

No Tax Gross-Ups

We generally have not made gross-up payments to cover our named executive officers’ personal income taxes that may pertain to any of the compensation paid or provided by our company.

Outstanding Equity Awards at Fiscal Year-End

The following table summarizes the number of shares of common stock underlying outstanding equity incentive plan awards for each named executive officer as of December 31, 2020. Each equity award listed in the following table was granted under the 2012 Plan (defined below).

 

          Option Awards  

Name

  Grant Date     Vesting
Commencement
Date
    Number of
Securities
Underlying
Unexercised
Options (#)
Exercisable
    Number of
Securities
Underlying
Unexercised
Options (#)
Unexercisable
    Option
Exercise
Price ($)
    Option
Expiration Date
 

Mario Schlosser(1)

   
November 20,
2013
 
 
   
December 1,
2012
 
(2) 
    1,685,650             0.157      
November 19,
2023
 
 
   
January 17,
2014
 
 
   
December 1,
2012
 
(2) 
    1,825,290             0.465      
January 16,
2024
 
 
   
December 7,
2015
 
 
   
December 7,
2015
 
(2) 
    1,665,495             2.12      
December 6,
2025
 
 
   
December 7,
2015
 
 
   
December 7,
2015
 
(2) 
    1,665,495             2.12      
December 6,
2025
 
 
   
December 17,
2019
 
 
   
January 1,
2019
 
(3) 
    6,325,000       6,875,000       3.25      
December 16,
2029
 
 

Meghan Joyce

   
August 30,
2019
 
 
   
September
9, 2019
 
(4) 
    4,500,000 (5)            3.17      
August 29,
2029
 
 
   
October 8,
2020
 
 
   
August 6,
2020
 
(6) 
    267,003       732,997       4.24      
October 7,
2030
 
 

Joel Klein

   

July 27,

2016

 

 

   
January 1,
2016
 
(4) 
    3,614,433             2.93      

July 26,

2026

 

 

   
December 29,
2017
 
 
   
December 1,
2017
 
(3) 
    600,000 (4)            2.92      
December 28,
2027
 
 
   
October 8,
2020
 
 
   
January 4,
2020
 
(7) 
    75,625       254,375       4.24      
October 7,
2030
 
 

 

(1)

Each of these options were reclassified to cover shares of our Class B common stock in connection with our initial public offering.

(2)

This option is fully vested and exercisable as of December 31, 2020.

 

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(3)

This option vests (and, to the extent not early exercisable, becomes exercisable) over a four-year period as to 1/48th of the shares underlying the option on each monthly anniversary of the vesting commencement date, subject to the executive’s continued service. In addition, the option will vest (and, to the extent not early exercisable, and become exercisable) in full upon the executive’s termination without cause or resignation for good reason within 12 months following a change in control.

(4)

This option vests (and, to the extent not early exercisable, became exercisable) over a four-year period with respect to 25% of the shares underlying the option on the first anniversary of the vesting commencement date, and as to 1/48th of the shares underlying the option on each monthly anniversary over the three-year period thereafter, subject to the executive’s continued service. In addition, the option will vest (and, to the extent not early exercisable, become exercisable) in full upon the executive’s termination without cause or resignation for good reason, in either case, within 12 months following a change in control and for Mr. Klein, within one month prior to a change in control.

(5)

This option is subject to early exercise, which permits the holder to exercise the option at any time following grant, including prior to the option becoming vested.

(6)

This option was vested with respect to 267,003 shares as of December 31, 2020. This option is scheduled to continue to vest (A) with respect to 53,399 shares on the sixth day of each month from January 2021 to June 2021 and (B) with respect to 412,603 shares upon our achievement of certain milestones in relation to our initial public offering.

(7)

This option vests and becomes exercisable over a four-year period as to 1/48th of the shares underlying the option on each monthly anniversary of the vesting commencement date, subject to the executive’s continued service.

Executive Compensation Arrangements

Existing Agreements

Mario Schlosser 2012 Offer Letter

On November 29, 2012, we entered into an offer letter with Mr. Schlosser, pursuant to which he serves as our Chief Executive Officer. Mr. Schlosser’s offer letter provides for at-will employment, an annual base salary, and eligibility to participate in the benefit plans and programs maintained for the benefit of our employees. Mr. Schlosser’s offer letter required that he sign a proprietary information and inventions agreement, which includes non-solicitation and non-competition covenants during the period of his employment and for 12 months following the termination of his employment.

Meghan Joyce 2019 Offer Letter

On June 26, 2019, we entered into an offer letter with Ms. Joyce, pursuant to which she serves as our EVP, Chief Operating Officer. This offer letter provides for at-will employment, an annual base salary, and eligibility to participate in the benefit plans and programs maintained for the benefit of its employees. Under the offer letter, Ms. Joyce is eligible to earn an annual cash incentive bonus of up to 30% of her annual salary based upon the achievement of various goals established by us. Pursuant to the offer letter, Ms. Joyce also received an option to purchase 4,500,000 shares of our Class A common stock of in connection with the commencement of her employment.

If Ms. Joyce is terminated without “cause” or incurs a resignation for “good reason” each, (as defined in her offer letter), then we will (i) continue to pay base salary for six months, (ii) pay a reasonable pro-rata bonus for the year of termination, and (iii) cause the options granted in connection with the commencement of her employment to be amended so that they expire ten years after the date granted. In addition, if Ms. Joyce is terminated without cause or resigns for good reason, in each case

 

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within one year after a “change in control” (as defined in her offer letter), then all options granted in connection with the commencement of her employment will accelerate and become fully vested. These severance payments and benefits are subject to her return of all company property, resignation as a member of our board of directors and that of our affiliates, if applicable, and timely execution and non-revocation of a release of claims against us and our affiliates.

Ms. Joyce’s offer letter requires that she sign a proprietary information and inventions agreement, which includes non-solicitation and non-competition covenants during the period of Ms. Joyce’s employment and for 12 months following the termination of her employment.

Joel Klein 2016 Offer Letter

On January 1, 2016, we entered into an offer letter with Mr. Klein, pursuant to which he serves as our Chief Policy and Strategy Officer. This offer letter provides for at-will employment, an annual base salary, and eligibility to participate in the benefit plans and programs maintained for the benefit of its employees. Under the offer letter, Mr. Klein is eligible to receive an annual performance bonus of up to $150,000 based upon the achievement of various goals established by us. Pursuant to the offer letter, Mr. Klein also received an option to purchase 3,894,693 shares of our Class A common stock in connection with the commencement of his employment.

If Mr. Klein is terminated without “cause” or incurs a resignation for “good reason” (each, as defined in his offer letter), then we will continue to pay his base salary for six months and Mr. Klein will be entitled to receive an annual bonus for the year of his termination based on actual performance and pro-rated for the number of days he was employed during the year of termination. These severance payments and benefits are subject to his return of all company property, resignation as a member of our board of directors and that of our affiliates, if applicable, and timely execution and non-revocation of a release of claims against us and our affiliates. In addition, if Mr. Klein is terminated without cause or resigns for good reason, in each case within one month prior to or one year after a “change in control” (as defined in his offer letter), then all options granted in connection with the commencement of his employment will accelerate and become fully vested and exercisable; and, subject to his timely execution and non-revocation of a release, the term of the option will be extended until the earlier of the fourth anniversary of his termination date and the maximum ten-year term of the option.

Mr. Klein’s offer letter required that he sign a proprietary information and inventions agreement, which includes non-solicitation and non-competition covenants during the period of Mr. Klein’s employment and for 12 months following the termination of his employment.

New Arrangements

General Description of New Employment Agreements

The following is a description of the employment agreements we entered into with Meghan Joyce and Joel Klein in connection with this offering, and of the employment agreement we entered into with R. Scott Blackley, who will become our Chief Financial Officer following the close of business on March 15, 2021. Mr. Blackley’s employment agreement became effective on December 5, 2020. The employment agreements for Ms. Joyce and Mr. Klein become effective upon the closing of this offering.

Under each of the agreements, the applicable executive reports to our Chief Executive Officer. Each agreement will continue until terminated in accordance with its terms, and provides for (A) an annual base salary paid in accordance with our normal payroll practices and which may be increased in the discretion of our board of directors, but not reduced, (B) a target annual bonus equal to 30% of

 

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base salary, with the actual amount of such bonus determined in the discretion of our board of directors, based on the achievement of individual and/or company performance goals determined by our board of directors and payable on the date annual bonuses are paid to the our other senior executives, but in no event later than March 15th and conditioned upon the executive’s continued employment through the payment date, and (C) eligibility to participate in customary health, welfare and fringe benefit plans we provide to our employees. Each of the agreements provide for the expense reimbursement of up to $30,000 in attorney’s fees incurred in connection with the review and negotiation of the employment agreement.

Under the employment agreements, if the executive’s employment is terminated by us without “cause,” or by the executive for “good reason” (each, as defined in the employment agreement, and referred to herein as a qualifying termination) then the executive will be entitled to receive the following severance payments and benefits:

 

   

an amount equal to the sum of (a) the executive’s annual base salary (at the highest rate in effect at any time in the six months prior to termination) and (b) the executive’s target annual bonus amount;

 

   

a lump sum cash payment on the 60th day following the applicable executive’s termination equal to the pro rata portion of the applicable executive’s target bonus for the year of termination (prorated based on the number of days served with the Company in the calendar year of termination);

 

   

continued healthcare coverage for 12 months after the termination date; and

 

   

an additional 12 months of vesting for each outstanding time-vesting equity award held by the executive or, if the termination date is on or within 12 months following a change in control, then full accelerated vesting of all outstanding and unvested time-based vesting equity awards then-held by the executive.

The severance payments and benefits described above are subject to the executive’s execution and non-revocation of a general release of claims in favor of the Company and continued compliance with customary confidentiality, non-competition and non-solicitation requirements (as described below), and are in addition to any accrued amounts (including, other than upon a termination without good reason or for cause, any prior year’s earned but unpaid annual bonus).

The employment agreements also reaffirm or require agreement to, as applicable, a proprietary information and inventions agreement, which includes non-solicitation and non-competition covenants during the applicable executive’s period of employment and for the 12 months following. Further, the employment agreements include a “best pay” provision under Section 280G of the Code, pursuant to which any “parachute payments” that become payable to the executive will either be paid in full or reduced so that such payments are not subject to the excise tax under Section 4999 of the Code, whichever results in the better after-tax treatment to the executive.

The following table sets forth each executive’s title and annual base salary under his or her employment agreement; the other individualized elements of the employment agreements are summarized below.

 

Name

 

Title

   Base Salary  

Meghan Joyce

  Chief Operating Officer    $ 600,000  

Joel Klein

  Chief Policy and Strategy Officer    $ 575,000  

R. Scott Blackley

  Chief Financial Officer    $ 600,000  

 

 

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Meghan Joyce Employment Agreement

In addition to the employment agreement components outlined above, Ms. Joyce’s employment agreement provides that upon a termination without cause or a termination by Ms. Joyce for good reason, both (i) the stock option to purchase 4,500,000 shares of our Class A common stock that she received in connection with her commencement of employment with the Company and (ii) the stock option to purchase 1,000,000 shares of our Class A common stock that she received in October 2020, will remain exercisable with respect to the vested portion of the applicable option until the tenth anniversary of the date the applicable option was granted.

R. Scott Blackley Employment Agreement

In connection with entering into his employment agreement, effective December 5, 2020, Mr. Blackley received a RSU award covering 3,000,000 shares of our Class A common stock (the “RSU Award”) and an option to purchase 3,000,000 shares of our Class A common stock (the “Option Award”). The RSU Award vests with respect to 25% of the underlying RSUs on December 5, 2021, with the remaining RSUs vesting in substantially equal installments on each of the 12 quarterly anniversaries thereafter. The Option Award vests and becomes exercisable with respect to 25% of the shares underlying the Option Award on December 5, 2021, with the remaining shares underlying the Option Award vesting and becoming exercisable in substantially equal installments on each of the 36 monthly anniversaries thereafter. Both the RSU Award and the Option Award will vest and become exercisable (as applicable) with respect to 25% of the shares underlying each award if Mr. Blackley is terminated without cause or terminates his employment for good reason (each as defined in his employment agreement) before December 5, 2021, in addition to the equity acceleration provisions described above that apply generally to each of the employment agreements described here.

Mr. Blackley’s employment agreement also provides for (i) a sign-on bonus of $500,000, which is subject to offset for any bonus Mr. Blackley receives from his prior employer and (ii) reimbursement for the costs of traveling between New York and Virginia (excluding housing and incidental expenses) during the first year of Mr. Blackley’s employment.

Director Compensation

In 2020, we did not make any equity awards or non-equity awards to, or provide any other compensation to our non-employee directors.

2021 Director Equity Grants

Pursuant to a Board appointment letter by and between us and Jeffery H. Boyd, dated December 29, 2020, we awarded Mr. Boyd an option to purchase 350,000 shares of our Class A common stock (the “Boyd Option Award”) and RSUs covering 150,000 shares of our Class A common stock (the “Boyd RSU Award”) on January 15, 2021. The Boyd Option Award vests and becomes exercisable in equal monthly installments over the 36 monthly anniversaries of December 15, 2020, subject to Mr. Boyd’s continued service. The Boyd RSU Award vests in equal quarterly installments over the 12 quarterly anniversaries of December 15, 2020, subject to Mr. Boyd’s continued service. Further, the Boyd RSU Award will accelerate and vest in full if Mr. Boyd is subject to an involuntary termination within 12 months following a change in control of the Company.

IPO-Related Equity Awards

In connection with this offering, our board of directors expects to approve the grant of RSU awards to certain of our non-employee directors. Each eligible director will receive an RSU award

 

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covering 150,000 shares of our Class A common stock, which will vest in substantially equal installments over a three-year period following the IPO date (or, if earlier, on a change in control of our company).

Post-IPO Director Compensation Program

In connection with this offering, our board of directors adopted and our stockholders approved a nonemployee director compensation program (the “Director Compensation Program”), which will become effective in connection with the completion of this offering. The Director Compensation Program provides for annual retainer fees and long-term equity awards for certain of our non-employee directors, currently expected to include         (each, an “Eligible Director”). The material terms of the Director Compensation Program are summarized below.

The Director Compensation Program consists of the following components:

Cash Compensation

 

   

Annual Retainer: $70,000

 

   

Annual Chairman Retainer: $55,000

 

   

Annual Committee Chair Retainer:

 

   

Audit: $25,000

 

   

Compensation: $20,000

 

   

Nominating and Governance: $15,000

 

   

Finance: $15,000

 

   

Annual Committee Member (Non-Chair) Retainer:

 

   

Audit: $10,000

 

   

Compensation: $7,500

 

   

Nominating and Governance: $5,000

 

   

Finance: $5,000

Annual cash retainers will be paid in quarterly installments in arrears and will be pro-rated for any partial calendar quarter of service.

Equity Compensation

 

   

Annual Grant: An Eligible Director who is serving on the board of directors as of the date of the annual meeting of the Company’s stockholders each calendar year beginning with calendar year 2022 will be granted, on such annual meeting date, a RSU award with a value of approximately $175,000 (each, an “Annual Grant”). Each Annual Grant will vest in full on the earlier to occur of (A) the first anniversary of the applicable grant date and (B) the date of the next annual meeting following the grant date, subject to such Eligible Director’s continued service through the applicable vesting date.

 

   

Initial Grant: Each Eligible Director who is initially elected or appointed to serve on our board of directors after the effective date of this offering will automatically be granted a RSU award with a value equal to the value of the Annual Grant prorated for the portion of the year such Eligible Director is expected to serve (each, an “Initial Grant”). The Initial Grants will vest in full on the

 

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earlier to occur of (A) the first anniversary of the applicable grant date and (B) the date of the next annual meeting following the grant date, subject to such Eligible Director’s continued service through the applicable vesting date.

In addition, each Initial Grant and Annual Grant will vest in full upon a change in control of our company (as defined in the 2021 Plan).

Compensation under our Director Compensation Program will be subject to the annual limits on non-employee director compensation set forth in the 2021 Plan, as described below.

Equity Incentive Plans

2012 Stock Plan

We maintain the 2012 Stock Plan (the “2012 Plan”), which was initially adopted on December 6, 2012 and most recently amended and restated in October 2020. The material terms of the 2012 Plan (as amended and restated) are summarized below.

Termination

The 2012 Plan is scheduled to expire on October 8, 2030; however, following the effectiveness of the 2021 Plan, the 2012 Plan will terminate and we will not make any further awards under the 2012 Plan. However, any outstanding awards granted under the 2012 Plan will remain outstanding, subject to the terms of the 2012 Plan and applicable award agreement. Shares of our common stock subject to awards granted under the 2012 Plan that expire unexercised or are cancelled, terminated, or forfeited in any manner without issuance of shares thereunder following the effective date of the 2021 Plan, will become available for issuance under the 2021 Plan in accordance with its terms.

Eligibility and Administration

Our employees, outside directors, and consultants are eligible to receive grants of nonqualified stock options, or NSOs, RSUs, or the direct award or sale of shares of our common stock. Only our employees may receive grants of incentive stock options, or ISOs. The 2012 Plan is administered by the compensation committee of our board of directors. Subject to the provisions of the 2012 Plan, our board of directors has the authority and discretion to take any actions it deems necessary or advisable for the administration of the 2012 Plan.

Limitation on Awards and Shares Available

An aggregate of 153,767,065 shares of our common stock, including our Class A common stock and our Class B common stock have been authorized for issuance under the 2012 Plan. Awards under the 2012 Plan cover shares of Class A common stock, other than awards granted to Mr. Schlosser. Each of these shares may be issued as an ISO. The shares offered under the 2012 Plan may be authorized but unissued shares of our common stock or treasury shares. In the event that shares of our common stock previously issued under the 2012 Plan are reacquired by us, such shares are currently added to the number of shares then available for issuance under the 2012 Plan. Additionally, if shares that otherwise would have been issuable under the 2012 Plan are withheld in payment of the purchase price, exercise price, or withholding taxes with respect to an award, such shares are currently added back to the available for issuance under the 2012 Plan. In the event that an outstanding award expires or is cancelled for any reason, the shares allocable to the unexercised or otherwise canceled portion of such award are currently added back to the shares of our common stock available for issuance under the 2012 Plan. Following the effective date of the 2021 Plan, such shares will become available for issuance under the 2021 Plan in accordance with its terms.

 

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Awards

The 2012 Plan provides for the grant of stock options, including ISOs and NSOs, stock payments, and RSUs. All awards under the Plan will be set forth in award agreements, which will detail all terms and conditions of the awards, including any applicable vesting and payment terms and post-termination exercise limitations. A brief description of each award type follows.

 

   

Stock Options. Stock options provide for the purchase of shares of our common stock in the future at an exercise price set on the grant date. ISOs, by contrast to NSOs, may provide tax deferral beyond exercise and favorable capital gains tax treatment to their holders if certain holding period and other requirements of the Code are satisfied. The per share exercise price of a stock option may not be less than 100% of the fair market value of the underlying share on the date of grant (or 110% in the case of ISOs granted to a person who owns more than 10% of the total combined voting power of all classes of outstanding common stock of the Company, its parent, or any of its subsidiaries). The term of a stock option may not be longer than ten years (or five years in the case of ISOs granted to a person who owns more than 10% of the total combined voting power of all classes of outstanding shares of our common stock, its parent, or any of its subsidiaries).

 

   

RSUs. RSUs are contractual promises to deliver shares of our common stock in the future, which may also remain forfeitable unless and until specified conditions are met, and may be accompanied by the right to receive the equivalent value of dividends paid on shares of our common stock prior to the delivery of the underlying shares. Delivery of the shares underlying RSUs may be deferred under the terms of the award or at the election of the participant, if the plan administrator permits such a deferral.

 

   

Stock Grant or Purchase. Stock grants or purchases are awards of shares of our common stock.

Certain Transactions

The plan administrator has broad discretion to take action under the Plan, as well as make adjustments to the terms and conditions of awards, to facilitate changes in the event of certain transactions and events affecting our common stock without us receiving consideration. In addition, in the event of certain non-reciprocal transactions with our stockholders known as “equity restructurings,” the plan administrator will make equitable adjustments to the Plan and outstanding awards. In the event of a corporate transaction, which includes us being a party to a merger or consolidation, or the sale of substantially all of our assets, all shares of our common stock acquired under the 2012 Plan and all awards outstanding on the effective date of the corporate transaction shall be treated in the manner described in the definitive transaction agreement or, in the event the transaction does not entail a definitive agreement to which we are a party, our board of directors has discretion to determine the treatment of outstanding awards, including the discretion to accelerate the vesting and exercisability of awards.

Plan Amendment and Termination

Our board of directors may amend, suspend, or terminate the 2012 Plan at any time; however, except in connection with certain changes in our capital structure, stockholder approval will be required for any amendment that increases the number of shares available under the 2012 Plan or materially changes the class of persons eligible for the grant of ISOs. No award may be granted pursuant to the 2012 Plan after October 8, 2030.

 

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2021 Incentive Award Plan

We have adopted the 2021 Incentive Award Plan, or the 2021 Plan, subject to approval by our stockholders, under which we may grant cash and equity incentive awards to eligible service providers in order to attract, motivate, and retain the talent for which we compete. The material terms of the 2021 Plan are summarized below.

Eligibility and Administration

Our employees, consultants and directors, and employees, consultants, and directors of our subsidiaries will be eligible to receive awards under the 2021 Plan. Following our initial public offering, the 2021 Plan will be administered by our board of directors with respect to awards to non-employee directors and by our compensation committee with respect to other participants, each of which may delegate its duties and responsibilities to committees of our directors and/or officers (referred to collectively as the plan administrator below), subject to certain limitations that may be imposed under Section 16 of the Securities Exchange Act of 1934, as amended, or the Exchange Act, and/or stock exchange rules, as applicable. The plan administrator will have the authority to make all determinations and interpretations under, prescribe all forms for use with, and adopt rules for the administration of, the 2021 Plan, subject to its express terms and conditions. The plan administrator will also set the terms and conditions of all awards under the 2021 Plan, including any vesting and vesting acceleration conditions.

Limitation on Awards and Shares Available

The initial share reserve under the 2021 Plan will equal 10% of the number of shares of our outstanding Class A common stock and Class B common stock upon completion of this offering, which we expect will be equal to                 shares of common stock, excluding any shares that may be issued by us upon exercise of the underwriters’ over-allotment option. Shares may be issued under the 2021 Plan as either Class A or Class B common stock, and may be authorized but unissued shares, or shares purchased in the open market. Notwithstanding anything to the contrary in the 2021 Plan, no more than         shares of our common stock (either Class A or Class B common stock) may be issued pursuant to the exercise of incentive stock options under the 2021 Plan.

The number of shares available for issuance will be increased by (i) the number of shares available under the 2012 Plan as of the effective date of the 2021 Plan, with the maximum number of shares to be added to the 2021 Plan equal to                shares, and (ii) an annual increase on the first day of each calendar year beginning January 1, 2022 and ending on and including January 1, 2031, equal to the lesser of (A) 5% of the aggregate number of shares of common stock outstanding on the final day of the immediately preceding calendar year and (B) such smaller number of shares as is determined by our board of directors, provided, however, that following the annual increase, the available 2021 Plan share reserve does not exceed 5% of the aggregate number of shares of common stock outstanding on the final day of the immediately preceding calendar year.

If an award under the 2021 Plan or the 2012 Plan expires, lapses, or is terminated, exchanged for or settled for cash, surrendered, repurchased, cancelled without having been fully exercised or forfeited, any shares subject to such award may, to the extent of such forfeiture, expiration or cash settlement, be used again for new grants under the 2021 Plan. Further, shares delivered to us to satisfy the applicable exercise or purchase price of an award under the 2021 Plan or the 2012 Plan and/or to satisfy any applicable tax withholding obligations (including shares retained by us from the award under the 2021 Plan or the 2012 Plan being exercised or purchased, and/or creating the tax obligation) will become or again be available for award grants under the 2021 Plan. The payment of dividend equivalents in cash in conjunction with any awards under the 2021 Plan will not reduce the shares available for grant under the 2021 Plan. However, the following shares may not be used again

 

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for grant under the 2021 Plan: (i) shares subject to stock appreciation rights, or SARs, that are not issued in connection with the stock settlement of the SAR on exercise, and (ii) shares purchased on the open market with the cash proceeds from the exercise of options.

Awards granted under the 2021 Plan upon the assumption of, or in substitution for, awards authorized or outstanding under a qualifying equity plan maintained by an entity with which we enter into a merger or similar corporate transaction will not reduce the shares available for grant under the 2021 Plan. The 2021 Plan provides that, commencing with the calendar year following the calendar year in which the effective date of the 2021 Plan occurs, the sum of any cash compensation and the aggregate grant date fair value (determined as of the date of the grant under ASC 718, or any successor thereto) of all awards granted to a non-employee director as compensation for services as a non-employee director during any calendar year may not exceed $750,000, increased to $1,000,000, in the fiscal year of a non-employee director’s initial service as a non-employee director.

Awards

The 2021 Plan provides for the grant of stock options, including ISOs and NSOs, restricted stock, dividend equivalents, RSUs, performance shares, other incentive awards, SARs, and cash awards. No determination has been made as to the types or amounts of awards that will be granted to specific individuals pursuant to the 2021 Plan. Certain awards under the 2021 Plan may provide for a deferral of compensation, subject to Section 409A of the Code, which may impose additional requirements on the terms and conditions of such awards. All awards under the 2021 Plan will be set forth in award agreements, which will detail all terms and conditions of the awards, including any applicable vesting and payment terms and post-termination exercise limitations. Awards other than cash awards generally will be settled in shares of our common stock, but the plan administrator may provide for cash settlement of any award. A brief description of each award type follows.

 

   

Stock Options. Stock options provide for the purchase of shares of our common stock in the future at an exercise price set on the grant date. ISOs, by contrast to NSOs, may provide tax deferral beyond exercise and favorable capital gains tax treatment to their holders if certain holding period and other requirements of the Code are satisfied. The exercise price of a stock option may not be less than 100% of the fair market value of the underlying share on the date of grant (or 110% in the case of ISOs granted to certain significant stockholders), except with respect to certain substitute options granted in connection with a corporate transaction. The term of a stock option may not be longer than ten years (or five years in the case of ISOs granted to certain significant stockholders). Vesting conditions determined by the plan administrator may apply to stock options and may include continued service, performance and/or other conditions.

 

   

SARs. SARs entitle their holder, upon exercise, to receive from us an amount equal to the appreciation of the shares subject to the award between the grant date and the exercise date. The exercise price of a SAR may not be less than 100% of the fair market value of the underlying share on the date of grant (except with respect to certain substitute SARs granted in connection with a corporate transaction) and the term of a SAR may not be longer than ten years. Vesting conditions determined by the plan administrator may apply to SARs and may include continued service, performance, and/or other conditions.

 

   

Restricted Stock and RSUs. Restricted stock is an award of nontransferable shares of our common stock that remain forfeitable unless and until specified conditions are met, and which may be subject to a purchase price. RSUs are contractual promises to deliver shares of our common stock in the future, which may also remain forfeitable unless and until specified conditions are met, and may be accompanied by the right to receive the equivalent value of dividends paid on shares of our common stock prior to the delivery of the underlying shares.

 

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Delivery of the shares underlying RSUs may be deferred under the terms of the award or at the election of the participant, if the plan administrator permits such a deferral. Conditions applicable to restricted stock and RSUs may be based on continuing service, the attainment of performance goals, and/or such other conditions as the plan administrator may determine.

 

   

Other Stock or Cash Based Awards. Other stock or cash based awards of cash, fully vested shares of our common stock, and other awards valued wholly or partially by referring to, or otherwise based on, shares of our common stock may be granted under the 2021 Plan. Other stock or cash based awards may be granted to participants and may also be available as a payment form in the settlement of other awards, as standalone payments and as payment in lieu of base salary, bonus, fees, or other cash compensation otherwise payable to any individual who is eligible to receive awards.

 

   

Dividend Equivalents. Dividend equivalents represent the right to receive the equivalent value of dividends paid on shares of our common stock and may be granted alone or in tandem with awards other than stock options or SARs. Dividend equivalents are credited as of dividend record dates during the period between the date an award is granted and the date such award vests, is exercised, is distributed, or expires, as determined by the plan administrator.

Performance Awards

Performance awards include any of the foregoing awards that are granted subject to vesting and/or payment based on the attainment of specified performance goals or other criteria the plan administrator may determine, which may or may not be objectively determinable. Performance criteria upon which performance goals are established by the plan administrator may include but are not limited to: (1) net earnings (either before or after one or more of the following: (a) interest, (b) taxes, (c) depreciation, (d) amortization and (e) non-cash equity-based compensation expense); (2) gross or net sales or revenue; (3) net income (either before or after taxes); (4) adjusted net income; (5) operating earnings or profit; (6) cash flow (including, but not limited to, operating cash flow, and free cash flow); (7) return on assets; (8) return on capital; (9) return on stockholders’ equity; (10) total stockholder return; (11) return on sales; (12) gross or net profit or operating margin; (13) costs; (14) funds from operations; (15) expenses; (16) working capital; (17) earnings per share; (18) adjusted earnings per share; (19) price per share of common stock; (20) regulatory achievements or compliance; (21) implementation or completion of critical projects; (22) market share; (23) economic value; (24) debt levels or reduction; (25) sales-related goals; (26) comparisons with other stock market indices; (27) operating efficiency; (28) employee satisfaction; (29) financing and other capital raising transactions; (30) recruiting and maintaining personnel; and (31) year-end cash, any of which may be measured either in absolute terms for us or any operating unit of our company or as compared to any incremental increase or decrease or as compared to results of a peer group, or to market performance indicators or indices.

Certain Transactions

The plan administrator has broad discretion to take action under the 2021 Plan, as well as make adjustments to the terms and conditions of existing and future awards, to prevent the dilution or enlargement of intended benefits, and facilitate necessary or desirable changes in the event of certain transactions and events affecting our common stock, such as stock dividends, stock splits, mergers, acquisitions, consolidations, and other corporate transactions. In addition, in the event of certain non-reciprocal transactions with our stockholders known as “equity restructurings,” the plan administrator will make equitable adjustments to the 2021 Plan and outstanding awards. In the event of a change in control of our company (as defined in the 2021 Plan), to the extent that the surviving entity declines to continue, convert, assume, or replace outstanding awards, then all such awards will become fully vested and exercisable in connection with the transaction. Upon or in anticipation of a

 

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change of control, the plan administrator may cause any outstanding awards to terminate at a specified time in the future and give the participant the right to exercise such awards during a period of time determined by the plan administrator in its sole discretion. Individual award agreements may provide for additional accelerated vesting and payment provisions.

Foreign Participants, Claw-Back Provisions, Transferability, and Participant Payments

The plan administrator may modify award terms, establish subplans, and/or adjust other terms and conditions of awards, subject to the share limits described above, in order to facilitate grants of awards subject to the laws and/or stock exchange rules of countries outside of the United States. All awards will be subject to the provisions of any claw-back policy implemented by our company to the extent set forth in such claw-back policy and/or in the applicable award agreement. With limited exceptions for estate planning, domestic relations orders, certain beneficiary designations and the laws of descent and distribution, awards under the 2021 Plan are generally non-transferable prior to vesting, and are exercisable only by the participant. With regard to tax withholding, exercise price, and purchase price obligations arising in connection with awards under the 2021 Plan, the plan administrator may, in its discretion, accept cash or check, shares of our common stock that meet specified conditions, a “market sell order,” or such other consideration as it deems suitable.

Plan Amendment and Termination

Our board of directors may amend or terminate the 2021 Plan at any time; however, except in connection with certain changes in our capital structure, stockholder approval will be required for any amendment that increases the number of shares available under the 2021 Plan. Stockholder approval is not required for any amendment that “reprices” any stock option or SAR, or cancels any stock option or SAR in exchange for cash, or another award when the option or SAR price per share exceeds the fair market value of the underlying shares. No award may be granted pursuant to the 2021 Plan after the tenth anniversary of the earlier of the date on which our stockholders approved the 2021 Plan or the date on which our board of directors adopted the 2021 Plan.

2021 Employee Stock Purchase Plan

In connection with the offering, we intend to adopt the ESPP, which will become effective on the day the ESPP is adopted by our board of directors. The material terms of the ESPP, as it is currently contemplated, are summarized below. Our board of directors is still in the process of developing, approving, and implementing the ESPP and, accordingly, this summary is subject to change.

Shares Available; Administration

We expect a total of 2% of the number of shares of our outstanding Class A common stock and Class B common stock upon completion of this offering, which we expect will be equal to         shares of common stock, excluding any shares that may be issued by us upon exercise of the underwriters’ over-allotment option, will be initially reserved for issuance under our ESPP. In addition, we expect that the number of shares available for issuance under the ESPP will be annually increased on January 1 of each calendar year beginning in 2022 and ending in 2031, by an amount equal to the lesser of: (i) 1% of the aggregate number of shares of common stock outstanding, including our Class A and Class B common stock, on the final day of the immediately preceding calendar year and (ii) such smaller number of shares as is determined by our board of directors. All shares issued under the ESPP will cover shares of Class A common stock. In no event will more than                 shares of our Class A common stock be available for issuance under the ESPP.

 

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Our board of directors or a committee designated by our board of directors will have authority to interpret the terms of the ESPP and determine eligibility of participants. We expect that the compensation committee will be the administrator of the ESPP.

Eligibility

The plan administrator may designate certain of our subsidiaries as participating “designated subsidiaries” in the ESPP and may change these designations from time to time. Employees of our company and our designated subsidiaries are eligible to participate in the ESPP if they meet the eligibility requirements under the ESPP established from time to time by the plan administrator. However, an employee may not be granted rights to purchase stock under the ESPP if such employee, immediately after the grant, would own (directly or through attribution) stock possessing 5% or more of the total combined voting power or value of all classes of our common or other class of stock.

If the grant of a purchase right under the ESPP to any eligible employee who is a citizen or resident of a foreign jurisdiction would be prohibited under the laws of such foreign jurisdiction or the grant of a purchase right to such employee in compliance with the laws of such foreign jurisdiction would cause the ESPP to violate the requirements of Section 423 of the Code, as determined by the plan administrator in its sole discretion, such employee will not be permitted to participate in the ESPP.

Eligible employees become participants in the ESPP by enrolling and authorizing payroll deductions by the deadline established by the plan administrator prior to the relevant offering date. Directors who are not employees, as well as consultants, are not eligible to participate. Employees who choose not to participate, or are not eligible to participate at the start of an offering period but who become eligible thereafter, may enroll in any subsequent offering period.

Participation in an Offering

We intend for the ESPP to qualify under Section 423 of the Code and stock will be offered under the ESPP during offering periods. The length of offering periods under the ESPP will be determined by the plan administrator and may be up to 27 months long. Employee payroll deductions will be used to purchase shares on each purchase date during an offering period. The number of purchase periods within, and purchase dates during, each offering period will be established by the plan administrator. Offering periods under the ESPP will commence when determined by the plan administrator. The plan administrator may, in its discretion, modify the terms of future offering periods.

We expect that the ESPP will permit participants to purchase our common stock through payroll deductions of up to 20% of their eligible compensation, which will include a participant’s gross base compensation for services to us, including overtime payments and excluding sales commissions, incentive compensation, bonuses, expense reimbursements, fringe benefits, and other special payments. The plan administrator will establish a maximum number of shares that may be purchased by a participant during any offering period or purchase period, which, in the absence of a contrary designation, will be                shares for an offering period and/or a purchase period. In addition, no employee will be permitted to accrue the right to purchase stock under the ESPP at a rate in excess of $25,000 worth of shares during any calendar year during which such a purchase right is outstanding (based on the fair market value per share of our common stock as of the first day of the offering period).

On the first trading day of each offering period, each participant automatically will be granted an option to purchase shares of our common stock. The option will be exercised on the applicable purchase date(s) during the offering period, to the extent of the payroll deductions accumulated during the applicable purchase period. We expect that the purchase price of the shares, in the absence of a contrary determination by the plan administrator, will be 85% of the lower of the fair market value of our common stock on the first trading day of the offering period or on the applicable purchase date, which will be the final trading day of the applicable purchase period.

 

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Participants may voluntarily end their participation in the ESPP at any time at least one week prior to the end of the applicable offering period (or such longer or shorter period specified by the plan administrator), and will be paid their accrued payroll deductions that have not yet been used to purchase shares of common stock. Participation ends automatically upon a participant’s termination of employment.

Transferability

A participant may not transfer rights granted under the ESPP other than by will, the laws of descent and distribution or as otherwise provided in the ESPP.

Certain Transactions

In the event of certain transactions or events affecting our common stock, such as any stock dividend or other distribution, change in control, reorganization, merger, consolidation, or other corporate transaction, the plan administrator will make equitable adjustments to the ESPP and outstanding rights. In addition, in the event of the foregoing transactions or events, or certain significant transactions, including a change in control, the plan administrator may provide for (i) either the replacement of outstanding rights with other rights or property, or termination of outstanding rights in exchange for cash, (ii) the assumption or substitution of outstanding rights by the successor or survivor corporation or parent, or subsidiary thereof, (iii) the adjustment in the number and type of shares of stock subject to outstanding rights, (iv) the use of participants’ accumulated payroll deductions to purchase stock on a new purchase date prior to the next scheduled purchase date and termination of any rights under ongoing offering periods, or (v) the termination of all outstanding rights. Under the ESPP, a change in control has the same definition as given to such term in the 2021 Plan.

Plan Amendment; Termination

The plan administrator may amend, suspend, or terminate the ESPP at any time. However, stockholder approval of any amendment to the ESPP must be obtained for any amendment which increases the aggregate number or changes the type of shares that may be sold pursuant to rights under the ESPP, changes the corporations or classes of corporations whose employees are eligible to participate in the ESPP, or changes the ESPP in any manner that would cause the ESPP to no longer be an employee stock purchase plan within the meaning of Section 423(b) of the Code. The ESPP will terminate on the tenth anniversary of the date it is initially approved by our board of directors.

 

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PRINCIPAL AND SELLING STOCKHOLDERS

The following table sets forth information with respect to the beneficial ownership of our Class A common stock and Class B common stock as of                     , 2021, and as adjusted to reflect the Preferred Stock Conversion, the Series B Conversion, and the Reclassification, in each case as if such event had occurred on                     , 2021, and to give effect to this offering, for:

 

   

each person known by us to beneficially own more than 5% of our Class A common stock and Class B common stock;

 

   

each of our named executive officers and directors;

 

   

all of our executive officers and directors as a group; and

 

   

each of our selling stockholders.

The number of shares beneficially owned by each stockholder as described in this prospectus is determined under rules issued by the SEC. Under these rules, beneficial ownership includes any shares as to which the individual or entity has sole or shared voting power or investment power. In computing the number of shares beneficially owned by an individual or entity and the percentage ownership of that person, shares of Class A common stock and Class B common stock subject to options, warrants, or other rights held by such person that are currently exercisable or will become exercisable within 60 days of                     , 2021 or issuable pursuant to RSUs that are subject to vesting and settlement conditions expected to occur within 60 days of             , 2021 are considered outstanding, although these shares are not considered outstanding for purposes of computing the percentage ownership of any other person.

The applicable percentage ownership before the offering is based on              shares of our Class A common stock and              shares of our Class B common stock, in each case, outstanding as of              after giving effect to: (i) the Preferred Stock Conversion, (ii) the Series B Conversion, and (iii) the Reclassification. For purposes of calculating the percentage of beneficial ownership prior to this offering, we did not include the effect of any voting agreements or voting proxies that terminate upon the offering.

The applicable percentage ownership after this offering is based on              shares of our Class A common stock and              shares of our Class B common stock, in each case, outstanding immediately following the completion of this offering, assuming that the underwriters will not exercise their option to purchase additional shares of Class A common stock and assuming the issuance of up to              shares of Class A common stock at the closing of this offering (including              shares of Class A common stock to be issued to certain selling stockholders upon the exercise of options and settlement of RSUs in connection with the sale of such shares in this offering), after giving effect to: (i) the Series B Conversion, (ii) the Selling Stockholder Class B Conversion,(iii) the Reclassification, and (iv) the filing and effectiveness of our Amended Charter. The table below excludes any purchases that may be made through our directed share program or otherwise in this offering. See “Underwriting—Directed Share Program.” Unless otherwise indicated, the address of all listed stockholders is 75 Varick Street, 5th Floor, New York, New York 10013.

 

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We believe, based on the information furnished to us, that each of the stockholders listed below has sole voting and investment power with respect to the shares beneficially owned by such stockholder unless noted otherwise, subject to community property laws where applicable.

 

    Shares of Common Stock
Beneficially Owned Before This
Offering
    % of
Voting
Power
Before this
Offering(1)
    Number of
Shares of
Class A
Being
Offered
    Shares of Common Stock
Beneficially Owned After This
Offering
    % of
Voting
Power
After this
Offering(1)
 
    Class A     Class B     Class A     Class B  

Name of Beneficial Owner

  Shares     Percent     Shares     Percent     Shares     Percent     Shares     Percent  

5% Stockholders:

                     

Entities affiliated with Alphabet Holdings LLC(2)

                     

Entities managed by FMR LLC(3)

                     

Entities affiliated with Formation8(4)

                     

Entities affiliated with Founders Fund(5)

                     

Entities affiliated with General Catalyst Group(6)

                     

Entities affiliated with Khosla Ventures(7)

                     

Entities affiliated with Thrive Capital(8)

                     

Named Executive Officers and Directors:

                     

Mario Schlosser(9)**

                     

Meghan Joyce(10)**

                     

Joel Klein(11)**

                     

Jeffery H. Boyd(12)

                     

Joel Cutler

                     

Joshua Kushner(8)

                     

Teri List-Stoll

                     

Charles E. Phillips, Jr.

                     

David Plouffe

                     

Robbie Robinson

                     

Siddhartha Sankaran(13)**

                     

Vanessa A. Wittman

                     

All executive officers and directors as a group (13 individuals)

                     

Other Selling Stockholders:

                     

Dennis Weaver**

                     

Ari Fischel**

                     

 

*

Represents beneficial ownership of less than 1.0%.

**

Represents a selling stockholder.

(1)

Percentage of voting power represents voting power with respect to all shares of our Class A common stock and Class B common stock, held beneficially as a single class. The holders of our Class B common stock will be entitled to 20 votes per share, and holders of our Class A common stock will be entitled to one vote per share. For additional information about the voting rights of

  our Class A common stock and Class B common stock, see “Description of Capital Stock—Common Stock.”
(2)

Consists of: (i)              shares of Class A common stock held by Alphabet Holdings LLC; (ii)              shares of Class A common stock held by CapitalG 2015 LP; (iii)              shares of Class A common stock held by CapitalG LP; (iv)              shares of Class A common stock held by Google

 

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  Ventures 2014, L.P.; and (v)              shares of Class A common stock held by Verily Life Sciences LLC. XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc. may each be deemed to have sole voting and dispositive power with respect to the shares held by Alphabet Holdings LLC. CapitalG 2015 GP LLC, the general partner of CapitalG 2015 LP, Alphabet Holdings LLC, the managing member of CapitalG 2015 GP LLC, XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., may each be deemed to have sole voting and dispositive power with respect to the shares held by CapitalG 2015 LP. CapitalG GP LLC, the general partner of CapitalG LP, Alphabet Holdings LLC, the managing member of CapitalG GP LLC, XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., may each be deemed to have sole voting and dispositive power with respect to the shares held by CapitalG LP. Google Ventures 214 GP, L.L.C., the general partner of Google Ventures 2014, L.P., Alphabet Holdings LLC, the managing member of Google Ventures 2014 GP, L.L.C., XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., may each be deemed to have sole voting and dispositive power with respect to the shares held by Google Ventures 2014, L.P. Alphabet Holdings LLC, the managing member of Verily Life Sciences LLC, XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., may each be deemed to have sole voting and dispositive power with respect to the shares held by Verily Life Sciences LLC. The principal mailing address for each of the foregoing entities is 1600 Amphitheatre Parkway, Mountain View, CA 94043.
(3)

Consists of: (i)              shares of Class A common stock held by Fidelity Mt. Vernon Street Trust: Fidelity Series Growth Company Fund; (ii)              shares of Class A common stock held by Fidelity Mt. Vernon Street Trust: Fidelity Growth Company Fund; (iii)              shares of Class A common stock held by Fidelity Growth Company Commingled Pool; (iv)              shares of Class A common stock held by Fidelity Contrafund: Fidelity Contrafund; (v)              shares of Class A common stock held by Fidelity Contrafund Commingled Pool; (vi)              shares of Class A common stock held by Fidelity Contrafund: Fidelity Advisor New Insights Fund; (vii)              shares of Class A common stock held by Fidelity Contrafund: Fidelity Series Opportunistic Insights Fund; (viii)              shares of Class A common stock held by Fidelity Securities Fund: Fidelity Blue Chip Growth Fund; (ix)              shares of Class A common stock held by Fidelity Blue Chip Growth Commingled Pool; (x)              shares of Class A common stock held by Fidelity Securities Fund: Fidelity Series Blue Chip Growth Fund; and (xi)              shares of Class A common stock held by FIAM Target Date Blue Chip Growth Commingled Pool, or collectively, the Fidelity Entities. The Fidelity Entities are managed by direct or indirect subsidiaries of FMR LLC. Abigail P. Johnson is a Director, the Chairman, the Chief Executive Officer, and the President of FMR LLC. Members of the Johnson family, including Abigail P. Johnson, are the predominant owners, directly or through trusts, of Series B voting common shares of FMR LLC, representing 49% of the voting power of FMR LLC. The Johnson family group and all other Series B shareholders have entered into a shareholders’ voting agreement under which all Series B voting common shares will be voted in accordance with the majority vote of Series B voting common shares. Accordingly, through their ownership of voting common shares and the execution of the shareholders’ voting agreement, members of the Johnson family may be deemed, under the Investment Company Act of 1940, to form a controlling group with respect to FMR LLC. Neither FMR LLC nor Abigail P. Johnson has the sole power to vote or direct the voting of the shares owned directly by the various investment companies registered under the Investment Company Act, or the Fidelity Funds, advised by Fidelity Management & Research Company, LLC, or FMR Co, a wholly owned subsidiary of FMR LLC, which power resides with the Fidelity Funds’ Boards of Trustees. Fidelity Management & Research Company, LLC carries out the voting of the shares under written guidelines established by the Fidelity Funds’ Boards of Trustees.

 

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(4)

Consists of: (i)             shares of Class A common stock held by F8 Oscar SPV, L.P.; (ii)             shares of Class A common stock held by F8 Oscar II SPV, L.P.; and (iii)             shares of Class A common stock held by Formation8 Partners Fund I, L.P. Formation8 GP, LLC is the general partner of each of F8 Oscar II SPV, L.P., F8 Oscar SPV, L.P., and Formation8 Partners Fund I, L.P., collectively referred to as the F8 Entities, and has sole voting and investment power over the shares held by the F8 Entities. The managing members of Formation8 GP, LLC are James Kim, Brian Koo, and Joseph Lonsdale. The address for each of the foregoing entities is 4962 El Camino Real, Suite 212, Los Altos, California 94022.

(5)

Consists of: (i)              shares of Class A common stock held by CN2T Capital, LLC; (ii)             shares of Class A common stock held by John Luttig; (iii)              shares of Class A common stock held by Neil Ruthven and Julia Ruthven, Trustees of the Ruthven Family Trust, Dated October 1, 2012; (iv)              shares of Class A common stock held by Pai Family Trust; (v)              shares of Class A common stock held by Everett Randle; (vi)              shares of Class A common stock held by Napoleon Ta; (vii)              shares of Class A common stock held by The Founders Fund Growth, LP, or FFG; (viii)              shares of Class A common stock held by The Founders Fund Growth Principals Fund, LP, or FFGP; (ix)              shares of Class A common stock held by The Founders Fund IV, LP, or FFIV; (x)              shares of Class A common stock held by The Founders Fund IV Principals Fund, LP, or FFIVP; (xi)              shares of Class A common stock held by The Founders Fund V, LP, or FFV; (xii)              shares of Class A common stock held by The Founders Fund V Entrepreneurs Fund, LP, or FFVE; (xiii)              shares of Class A common stock held by The Founders Fund VI, LP, or FFVI; (xiv)              shares of Class A common stock held by The Founders Fund VI Entrepreneurs Fund, LP, or FFVIE; (xv)              shares of Class A common stock held by The Founders Fund VI Principals Fund, LP, or FFVIP; (xvi)              shares of Class A common stock held by The Founders Fund V Principals Fund, LP, or FFVP; and (xvii)              shares of Class A common stock held by Matias Van Thienen. Napoleon Ta is a partner of CN2T Capital, LLC and exercises investment and voting control over the shares held by CN2T Capital, LLC. Neil Pai is trustee of the Pai Family Trust and exercises investment and voting control over the shares held by the Pai Family Trust. The Founders Fund Growth Management, LLC is the general partner of each of FFG and FFGP and exercises investment and voting control over the shares held by the FFG and FFGP through a management committee comprised of Peter Thiel, Keith Rabois, and Brian Singerman. The Founders Fund IV Management, LLC, or FFIVM, is the general partner of FFIV and FFIVP and exercises investment and voting control over the shares held by the FFIV and FFIVP through a management committee comprised of Mr. Thiel and Mr. Singerman. The Founders Fund V Management, LLC is the general partner of FFV, FFVE, and FFVP and exercises investment and voting control over the shares held by the FFV, FFVE, and FFVP through a management committee comprised of Mr. Thiel and Mr. Singerman. The Founders Fund VI Management LLC is the general partner of each of FFVI, FFVIE, and FFVIP and exercises investment and voting control over the shares held by the FFVI, FFIE, and FFVIP through a management committee comprised of Mr. Thiel and Mr. Singerman. The principal business address of each of the foregoing entities is One Letterman Drive, Building D, 5th Floor, San Francisco, California 94129.

(6)

Consists of: (i)              shares of Class A common stock held by General Catalyst Group VI, L.P., or GC Group VI LP; and (ii)              shares of Class A common stock held by General Catalyst Group X - Growth Venture, L.P., or GC Group X Growth. General Catalyst GP VI, LLC, or GP VI, LLC, is the general partner of General Catalyst Partners VI, L.P., or GP VI LP, which is the general partner of GC Group VI LP. General Catalyst GP X - Growth Venture, LLC, or GP X, LLC, is the general partner of General Catalyst Partners X - Growth Venture, L.P., which is the general partner of GC Group X Growth. General Catalyst Group Management Holdings GP, LLC, or GCGMH LLC, is the general partner of General Catalyst Group Management Holdings, L.P., or GCGMH, which is the manager General Catalyst Group Management, LLC, or GCGM, which is the manager of GP VI LLC and GC Group X Growth. As the managing members of GCGMH LLC, Kenneth Chenault, Joel Cutler, David Fialkow, and Hemant Taneja share voting and investment

 

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  power with respect to shares held by GC Group VI LP and GC Group X Growth. Each party named above disclaims beneficial ownership of such shares. The principal business address for each of the foregoing entities is 20 University Road, 4th Floor, Cambridge, Massachusetts 02138.
(7)

Consists of: (i)              shares of Class A common stock held by Khosla Ventures IV, LP, or KV IV; (ii)              shares of Class A common stock held by Khosla Ventures IV (CF), LP, or KV IV (CF); (iii)              shares of Class A common stock held by Khosla Ventures VI, LP, or KV VI, and (iv) shares of Class A common stock held by Khosla Ventures Opportunity I, LP, or KV Opp I. Khosla Ventures Associates IV, LLC, or KVA IV, is the general partner of each of KV IV and KV IV (CF); Khosla Ventures Associates VI, LLC, or KVA VI, is the general partner of KV VI; and Khosla Ventures Opportunity Associates I, LLC, or KVOA I, is the general partner of KV Opp I. Vinod Khosla is the managing member of VK Services, LLC, or VK Services, which is the sole manager of KVA IV, KVA VI, and KVOA I and may be deemed to have voting and investment control over the shares held by KV IV, KV IV (CF), KV VI, and KV Opp I. Each party disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interests therein. The principal business address for each of the foregoing entities is 2128 Sand Hill Road, Menlo Park, California 94025.

(8)

(i)              shares of Class B common stock held by Thrive Capital Partners II, L.P., or Thrive II; (ii)              shares of Class B common stock held by Thrive Capital Partners III, L.P., or Thrive III; (iii)              shares of Class B common stock held by Thrive Capital Partners V, L.P., or Thrive V; (iv)              shares of Class B common stock held by Thrive Capital Partners VI Growth, L.P, or Thrive VI Growth; (v)              shares of Class B common stock held by Claremount TW, L.P., or Claremount TW; (vi)              shares of Class B common stock held by Claremount V Associates, L.P., or Claremount V; and (vii) shares of Class B common stock held by Claremount VI Associates, L.P., or Claremount VI; and collectively, the “Thrive Capital Funds.” Thrive Partners II GP, LLC is the general partner of Thrive II; Thrive Partners III GP, LLC is the general partner of each of Claremount TW and Thrive III; Thrive Partners V GP, LLC is the general partner of each of Claremount V and Thrive V; and Thrive Partners VI GP, LLC is the general partner of each of Claremount VI and Thrive VI Growth, or collectively, the “Thrive General Partners.” Joshua Kushner, a member of our board of directors, is the sole managing member of the Thrive General Partners, and, in his capacity as managing member, has voting and investment power over the shares held by each of the Thrive Capital Funds. The principal business address of each of the foregoing entities is c/o Thrive Capital, 295 Lafayette Street, Suite 701, New York, New York 10012.

(9)

Consists of: (i)              shares of Class B common stock held by Noah Pizzo-Schlosser Dynasty Trust; (ii)              shares of Class B common stock held by Pizzo-Schlosser 2020 GRAT and Spousal Trust; (iii)              shares of Class B common stock held by Pizzo-Schlosser Family Dynasty Trust; (iv)              shares of Class B common stock held by Pizzo-Schlosser Family Dynasty Trust, such trusts, collectively referred to as the Schlosser Trusts; and (v)              shares of Class B common stock underlying options to purchase Class B common stock held by Mr. Schlosser that are currently exercisable or would be exercisable within 60 days of             , 2021. All of the shares held by the Schlosser Trusts are subject to a voting agreement and proxy pursuant to which Mr. Schlosser exercises voting authority over the shares. The principal business address of the Schlosser Trusts is 105 Brandywine Lane, Melville, New York 11747.

(10)

Consists of: (i)              shares of Class A common stock held by Ms. Joyce; (ii)              shares of Class A common stock held by the spouse of Ms. Joyce; (iii)              shares of Class A common underlying options to purchase Class A common stock held by Ms. Joyce that are currently exercisable or would be exercisable within 60 days of             , 2021 (including             shares of Class A common stock underlying options with performance-based vesting conditions that have been satisfied or that we expect will be satisfied in connection with this offering); and (iv)              shares of Class A common stock issuable upon the vesting and settlement of RSUs held by Ms. Joyce for which the service-based vesting condition was satisfied as of                     , 2021 and

 

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  for which we expect the liquidity-based vesting condition to be satisfied or settlement to occur in connection with this offering.
(11)

Consists of              shares of Class A common underlying options to purchase Class A common stock held by Mr. Klein that are currently exercisable or would be exercisable within 60 days of             , 2021.

(12)

Consists of              shares of Class A common underlying options to purchase Class A common stock held by Mr. Boyd that are currently exercisable or would be exercisable within 60 days of             , 2021.

(13)

Consists of (i)              shares of Class A common stock held by Mr. Sankaran; (ii)              shares of Class A common stock held by Victoria Family LLC, and (iii)              shares of Class A common stock underlying options to purchase Class A common stock held by Mr. Sankaran that are currently exercisable or would be exercisable within 60 days of             , 2021 (including              shares of Class A common stock underlying options with performance-based vesting conditions that have been satisfied or that we expect will be satisfied in connection with this offering). Victoria Family LLC is wholly-owned by the fiduciaries of The Victoria 2020 Trust. As the Investment Adviser to The Victoria 2020 Trust, Mr. Sankaran may be deemed to have shared voting and investment control over the shares held by Victoria Family LLC.

 

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CERTAIN RELATIONSHIPS AND RELATED PARTY TRANSACTIONS

In addition to the compensation arrangements, including employment, termination of employment, and change in control arrangements, discussed in the sections titled “Management” and “Executive Compensation,” the following is a description of each transaction since January 1, 2018 and each currently proposed transaction in which:

 

   

we have been or are to be a participant;

 

   

the amount involved exceeded or exceeds $120,000; and

 

   

any of our directors, executive officers or holders of more than 5% of our outstanding capital stock, or any immediate family member of, or person sharing the household with, any of these individuals or entities, had or will have a direct or indirect material interest.

Series A9, Series AA-9, Series A10, Series A11, and Series A12 Preferred Stock Financings

In March 2018, we issued and sold an aggregate of 23,177,793 shares of our Series A9 Preferred Stock at a purchase price of $7.13489 per share, for an aggregate purchase price of $165.4 million.

In March 2018, we issued and sold an aggregate of 11,820,502 shares of our Series AA-9 Preferred Stock at a purchase price of $2.92000 per share, for an aggregate purchase price of $34.5 million.

From October 2018 to December 2018, we issued and sold an aggregate of 53,877,952 shares of our Series A10 Preferred Stock at a purchase price of $7.14578 per share, for an aggregate purchase price of $385.0 million.

In May 2020 and June 2020, we issued and sold an aggregate of 37,287,281 shares of our Series A11 Preferred Stock at a purchase price of $6.01898 per share, for an aggregate purchase price of $224.4 million. We refer to such issuances and sales collectively as the Series A11 Financing. In connection with the Series A11 Financing, each accredited investor received a right to purchase additional shares of our Series A11 Preferred Stock until March 1, 2021 in an aggregate amount up to 33% of the number of shares purchased by such accredited investor in the Series A11 Financing. Pursuant to the exercise of such rights, in November 2020 and December 2020, we issued and sold an aggregate of 12,390,888 shares of our Series A11 Preferred Stock to 20 accredited investors at a purchase price of $6.01898 per share, for an aggregate purchase price of $74.6 million.

In December 2020, we issued and sold an aggregate of 15,600,784 shares of our Series A12 Preferred Stock at a purchase price of $9.69438 per share, for an aggregate purchase price of $151.2 million.

 

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The following table summarizes the participation in the foregoing transactions by our directors, executive officers, and holders of more than 5% of our capital stock:

 

Related Party

  Shares of
Series A9
Preferred
Stock
    Shares of
Series AA-9
Preferred
Stock
    Shares of
Series A10
Preferred
Stock
    Shares of
Series A11
Preferred
Stock
    Shares of
Series A12
Preferred
Stock
    Aggregate
Purchase Price
 

Entities affiliated with Alphabet Holdings LLC(1)

    1,401,564       116,290       52,478,526       11,076,073       —     $ 452,006,235  

Entities managed by FMR LLC(2)

    1,401,563       116,290       —         —         1,031,525     $ 20,339,560  

Entities affiliated with Founders Fund(3)

    9,810,943       10,123,326       —         221,518       2,578,813     $ 125,893,417  

Entities affiliated with General Catalyst Group(4)

    840,938       —         —         4,430,429       —     $ 32,666,664  

Entities affiliated with Khosla Ventures(5)

    700,782       —         —         4,430,429       1,547,288     $ 46,666,664  

Entities affiliated with Thrive Capital(6)

    1,289,025       106,952       —         11,076,073       —     $ 76,176,013  

 

(1)

Includes shares of preferred stock purchased by Alphabet Holdings LLC, CapitalG LP, and Verily Life Sciences LLC. These entities hold an aggregate of more than 5% of our capital stock.

(2)

Includes shares of preferred stock purchased by Fidelity Contrafund: Fidelity Contrafund, Fidelity Contrafund Commingled Pool, and Fidelity Puritan Trust: Fidelity Puritan Fund. These entities hold an aggregate of more than 5% of our capital stock.

(3)

Includes shares of preferred stock purchased by CN2T Capital, LLC, The Founders Fund V, LP, The Founders Fund V Principals Fund, LP, The Founders Fund V Entrepreneurs Fund, LP, The Founders Fund VI, LP, The Founders Fund VI Principals Fund, LP, The Founders Fund VI Entrepreneurs Fund, LP., and certain employees of Founders Fund. These entities and individuals hold an aggregate of more than 5% of our capital stock.

(4)

Includes shares of preferred stock purchased by General Catalyst Group VI, L.P. and General Catalyst Group X—Growth Venture, L.P. These entities hold an aggregate of more than 5% of our capital stock. Joel Cutler, a member of our board of directors, is a Managing Director at General Catalyst Group.

(5)

Includes shares of preferred stock purchased by Khosla Ventures IV, LP, Khosla Ventures IV (CF), LP., Khosla Ventures VI, LP, and Khosla Ventures, LLC (which were subsequently transferred from Khosla Ventures, LLC to Khosla Ventures Opportunity I, LP). These entities hold an aggregate of more than 5% of our capital stock.

(6)

Includes shares of preferred stock purchased by Thrive Capital Partners III, L.P., Thrive Capital Partners V, L.P., Thrive Capital Partners VI Growth, L.P., Claremount TW, L.P., Claremount V Associates, L.P., and Claremount VI Associates, L.P. These entities hold an aggregate of more than 5% of our capital stock. Joshua Kushner, a member of our board of directors, is the sole managing member of each of Thrive General Partners that control these entities.

 

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Stock Repurchases

In December 2018, we repurchased an aggregate of 1,548,053 shares of our Series A Common Stock from certain of our existing stockholders at a purchase price of $6.4312 per share, for an aggregate purchase price of $9.9 million. 280,260 of these shares were repurchased from Joel Klein, one of our executive officers, as part of a Company-wide share repurchase program, for an aggregate purchase price of $1.8 million.

In August 2019, we repurchased 503,750 shares of our Series B Common Stock and 440,050 shares of our Series A Common Stock from Mario Schlosser, our Co-Founder and Chief Executive Officer, at a purchase price of $6.4312 per share, for an aggregate purchase price of $6.1 million.

Amended and Restated Investors’ Rights Agreement

We are party to an Eleventh Amended and Restated Investors’ Rights Agreement, or the Existing IRA, dated December 17, 2020, with certain holders of our capital stock, including entities affiliated with Alphabet Holdings LLC, Formation8, Founders Fund, FMR LLC, General Catalyst Group, Khosla Ventures, and Thrive Capital, all of which are beneficial holders of more than 5% of our capital stock or are entities with which certain of our directors are affiliated. Mario Schlosser, our Co-Founder and Chief Executive Officer, is also party to the Existing IRA. Under the Existing IRA, certain holders of our capital stock have the right to demand that we file a registration statement or request that their shares of our capital stock be covered by a registration statement that we are otherwise filing. The Existing IRA also imposes certain affirmative obligations on us and provides for a right of first refusal in favor of certain holders with regard to certain issuances of our capital stock.

Upon closing of this offering, we will amend and restate the Existing IRA, which we refer to as the Amended IRA, to eliminate certain provisions thereof (but maintaining those related to the registration rights, which are described in the section titled “Description of Capital Stock—Registration Rights”).

Right of First Refusal and Co-Sale Agreement

We are party to an Eleventh Amended and Restated First Refusal and Co-Sale Agreement, or the ROFR Agreement, dated December 17, 2020, with certain holders of our capital stock, including entities affiliated with Alphabet Holdings LLC, Formation8, Founders Fund, FMR LLC, General Catalyst Group, Khosla Ventures, and Thrive Capital, all of which are beneficial holders of more than 5% of our capital stock or are entities with which our directors are affiliated. Mario Schlosser, our Co-Founder and Chief Executive Officer, is also party to the ROFR Agreement. Under the ROFR Agreement, certain holders of our capital stock and we have a right to purchase shares of our capital stock that our stockholders propose to sell to other parties. See “Principal and Selling Stockholders” for additional information regarding beneficial ownership of our capital stock. Upon completion of this offering, the ROFR Agreement will terminate.

Voting Agreement

We are party to an Eleventh Amended and Restated Voting Agreement, or the Voting Agreement, dated December 17, 2020, under which certain holders of our capital stock, including entities affiliated with Alphabet Holdings LLC, Formation8, Founders Fund, FMR LLC, General Catalyst Group, Khosla Ventures, and Thrive Capital, all of which are beneficial holders of more than 5% of our capital stock or are entities with which our directors are affiliated, have agreed to vote their shares of our capital stock on certain matters, including with respect to the election of directors. Mario Schlosser, our Co-Founder

 

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and Chief Executive Officer, is also party to the Voting Agreement. Upon completion of this offering, the Voting Agreement will terminate, and none of our stockholders will have any special rights regarding the election or designation of members of our board of directors.

Puck Lease Agreement

Our former principal place of business was located in a building owned by New Puck, LLC, a Delaware limited liability company. New Puck, LLC is affiliated with Joshua Kushner, a member of our board of directors and the sole managing member of each of the Thrive General Partners that control the Thrive Capital Funds, beneficial holders of more than 5% of our capital stock. Rental expense recorded for this office space for the years ended December 31, 2018 and 2019 was $3.0 million and $1.5 million, respectively. Our sublease and lease agreements for such office space expired between May 2019 and August 2019.

Alphabet Agreements

We have entered into various technology service agreements with affiliates of Alphabet Holdings LLC, who is a beneficial holder of more than 5% of our capital stock, pursuant to which such affiliates have agreed to provide us with technology infrastructure and enterprise services. From January 1, 2018 through December 31, 2020, we have paid these affiliates an aggregate of $4.6 million under these agreements.

Equity Award to Directors and Executive Officers

We have granted stock options to and RSUs certain of our directors and executive officers. For more information regarding the equity awards granted to our directors and named executive officers, see “Executive Compensation.”

Directed Share Program

At our request, the underwriters have reserved for sale at the initial public offering price up to three percent of the shares of Class A common stock offered by this prospectus, to certain individuals through a directed share program, including our provider and distribution partners and certain other individuals identified by management.

Director and Officer Indemnification and Insurance

Our Amended Bylaws will provide indemnification and advancement of expenses for our directors and officers to the fullest extent permitted by the DGCL. In addition, prior to the consummation of this offering, we intend to enter into separate indemnification agreements with each of our directors and executive officers. We have also purchased directors’ and officers’ liability insurance. See “Description of Capital Stock—Limitations on Liability and Indemnification of Officers and Directors.”

Our Policy Regarding Related Party Transactions

Prior to the closing of this offering, we expect that our board of directors will adopt a policy providing that the audit committee will review and approve or ratify material transactions, arrangements, or relationships in which we participate and in which any related person has or will have a direct or indirect material interest. A “related person” is a director, director-nominee, executive officer,

 

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or beneficial holder of more than 5% of any class of our voting securities, or an immediate family member thereof. A transaction involving an amount in excess of $120,000 of value is presumed to be a material transaction, though transactions involving lower amounts may be material based on the facts and circumstances. Direct or indirect material interests may arise by virtue of control or significant influence of the related person to the transaction or by a direct or indirect pecuniary interest of the related person in the transaction. Under this policy, the audit committee shall review if the transaction is on terms comparable to those that could be obtained in arm’s length dealings with an unrelated third party, the extent of the related person’s interest in the transaction, and shall also take into account the conflicts of interest and corporate opportunity provisions of our Code of Business Conduct and Ethics. All of the transactions described above were entered into prior to the adoption of this policy.

Certain of the foregoing disclosures are summaries of certain provisions of our related party agreements, and are qualified in their entirety by reference to all of the provisions of such agreements. Because these descriptions are only summaries of the applicable agreements, they do not necessarily contain all of the information that you may find useful. Copies of certain of the agreements (or forms of the agreements) have been filed as exhibits to the registration statement of which this prospectus is a part, and are available electronically on the website of the SEC at www.sec.gov.

 

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DESCRIPTION OF CAPITAL STOCK

The following is a description of the material terms of our Amended Charter and our Amended Bylaws, each of which will be in effect upon the completion of this offering, and certain provisions of the DGCL. The descriptions herein are qualified in their entirety by our Amended Charter and Amended Bylaws, copies of which have been filed as exhibits to the registration statement of which this prospectus forms a part, as well as the relevant provisions of the DGCL. In this “Description of Capital Stock” section, “we,” “us,” “our,” and “our company” refer to Oscar Health, Inc., formerly known as Mulberry Health Inc., and not any of its subsidiaries.

General

Prior to the completion of this offering, we will file our Amended Charter and we will adopt our Amended Bylaws. Our Amended Charter will authorize capital stock consisting of:

 

   

             shares of Class A common stock, par value $             per share;

 

   

             shares of Class B common stock, par value $             per share; and

 

   

             shares of preferred stock, par value $             per share, the rights and preferences of which the board of directors may establish from time to time.

As of December 31, 2020, after giving effect to (i) the Preferred Stock Conversion, (ii) the Series B Conversion and (iii) the Reclassification, there were              shares of our Class A common stock outstanding held by              stockholders of record,              shares of our Class B common stock outstanding held by              stockholders of record, and no shares of our preferred stock outstanding. Pursuant to our Amended Charter, our board of directors will have the authority, without stockholder approval, except as required by the listing standards of the NYSE, to issue additional shares of our Class A common stock.

Certain provisions of our Amended Charter and our Amended Bylaws summarized below may be deemed to have an anti-takeover effect and may delay or prevent a tender offer or takeover attempt that a stockholder might consider in its best interest, including those attempts that might result in a premium over the market price for the shares of Class A common stock.

Common Stock

Upon completion of this offering, we will have two classes of authorized common stock: Class A common stock and Class B common stock. The rights of the holders of Class A common stock and Class B common stock will be identical, except with respect to voting, conversion, and transfer rights.

Dividend Rights

Holders of shares of our Class A common stock and Class B common stock will be entitled to receive dividends when, as and if declared by our board of directors out of funds legally available therefor, subject to any statutory or contractual restrictions on the payment of dividends and to any restrictions on the payment of dividends imposed by the terms of any outstanding stock. Under Delaware law, we can only pay dividends either out of “surplus” or out of the current or the immediately preceding year’s net profits. Surplus is defined as the excess, if any, at any given time, of the total assets of a corporation over its total liabilities and statutory capital. The value of a corporation’s assets can be measured in a number of ways and may not necessarily equal their book value.

Applicable insurance laws restrict the ability of our health insurance subsidiaries to declare stockholder dividends and require insurance companies to maintain specified levels of statutory capital

 

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and surplus. Insurance regulators have broad powers to prevent reduction of statutory surplus to inadequate levels, and there is no assurance that dividends of the maximum amounts calculated under any applicable formula would be permitted. State insurance regulatory authorities that have jurisdiction over the payment of dividends by our health insurance subsidiaries may in the future adopt statutory provisions more restrictive than those currently in effect.

We currently intend to retain any future earnings and do not expect to pay any dividends in the foreseeable future. See “Dividend Policy” and “Risk Factors—Risks Related to this Offering and Ownership of Our Class A Common Stock—We do not intend to pay dividends on our Class A common stock for the foreseeable future.”

Voting Rights

Holders of our Class A common stock will be entitled to one vote for each share held on all matters submitted to a vote of stockholders, and holders of our Class B common stock will be entitled to 20 votes for each share held on all matters submitted to a vote of stockholders. The holders of our Class A common stock and Class B common stock will vote together as a single class, unless otherwise required by law or our Amended Charter. Delaware law could require either holders of our Class A common stock or Class B common stock to vote separately as a single class in the following circumstances:

 

  1)

if we were to seek to amend our Amended Charter to increase or decrease the par value of a class of our capital stock, then that class would be required to vote separately to approve the proposed amendment; and

 

  2)

if we were to seek to amend our Amended Charter in a manner that alters or changes the powers, preferences, or special rights of a class of our capital stock in a manner that affected its holders adversely, then that class would be required to vote separately to approve the proposed amendment.

The holders of our Class A common stock and Class B common stock will not have cumulative voting rights in the election of directors.

No Preemptive or Similar Rights

Holders of our Class A common stock and Class B common stock will not have preemptive, subscription, redemption, or conversion rights (except, in respect of the Class B common stock, for the conversion rights noted below). There will be no redemption or sinking fund provisions applicable to our common stock. The rights, preferences, and privileges of the holders of our common stock will be subject to and may be adversely affected by the rights of the holders of shares of any series of our preferred stock that we may designate in the future.

Conversion

Each outstanding share of our Class B common stock will be convertible at any time at the option of the holder into one share of our Class A common stock. Each share of our Class B common stock will convert automatically into one share of our Class A common stock upon any transfer, except for certain permitted transfers described in our Amended Charter, including (A) for Joshua Kushner and Mario Schlosser, transfers to (i) affiliates of such stockholder (i.e., persons or entities directly or indirectly controlling, controlled by or under common control with such stockholder), (ii) trusts controlled directly or indirectly by such stockholder that are solely for the benefit of such stockholder or his family members or a corporation, partnership or limited liability company directly or indirectly controlled by such stockholder and exclusively owned by such stockholder or his family members, which trusts or

 

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other entities were established for bona fide estate planning purposes and (iii) in the case of Joshua Kushner, a private foundation or similar entity established by him or his family members and controlled directly or indirectly by him (collectively with respect to (and including) Joshua Kushner or Mario Schlosser, as applicable, each’s “Permitted Ownership Group”) and (B) for the Thrive Capital Funds, transfers to (i) Joshua Kushner, (ii) any person or entity in Joshua Kushner’s Permitted Ownership Group and (iii) the Thrive Capital Funds and any affiliates of the Thrive Capital Funds that are directly or indirectly controlled by Joshua Kushner (with respect to the Thrive Capital Funds, their “Permitted Ownership Group”).

All outstanding shares of our Class B common stock will automatically convert into shares of Class A common stock on a one-for-one basis upon the date that is the earlier of (i) transfer of Class B common stock to a person or entity that is not in the transferor’s Permitted Ownership Group, (ii) the date that is seven years from the date of this prospectus, (iii) with respect to any Class B common stock held by any person or entity in Joshua Kushner’s Permitted Ownership Group or the Thrive Capital Funds’ Permitted Ownership Group, (A) such time as Joshua Kushner ceases to serve on the board of directors, (B) such time as Joshua Kushner is terminated for cause from any management position within the Company, (C) upon the violation of a non-compete or non-solicitation covenant in any written agreement with the Company entered into by Joshua Kushner after the effectiveness of the Amended Charter or (D) the date that is 12 months after the death or disability of Joshua Kushner, (iv) with respect to any Class B common stock held by any person or entity in Mario Schlosser’s Permitted Ownership Group, (A) such time as Mario Schlosser ceases to serve on the board of directors, (B) such time as Mario Schlosser is terminated for cause from any management position within the Company, (C) upon the violation of a non-compete or non-solicitation covenant in any written agreement with the Company or (D) the date that is 12 months after the death or disability of Mario Schlosser, (v) with respect to any Class B common stock held by or subject to the voting control of Mario Schlosser and persons or entities in his Permitted Ownership Group, such time as he and persons or entities in his Permitted Ownership Group cease to hold or control the vote of, in the aggregate, at least twenty-five percent (25%) of the shares of Class B common stock held by persons or entities in such Permitted Ownership Group as of the closing of this offering, (vi) with respect to any Class B common stock held by or subject to the voting control of the Thrive Capital Funds and persons or entities in their Permitted Ownership Group, such time as the persons or entities in such Permitted Ownership Group cease to hold or control the vote of, in the aggregate, at least twenty-five percent (25%) of the shares of Class B common stock held by or subject to the voting control of such Permitted Ownership Group as of the closing of this offering (the “Thrive Threshold”); provided, that, for this clause (vi) (a) any such shares of Class B common stock that are then-held by or subject to the voting control of Joshua Kushner’s Permitted Ownership Group (other than those then-held by or subject to the voting control of the Thrive Capital Funds) shall not convert into shares of Class A common stock until such time as they are otherwise converted in accordance with the provisions of our Amended Charter and (b) any shares of Class B common stock which are transferred to Joshua Kushner’s Permitted Ownership Group in connection with the transaction that results in the Thrive Capital Funds and persons or entities in the Thrive Capital Funds’ Permitted Ownership Group ceasing to hold or control the vote of, in the aggregate, a number of shares of Class B common stock that is at or above the Thrive Threshold shall not be subject to mandatory conversion pursuant to this clause and (vii) if such share of Class B common stock is held by any person or entity in the Thrive Capital Funds’ Permitted Ownership Group, such time as such holder eliminates, removes or otherwise ceases, directly or indirectly, to confer direct or indirect voting control over any such share to Joshua Kushner.

Right to Receive Liquidation Distributions

In the event of our liquidation, dissolution, or winding-up, the assets legally available for distribution to our stockholders would be distributable ratably among the holders of our Class A

 

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common stock and Class B common stock and any participating preferred stock outstanding at that time, subject to prior satisfaction of all outstanding debt and liabilities and the preferential rights of, and the payment of liquidation preferences, if any, on any outstanding shares of preferred stock.

Fully Paid and Non-Assessable

All shares of our Class A common stock and Class B common stock outstanding upon the completion of this offering will be fully paid and non-assessable.

Preferred Stock

No shares of preferred stock will be issued or outstanding immediately after the offering contemplated by this prospectus. Our Amended Charter will authorize our board of directors to establish one or more series of preferred stock. Unless required by law or any stock exchange, the authorized shares of preferred stock will be available for issuance without further action by the holders of our Class A common stock or Class B common stock. Our board of directors will have the discretion to determine, without stockholder approval and with respect to any series of preferred stock, the powers (including voting powers), preferences, and relative, participating, optional, or other special rights, and the qualifications, limitations, or restrictions thereof, including, without limitation:

 

   

the designation of the series;

 

   

the number of shares of the series, which our board of directors may, except where otherwise provided in the preferred stock designation, increase (but not above the total number of authorized shares of the class) or decrease (but not below the number of shares then outstanding);

 

   

whether dividends, if any, will be cumulative or non-cumulative and the dividend rate of the series;

 

   

the dates at which dividends, if any, will be payable;

 

   

the redemption or repurchase rights and price or prices, if any, for shares of the series;

 

   

the terms and amounts of any sinking fund provided for the purchase or redemption of shares of the series;

 

   

the amounts payable on shares of the series in the event of any voluntary or involuntary liquidation, dissolution, or winding-up of our affairs;

 

   

whether the shares of the series will be convertible into shares of any other class or series, or any other security, of us or any other entity, and, if so, the specification of the other class or series or other security, the conversion price or prices, or rate or rates, any rate adjustments, the date or dates as of which the shares will be convertible and all other terms and conditions upon which the conversion may be made;

 

   

restrictions on the issuance of shares of the same series or of any other class or series; and

 

   

the voting rights, if any, of the holders of the series.

We could issue a series of preferred stock that could, depending on the terms of the series, impede or discourage an acquisition attempt or other transaction that some, or a majority, of the holders of our common stock might believe to be in their best interests or in which the holders of our common stock might receive a premium over the market price of the shares of our Class A common stock. Additionally, the issuance of preferred stock may adversely affect the rights of holders of our common stock by restricting dividends on our common stock, diluting the voting power of our common stock or subordinating the liquidation rights of our common stock. As a result of these or other factors,

 

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the issuance of preferred stock could have an adverse impact on the market price of our Class A common stock. We have no current plan for the issuance of any shares of preferred stock.

Options

As of December 31, 2020, after giving effect to the Reclassification, we had outstanding options to purchase an aggregate of 122,472,044 shares of our Class A common stock, with a weighted-average exercise price of $3.06 per share, under the 2012 Plan. In connection with the sale of shares by certain selling stockholders in this offering,             shares of our Class A common stock will be issued upon exercise of options by such selling stockholders.

RSUs

As of December 31, 2020, after giving effect to the Reclassification, we had outstanding RSUs that may be settled for an aggregate of             shares of Class A common stock granted pursuant to our 2012 Plan. In connection with the sale of shares by certain selling stockholders in this offering,              shares of our Class A common stock will be issued upon settlement of RSUs to such selling stockholders.

Warrants

As of December 31, 2020, after giving effect to the Reclassification, we had outstanding (i) warrants to purchase an aggregate of 1,887,460 shares of our Class A common stock at an exercise price of $0.5563 per share and (ii) warrants to purchase 500,000 shares of our Class A common stock and 1,750,000 shares of our Class A common stock at exercise prices of $6.7548 and $7.1349, respectively.

Registration Rights

Under the Amended IRA, following the completion of this offering, certain holders of our Class A common stock and Class B common stock, including, but not limited to, certain holders of at least 5% of our capital stock and entities affiliated with certain of our directors, will have certain registration rights, as set forth below. Such registration rights will terminate upon the earliest of (i) the date that is five years after the completion of this offering, (ii) as to a given holder of registration rights, the date after the completion of this offering when such holder of registration rights and its affiliates can sell all of their shares pursuant to Rule 144 of the Securities Act during a three-month period without registration, and (iii) the completion of certain liquidation events. Under the Registration Rights Agreement, we will generally be required to pay all expenses (other than underwriting discounts and commissions and certain other expenses) related to any registration effected pursuant to the exercise of such registration rights.

Demand Registration Rights

After the completion of this offering, the holders of up to              shares of our Class A common stock (including certain shares of Class A common stock issued or issuable upon the conversion of Class B common stock) will be entitled to certain demand registration rights. At any time beginning six months after the effective date of this registration statement, the holders of at least 50% of the shares having registration rights then outstanding may request that we file a registration statement to register the offer and sale of their shares. We will only be obligated to effect up to two such registrations. Each such request for registration must cover securities the anticipated aggregate offering price of which is at least $50.0 million. If we determine that it would be seriously detrimental to us and our stockholders to effect such a demand registration, we will have the right to defer such registration, not more than once in any twelve-month period, for a period of up to 90 days.

 

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Form S-3 Registration Rights

After the completion of this offering, holders of up to              shares of our Class A common stock (including certain shares of Class A common stock issued or issuable upon the conversion of Class B common stock) will be entitled to certain Form S-3 registration rights. At any time when we are eligible to file a registration statement on Form S-3, the holders of at least 30% of the shares having these rights then outstanding will be able to request that we register the offer and sale of their shares on a registration statement on Form S-3 so long as the request covers securities the anticipated aggregate public offering price of which, net of any underwriters’ discounts or commissions, is at least $5.0 million. These holders may make an unlimited number of requests for registration on a registration statement on Form S-3. However, we will not be required to effect a registration on Form S-3 if we have effected two such registrations within the twelve-month period preceding the date of the request. If we determine that it would be seriously detrimental to us and our stockholders to effect such a demand registration, we will have the right to defer such registration, not more than once in any twelve-month period, for a period of up to 90 days.

Piggyback Registration Rights

After the completion of this offering, the holders of up to              shares of our Class A common stock (including certain shares of Class A common stock issued or issuable upon the conversion of Class B common stock) will be entitled to certain “piggyback” registration rights. If we propose to register shares of our Class A common stock or other securities under the Securities Act, either for our own account or for the account of other security holders, in connection with such offering, all holders of these shares then outstanding will be able to request that we include their shares in such registration, subject to certain marketing and other limitations. As a result, whenever we propose to file a registration statement under the Securities Act, other than with respect to (i) a registration pursuant to the demand registration rights described in the preceding paragraph above, (ii) a registration relating solely to our stock plans, (iii) a registration relating to a corporate reorganization or other transaction covered by Rule 145 promulgated under the Securities Act, (iv) a registration on any form that does not include substantially the same information as would be required to be included in a registration statement covering the sale of the shares having registration rights, or (v) a registration relating to the offer and sale of debt securities, the holders of these shares will be entitled to notice of the registration and have the right, subject to certain limitations, to include their shares in the registration.

Anti-Takeover Effects of Delaware Law and our Amended Charter and Amended Bylaws

The DGCL contains, and our Amended Charter and Amended Bylaws will contain provisions that may delay, defer, or discourage another party from acquiring control of us. We expect that these provisions, which are summarized below, will discourage coercive takeover practices or inadequate takeover bids. These provisions are also designed to encourage persons seeking to acquire control of us to first negotiate with our board of directors, which we believe may result in an improvement of the terms of any such acquisition in favor of our stockholders. However, they also give our board of directors the power to discourage acquisitions that some stockholders may favor.

Authorized but Unissued Shares

The authorized but unissued shares of Class A common stock, Class B common stock, and preferred stock are available for future issuance without stockholder approval, subject to any limitations imposed by the listing standards of the NYSE. These additional shares may be used for a variety of corporate finance transactions, acquisitions, and employee benefit plans. The existence of authorized but unissued and unreserved Class A common stock, Class B common stock, and preferred stock could make more difficult or discourage an attempt to obtain control of us by means of a proxy contest, tender offer, merger, or otherwise.

 

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Advance Notice Requirements for Stockholder Proposals and Director Nominations

Our Amended Bylaws will provide advance notice procedures for stockholder proposals to be brought before an annual meeting of stockholders, including proposed nominations of candidates for election to our board of directors. Our Amended Bylaws will also specify certain requirements regarding the form and content of a stockholder’s notice. These provisions might preclude our stockholders from bringing matters before our annual meeting of stockholders or from making nominations for directors at our annual meeting of stockholders if the proper procedures are not followed. We expect that these provisions may also discourage or deter a potential acquirer from conducting a solicitation of proxies to elect the acquirer’s own slate of directors or otherwise attempting to obtain control of our company.

Stockholder Action by Written Consent; Special Meetings of Stockholders

Pursuant to Section 228 of the DGCL, any action required to be taken at any annual or special meeting of the stockholders may be taken without a meeting, without prior notice, and without a vote if a consent or consents in writing, setting forth the action so taken, is signed by the holders of outstanding stock having not less than the minimum number of votes that would be necessary to authorize or take such action at a meeting at which all shares of our stock entitled to vote thereon were present and voted, unless the company’s certificate of incorporation provides otherwise. Our Amended Charter will provide that our stockholders may not take action by written consent, but may only take action at annual or special meetings of our stockholders. As a result, a holder controlling at least two-thirds of our capital stock would not be able to amend our Amended Bylaws or remove directors without holding a meeting of our stockholders called in accordance with our Amended Bylaws. Our Amended Bylaws will further provide that special meetings of our stockholders may be called only by a chairperson or co-chairperson of the board of directors or pursuant to a resolution adopted by a majority of the total authorized number of directors. These provisions might delay the ability of our stockholders to force consideration of a proposal or for stockholders controlling a majority of our capital stock to take any action, including the removal of directors.

No Cumulative Voting

The DGCL provides that stockholders are not entitled to cumulate votes in the election of directors unless a corporation’s certificate of incorporation provides otherwise. Our Amended Charter will not provide for cumulative voting.

Amendment of Amended Charter or Amended Bylaws

Our Amended Charter will require the approval of the holders of at least two-thirds in the voting power of the outstanding shares of our capital stock, voting together as a single class, in order to amend certain provisions, including those relating to removal of directors, our authorized capital stock, voting rights, exculpation, exclusive forum, and the prohibition on stockholder action by written consent. Our Amended Charter and Amended Bylaws will provide that the approval of the holders of at least two-thirds in the voting power of the outstanding shares of our capital stock entitled to vote generally in the election of directors, voting together as a single class, is required for stockholders to amend or adopt any provision of our Amended Bylaws.

The foregoing provisions of our Amended Charter and Amended Bylaws could discourage potential acquisition proposals and could delay or prevent a change in control. These provisions are intended to enhance the likelihood of continuity and stability in the composition of our board of directors and in the policies formulated by our board of directors and to discourage certain types of transactions that may involve an actual or threatened change of control. These provisions are designed to reduce

 

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our vulnerability to an unsolicited acquisition proposal. The provisions also are intended to discourage certain tactics that may be used in proxy fights. However, such provisions could have the effect of discouraging others from making tender offers for our shares and, as a consequence, they also may inhibit fluctuations in the market price of our shares of Class A common stock that could result from actual or rumored takeover attempts. Such provisions also may have the effect of preventing changes in our management or delaying or preventing a transaction that might benefit you or other minority stockholders.

Dual Class Stock

As described above in “—Common Stock—Voting Rights,” our Amended Charter provides for a dual class common stock structure, which will provide holders of our Class B common stock with significant influence over matters requiring stockholder approval, including the election of directors and significant corporate transactions, such as a merger or other sale of our company or all or substantially all of its assets.

Issuance of Undesignated Preferred Stock

Our board of directors will have the authority, without further action by our stockholders, to issue up to              shares of undesignated preferred stock with rights and preferences, including voting rights, designated from time to time by our board of directors. The existence of authorized but unissued shares of preferred stock would enable our board of directors to render more difficult or to discourage an attempt to obtain control of us by means of a merger, tender offer, proxy contest, or other means.

Section 203 of the DGCL

We will be governed by the provisions of Section 203 of the DGCL. In general, Section 203 prohibits a public Delaware corporation from engaging in a “business combination” with an “interested stockholder” for a period of three years after the time of the transaction in which the person became an interested stockholder, unless:

 

   

the business combination or transaction which resulted in the stockholder becoming an interested stockholder was approved by the board of directors prior to the time that the stockholder became an interested stockholder;

 

   

upon consummation of the transaction which resulted in the stockholder becoming an interested stockholder, the interested stockholder owned at least 85% of the voting stock of the corporation outstanding at the time the transaction commenced, excluding shares owned by directors who are also officers of the corporation and shares owned by employee stock plans in which employee participants do not have the right to determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange offer; or

 

   

at or subsequent to the time the stockholder became an interested stockholder, the business combination was approved by the board of directors and authorized at an annual or special meeting of the stockholders, and not by written consent, by the affirmative vote of at least 6623% of the outstanding voting stock which is not owned by the interested stockholder at an annual or special meeting of the stockholders.

In general, Section 203 defines a “business combination” to include mergers, asset sales, and other transactions resulting in financial benefit to a stockholder and an “interested stockholder” as a person who, together with affiliates and associates, owns, or, if such person is an affiliate or associate of the corporation within three years did own, 15% or more of the corporation’s outstanding voting stock.

 

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Under Section 203, “Owner,” including the terms “own” and “owned,” when used with respect to any stock, means a person that individually or with or through any of its affiliates or associates: (i) beneficially owns such stock, directly or indirectly; or (ii) has (A) the right to acquire such stock or (B) the right to vote such stock; provided, however, that a person shall not be deemed the owner of any stock because of such person’s right to vote such stock if the agreement, arrangement or understanding to vote such stock arises solely from a revocable proxy or consent given in response to a proxy or consent solicitation made to 10 or more persons; or (iii) has any agreement, arrangement or understanding for the purpose of acquiring, holding, voting (except voting pursuant to a revocable proxy or consent as described in item (B) in this paragraph), or disposing of such stock with any other person that beneficially owns, or whose affiliates or associates beneficially own, directly or indirectly, such stock.

These provisions may have the effect of delaying, deferring, or preventing changes in control of our company.

Exclusive Venue

Our Amended Charter will provide that, unless we consent to the selection of an alternative forum, the Court of Chancery of the State of Delaware is the sole and exclusive forum for: (a) any derivative action, suit, or proceeding brought on our behalf; (b) any action, suit, or proceeding asserting a claim of breach of fiduciary duty owed by any of our current or former directors, officers or other employees or stockholder to us or to our stockholders, creditors or other constituents; (c) any action, suit, or proceeding asserting a claim arising pursuant to the DGCL, our Amended Charter or Amended Bylaws, or as to which the DGCL confers exclusive jurisdiction on the Court of Chancery of the State of Delaware; or (d) any action, suit, or proceeding asserting a claim governed by the internal affairs doctrine; provided that the exclusive forum provisions will not apply to suits brought to enforce any liability or duty created by the Exchange Act, or to any claim for which the federal courts have exclusive jurisdiction.

Our Amended Charter will further provide that, unless we consent in writing to the selection of an alternative forum, the federal district courts are the exclusive forum for the resolution of any complaint asserting a cause of action arising under the Securities Act. We note that investors cannot waive compliance with the federal securities laws and the rules and regulations thereunder. Although we believe the provision benefits us by providing increased consistency in the application of Delaware law in the types of lawsuits to which it applies, the provision may have the effect of discouraging lawsuits against our directors and officers. See “Risk Factors—Risks Related to this Offering and Ownership of Our Class A Common Stock—Our Amended Charter will provide that the Court of Chancery of the State of Delaware will be the sole and exclusive forum for substantially all disputes between us and our stockholders, and federal district courts will be the sole and exclusive forum for Securities Act claims, which could limit our stockholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers, or employees.”

Limitations on Liability and Indemnification of Officers and Directors

The DGCL authorizes corporations to limit or eliminate the personal liability of directors to corporations and their stockholders for monetary damages for breaches of directors’ fiduciary duties, subject to certain exceptions. Our Amended Charter will include a provision that eliminates the personal liability of directors for monetary damages to the corporation or its stockholders for any breach of fiduciary duty as a director, except to the extent such exemption from liability or limitation thereof is not permitted under the DGCL. The effect of these provisions is to eliminate the rights of us and our stockholders, through stockholders’ derivative suits on our behalf, to recover monetary

 

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damages from a director for breach of fiduciary duty as a director, including breaches resulting from grossly negligent behavior. However, exculpation does not apply to any breaches of the director’s duty of loyalty, any acts or omissions not in good faith or that involve intentional misconduct or knowing violation of law, any authorization of dividends or stock redemptions or repurchases paid or made in violation of the DGCL, or for any transaction from which the director derived an improper personal benefit.

Our Amended Bylaws generally will provide that we must indemnify and advance expenses to our directors and officers to the fullest extent authorized by the DGCL. We also will be expressly authorized to carry directors’ and officers’ liability insurance providing indemnification for our directors, officers, and certain employees for some liabilities. We believe that these indemnification and advancement provisions and insurance are useful to attract and retain qualified directors and executive officers.

The limitation of liability, indemnification, and advancement provisions in our Amended Charter and Amended Bylaws may discourage stockholders from bringing a lawsuit against directors for breach of their fiduciary duty. These provisions also may have the effect of reducing the likelihood of derivative litigation against directors and officers, even though such an action, if successful, might otherwise benefit us and our stockholders. In addition, your investment may be adversely affected to the extent we pay the costs of settlement and damage awards against directors and officers pursuant to these indemnification provisions.

There is currently no pending material litigation or proceeding involving any of our directors, officers, or employees for which indemnification is sought.

Indemnification Agreements

Prior to the completion of this offering, we intend to enter into an indemnification agreement with each of our directors and executive officers as described in “Certain Relationships and Related Party Transactions—Director and Officer Indemnification and Insurance.” Insofar as indemnification for liabilities arising under the Securities Act may be permitted to directors or executive officers, we have been informed that in the opinion of the SEC such indemnification is against public policy and is therefore unenforceable.

Corporate Opportunities

Delaware law permits corporations to adopt provisions renouncing any interest or expectancy in certain opportunities that are presented to the corporation or its officers, directors or stockholders. Our Amended Charter will, to the maximum extent permitted by Delaware law, renounce any interest or expectancy that we have in, or right to be offered an opportunity to participate in, any business opportunities that are from time to time presented to our directors or stockholders that are not employed by us, such person being an Exempt Person. Our Amended Charter will provide that, to the fullest extent permitted by law, our Exempt Persons will not have any duty to refrain from (1) engaging in a corporate opportunity in the same or similar lines of business in which we now engage or propose to engage or (2) otherwise competing with us. In addition, to the fullest extent permitted by law, if any Exempt Person acquires knowledge of a potential transaction or other business opportunity which may be a corporate opportunity both for such Exempt Person or any of his or her respective affiliates, on the one hand, and for the Corporation or its subsidiaries, on the other hand, such Exempt Person shall have no duty to communicate or offer such transaction or business opportunity to the us and such Exempt Person may take any and all such transactions or opportunities for itself or offer such transactions or opportunities to any other Person. To the maximum extent permitted by Delaware law,

 

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no potential transaction or business opportunity may be deemed to be a corporate opportunity of ours unless (i) we would be permitted to undertake such transaction or opportunity in accordance with this Amended Charter, (ii) we have sufficient financial resources to undertake such transaction or opportunity, (iii) we have an interest or expectancy in such transaction or opportunity and (iv) such transaction or opportunity would be in the same or similar line of business in which we are engaged or a line of business that is reasonably related to, or a reasonable extension of, such line of business. Our Amended Charter will not renounce our interest in any business opportunity that is expressly offered to a director, executive officer or employee of the Company, solely in his or her capacity as a director, executive officer or employee of the Company.

Dissenters’ Rights of Appraisal and Payment

Under the DGCL, with certain exceptions, our stockholders will have appraisal rights in connection with a merger or consolidation of Oscar. Pursuant to the DGCL, stockholders who properly demand and perfect appraisal rights in connection with such merger or consolidation will have the right to receive payment in cash of the fair value of their shares as determined by the Court of Chancery in the State of Delaware.

Stockholders’ Derivative Actions

Under the DGCL, any of our stockholders may bring an action in our name to procure a judgment in our favor, also known as a derivative action, provided that the stockholder bringing the action is a holder of our shares at the time of the transaction of which such stockholder complains or such stockholder’s shares thereafter devolved upon such stockholder by operation of law and such suit is brought in the Court of Chancery in the State of Delaware. See “—Exclusive Venue” above.

Change in Control pursuant to Insurance Laws

Insurance laws in most states requires regulatory review and approval of a change in control of our domestic insurers. “Control” generally means the possession, direct or indirect, of the power to direct, or cause the direction of, the management and policies of an insurer, whether through the ownership of voting securities, by contract, or otherwise. The state statutes usually presume that control exists if a person or company, directly or indirectly, owns, controls, or holds with the power to vote ten percent (10%) or more of the voting securities of an insurer or a parent company, but some states may presume control at a lower percentage. This presumption can then be rebutted by a showing that control does not exist. Accordingly, a change in control could trigger regulatory review and approval in one or more states in which we operate.

Stock Exchange Listing

We intend to apply to list our Class A common stock on the NYSE under the symbol “OSCR.”

Transfer Agent and Registrar

The transfer agent and registrar for our Class A common stock is American Stock Transfer & Trust Company. The transfer agent and registrar’s address is 6201 15th Avenue, Brooklyn, New York, 11219, and its telephone number is (800) 937-5449.

 

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DESCRIPTION OF CERTAIN INDEBTEDNESS

Term Loan Facility

General

On October 30, 2020, Holdco, as borrower, or the Borrower, entered into a senior secured credit agreement, or the Credit Agreement, with HPS Investment Partners, LLC, as administrative agent, and certain other lenders for a term loan credit facility, or the Term Loan Facility, in the aggregate principal amount of $150.0 million. The Term Loan Facility is guaranteed by Mulberry Management Corporation, a wholly owned subsidiary of Oscar, and all of the Borrower’s future direct and indirect subsidiaries (subject to certain permitted exceptions, including exceptions guarantees that would require material governmental consents or in respect of joint venture). Our Term Loan Facility is secured by a lien on substantially all of the Borrower’s and the guarantors’ assets (subject to certain exceptions). As of December 31, 2020, we had $150.0 million outstanding on the Term Loan Facility.

Interest Rate

The interest rate applicable to borrowings under our Term Loan Facility is determined as follows, at our option: (a) a rate per annum equal to the Adjusted LIBO Rate plus an applicable margin of 11.75% (Adjusted LIBO Rate is calculated based on one-, two-, three- or six-month LIBOR rates, which is determined by reference to ICE Benchmark Administration London Interbank Offered Rate, or LIBO, but not less than 1.00%) or (b) a rate per annum equal to the Alternative Base Rate plus the applicable margin of 10.75% (the Alternative Base Rate is equal to the highest of (i) the prime rate, (ii) the federal funds effective rate plus 0.50%, and (iii) the Adjusted LIBO Rate based on a three-month interest period, plus 1.00%). For the first three years of the Term Loan Facility, so long as there exists no continuing event of default, we may elect to capitalize up to 50% of the accrued interest and add it to the outstanding principal of the loans under the Term Loan Facility.

Voluntary Prepayments

We may voluntarily prepay loans or reduce commitments under the Term Loan Facility, in whole or in part, subject to minimum amounts, with prior notice. Such voluntary prepayments will be accompanied by a prepayment payment equal to (i) if a qualified initial public offering has occurred on or after the six-month anniversary of October 30, 2020, a percentage from 6.50% to 1.00% as set forth in the documentation governing the Term Loan Facility, based on the valuation of such initial public offering and the prepayment date or (ii) otherwise, if such prepayment occurs prior to the two-year anniversary of the closing date, a customary “make-whole,” or if such prepayment occurs thereafter 1.0%.

Mandatory Prepayments

We will be required to prepay the Term Loan Facility with 100% of the net cash proceeds of certain asset sales, 100% of the net cash proceeds of equity issuances at a valuation of less than $2,000,000,000, 100% of the net cash proceeds of certain debt issuances and 100% of the net cash proceeds of certain extraordinary events, in each case, subject to certain reinvestment rights and other exceptions. Under the documentation governing the Term Loan Facility, “valuation” in the context of this offering means an amount equal to (i) the Borrower’s market capitalization based on the initial public offering price per share of Class A common stock plus (ii) all of the indebtedness of the Borrower and the Borrower’s subsidiaries minus (iii) all of the unrestricted cash of the Borrower and the Borrower’s subsidiaries.

 

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Maturity

The Term Loan Facility matures on October 30, 2024; provided that upon the invalidation of certain provisions of the ACA by the Supreme Court of the United States or any other federal courts that could reasonably be likely to result in a material adverse effect, upon the election of the majority lenders, the maturity of the Term Loan Facility will be 12 months from such election, which is referred to as the “Springing Maturity Date.” Notwithstanding the Springing Maturity Date, upon certain events (including the consummation of this initial public offering), the maturity date of the Term Loan Facility will revert to October 30, 2024.

Covenants and Other Matters

The Term Loan Facility requires us to comply with certain restrictive covenants, including but not limited to covenants relating to limitations on indebtedness, liens, investments, loans and advances, restricted payments and restrictive agreements, mergers, consolidations, sale of assets and acquisitions, sale and leaseback transactions and affiliate transactions.

In addition, the Term Loan Facility contains financial covenants as detailed below.

 

   

The Borrower may not permit gross premiums (as defined in the Credit Agreement) for any period as of the last day of any fiscal quarter to be less than certain thresholds, which such threshold ranges from $382,100,000 for the quarter ending December 31, 2020 to $1,498,900,000 for the quarter ending September 30, 2024.

 

   

Commencing with the fiscal quarter ending December 31, 2022, the Borrower may not permit the combined ratio (as defined in the Credit Agreement) as of the last day of any fiscal quarter to be less than (i) for December 31, 2022, 106.7%, (ii) from March 31, 2023 through and including December 31, 2023, 101.5% and (iii) for March 31, 2024 and thereafter, 97.6%.

 

   

The Borrower may not permit liquidity (as defined in the Credit Agreement) at any time to be less than $60,000,000.

As of December 31, 2020, we were in compliance with all covenants.

The Term Loan Facility also contains certain customary representations and warranties and affirmative covenants, and certain reporting obligations. In addition, the lenders under the Term Loan Facility will be permitted to accelerate all outstanding borrowings and other obligations and exercise other specified remedies upon the occurrence of certain events of default (subject to certain grace periods and exceptions), which include, among other things, payment defaults, breaches of representations and warranties, covenant defaults, certain cross-defaults and cross-accelerations to other indebtedness, certain events of bankruptcy and insolvency, certain judgments and changes of control.

The foregoing summary describes the material provisions of the Credit Agreement, but may not contain all information that is important to you. We urge you to read the provisions of the Credit Agreement, which has been filed as an exhibit to the registration statement of which this prospectus forms a part.

In connection with this offering, we expect to repay in full outstanding borrowings, including fees and expenses, under our Term Loan Facility.

 

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SHARES ELIGIBLE FOR FUTURE SALE

Immediately prior to this offering, there was no public market for our Class A common stock. Future sales of substantial amounts of Class A common stock in the public market, or the perception that such sales may occur, could adversely affect the market price of our Class A common stock. Although we intend to apply to have our Class A common stock listed on the NYSE, we cannot assure you that there will be an active public market for our Class A common stock.

Upon the closing of this offering, based on the number of shares of our capital stock outstanding as of December 31, 2020 after giving effect to (i) the Preferred Stock Conversion, (ii) the Series B Conversion, (iii) the Reclassification, (iv) the filing and effectiveness of our Amended Charter, and (v) the Selling Stockholder Class B Conversion, we will have a total of                  shares of our Class A common stock outstanding and                  shares of our Class B common stock outstanding. This includes                  shares that we and the selling stockholders are selling in this offering, as well as the issuance of                shares of our Class A common stock to certain selling stockholders upon the exercise of options and settlement of RSUs in connection with the sale of such shares in this offering, which shares may be resold in the public market immediately following this offering, and assumes no additional exercise of outstanding options or settlement of outstanding RSUs. Shares of our Class B common stock are convertible into an equivalent number of shares of our Class A common stock and generally convert into shares of our Class A common stock upon transfer.

The remaining                shares of Class A common stock and Class B common stock will be “restricted securities,” as that term is defined in Rule 144. These restricted securities are eligible for public sale only if they are registered under the Securities Act or if they qualify for an exemption from registration under Rules 144 or 701 under the Securities Act, which are summarized below.

As a result of the lock-up agreements and market standoff agreements described below and subject to the provisions of Rules 144 or 701, these restricted securities will be available for sale in the public market as follows:

 

Earliest Date Available for Sale in the Public Market

  

Number of Shares of Class A Common Stock

The first trading day on which our Class A common stock is traded on NYSE (the “first release window”).    Up to         million shares. Includes certain securities held by Employee Stockholders (as defined below). Excludes “affiliates” for the purposes of Rule 144, as described below under “—Rule 144.”
The second trading day immediately following our public release of earnings for the first quarter following the most recent period for which financial statements are included in this prospectus (the “second release window”) provided that the closing price of our Class A common stock on NYSE is at least 33% greater than the initial public offering price per share set forth on the cover page of this prospectus for the periods described in the section titled “Underwriting.”    Up to         million additional shares. Includes certain securities held by Employee Stockholders. Excludes “affiliates” for the purposes of Rule 144. Does not give effect to up to         million shares available for sale under the first release window that may be sold during this second release window if not sold during the first release window.
The opening of trading on the second trading day immediately following our public release of earnings for the second quarter following the most recent period for which financial statements are included in this prospectus.    All remaining shares held by our stockholders not previously eligible for sale, subject to volume limitations applicable to “affiliates” under Rule 144 as described below.

 

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Registration Rights

Pursuant to the Amended IRA, after the completion of this offering, the holders of up to                  shares of our Class A common stock (including certain shares of Class A common stock issued or issuable upon conversion of Class B common stock) will be entitled to certain rights with respect to the registration of the offer and sale of their shares of our Class A common stock under the Securities Act. See “Description of Capital Stock—Registration Rights” for a description of these registration rights. If the offer and sale of these shares of our Class A common stock are registered, the shares will be freely tradable without restriction under the Securities Act, subject to the Rule 144 limitations applicable to affiliates, and a large number of shares may be sold into the public market.

Lock-Up Agreements and Market Stand-Off Provisions

We, our officers and directors, and holders of substantially all of our Class A common stock and securities convertible into or exchangeable for our Class A common stock will agree that, without the prior written consent of Goldman Sachs & Co. LLC, as a representative of the underwriters, we and they will not, subject to certain exceptions, during the period ending on the earlier of 180 days after the date of this prospectus and the opening of trading on the second trading day immediately following our public release of earnings for the second quarter following the most recent period for which financial statements are included in this prospectus, or the restricted period:

 

   

offer, sell, contract to sell, pledge, grant any option to purchase, make any short sale or otherwise dispose of any shares of Class A common stock, or any options or warrants to purchase any shares of Class A common stock, or any securities convertible into, exchangeable for or that represent the right to receive shares of Class A common stock, or publicly disclose an intention to do any of the foregoing, whether now owned or hereinafter acquired, owned directly by the undersigned (including holding as a custodian) or with respect to which the undersigned has beneficial ownership (as such term is used in Rule 13d-3 of the Exchange Act); or

 

   

enter into any swap or other arrangement that transfers to another, all or a portion of the economic consequences of ownership of our Class A common stock or any securities convertible into or exercisable, or exchangeable for shares of our Class A common stock,

whether any transaction described above is to be settled by delivery of our Class A common stock or such other securities, in cash or otherwise. Holders of substantially all of our capital stock and options are subject to market stand-off provisions in agreements with us that impose similar restrictions.

Notwithstanding the foregoing,

 

  A.

up to 15% of the shares of our outstanding Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock (including, any unexercised warrants, convertible securities, stock options, RSUs or other equity awards issued by the Company, but excluding equity awards that have not vested (the “Included Securities”)) held by our current and former employees, consultants, and contractors (but excluding current executive officers, our principal accounting officer, and directors) (the “Employee Stockholders”) may be sold for a 7-trading day period beginning at the commencement of trading on the first trading day on which our Class A common stock is traded on NYSE; and

 

  B.

up to 15% of the shares of our outstanding Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock

 

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  (including Included Securities) held by Employee Stockholders, plus any first release window eligible shares held by such person not sold during the first release window described in (A) above, may be sold beginning at the opening of trading on the second trading day immediately following our public release of earnings for the first quarter following the most recent period for which financial statements are included in this prospectus (such release, our “first post-public offering earnings release”), provided that the last reported closing price of our common stock on the NYSE is at least 33% greater than the initial public offering price per share set forth on the cover page of this prospectus:

 

   

for any 10 trading days out of the 15-consecutive full trading day period ending on the closing of the first full trading day immediately following our first post-public offering earnings release; and

 

   

at the closing of the first full trading day immediately following our first post-public offering earnings release.

The lock-up agreements and market standoff agreements described above are subject to a number of exceptions. See “Underwriting” for information about these exceptions and a further description of these agreements. Upon the expiration of the restricted period, substantially all of the securities subject to such transfer restrictions will become eligible for sale, subject to the limitations discussed above.

Goldman Sachs & Co. LLC, as a representative of the underwriters, has advised us that they have no present intent or arrangement to release any shares subject to a lock-up, and will consider the release of any lock-up on a case-by-case basis. Upon a request to release any shares subject to a lock-up, Goldman Sachs & Co. LLC would consider the particular circumstances surrounding the request, including, but not limited to, the length of time before the lock-up expires, the number of shares requested to be released, reasons for the request, the possible impact on the market or our Class A common stock and whether the holder of our shares requesting the release is an officer, director, or other affiliate of ours.

Upon the expiration of the applicable lock-up periods, substantially all of the shares subject to such lock-up restrictions and market stand-off restrictions will become eligible for sale, subject to the limitations discussed above. For additional information, see “Underwriting.”

Rule 144

Affiliate Resales of Restricted Securities

In general, beginning 90 days after the effective date of the registration statement of which this prospectus is a part, a person who is an affiliate of ours, or who was an affiliate at any time during the 90 days before a sale, who has beneficially owned shares of our common stock for at least 180 days would be entitled to sell in “broker’s transactions” or certain “riskless principal transactions,” or to market makers, a number of shares within any three-month period that does not exceed the greater of:

 

   

1% of the number of shares of our Class A common stock then outstanding (including the issuance of shares of our Class A common stock upon the exercise of options by certain selling stockholders in connection with the sale of such shares in this offering); and

 

   

the average weekly trading volume in our Class A common stock on the NYSE during the four calendar weeks preceding the filing of a notice on Form 144 with respect to such sale.

Affiliate resales under Rule 144 are also subject to the availability of current public information about us. In addition, if the number of shares being sold under Rule 144 by an affiliate during any

 

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three-month period exceeds 5,000 shares or has an aggregate sale price in excess of $50,000, the seller must file a notice on Form 144 with the SEC and the NYSE concurrently with either the placing of a sale order with the broker or the execution directly with a market maker.

Non-Affiliate Resales of Restricted Securities

Under Rule 144, a person who is not an affiliate of ours at the time of sale, and has not been an affiliate at any time during the 90 days preceding a sale, and who has beneficially owned shares of our common stock for at least six months but less than a year, is entitled to sell such shares subject only to the availability of current public information about us. If such person has held our shares for at least one year, such person can resell without regard to any Rule 144 restrictions, including the 90-day public company requirement and the current public information requirement.

Non-affiliate resales are not subject to the manner of sale, volume limitation, or notice filing provisions of Rule 144.

Rule 701

In general, under Rule 701, any of our employees, directors, officers, consultants or advisors who purchases shares from us in connection with a compensatory stock or option plan or other written agreement before the effective date of the registration statement of which this prospectus forms a part is entitled to sell such shares 90 days after such effective date in reliance on Rule 144. Our affiliates can resell shares in reliance on Rule 144 without having to comply with the holding period requirement, and non-affiliates of the issuer can resell shares in reliance on Rule 144 without having to comply with the current public information and holding period requirements.

The SEC has indicated that Rule 701 will apply to typical stock options granted by an issuer before it becomes subject to the reporting requirements of the Exchange Act, along with the shares acquired upon exercise of such options, including exercises after an issuer becomes subject to the reporting requirements of the Exchange Act.

Equity Plans

We intend to file one or more registration statements on Form S-8 under the Securities Act to register the offer and sale of all shares of Class A common stock subject to outstanding stock options issued and Class A common stock issuable under our 2012 Plan, as well as Class A common stock subject to equity awards that will be granted under our 2021 Plan and ESPP. As of December 31, 2020, options to purchase 122,472,044 shares of Class A common stock were outstanding. We expect to file the registration statement covering shares offered pursuant to our equity incentive plans shortly after the date of this prospectus, permitting the resale of such shares by non-affiliates in the public market without restriction under the Securities Act and the sale by affiliates in the public market subject to compliance with the resale provisions of Rule 144. See “Executive Compensation—Equity Incentive Plans” for a description of our equity compensation plans.

 

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MATERIAL U.S. FEDERAL INCOME TAX CONSIDERATIONS

FOR NON-U.S. HOLDERS OF COMMON STOCK

The following discussion is a summary of the material U.S. federal income tax considerations for Non-U.S. Holders (as defined below) of the purchase, ownership and disposition of our Class A common stock issued pursuant to this offering, but does not purport to be a complete analysis of all potential tax effects. The effects of other U.S. federal tax laws, such as estate and gift tax laws, and any applicable state, local, or non-U.S. tax laws are not discussed. This discussion is based on the Code, Treasury Regulations promulgated thereunder, judicial decisions, and published rulings and administrative pronouncements of the U.S. Internal Revenue Service, or the IRS, in each case in effect as of the date hereof. These authorities may change or be subject to differing interpretations. Any such change or differing interpretation may be applied retroactively in a manner that could adversely affect a Non-U.S. Holder of our Class A common stock. We have not sought and will not seek any rulings from the IRS regarding the matters discussed below. There can be no assurance the IRS or a court will not take a contrary position to that discussed below regarding the tax consequences of the purchase, ownership, and disposition of our Class A common stock.

This discussion is limited to Non-U.S. Holders that hold our Class A common stock as a “capital asset” within the meaning of Section 1221 of the Code (generally, property held for investment). This discussion does not address all U.S. federal income tax consequences relevant to a Non-U.S. Holder’s particular circumstances, including the impact of the Medicare contribution tax on net investment income. In addition, it does not address consequences relevant to Non-U.S. Holders subject to special rules, including, without limitation:

 

   

U.S. expatriates and former citizens or long-term residents of the United States;

 

   

persons subject to the alternative minimum tax;

 

   

persons holding our Class A common stock as part of a hedge, straddle, or other risk reduction strategy or as part of a conversion transaction or other integrated investment;

 

   

banks, insurance companies, and other financial institutions;

 

   

brokers, dealers, or traders in securities;

 

   

“controlled foreign corporations,” “passive foreign investment companies,” and corporations that accumulate earnings to avoid U.S. federal income tax;

 

   

partnerships or other entities or arrangements treated as partnerships for U.S. federal income tax purposes, and other pass-through entities (and investors in such entities);

 

   

tax-exempt organizations or governmental organizations;

 

   

persons deemed to sell our Class A common stock under the constructive sale provisions of the Code;

 

   

persons who hold or receive our Class A common stock pursuant to the exercise of any employee stock option or otherwise as compensation;

 

   

persons that actually or constructively own 5% or more of our Class A common stock;

 

   

tax-qualified retirement plans;

 

   

“qualified foreign pension funds” as defined in Section 897(l)(2) of the Code and entities all of the interests of which are held by qualified foreign pension funds; and

 

   

persons subject to special tax accounting rules as a result of any item of gross income with respect to the Class A common stock being taken into account in an applicable financial statement.

 

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If an entity treated as a partnership for U.S. federal income tax purposes holds our Class A common stock, the tax treatment of a partner in the partnership will depend on the status of the partner, the activities of the partnership, and certain determinations made at the partner level. Accordingly, partnerships holding our Class A common stock and the partners in such partnerships should consult their tax advisors regarding the U.S. federal income tax consequences to them.

THIS DISCUSSION IS FOR INFORMATIONAL PURPOSES ONLY AND IS NOT TAX ADVICE. INVESTORS SHOULD CONSULT THEIR TAX ADVISORS WITH RESPECT TO THE APPLICATION OF THE U.S. FEDERAL INCOME TAX LAWS TO THEIR PARTICULAR SITUATIONS AS WELL AS ANY TAX CONSEQUENCES OF THE PURCHASE, OWNERSHIP, AND DISPOSITION OF OUR CLASS A COMMON STOCK ARISING UNDER THE U.S. FEDERAL ESTATE OR GIFT TAX LAWS OR UNDER THE LAWS OF ANY STATE, LOCAL, OR NON-U.S. TAXING JURISDICTION OR UNDER ANY APPLICABLE INCOME TAX TREATY.

Definition of a Non-U.S. Holder

For purposes of this discussion, a “Non-U.S. Holder” is any beneficial owner of our Class A common stock that is neither a “U.S. person” nor an entity treated as a partnership for U.S. federal income tax purposes. A U.S. person is any person that, for U.S. federal income tax purposes, is or is treated as any of the following:

 

   

an individual who is a citizen or resident of the United States;

 

   

a corporation created or organized under the laws of the United States, any state thereof, or the District of Columbia;

 

   

an estate, the income of which is subject to U.S. federal income tax regardless of its source; or

 

   

a trust that (1) is subject to the primary supervision of a U.S. court and the control of one or more “United States persons” (within the meaning of Section 7701(a)(30) of the Code), or (2) has a valid election in effect to be treated as a United States person for U.S. federal income tax purposes.

Distributions

As described in the section entitled “Dividend Policy,” we do not anticipate declaring or paying dividends to holders of our Class A common stock in the foreseeable future. However, if we do make distributions of cash or property on our Class A common stock, such distributions will constitute dividends for U.S. federal income tax purposes to the extent paid from our current or accumulated earnings and profits, as determined under U.S. federal income tax principles. Amounts not treated as dividends for U.S. federal income tax purposes will constitute a return of capital and first be applied against and reduce a Non-U.S. Holder’s adjusted tax basis in its Class A common stock, but not below zero. Any excess will be treated as capital gain and will be treated as described below under “—Sale or Other Taxable Disposition.”

Subject to the discussion below on effectively connected income, dividends paid to a Non-U.S. Holder of our Class A common stock will be subject to U.S. federal withholding tax at a rate of 30% of the gross amount of the dividends (or such lower rate specified by an applicable income tax treaty, provided the Non-U.S. Holder furnishes a valid IRS Form W-8BEN or W-8BEN-E (or other applicable documentation) certifying qualification for the lower treaty rate). A Non-U.S. Holder that does not timely furnish the required documentation, but that qualifies for a reduced treaty rate, may generally obtain a refund of any excess amounts withheld by timely filing an appropriate claim for refund with the IRS. Non-U.S. Holders should consult their tax advisors regarding their entitlement to benefits under any applicable income tax treaty.

 

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If dividends paid to a Non-U.S. Holder are effectively connected with the Non-U.S. Holder’s conduct of a trade or business within the United States (and, if required by an applicable income tax treaty, the Non-U.S. Holder maintains a permanent establishment in the United States to which such dividends are attributable), the Non-U.S. Holder will be exempt from the U.S. federal withholding tax described above. To claim the exemption, the Non-U.S. Holder must furnish to the applicable withholding agent a valid IRS Form W-8ECI (or other applicable documentation), certifying that the dividends are effectively connected with the Non-U.S. Holder’s conduct of a trade or business within the United States.

Any such effectively connected dividends will be subject to U.S. federal income tax on a net income basis at the regular graduated rates. A Non-U.S. Holder that is a corporation also may be subject to a branch profits tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty) on such effectively connected dividends, as adjusted for certain items. Non-U.S. Holders should consult their tax advisors regarding any applicable tax treaties that may provide for different rules.

Sale or Other Taxable Disposition

Subject to the discussion below on information reporting, backup withholding, and foreign accounts, a Non-U.S. Holder will not be subject to U.S. federal income tax on any gain realized upon the sale or other taxable disposition of our Class A common stock unless:

 

   

the gain is effectively connected with the Non-U.S. Holder’s conduct of a trade or business within the United States (and, if required by an applicable income tax treaty, the Non-U.S. Holder maintains a permanent establishment in the United States to which such gain is attributable);

 

   

the Non-U.S. Holder is a nonresident alien individual present in the United States for 183 days or more during the taxable year of the disposition and certain other requirements are met; or

 

   

our Class A common stock constitutes a U.S. real property interest, or a USRPI, by reason of our status as a U.S. real property holding corporation, or a USRPHC, for U.S. federal income tax purposes.

Gain described in the first bullet point above generally will be subject to U.S. federal income tax on a net income basis at the regular graduated rates. A Non-U.S. Holder that is a corporation also may be subject to a branch profits tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty) on such effectively connected gain, as adjusted for certain items.

Gain described in the second bullet point above will be subject to U.S. federal income tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty), which may be offset by U.S. source capital losses of the Non-U.S. Holder (even though the individual is not considered a resident of the United States), provided the Non-U.S. Holder has timely filed U.S. federal income tax returns with respect to such losses.

Because the determination of whether we are a USRPHC depends on the fair market value of our USRPIs relative to the fair market value of our non-U.S. real property interests and our other business assets, there can be no assurance we currently are not a USRPHC or will not become one in the future. Even if we are or were to become a USRPHC, gain arising from the sale or other taxable disposition by a Non-U.S. Holder of our Class A common stock will not be subject to U.S. federal income tax if our Class A common stock is “regularly traded,” as defined by applicable Treasury Regulations, on an established securities market, and such Non-U.S. Holder owned, actually and constructively, 5% or less of our Class A common stock throughout the shorter of the five-year period ending on the date of the sale or other taxable disposition or the Non-U.S. Holder’s holding period.

 

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Non-U.S. Holders should consult their tax advisors regarding potentially applicable income tax treaties that may provide for different rules.

Information Reporting and Backup Withholding

Payments of dividends on our Class A common stock will not be subject to backup withholding, provided the applicable withholding agent does not have actual knowledge or reason to know the holder is a United States person and the holder either certifies its non-U.S. status, such as by furnishing a valid IRS Form W-8BEN, W-8BEN-E or W-8ECI, or otherwise establishes an exemption. However, information returns are required to be filed with the IRS in connection with any distributions on our Class A common stock paid to the Non-U.S. Holder, regardless of whether such distributions constitute dividends or whether any tax was actually withheld. In addition, proceeds of the sale or other taxable disposition of our Class A common stock within the United States or conducted through certain U.S.-related brokers generally will not be subject to backup withholding or information reporting, if the applicable withholding agent receives the certification described above and does not have actual knowledge or reason to know that such holder is a United States person, or the holder otherwise establishes an exemption. Proceeds of a disposition of our Class A common stock conducted through a non-U.S. office of a non-U.S. broker generally will not be subject to backup withholding or information reporting.

Copies of information returns that are filed with the IRS may also be made available under the provisions of an applicable treaty or agreement to the tax authorities of the country in which the Non-U.S. Holder resides or is established.

Backup withholding is not an additional tax. Any amounts withheld under the backup withholding rules may generally be allowed as a refund or a credit against a Non-U.S. Holder’s U.S. federal income tax liability, provided the required information is timely furnished to the IRS.

Additional Withholding Tax on Payments Made to Foreign Accounts

Withholding taxes may be imposed under Sections 1471 to 1474 of the Code (such sections commonly referred to as the Foreign Account Tax Compliance Act, or FATCA), on certain types of payments made to non-U.S. financial institutions and certain other non-U.S. entities. Specifically, a 30% withholding tax may be imposed on dividends on, or (subject to the proposed Treasury Regulations discussed below) gross proceeds from the sale or other disposition of, our Class A common stock paid to a “foreign financial institution” or a “non-financial foreign entity” (each as defined in the Code), unless (1) the foreign financial institution undertakes certain diligence and reporting obligations, (2) the non-financial foreign entity either certifies it does not have any “substantial United States owners” (as defined in the Code) or furnishes identifying information regarding each substantial United States owner, or (3) the foreign financial institution or non-financial foreign entity otherwise qualifies for an exemption from these rules. If the payee is a foreign financial institution and is subject to the diligence and reporting requirements in (1) above, it must enter into an agreement with the U.S. Department of the Treasury requiring, among other things, that it undertake to identify accounts held by certain “specified United States persons” or “United States-owned foreign entities” (each as defined in the Code), annually report certain information about such accounts, and withhold 30% on certain payments to non-compliant foreign financial institutions and certain other account holders. Foreign financial institutions located in jurisdictions that have an intergovernmental agreement with the United States governing FATCA may be subject to different rules.

Under the applicable Treasury Regulations and administrative guidance, withholding under FATCA generally applies to payments of dividends on our Class A common stock. Such withholding

 

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may also apply to gross proceeds from the sale or disposition of our Class A common stock, although under recently proposed Treasury Regulations no withholding would apply to such gross proceeds. Taxpayers may rely on these proposed Treasury Regulations until final Treasury Regulations are issued. Under certain circumstances, a non-U.S. holder may be eligible for refunds or credits of the tax.

Prospective investors should consult their tax advisors regarding the potential application of withholding under FATCA to their investment in our Class A common stock.

 

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UNDERWRITING

We, the selling stockholders, and the underwriters named below have entered into an underwriting agreement with respect to the shares of Class A common stock being offered. Subject to certain conditions, each underwriter has severally agreed to purchase the number of shares of Class A common stock indicated in the following table. Goldman Sachs & Co. LLC and Morgan Stanley & Co. LLC are the representatives of the underwriters.

 

Underwriters

   Number of
Shares
 

Goldman Sachs & Co. LLC

                   

Morgan Stanley & Co. LLC

  

Allen & Company LLC

  

Wells Fargo Securities, LLC

  

BofA Securities, Inc.

  

Credit Suisse Securities (USA) LLC

  

Cowen and Company, LLC

  

LionTree Advisors LLC

  

Samuel A. Ramirez & Company, Inc.

  

Siebert Williams Shank & Co., LLC

  
  

 

 

 

Total

  
  

 

 

 

The underwriters are committed to take and pay for all of the shares of Class A common stock being offered, if any are taken, other than the shares of Class A common stock covered by the option described below unless and until this option is exercised. The underwriting agreement also provides that if an underwriter defaults, the purchase commitments of non-defaulting underwriters may also be increased or the offering may be terminated.

The underwriters have an option to buy up to an additional                     shares of Class A common stock from us to cover sales by the underwriters of a greater number of shares of Class A common stock than the total number set forth in the table above. They may exercise that option for 30 days. If any shares of Class A common stock are purchased pursuant to this option, the underwriters will severally purchase shares of Class A common stock in approximately the same proportion as set forth in the table above.

The following table shows the per share and total underwriting discounts and commissions to be paid to the underwriters by us and the selling stockholders. Such amounts are shown assuming both no exercise and full exercise of the underwriters’ option to purchase up to additional shares of Class A common stock from us.

Paid by Us

 

     No
Exercise
     Full
Exercise
 

Per Share

   $                    $                

Total

   $        $    

Paid by the Selling Stockholders

 

     No
Exercise
     Full
Exercise
 

Per Share

   $                  $              

Total

   $        $    

 

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Shares sold by the underwriters to the public will initially be offered at the initial public offering price set forth on the cover of this prospectus. Any shares of Class A common stock sold by the underwriters to securities dealers may be sold at a discount of up to $                     per share from the initial public offering price. After the initial offering of the shares of Class A common stock, the representatives may change the offering price and the other selling terms.

The offering of the shares of Class A common stock by the underwriters is subject to receipt and acceptance and subject to the underwriters’ right to reject any order in whole or in part. Sales of shares of Class A common stock made outside of the United States may be made by affiliates of the underwriters.

A prospectus in electronic format may be made available on the web sites maintained by one or more underwriters, or selling group members, if any, participating in the offering. The underwriters may agree to allocate a number of shares of Class A common stock to underwriters and selling group members for sale to their online brokerage account holders. Internet distributions will be allocated by the representatives to underwriters and selling group members that may make internet distributions on the same basis as other allocations.

We and our executive officers, directors, and holders of substantially all of our Class A common stock, including the selling stockholders, and securities convertible into or exchangeable for our Class A common stock have agreed or will agree with the underwriters, for the restricted period, except with the prior written consent of Goldman Sachs & Co. LLC, not to:

 

   

offer, sell, contract to sell, pledge, grant any option to purchase, make any short sale or otherwise dispose of any shares of Class A common stock, or any options or warrants to purchase any shares of Class A common stock, or any securities convertible into, exchangeable for or that represent the right to receive shares of Class A common stock, or publicly disclose an intention to do any of the foregoing, whether now owned or hereinafter acquired, owned directly by the undersigned (including holding as a custodian) or with respect to which the undersigned has beneficial ownership (as such term is used in Rule 13d-3 of the Exchange Act); or

 

   

enter into any swap or other arrangement that transfers to another, all or a portion of the economic consequences of ownership of our Class A common stock or any securities convertible into or exercisable, or exchangeable for shares of our Class A common stock.

The restrictions described in the immediately preceding paragraph do not apply to certain transfers, dispositions or transactions, including:

 

  (i)

as a bona fide gift or gifts or charitable contribution, or for bona fide estate planning purposes for no value, provided that the done or donees thereof agree to be bound in writing by these restrictions, and provided further that no filing under Section 13 or Section 16 of the Exchange Act nor any other public filing or disclosure of such transfer reporting a reduction in beneficial ownership by or on behalf of the holder shall be required or voluntarily made during the restricted period;

 

  (ii)

to any member of the holder’s immediate family or to any trust for the direct or indirect benefit of the holder or the holder’s immediate family, or if the holder is a trust, to a trustor, trustee or beneficiary of the trust or to the estate of a trustor, trustee or beneficiary of such trust, provided that the trustee of the trust agrees to be bound in writing by these restrictions, provided further that any such transfer shall not involve a disposition for value, and provided further that no filing under Section 13 or Section 16 of the Exchange Act nor any other public filing or disclosure of such transfer reporting a reduction in beneficial ownership by or on behalf of the holder shall be required or voluntarily made during the restricted period;

 

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  (iii)

upon death or by will, testamentary document or intestate succession, provided that the transferee or transferees agree to be bound in writing by these restrictions, and provided further that no filing under Section 13 or Section 16 of the Exchange Act nor any other public filing or disclosure of such transfer reporting a reduction in beneficial ownership by or on behalf of the holder shall be required or voluntarily made during the restricted period;

 

  (iv)

in connection with a sale of the holder’s shares of Class A common stock acquired in open market transactions after the date set forth on the prospectus (other than any shares purchased by an officer or director in the directed share program), provided that no filing under Section 13 or Section 16 of the Exchange Act nor any other public filing or disclosure of such transfer reporting a reduction in beneficial ownership by or on behalf of the holder shall be required or voluntarily made during the restricted period;

 

  (v)

if the holder is a corporation, partnership, limited liability company or other business entity, (A) to another corporation, partnership, limited liability company or other business entity that is an affiliate of the holder, or to any investment fund or other entity controlled or managed by the holder or affiliates of the holder, or (B) as part of a distribution by the holder to its stockholders, partners, members or other equityholders or to the estate of any such stockholders, partners, members or other equityholders, provided that any such transferee agrees to be bound in writing by the restrictions set forth herein, provided that no filing under Section 13 or Section 16 of the Exchange Act nor any other public filing or disclosure of such transfer reporting a reduction in beneficial ownership by or on behalf of the holder shall be required or voluntarily made during the restricted period;

 

  (vi)

to the Company in connection with the vesting or settlement of RSUs or the “net” or “cashless” exercise of options, warrants or other rights to purchase shares of Class A or Class B common stock, provided that any filing made under Section 16 of the Exchange Act shall include a footnote noting the circumstances described in this clause;

 

  (vii)

to the Company in connection with the repurchase of shares of Class A or Class B common stock in connection with the termination of the holder’s relationship with the Company, provided that any filing made under Section 16 of the Exchange Act shall include a footnote noting the circumstances described in this clause;

 

  (viii)

pursuant to a bona fide third-party tender offer, merger, consolidation or other similar transaction made to all holders of our capital stock involving a change of control, provided, that, in the event that such tender offer, merger, consolidation or other similar transaction is not completed, the holder’s Class A common stock shall remain subject to these restrictions;

 

  (ix)

in connection with the conversion or reclassification of the outstanding preferred stock or other classes of capital stock of the Company as described herein, provided, that, any such shares of Class A common stock received upon such conversion or reclassification shall remain subject to these restrictions;

 

  (x)

by operation of law or pursuant to a qualified domestic order or in connection with a divorce settlement or any related court order, provided that any filing made under Section 16 of the Exchange Act shall include a footnote noting the circumstances described in this clause;

 

  (xi)

to the underwriters pursuant to the underwriting agreement; or

 

  (xii)

the holder may enter into any plan designed to satisfy the requirements of Rule 10b5-1 under the Exchange Act, or a 10b5-1 Plan, other than the entry into such a plan in such a manner as to allow the sale of Class A common stock, in each case, within the restricted period, provided, that no sale of common stock may be made under such 10b5-1 Plan during the restricted period, and provided further that to the extent a public announcement or filing under the Exchange Act, if any, is required of or voluntarily made by or on behalf of

 

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  the holder or us regarding the establishment of such plan, such announcement or filing shall include a statement to the effect that no transfer of the holder’s Class A common stock may be made under such plan during the restricted period.

Notwithstanding the foregoing,

 

  A.

up to 15% of the shares of our outstanding Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock (including Included Securities) held by Employee Stockholders may be sold for a 7-trading day period beginning at the commencement of trading on the first trading day on which our Class A common stock is traded on NYSE; and

 

  B.

up to 15% of the shares of our outstanding Class A common stock and securities directly or indirectly convertible into or exchangeable or exercisable for our Class A common stock (including Included Securities) held by Employee Stockholders, plus any first release window eligible shares held by such person not sold during the first release window described in (A) above, may be sold beginning at the opening of trading on the second trading day immediately following our first post-public offering earnings release, provided that the last reported closing price of our common stock on NYSE is at least 33% greater than the initial public offering price per share set forth on the cover page of this prospectus:

 

   

for any 10 trading days out of the 15-consecutive full trading day period ending on the closing of the first full trading day immediately following our first post-public offering earnings release; and

 

   

at the closing of the first full trading day immediately following our first post-public offering earnings release.

Prior to the offering, there has been no public market for the shares of Class A common stock. The initial public offering price will be negotiated among us and the representatives. Among the factors to be considered in determining the initial public offering price of the shares of Class A common stock, in addition to prevailing market conditions, will be our historical performance, estimates of our business potential and earnings prospects, an assessment of our management, and the consideration of the above factors in relation to market valuation of companies in related businesses.

We intend to apply to list our Class A common stock on the NYSE under the symbol “OSCR.”

In connection with the offering, the underwriters may purchase and sell shares of our Class A common stock in the open market. These transactions may include short sales, stabilizing transactions and purchases to cover positions created by short sales. Short sales involve the sale by the underwriters of a greater number of shares of our Class A common stock than they are required to purchase in the offering, and a short position represents the amount of such sales that have not been covered by subsequent purchases. A “covered short position” is a short position that is not greater than the amount of additional shares of our Class A common stock for which the underwriters’ option described above may be exercised. The underwriters may cover any covered short position by either exercising their option to purchase additional shares of Class A common stock or purchasing shares of Class A common stock in the open market. In determining the source of shares to cover the covered short position, the underwriters will consider, among other things, the price of shares of Class A common stock available for purchase in the open market as compared to the price at which they may purchase additional shares of Class A common stock pursuant to the option described above. “Naked” short sales are any short sales that create a short position greater than the amount of additional shares of Class A common stock for which the option described above may be exercised. The underwriters must cover any such naked short position by purchasing shares of Class A common stock in the open market. A naked short position is more likely to be created if the underwriters are concerned that there

 

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may be downward pressure on the price of the Class A common stock in the open market after pricing that could adversely affect investors who purchase in the offering. Stabilizing transactions consist of various bids for or purchases of Class A common stock made by the underwriters in the open market prior to the completion of the offering.

The underwriters may also impose a penalty bid. This occurs when a particular underwriter repays to the underwriters a portion of the underwriting discount received by it because the representatives have repurchased shares of our Class A common stock sold by or for the account of such underwriter in stabilizing or short covering transactions.

Purchases to cover a short position and stabilizing transactions, as well as other purchases by the underwriters for their own accounts, may have the effect of preventing or retarding a decline in the market price of our Class A common stock, and together with the imposition of the penalty bid, may stabilize, maintain, or otherwise affect the market price of the Class A common stock. As a result, the price of the Class A common stock may be higher than the price that otherwise might exist in the open market. The underwriters are not required to engage in these activities and may end any of these activities at any time. These transactions may be effected on the NYSE, in the over-the-counter market or otherwise.

We estimate that our share of the total expenses of the offering, excluding underwriting discounts and commissions, will be approximately $                million. We have agreed to reimburse the underwriters for certain of their expenses in an amount up to $                .

We and the selling stockholders have agreed to indemnify the several underwriters against certain liabilities, including liabilities under the Securities Act.

The underwriters and their respective affiliates are full service financial institutions engaged in various activities, which may include sales and trading, commercial and investment banking, advisory, investment management, investment research, principal investment, hedging, market making, brokerage, and other financial and non-financial activities and services. Certain of the underwriters and their respective affiliates have provided, and may in the future provide, a variety of these services to the issuer and to persons and entities with relationships with the issuer, for which they received or will receive customary fees and expenses.

As of December 31, 2020, Goldman Sachs & Co. LLC and its affiliated funds beneficially owned 7,254 shares of Series A Common Stock, 17,532 shares of Series B Common Stock, and 308,115 shares of Series A6 Preferred Stock. All of the shares of capital stock owned by Goldman Sachs & Co. LLC and its affiliated funds were acquired in arms’ length transactions.

As of December 31, 2020, LionTree Advisors LLC and its affiliates beneficially owned 34,060 shares of Series A Common Stock and 136,220 shares of Series B Common Stock. All of the shares of capital stock owned by LionTree Advisors LLC and its affiliates were acquired in arms’ length transactions.

In the ordinary course of their various business activities, the underwriters and their respective affiliates, officers, directors, and employees may purchase, sell, or hold a broad array of investments and actively traded securities, derivatives, loans, commodities, currencies, credit default swaps and other financial instruments for their own account and for the accounts of their customers, and such investment and trading activities may involve or relate to assets, securities, or instruments of the issuer (directly, as collateral securing other obligations or otherwise) or persons and entities with relationships with the issuer. The underwriters and their respective affiliates may also communicate independent

 

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investment recommendations, market color or trading ideas or publish or express independent research views in respect of such assets, securities, or instruments and may at any time hold, or recommend to clients that they should acquire, long and/or short positions in such assets, securities, and instruments.

Other than in the United States, no action has been taken by us or the underwriters that would permit a public offering of the securities offered by this prospectus in any jurisdiction where action for that purpose is required. The securities offered by this prospectus may not be offered or sold, directly or indirectly, nor may this prospectus or any other offering material or advertisements in connection with the offer and sale of any such securities be distributed or published in any jurisdiction, except under circumstances that will result in compliance with the applicable rules and regulations of that jurisdiction. Persons into whose possession this prospectus comes are advised to inform themselves about and to observe any restrictions relating to the offering and the distribution of this prospectus. This prospectus does not constitute an offer to sell or a solicitation of an offer to buy any securities offered by this prospectus in any jurisdiction in which such an offer or a solicitation is unlawful.

Other Relationships

The underwriters and their respective affiliates are full service financial institutions engaged in various activities, which may include securities trading, commercial and investment banking, financial advisory, investment management, investment research, principal investment, hedging, financing, and brokerage activities.

Certain of the underwriters and their respective affiliates have, from time to time, performed, and may in the future perform, various financial advisory and investment banking services for us, for which they received or will receive customary fees and expenses. For example, certain of the underwriters or their respective affiliates are anticipated to be lenders and/or agents under the New Revolving Credit Facility.

In addition, from time to time, certain of the underwriters and their respective affiliates may effect transactions for their own account or for the account of customers, and hold on behalf of themselves or their customers, long or short positions in our debt or equity securities or loans, and may do so in the future.

Directed Share Program

At our request, the underwriters have reserved for sale at the initial public offering price up to three percent of the shares of Class A common stock offered by this prospectus, to certain individuals through a directed share program, including our provider and distribution partners, and certain other individuals or entities identified by management. If purchased by these persons, these shares of Class A common stock will not be subject to a lock-up restriction, except in the case of shares of Class A common stock purchased by any director or executive officer, which shares of Class A common stock will be subject to the lock-up restrictions described above. The number of shares of Class A common stock available for sale to the general public will be reduced by the number of reserved shares of Class A common stock sold to these persons. Any reserved shares of Class A common stock not purchased by these persons will be offered by the underwriters to the general public on the same terms as the other shares of Class A common stock offered under this prospectus. We have agreed to indemnify the underwriters against certain liabilities and expenses, including liabilities under the Securities Act, in connection with sales of the reserved shares of Class A common stock. Goldman Sachs & Co. LLC will administer our directed share program.

 

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European Economic Area and United Kingdom

In relation to each Member State of the European Economic Area and the United Kingdom, or each a Relevant State, no common stock have been offered or will be offered pursuant to the offering to the public in that Relevant State prior to the publication of a prospectus in relation to the common stock which has been approved by the competent authority in that Relevant State or, where appropriate, approved in another Relevant State and notified to the competent authority in that Relevant State, all in accordance with the Prospectus Regulation, except that offers of common stock may be made to the public in that Relevant State at any time under the following exemptions under the Prospectus Regulation:

 

   

to any legal entity which is a qualified investor as defined in the Prospectus Regulation;

 

   

to fewer than 150 natural or legal persons (other than qualified investors as defined in the Prospectus Regulation), subject to obtaining the prior consent of the representatives; or

 

   

in any other circumstances falling within Article 1(4) of the Prospectus Regulation, provided that no such offer of shares of Class A common stock shall require us or any of our representatives to publish a prospectus pursuant to Article 3 of the Prospectus Regulation or supplement a prospectus pursuant to Article 23 of the Prospectus Regulation and each person who initially acquires any shares of Class A common stock or to whom any offer is made will be deemed to have represented, acknowledged and agreed to, and with each of the representatives and us that it is a “qualified investor” as defined in the Prospectus Regulation.

In the case of any shares of Class A common stock being offered to a financial intermediary as that term is used in Article 5 of the Prospectus Regulation, each such financial intermediary will be deemed to have represented, acknowledged and agreed that the shares of Class A common stock acquired by it in the offer have not been acquired on a nondiscretionary basis on behalf of, nor have they been acquired with a view to their offer or resale to, persons in circumstances which may give rise to an offer of any shares to the public other than their offer or resale in a Member State to qualified investors as so defined, or in circumstances in which the prior consent of the representatives has been obtained to each such proposed offer or resale.

For the purposes of this provision, the expression an “offer of shares to the public” in relation to any shares of Class A common stock in any Member State means the communication in any form and by means of sufficient information on the terms of the offer and the shares to be offered so as to enable an investor to decide to purchase shares, the expression “Prospectus Regulation” means Regulation (EU) 2017/1129 (as amended).

United Kingdom

Each underwriter has represented and agreed that:

 

  (i)

it has only communicated or caused to be communicated and will only communicate or cause to be communicated an invitation or inducement to engage in investment activity (within the meaning of Section 21 of the Financial Services and Markets Act 2000, as amended, or the FSMA) received by it in connection with the issue or sale of the shares of Class A common stock in circumstances in which Section 21(1) of the FSMA does not apply to us; and

 

  (ii)

it has complied and will comply with all applicable provisions of the FSMA with respect to anything done by it in relation to the shares of Class A common stock in, from, or otherwise involving the United Kingdom.

 

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Canada

The securities may be sold in Canada only to purchasers purchasing, or deemed to be purchasing, as principal that are accredited investors, as defined in National Instrument 45-106 Prospectus Exemptions or subsection 73.3(1) of the Securities Act (Ontario), and are permitted clients, as defined in National Instrument 31-103 Registration Requirements, Exemptions, and Ongoing Registrant Obligations. Any resale of the securities must be made in accordance with an exemption form, or in a transaction not subject to, the prospectus requirements of applicable securities laws.

Securities legislation in certain provinces or territories of Canada may provide a purchaser with remedies for rescission or damages if this prospectus (including any amendment thereto) contains a misrepresentation, provided that the remedies for rescission or damages are exercised by the purchaser within the time limit prescribed by the securities legislation of the purchaser’s province or territory. The purchaser should refer to any applicable provisions of the securities legislation of the purchaser’s province or territory for particulars of these rights or consult with a legal advisor.

Pursuant to section 3A.3 of National Instrument 33-105 Underwriting Conflicts (NI 33-105), the underwriters are not required to comply with the disclosure requirements of NI 33-105 regarding underwriter conflicts of interest in connection with this offering.

Hong Kong

The securities may not be offered or sold in Hong Kong by means of any document other than (i) in circumstances which do not constitute an offer to the public within the meaning of the Companies (Winding Up and Miscellaneous Provisions) Ordinance (Cap. 32 of the Laws of Hong Kong), or Companies (Winding Up and Miscellaneous Provisions) Ordinance, or which do not constitute an invitation to the public within the meaning of the Securities and Futures Ordinance (Cap. 571 of the Laws of Hong Kong), or Securities and Futures Ordinance, or (ii) to “professional investors” as defined in the Securities and Futures Ordinance and any rules made thereunder, or (iii) in other circumstances which do not result in the document being a “prospectus” as defined in the Companies (Winding Up and Miscellaneous Provisions) Ordinance, and no advertisement, invitation, or document relating to the securities may be issued or may be in the possession of any person for the purpose of issue (in each case whether in Hong Kong or elsewhere), which is directed at, or the contents of which are likely to be accessed or read by, the public in Hong Kong (except if permitted to do so under the securities laws of Hong Kong) other than with respect to shares of Class A common stock which are or are intended to be disposed of only to persons outside Hong Kong or only to “professional investors” in Hong Kong as defined in the Securities and Futures Ordinance and any rules made thereunder.

Singapore

This prospectus has not been registered as a prospectus with the Monetary Authority of Singapore. Accordingly, this prospectus and any other document or material in connection with the offer or sale, or invitation for subscription or purchase, of the shares of Class A common stock may not be circulated or distributed, nor may the shares of Class A common stock be offered or sold, or be made the subject of an invitation for subscription or purchase, whether directly or indirectly, to persons in Singapore other than (i) to an institutional investor (as defined under Section 4A of the Securities and Futures Act, Chapter 289 of Singapore, or the SFA) under Section 274 of the SFA, (ii) to a relevant person (as defined in Section 275(2) of the SFA) pursuant to Section 275(1) of the SFA, or any person pursuant to Section 275(1A) of the SFA, and in accordance with the conditions specified in Section 275 of the SFA, or (iii) otherwise pursuant to, and in accordance with the conditions of, any other applicable provision of the SFA, in each case subject to conditions set forth in the SFA.

 

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Where the shares of Class A common stock are subscribed or purchased under Section 275 of the SFA by a relevant person which is a corporation (which is not an accredited investor (as defined in Section 4A of the SFA)) the sole business of which is to hold investments and the entire share capital of which is owned by one or more individuals, each of whom is an accredited investor, the securities (as defined in Section 239(1) of the SFA) of that corporation shall not be transferable for 6 months after that corporation has acquired the shares of Class A common stock under Section 275 of the SFA except: (1) to an institutional investor under Section 274 of the SFA or to a relevant person (as defined in Section 275(2) of the SFA), (2) where such transfer arises from an offer in that corporation’s securities pursuant to Section 275(1A) of the SFA, (3) where no consideration is or will be given for the transfer, (4) where the transfer is by operation of law, (5) as specified in Section 276(7) of the SFA, or (6) as specified in Regulation 32 of the Securities and Futures (Offers of Investments) (Shares and Debentures) Regulations 2005 of Singapore, or Regulation 32.

Where the shares are subscribed or purchased under Section 275 of the SFA by a relevant person which is a trust (where the trustee is not an accredited investor (as defined in Section 4A of the SFA)) whose sole purpose is to hold investments and each beneficiary of the trust is an accredited investor, the beneficiaries’ rights and interest (howsoever described) in that trust shall not be transferable for 6 months after that trust has acquired the shares under Section 275 of the SFA except: (1) to an institutional investor under Section 274 of the SFA or to a relevant person (as defined in Section 275(2) of the SFA), (2) where such transfer arises from an offer that is made on terms that such rights or interest are acquired at a consideration of not less than $200,000 (or its equivalent in a foreign currency) for each transaction (whether such amount is to be paid for in cash or by exchange of securities, or other assets), (3) where no consideration is or will be given for the transfer, (4) where the transfer is by operation of law,(5) as specified in Section 276(7) of the SFA, or (6) as specified in Regulation 32.

Japan

The securities have not been and will not be registered under the Financial Instruments and Exchange Act of Japan (Act No. 25 of 1948, as amended), or the FIEA. The securities may not be offered or sold, directly or indirectly, in Japan or to or for the benefit of any resident of Japan (including any person resident in Japan or any corporation or other entity organized under the laws of Japan) or to others for reoffering or resale, directly or indirectly, in Japan or to or for the benefit of any resident of Japan, except pursuant to an exemption from the registration requirements of the FIEA and otherwise in compliance with any relevant laws and regulations of Japan.

Australia

No placement document, prospectus, product disclosure statement, or other disclosure document has been lodged with the Australian Securities and Investments Commission, or ASIC, in relation to the offering. This offering document does not constitute a prospectus, product disclosure statement, or other disclosure document under the Corporations Act 2001, or the Corporations Act, and does not purport to include the information required for a prospectus, product disclosure statement, or other disclosure document under the Corporations Act.

Any offer in Australia of the shares of Class A common stock may only be made to persons, or the Exempt Investors, who are “sophisticated investors” (within the meaning of section 708(8) of the Corporations Act), “professional investors” (within the meaning of section 708(11) of the Corporations Act) or otherwise pursuant to one or more exemptions contained in section 708 of the Corporations Act so that it is lawful to offer the shares of Class A common stock without disclosure to investors under Chapter 6D of the Corporations Act.

 

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The shares of Class A common stock applied for by Exempt Investors in Australia must not be offered for sale in Australia in the period of 12 months after the date of allotment under the offering, except in circumstances where disclosure to investors under Chapter 6D of the Corporations Act would not be required pursuant to an exemption under section 708 of the Corporations Act or otherwise or where the offer is pursuant to a disclosure document which complies with Chapter 6D of the Corporations Act. Any person acquiring shares of Class A common stock must observe such Australian on-sale restrictions.

This offering document contains general information only and does not take account of the investment objectives, financial situation, or particular needs of any particular person. It does not contain any securities recommendations or financial product advice. Before making an investment decision, investors need to consider whether the information in this offering document is appropriate to their needs, objectives, and circumstances, and, if necessary, seek expert advice on those matters.

Dubai International Financial Centre

This offering document relates to an Exempt Offer in accordance with the Offered Securities Rules of the Dubai Financial Services Authority, or DFSA. This offering document is intended for distribution only to persons of a type specified in the Offered Securities Rules of the DFSA. It must not be delivered to, or relied on by, any other person. The DFSA has no responsibility for reviewing or verifying any documents in connection with Exempt Offers. The DFSA has not approved this prospectus nor taken steps to verify the information set forth in this prospectus and has no responsibility for the offering document. The securities to which this offering document relates may be illiquid and/or subject to restrictions on their resale. Prospective purchasers of the securities offered should conduct their own due diligence on the securities. If you do not understand the contents of this offering document you should consult an authorized financial advisor.

Switzerland

We have not and will not register with the Swiss Financial Market Supervisory Authority, or FINMA, as a foreign collective investment scheme pursuant to Article 119 of the Federal Act on Collective Investment Scheme of 23 June 2006, as amended, or CISA, and accordingly the securities being offered pursuant to this prospectus have not and will not be approved, and may not be licensable, with FINMA. Therefore, the securities have not been authorized for distribution by FINMA as a foreign collective investment scheme pursuant to Article 119 CISA and the securities offered hereby may not be offered to the public (as this term is defined in Article 3 CISA) in or from Switzerland. The securities may solely be offered to “qualified investors,” as this term is defined in Article 10 CISA, and in the circumstances set out in Article 3 of the Ordinance on Collective Investment Scheme of 22 November 2006, as amended, or CISO, such that there is no public offer. Investors, however, do not benefit from protection under CISA or CISO, or supervision by FINMA. This prospectus and any other materials relating to the securities are strictly personal and confidential to each offeree, and do not constitute an offer to any other person. This prospectus may only be used by those qualified investors to whom it has been handed out in connection with the offer described in this prospectus and may neither directly or indirectly be distributed or made available to any person or entity other than its recipients. It may not be used in connection with any other offer and shall in particular not be copied and/or distributed to the public in Switzerland or from Switzerland. This prospectus does not constitute an issue prospectus as that term is understood pursuant to Article 652a and/or 1156 of the Swiss Federal Code of Obligations. We have not applied for a listing of the securities on the SIX Swiss Exchange or any other regulated securities market in Switzerland, and consequently, the information presented in this prospectus does not necessarily comply with the information standards set out in the listing rules of the SIX Swiss Exchange and corresponding prospectus schemes annexed to the listing rules of the SIX Swiss Exchange.

 

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LEGAL MATTERS

The validity of the shares of Class A common stock offered hereby will be passed upon for us by Latham & Watkins LLP, New York, New York. Certain legal matters related to this offering will be passed upon for the underwriters by Goodwin Procter LLP, Boston, Massachusetts.                                           has acted as counsel for the selling stockholders in connection with certain legal matters related to this offering. Investment funds affiliated with Latham & Watkins LLP and certain attorneys of the firm own shares of our convertible preferred stock that will be converted into less than 1% of our common stock prior to the closing of this offering.

 

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CHANGE IN ACCOUNTANTS

Dismissal of Deloitte & Touche LLP

Deloitte & Touche LLP, or Deloitte, was previously engaged as our independent auditors to perform an audit of the Company and its subsidiaries’ consolidated financial statements for the years ended December 31, 2018 and 2019 in accordance with auditing standards generally accepted in the United States. On June 12, 2020, Deloitte was dismissed effective immediately, which such action was ratified by the Audit Committee of our board of directors. PricewaterhouseCoopers LLP, or PwC, and Grant Thornton LLP, or Grant Thornton, were each engaged to serve as independent registered public accounting firms for the years indicated, and as further described, below.

The reports of Deloitte on the Company’s consolidated financial statements for the years ended December 31, 2018 and 2019 did not contain any adverse opinion or disclaimer of opinion, nor were such reports qualified or modified as to uncertainty, audit scope, or accounting principles.

During the years ended December 31, 2018 and 2019 and the subsequent interim period through June 12, 2020, Deloitte did not have any “disagreement” (as such term is defined in Item 304(a)(1)(iv) of Regulation S-K and the related instructions thereto) with the Company on any matter of accounting principles or practices, financial statement disclosure or auditing scope or procedure, which disagreement, if not resolved to the satisfaction of Deloitte, would have caused it to make reference to the subject matter of the disagreement in connection with its report on the Company’s consolidated financial statements.

During the years ended December 31, 2018 and 2019 and the subsequent interim period through June 12, 2020, there were no “reportable events” (as such term is defined in Item 304(a)(1)(v) of Regulation S-K and the related instructions thereto).

The Company has provided a copy of this disclosure to Deloitte and requested that they furnish a letter addressed to the Securities and Exchange Commission, or Commission, stating whether or not it agrees with the statements made herein. A copy of the letter, dated November 6, 2020, is filed as an Exhibit to the registration statement of which this prospectus is a part.

Engagement and Dismissal of Grant Thornton LLP

In anticipation of the initial public offering, due to independence matters impeding Deloitte’s ability to provide assurance under the standards of the Public Company Accounting Oversight Board (United States), or PCAOB, on August 25, 2020, Grant Thornton was engaged as the independent registered public accounting firm, which such action was ratified by the Audit Committee of our board of directors, solely to audit the Company’s consolidated financial statements for the year ended December 31, 2019 in accordance with auditing standards generally accepted in the United States and the standards of the PCAOB. Effective upon completion of the audit, the Audit Committee of our board of directors has dismissed Grant Thornton.

During the two most recent years and the subsequent period preceding the engagement of Grant Thornton, the Company did not consult with Grant Thornton with respect to: (i) the application of accounting principles to a specified transaction, either completed or proposed, or the type of audit opinion that might be rendered on the consolidated financial statements, and no written report or oral advice of Grant Thornton was provided that was an important factor considered by us in reaching a decision as to the accounting, auditing, or financial reporting issue; or (ii) any matter that was either the subject of a “disagreement” (as defined in Item 304(a)(1)(iv) of Regulation S-K), or any “reportable event” (as defined in Item 304(a)(1)(v) of Regulation S-K).

 

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The Company has provided a copy of this disclosure to Grant Thornton and requested that they furnish a letter addressed to the Commission stating whether or not it agrees with the statements made herein. A copy of the letter, dated November 6, 2020, is filed as an Exhibit to the registration statement of which this prospectus is a part.

Engagement of PricewaterhouseCoopers LLP

On June 9, 2020, the Audit Committee of our board of directors engaged PwC to serve as our independent auditors to perform an audit of the Company’s consolidated financial statements for the year ended December 31, 2020 in accordance with auditing standards generally accepted in the United States. In anticipation of the initial public offering and upon dismissal of Grant Thornton at the completion of the audit of the Company’s consolidated financial statements for the year ended December 31, 2019, as discussed above, PwC was engaged on November 11, 2020 as our independent registered public accounting firm to audit the Company’s consolidated financial statements as of the year ended December 31, 2020 in accordance with the standards of the PCAOB, contingent upon completion of PwC’s client acceptance procedures.

During the two most recent years and the subsequent period preceding the engagement of PwC, the Company did not consult with PwC with respect to: (i) the application of accounting principles to a specified transaction, either completed or proposed, or the type of audit opinion that might be rendered on the consolidated financial statements, and no written report or oral advice of PwC was provided that was an important factor considered by the Company in reaching a decision as to the accounting, auditing, or financial reporting issue; or (ii) any matter that was either the subject of a “disagreement” (as defined in Item 304(a)(1)(iv) of Regulation S-K), or any “reportable event” (as defined in Item 304(a)(1)(v) of Regulation S-K).

 

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EXPERTS

The consolidated financial statements of Oscar Health, Inc., formerly known as Mulberry Health Inc., as of December 31, 2019 and for the year ended December 31, 2019, included in this prospectus and elsewhere in the registration statement, have been so included in reliance upon the report of Grant Thornton LLP, independent registered public accountants, upon the authority of said firm as experts in accounting and auditing.

The consolidated financial statements of Oscar Health, Inc. as of December 31, 2020 and for the year ended December 31, 2020, included in this prospectus have been so included in reliance on the report of PricewaterhouseCoopers LLP, an independent registered public accounting firm, given on the authority of said firm as experts in auditing and accounting.

 

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WHERE YOU CAN FIND MORE INFORMATION

We have filed with the SEC a registration statement on Form S-1 under the Securities Act with respect to the shares of Class A common stock offered hereby. This prospectus, which constitutes a part of the registration statement, does not contain all of the information set forth in the registration statement or the exhibits and schedules filed with the registration statement. For further information about us and the Class A common stock offered hereby, we refer you to the registration statement and the exhibits filed with the registration statement. Statements contained in this prospectus regarding the contents of any contract or any other document that is filed as an exhibit to the registration statement are not necessarily complete, and each such statement is qualified in all respects by reference to the full text of such contract or other document filed as an exhibit to the registration statement. The SEC also maintains an internet website that contains reports, proxy statements and other information about registrants, like us, that file electronically with the SEC. The address of that website is www.sec.gov.

Upon the closing of this offering, we will be required to file periodic reports, proxy statements, and other information with the SEC pursuant to the Exchange Act. These reports, proxy statements, and other information will be available on the website of the SEC referred to above.

We also maintain a website at www.hioscar.com, through which you may access these materials free of charge as soon as reasonably practicable after they are electronically filed with, or furnished to, the SEC. Information contained on, or that can be accessed through, our website is not a part of this prospectus and the inclusion of our website address in this prospectus is an inactive textual reference only.

 

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OSCAR HEALTH, INC.

TABLE OF CONTENTS

 

     Page number  

Reports of Independent Registered Public Accounting Firms

     F-2  

CONSOLIDATED FINANCIAL STATEMENTS

  

Years ended December 31, 2019 and 2020

  

Consolidated Balance Sheets

     F-4  

Consolidated Statements of Operations and Comprehensive Loss

     F-5  

Consolidated Statements of Convertible Preferred Stock and Stockholders’ Deficit

     F-6  

Consolidated Statements of Cash Flows

     F-7  

Notes to Consolidated Financial Statements

     F-8  

 

F-1


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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors

and Stockholders

Oscar Health, Inc.

(formerly known as Mulberry Health Inc.)

New York, New York

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheet of Oscar Health, Inc. (a Delaware corporation) and subsidiaries (the “Company”) as of December 31, 2019, the related consolidated statements of operations and comprehensive loss, convertible preferred stock and stockholders’ deficit, and cash flows for the year then ended, and the related notes (collectively referred to as the “financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2019, and the results of its operations and its cash flows for the year then ended, in conformity with accounting principles generally accepted in the United States of America.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audit. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are required to be independent with respect to the Company in accordance with U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audit we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audit included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures include examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audit also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audit provides a reasonable basis for our opinion.

/s/ GRANT THORNTON LLP

We have served as the Company’s auditor in 2020.

Hartford, Connecticut

December 16, 2020

 

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Shareholders of Oscar Health, Inc.

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheet of Oscar Health, Inc. and its subsidiaries (the “Company”) as of December 31, 2020, and the related consolidated statements of operations and comprehensive loss, convertible preferred stock and shareholders’ deficit, and cash flows for the year then ended, including the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2020, and the results of its operations and its cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America.

Basis for Opinion

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s consolidated financial statements based on our audit. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit of these consolidated financial statements in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audit we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audit included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audit also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audit provides a reasonable basis for our opinion.

/s/ PricewaterhouseCoopers LLP

Philadelphia, PA

February 4, 2021

We have served as the Company’s auditor since 2020.

 

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CONSOLIDATED BALANCE SHEETS

 

     As of December 31,   
     2019     2020  
     (In thousands, except
share and per share data)
 

ASSETS:

    

Current assets:

    

Cash and cash equivalents

     336,644       826,326  

Short-term investments

     333,753       366,387  

Premium and other receivables, less allowance for doubtful accounts of $3,897 and $4,477, respectively

     30,068       65,322  

Risk adjustment transfer receivable

     25,122       31,157  

Accrued investment income

     1,444       1,862  

Balances due from reinsurance programs

     516,064       579,393  
  

 

 

   

 

 

 

Total current assets

     1,243,095       1,870,447  

Property, equipment, and capitalized software, net

     33,076       35,812  

Long-term investments

     29,475       325,740  

Restricted deposits

     25,079       26,478  

Other assets

     15,763       13,136  

Net deferred tax asset

     426       493  
  

 

 

   

 

 

 

TOTAL ASSETS

   $ 1,346,914   $ 2,272,106  
  

 

 

   

 

 

 

LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT

    

Current liabilities:

    

Benefits payable

     156,557       311,914  

Risk adjustment transfer payable

     298,634       716,370  

Premium deficiency reserve

     12,755       84,571  

Advanced premiums

     25,308       71,904  

Accounts payable and accrued liabilities

     61,724       137,524  

Reinsurance payable

     432,511       343,313  
  

 

 

   

 

 

 

Total current liabilities

     987,489       1,665,596  

Long-term debt

     —         142,487  

Warrant liabilities

     8,819       15,005  
  

 

 

   

 

 

 

Total liabilities

     996,308       1,823,088  

Commitments and contingencies (Note 16)

    

Convertible preferred stock, (Series A, A1, AA, AAA, A4, A5, A6, A7, A8, A9, AA9, A10); $0.00001 par value; 339,262,809 shares authorized; 335,625,349 issued and outstanding; aggregate liquidation preference of $1,295,744 as of December 31, 2019; (Series A, A1, AA, AAA, A4, A5, A6, A7, A8, A9, AA9, A10, A11, A12); $0.00001 par value; 407,156,831 shares authorized; 400,904,302 issued and outstanding; aggregate liquidation preference of $1,745,996 as of December 31, 2020

     1,295,744       1,744,911  

STOCKHOLDERS’ DEFICIT

    

Common stock, Series A, $0.0001 par value, 602,000,000 and 680,000,000 shares authorized; 17,034,585 and 24,875,753 issued and outstanding; Series B common Stock $0.0001 par value, 69,991,713 and 69,487,963 shares authorized, 69,487,963 and 69,487,963 shares issued and outstanding; as of December 31, 2019 and 2020, respectively; Series C $0.00001 par value, 10,000,000 shares authorized, no shares issued and outstanding as of December 31, 2019 and 2020

     2       2  

Treasury stock (943,800 shares)

     (2,923     (2,923

Additional paid-in capital

     70,673       133,255  

Accumulated deficit

     (1,012,863     (1,427,106

Accumulated other comprehensive income (loss)

     (27     879  
  

 

 

   

 

 

 

Total stockholders’ deficit

     (945,138     (1,295,893
  

 

 

   

 

 

 

TOTAL LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT

   $ 1,346,914     $ 2,272,106  
  

 

 

   

 

 

 

See accompanying notes to consolidated financial statements

 

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OSCAR HEALTH, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands, except share and
per share data)
 

REVENUE

    

Premiums before ceded reinsurance

   $ 1,041,145     $ 1,672,339  

Reinsurance premiums ceded

     (572,284     (1,217,304
  

 

 

   

 

 

 

Premiums earned

     468,861       455,035  

Investment income and other revenue

     19,327       7,766  
  

 

 

   

 

 

 

Total revenue

     488,188     462,801  

OPERATING EXPENSES

    

Claims incurred, net

     408,259       309,353  

Other insurance costs (including non-cash stock-based compensation of $17,615 in 2019 and $18,299 in 2020 (Note 12)

     167,851       216,534  

General and administrative expenses (including non-cash stock-based compensation of $15,943 in 2019 and $17,570 in 2020 (Note 12)

     110,682       166,655  

Federal and state assessments

     48,170       81,458  

Health insurance industry fee

     —         19,251  

Premium deficiency reserve expense

     12,615       71,816  
  

 

 

   

 

 

 

Total operating expenses

     747,577       865,067  
  

 

 

   

 

 

 

Loss from operations

     (259,389     (402,266

Interest expense

     —         3,514  
  

 

 

   

 

 

 

Loss before income tax expense

     (259,389     (405,780

Income tax expense

     1,793       1,045  
  

 

 

   

 

 

 

Net loss

     (261,182     (406,825

Other comprehensive income - net of tax

    

Unrealized gain on investments

     17       906  
  

 

 

   

 

 

 

Comprehensive loss

   $ (261,165   $ (405,919
  

 

 

   

 

 

 

Net loss per share attributable to common stockholders, basic and diluted

   $ (3.02   $ (4.72

Weighted-average common shares outstanding, basic and diluted

     86,439,407       87,790,273  

See accompanying notes to consolidated financial statements

 

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OSCAR HEALTH, INC.

CONSOLIDATED STATEMENTS OF CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT

FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2020

 

    Convertible
Preferred Stock

All Series
    Common Stock                                
    Shares
Issued and
Outstanding
    Amount     Shares
Issued and
Outstanding
    Amount     Additional
Paid-In
Capital
    Accumulated
Deficit
    Treasury
Stock
    Other
Comprehensive
Income (Loss)
    Total
Stockholders’
Deficit
 
    ($ in thousands)  

December 31, 2018

    335,625,349     $ 1,295,744       86,108,270     $ 2     $ 36,311     $ (751,681   $ —       $ (44   $ (715,412

Options exercised

    —         —         1,358,078       —         873       —         —         —         873  

Stock repurchased

    —         —         (943,800     —         (69     —         (2,923     —         (2,992

Stock-based compensation

    —         —         —         —         33,558       —         —         —         33,558  

Unrealized gain, net

    —         —         —         —         —         —         —         17       17  

Net loss

    —         —         —         —         —         (261,182     —         —         (261,182
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

December 31, 2019

    335,625,349     $ 1,295,744       86,522,548     $ 2     $ 70,673     $ (1,012,863   $ (2,923   $ (27   $ (945,138

Preferred stock Series A11 issuance, net (Note 9)

    37,287,281       210,943       —         —         —         —         —         —         —    

Recognition of beneficial conversion feature

    —         —         —         —         7,418       (7,418     —         —         —    

Preferred stock Series A12 issuance

    15,600,784       151,240       —         —         —         —         —         —         —    

Exercise of Series A11 Call Option (Note 9)

    12,390,888       86,984       —         —         —         —         —         —         —    

Options exercised

    —         —         7,705,400       —         19,295       —         —         —         19,295  

Stock repurchased

    —         —         —         —         —         —         —         —         —    

Stock-based compensation

    —         —         —         —         35,869       —         —         —         35,869  

Unrealized gain, net

    —         —         —         —         —         —         —         906       906  

Net loss

    —         —         —         —         —         (406,825     —         —         (406,825
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

December 31, 2020

    400,904,302     $ 1,744,911       94,227,948     $ 2     $ 133,255     $ (1,427,106   $ (2,923   $ 879     $ (1,295,893
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying notes to consolidated financial statements

 

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OSCAR HEALTH, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

 

     For the years ended
December 31, 
 
     2019     2020  
     (In thousands)  

CASH FLOWS FROM OPERATING ACTIVITIES:

    

Net loss

   $ (261,182   $ (406,825

Adjustments to reconcile net loss to net cash (used in)/provided by operating activities:

    

Net deferred tax asset

     (426     (67

Net realized gain on sale of financial instruments

     (481     (1,246

Warrant expense

     704       5,101  

Depreciation and amortization expense

     6,899       11,285  

Stock-based compensation expense

     33,558       35,869  

Investment amortization, net of accretion

     (6,649     2,588  

Amortization of debt issuance cost and debt discount

     —         327  

Changes in assets and liabilities:

    

(Increase) / decrease in:

    

Premium and other receivables

     (8,596     (35,254

Risk adjustment transfer receivable

     (25,122     (6,035

Accrued investment income

     115       (417

Balances due from reinsurance programs

     (305,721     (63,329

Other assets

     (11,893     2,627  

Increase / (decrease) in:

    

Benefits payable

     21,432       155,357  

Advanced premiums

     5,509       46,596  

Premium deficiency reserve

     12,615       71,816  

Accounts payable and accrued liabilities

     7,508       75,800  

Reinsurance payable

     274,623       (89,197

Risk adjustment transfer payable

     91,737       417,736  
  

 

 

   

 

 

 

Net cash (used in)/provided by operating activities

     (165,370     222,732  

CASH FLOWS FROM INVESTING ACTIVITIES:

    

Purchase of fixed maturity securities

     (877,670     (1,001,038

Sale of investments

     716,232       489,528  

Maturity of investments

     345,024       182,060  

Purchase of property, equipment and capitalized software

     (25,996     (14,021

Change in restricted deposits

     (7,113     (1,243

Other, net

     36       —    
  

 

 

   

 

 

 

Net cash provided by/(used in) investing activities

     150,513       (344,714

CASH FLOWS FROM FINANCING ACTIVITIES:

    

Proceeds from long-term debt

     —         147,000  

Payments of debt issuance costs

     —         (4,840

Convertible preferred stock and call option issuances

     —         375,671  

Exercise of convertible preferred stock call options

     —         74,581  

Stock options exercised

     873       19,295  

Stock repurchase

     (2,992     —    
  

 

 

   

 

 

 

Net cash (used in)/provided by financing activities

     (2,119     611,707  

Increase/(decrease) in cash, cash equivalents and restricted cash equivalents

     (16,976     489,725  

Cash, cash equivalents, restricted cash and cash equivalents—Beginning of year

     370,356       353,380  
  

 

 

   

 

 

 

Cash, cash equivalents, restricted cash and cash equivalents—end of year

   $ 353,380     $ 843,105  
  

 

 

   

 

 

 

Cash, cash equivalents, restricted cash and cash equivalents—end of year:

    

Cash and cash equivalents

   $ 336,644     $ 826,326  

Restricted cash and cash equivalents included in restricted deposits

     16,736       16,779  
  

 

 

   

 

 

 

Total cash, cash equivalents and restricted cash and cash equivalents

   $ 353,380     $ 843,105  
  

 

 

   

 

 

 

Supplemental Disclosures:

    

Income taxes payments

   $ 1,833     $ 1,525  

See accompanying notes to consolidated financial statements

 

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Table of Contents

OSCAR HEALTH, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

(In thousands, except share and per share amounts, or as otherwise stated herein)

1. ORGANIZATION

Oscar Health, Inc., formerly known as Mulberry Health Inc. (“Oscar” or the “Company” or the “Parent”), is a holding company domiciled in New York and incorporated in Delaware since October 25, 2012. Oscar provides individual health insurance benefits in Arizona, California, Colorado, Florida, Georgia, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Tennessee and Texas markets through its wholly owned subsidiaries Oscar Insurance Corporation (“ONY”), Oscar Health Plan of California (“OCA”), Oscar Insurance Corporation of Ohio (“OOH”), Oscar Garden State Insurance Corporation (“OGS”), Oscar Health Plan, Inc. (“OAZ”), Oscar Buckeye State Insurance Corporation (“OBS”), Oscar Health Plan of New York (“ONYMA”), Oscar Insurance Company of Florida (“OFL”), Oscar Health Plan of Georgia (“OGA”), Oscar Health Plan of Pennsylvania, Inc. (“OPA”), and Oscar Insurance Company (“OTX”). Oscar provides small group health insurance benefits in New York, California, New Jersey and Tennessee. Beginning in 2020, Oscar began offering Medicare Advantage health insurance benefits in New York and Texas. Together, these subsidiaries represent the Company’s health plans which the Company operates as one segment to sell insurance to its members directly as well as through the state-run health care exchanges formed in conjunction with the Patient Protection and Affordable Care Act (“ACA”). The Company’s concierge-like business plan leverages technology to enhance interaction between its members and the medical providers. The Company has arrangements with integrated health systems through its wholly-owned subsidiaries OOH and ONYMA which are consolidated into the Company’s financial results pursuant to the guidance regarding Variable Interest Entities. See Note 2. Summary of Significant Accounting Policies. Integrated health systems include multiple hospitals, health care centers, large independent practice associations, physicians and ancillary providers licensed to provide health care services in the States of Ohio and New York. For the Company’s arrangements with integrated health systems the Company shares 50% of the underwriting risks through shared savings and 50% of net income. For the years ending December 31, 2019 and 2020, the Company incurred $3.6 million and $4.3 million, respectively, of expense through shared savings arrangements, which expense is included in claims incurred, net in the consolidated statement of operations and comprehensive loss.

The Company is affiliated with several medical professional corporations (collectively, “professional corporations”) that employ health care providers to deliver telemedical health care services to its covered member population in various states. As part of the arrangements with the professional corporations, the Company has guaranteed their debt. The Company concluded that the professional corporations are variable interest entities as the Company has guaranteed their debt and the equity at risk is insufficient to finance their activities without additional subordinated financial support from the Company. The Company has determined it has a controlling financial interest in the professional corporations, and, thus, is their primary beneficiary, as the Company has (i) the power to direct the activities of the professional corporations that most significantly impact their economic performance, and (ii) the obligation to absorb losses of the professional corporations that could potentially be significant to it or the right to receive benefits from the professional corporations that could potentially be significant to it. As of December 31, 2019, the collective assets and liabilities of the professional corporations were $1.6 million and $2.7 million, respectively; and for the year ended December 31, 2019, the collective revenues and operating expenses were $5.7 million and $6.6 million, respectively. As of December 31, 2020, the collective assets and liabilities of the professional corporations were $1.9 million and $7.6 million, respectively; and for the year ended December 31, 2020, the collective revenues and operating expenses were $7.6 million and $12.3 million, respectively.

 

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2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of Presentation - The consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Variable Interest Entities - The Company enters arrangements with various entities that are deemed to be variable interest entities (“VIE”). A VIE is an entity that either (1) has equity investors that lack certain essential characteristics of a controlling financial interest (including the ability to control activities of the entity, the obligation to absorb the entity’s expected losses and the right to receive the entity’s expected residual returns) or (2) lacks sufficient equity to finance its own activities without financial support provided by other entities, which in turn would be expected to absorb at least some of the expected losses of the VIE. The Company is deemed a primary beneficiary of a VIE if it has (1) the power to direct the activities of the VIE that most significantly impact the economic performance of the VIE and (2) the obligation to absorb losses of, or the right to receive benefits from, the VIE that could be potentially significant to the VIE. If both conditions are present, the Company is required to consolidate the VIE. OOH and ONYMA are subject to collaborative arrangements with prominent healthcare networks, through which the healthcare networks are entitled to 50% of net income of the entities. Payments to the healthcare networks are treated as expenses to the Company and are included in claims incurred, net.

Use of Estimates - The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of certain assets, liabilities, revenue, and expenses as well as the related disclosures. The Company must often make estimates about effects of matters that are inherently uncertain and will likely change in subsequent periods. Actual results could differ materially from those estimates. Principal areas requiring the use of estimates include health care costs incurred but not yet reported (“IBNR”), reinsurance, premium deficiency reserve (“PDR”), risk adjustment, stock-based compensation, premium receivable allowance and income taxes.

Segment Information - The Company operates and manages its business as one reportable and operating segment.

COVID-19 - The Company is monitoring the ongoing COVID-19 pandemic, which has disrupted the global economy and financial markets. There is a significant amount of uncertainty about the length and severity of the consequences caused by the pandemic. While governmental and non-governmental organizations are engaging in efforts to combat the spread and severity of the COVID-19 pandemic and related public health issues, the full extent to which the outbreak of COVID-19 could impact the Company’s business, results of operations and financial condition is still unknown and will depend on future developments, which are highly uncertain and cannot be predicted. The Company has considered information available to it as of the date of issuance of these financial statements and has not currently experienced significant negative impact to its operations, liquidity or capital resources as a result of the COVID-19 pandemic.

Cash and Cash Equivalents - The Company considers all short-term investments with an original maturity of three months or less when purchased to be cash equivalents.

Restricted Cash and Cash Equivalents - The Company maintains cash, cash equivalents and investments on deposit or pledged to various state agencies as a condition for licensure. These restricted deposits are recorded as long-term, due to the nature of the states’ requirements. The Company’s restricted cash and cash equivalents portion of its restricted deposits are disclosed on its Consolidated Statement of Cash Flows. (See restricted deposits for additional information)

 

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Premiums Earned and Premium and Other Receivables - Premium revenue is recognized over the period that coverage is effective. Premiums billed and received in advance of the coverage period are recorded as advanced premiums. Monthly premiums billed, but not received by the end of the coverage period are classified as premiums receivable. Other receivables include pharmaceutical rebates and other claim related receivables. Allowances are estimated based on the Company’s best information available at the time revenue is recognized and updated each reporting period. Receivables are written off against allowances only when such amounts are determined unrecoverable and all collection attempts have failed. The Company regularly reviews the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.

Affordable Care Act (“ACA”) Premium Stabilization Programs - The Company conducts business primarily in the individual health insurance market and is therefore subject to the Premium Stabilization Programs (“Programs”) of the ACA. These Programs included risk adjustment, reinsurance and risk corridors, of which the reinsurance and risk corridors programs were transitional and only in effect for 2014 through 2016.

Risk Adjustment Transfer Receivables and Payable - The permanent risk adjustment program is designed to mitigate the potential impact of adverse selection and provide stability for health insurers applies to plans sold inside and outside of the insurance exchanges. Under the risk adjustment program, each plan is assigned a risk score based upon demographic information and current year claims information related to its members. Plans with lower than average risk scores will generally pay into the pool, while plans with higher than average risk scores will generally receive distributions. This amount is calculated based on the risk score of the Company’s members. The Company refines its estimate as new information becomes available and the Company receives the final report from Centers for Medicare & Medicaid Service (“CMS”) in August of the following year.

Health Insurance Industry Fee (“HIF”) - The ACA, as amended by the Health Care Education Reconciliation Act, includes an annual, nondeductible insurance industry tax that is levied proportionally across the insurance industry for risk-based health insurance products. The Company is subject to paying this tax. It is calculated based on a ratio of the Company’s applicable net premiums written, compared to the total U.S. health insurance industry applicable net premiums written during the previous calendar year. The Company records the HIF liability in accounts payable and accrued liabilities at the beginning of the calendar year. A corresponding deferred cost is recorded in receivables and other assets that is amortized to health insurance industry fee in the consolidated statement of operations and comprehensive loss using a straight-line method of allocation over the calendar year. There was a one year suspension for 2019, but it resumed in 2020. The fee has been permanently repealed for calendar years beginning in 2021. Refer to Note 7. Regulation for more information.

Reinsurance - The Company is party to quota share reinsurance agreements with two reinsurers under which the reinsurer assumes an agreed percentage of the underlying policies being reinsured and shares all premiums and incurred claims accordingly. All premiums and claims ceded under the Company’s quota share arrangements are shared proportionally with the Company’s reinsurers, up to a claims limit specified in each agreement, which varies from 100% to 105% of ceded premiums for the agreements applicable to the years ended December 31, 2019 and 2020. Reinsurance recoveries are recorded as a reduction to claims incurred, net. To the extent ceded premiums exceed ceded claims and commissions and a specified margin, the Company receives an experience refund. See reconciliation of reinsurance premiums in Note 4. Reinsurance.

The Company also has reinsurance assumed agreements, which is included as an addition to premiums earned in the accompanying consolidated statement of operations and comprehensive loss.

 

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The Company stopped assuming reinsurance on the Tennessee Small Group market for the 2018 policy year and it is currently in run off.

The Company regularly evaluates the financial condition of its reinsurers to minimize exposure to significant losses. For its unauthorized reinsurers, the Company strives to maintain sufficient qualifying assets of the reinsurer in trusts or collateral, mostly in excess of net reinsurance recoverables.

The Company has other reinsurance agreements to limit its losses and individual claims of enrolled members. Premiums for these reinsurance agreements are based on enrollment calculated on a per member, per month basis. Reinsurance recoveries are recorded as reductions to claims incurred, net. The reinsurance coverage does not relieve the Company of its primary obligations. The Company’s reinsurers have ratings from A++ to AA-.

Restricted Deposits - As a condition for licensure, the Company is required to maintain certain funds on deposit or pledged to various state agencies. These funds consist of cash, cash equivalents and investments that the Company records at fair value. The states require that these funds remain on deposit for an indefinite period-of-time and, therefore, the Company classifies these restricted deposits as long-term regardless of the contractual maturity date of the securities held.

Benefits Payable - Medical claims expenses are recognized in the period health care services are provided. Benefits payable include claims reported, but not yet paid (“IBNP”) as well as claims incurred but not reported (“IBNR”) and accrued liabilities resulting from provider risk target arrangements. Risk target arrangements established certain contractual targets and if providers have positive performance to target the accrual is included in benefits payable. IBNR is an actuarial estimate that is based on claim payment patterns, medical cost inflation, historical developments such as claim inventory levels and claim receipt patterns, and other relevant factors. The methods for making such estimates and for establishing the resulting liability are continuously reviewed and any adjustments are reflected in the period determined. Given the extensive degree of judgment in this estimate, it is possible that the Company’s estimates of benefits payable could develop either favorably or unfavorably. Due to the Company’s limited operating history and recent growth, there is greater uncertainty in estimating benefits payable. Additionally, when the Company expands its product offerings, it has limited information with which to develop its anticipated claims liability. The changes in the Company’s estimate of benefits payable may relate to a prior quarter, prior year, or earlier periods. For rollforward of its benefits payable, refer to Note 8. Benefits Payable.

The Company records as part of benefits payable, its best estimate of the ultimate liability for claims disputed by out of network providers based on what the Company considers usual and customary allowed charges and any related uncertainty at arriving at mutually agreed upon rates. As these liabilities are part of the overall claim reserve, they are proportionally ceded to the Company’s quota-share reinsurers for historical policy years with contracts in force. At December 31, 2019 and December 31, 2020, settlements reserves were approximately $41 million and $109 million, respectively.

The completion factor development method is utilized for ACA and Medicare Advantage claims under $0.25 million and $0.1 million, respectively, and is supplemented by the incurred claim methodology for the most recent incurral months. A seriatim methodology is utilized for ACA and Medicare Advantage claims over $0.25 million and $0.1 million, respectively, supplemented by case management data supplied by medical and claims operations areas. Claims reserve triangle analytical cohorts are segmented by plan type within a given state and region, and all reserves are determined separately incorporating the current inventory of claims in course of settlement. The reserve model incorporates historical reserve testing and detail on prior period development down to the incurral month. Claims reserve triangles are inclusive of medical and behavioral health claims only. Pharmacy

 

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costs represent payments for members’ prescription drug benefits, net of rebates from drug manufacturers. Receivables for such pharmacy rebates are included in other receivables in the Company’s consolidated balance sheet. Pharmacy claims are point of sale claims and have no runoff.

Premium Deficiency Reserve (“PDR”) - Premium deficiency reserve liabilities are established when it is probable that expected future claims and maintenance expenses will exceed future premium and reinsurance recoveries on existing medical insurance contracts without consideration of investment income. For purposes of determining premium deficiency losses, contracts are grouped consistent with the Company’s method of acquiring, servicing, and measuring the profitability of such contracts which is generally on a line of business basis.

Other Insurance Costs - Other insurance costs primarily include wages, benefits, marketing, rent, costs of software and hardware, distribution costs, unallocated claims adjustment expenses, and administrative costs associated with functions that are necessary to support the Company health insurance business and are net of ceding commissions. Such functions include, but are not limited to, information systems, legal, finance, compliance, concierge and claims processing. Marketing expenses include short duration policy acquisition costs which are expensed as incurred. Policy acquisition costs are those costs that relate directly to the successful acquisition of new and renewal insurance policies. Such costs include commissions, costs of policy issuance, and other costs the Company incur to acquire new business or renew existing business. The Company expenses policy acquisition costs related to its employer-group prepaid health services policies as incurred. These short-duration employer-group prepaid health services policies typically have a 1-year term, are paid and expensed on a monthly basis and may be canceled upon 30 days notice by the employer group. Marketing and commissions costs for the years ended December 31, 2019 and 2020 were $45.9 million and $94.1 million, respectively.

General and Administrative Expenses - General and administrative expenses primarily include wages, benefits, research and development, costs of software and hardware and administrative costs for the Company’s corporate and technology functions. Such functions include, but are not limited to, information systems, executive management, legal, and finance.

Federal and State Assessments - Federal and State Assessments represent non-income tax charges from federal and state governments, including but not limited to healthcare exchange user fees, premium taxes, and franchise taxes. The Company wholly-owns health insurance companies that file state statutory reports and are liable for Premium Taxes.

Property, Equipment and Capitalized Software - Property, equipment and capitalized software are recorded at cost and presented net of accumulated depreciation. Depreciation and amortization expense is recognized on a straight-line basis over the estimated useful lives of the related assets ranging between 3 and 10 years. The Company recorded depreciation and amortization expense of $6.9 million for the year ended December 31, 2019, of which $5.8 million is allocated to other insurance costs and $1.1 million is allocated to general and administrative expenses; and $11.3 million for the year ended December 31, 2020, of which $9.6 million is allocated to other insurance costs and $1.7 million is allocated to general and administrative expenses. The Company capitalizes costs incurred related to certain software projects for internal use incurred during the application development stage. Costs related to planning activities and post implementation activities are expensed as incurred. Internal-use software is amortized on a straight-line basis over its estimated useful life, which generally is three years. The Company evaluates the useful lives of these assets on an annual basis and tests for impairment whenever events or changes in circumstances occur that could impact the recoverability of these assets.

 

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Impairment of Long-Lived Assets - A review of long-lived assets for impairment is performed when events or changes in circumstances indicate that the carrying value of such assets may not be recoverable. If an indication of impairment is present, the Company compares the estimated undiscounted future cash flows to be generated by the asset group to the asset group’s carrying amount. If the undiscounted future cash flows are less than the carrying amount of the asset group, the Company records an impairment loss equal to the amount by which the asset group’s carrying amount exceeds its fair value. The fair value is determined based on valuation techniques such as a comparison to fair values of similar assets or using a discounted cash flow analysis.

This fair value measurement is based on significant inputs that are not observable in the market and thus represents Level 3 inputs. Significant changes in the underlying assumptions used to value long lived assets could significantly increase or decrease the fair value estimates used for impairment assessments.

Long lived assets that do not have indefinite lives are amortized/depreciated over their useful lives and reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable. The Company reevaluates the useful life determinations each year to determine whether events and circumstances warrant a revision to the remaining useful lives.

Leases - For lease agreements in which the Company is the lessee and that provide for escalating rent payments or rent-free occupancy periods, the Company recognizes rent expense on a straight-line basis over the noncancelable lease term and option renewal periods in which failure to exercise such options would result in an economic penalty in such amount that renewal appears, at the inception of the lease, to be reasonably assured. The Company records deferred rent in accounts payable and accrued liabilities on the consolidated balance sheet. The lease term commences on the date that the Company takes possession of or controls the physical use of the property.

Accounts Payable and Accrued Liabilities - Accounts payable and accrued liabilities include accrued general and administrative expenses and other insurance costs.

Stock-Based Compensation - The Company accounts for stock-based awards to employees in accordance with the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 718, Compensation—Stock Compensation (“ASC 718”). Employee options are valued on the date of grant, using the Black-Scholes-Merton option-pricing model and are expensed on a straight-line basis over the related service period (generally the vesting period) of the award. Both, option and stock awards, generally vest over a period of 4 years and are exercisable up to 10 years from the date of grant.

The Company made an accounting policy election to account for forfeitures as they occur and stop estimating a forfeiture rate in accordance with ASC 718. This change has been applied on a modified retrospective basis.

Investments - The Company regularly evaluates its investments in debt securities to determine if a decline in value is other-than-temporary. When evaluating these declines, the Company assesses the severity of the loss relative to its original cost, the time that the market value has been less than its original cost and considers the Company’s intent to retain the investments for a long enough period to allow for a sufficient market recovery. If a decline in the value of a debt security is considered other-than-temporary, the Company reduces the investment through a charge to the consolidated statement of operations and comprehensive loss. No adjustments were necessary during the period presented. The Company considers investments with maturities of twelve months or longer when purchased as long term investments.

 

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Fair Value Measurements - Fair value represents the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that is determined based on assumptions that market participants would use in pricing an asset or a liability. Assets and liabilities recorded at fair values are measured in accordance with a three-tier fair value hierarchy based on the observability of the inputs available in the market used to measure fair value:

Level 1 - Quoted prices in active markets for identical assets or liabilities.

Level 2 - Observable inputs other than quoted prices in active markets for identical assets and liabilities, quoted prices for identical or similar assets or liabilities in inactive markets, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3 - Inputs that are generally unobservable and typically reflect management’s estimate of assumptions that market participants would use in pricing the assets or liability.

The Company’s financial assets including cash equivalents and investments are measured at fair value on a recurring basis.

Income Taxes - The Company records deferred tax assets (“DTAs”) and deferred tax liabilities (“DTLs”) based on differences between the book and tax bases of assets and liabilities. The deferred tax assets and liabilities are calculated by applying enacted tax rates and laws to taxable years in which such differences are expected to reverse.

The Company continually reviews the need for, and the adequacy of, a valuation allowance and recognizes the benefits from the Company’s deferred tax assets only when an analysis of both positive and negative factors indicate that it is more likely than not that the benefits will be realized. With respect to net operating losses, tax credits, and deferred taxes the Parent funds its subsidiaries as such attributes are consolidated from the Company’s subsidiaries and realized by Oscar Health, Inc. The Company has recorded a valuation allowance on the value of the deferred tax assets as of December 31, 2019 and 2020.

Oscar files a consolidated federal income tax return on behalf of itself and substantially all of its various operating subsidiaries. The Company’s Ohio entity is considered outside of the U.S. Consolidated group and files tax returns separately. Oscar files as part of a unitary group in various states. Often, application of tax rules within the various jurisdictions is subject to differing interpretation. An analysis is performed of the amount at which each tax position meets a “more likely than not” standard for sustainability upon examination by taxing authorities. Only tax benefit or provision amounts meeting or exceeding this standard will be reflected in the tax expense and deferred tax balances. At present, the Company has not recorded any tax amounts which fail to meet this standard. Any differences between the amounts of tax benefits reported on tax returns and tax benefits reported in the financial statements will be recorded as a liability for unrecognized tax benefits. Any liability for unrecognized tax benefits would be reported separately from deferred tax assets and liabilities. Refer to Note 17. Income Taxes for additional information.

Net Loss Per Share - The Company follows the two-class method when computing net loss per share as the Company has issued shares that meet the definition of participating securities. The two-class method determines net loss per share for each class of common and participating securities according to dividends declared or accumulated and participation rights in undistributed earnings. The two-class method requires income or loss available to common stockholders for the period to be allocated between common and participating securities based upon their respective rights to receive dividends as if all income or losses for the period had been distributed. In connection with the triggering

 

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of the beneficial conversion feature associated with the issuance of Series A 11 convertible preferred stock during the year ended December 31, 2020 (see Note 10. Convertible Preferred Stock - Conversion), the $7.4 million charge to accumulated deficit is reflected as a deemed dividend in the calculation of net loss per share. Accordingly, net loss attributable to common stockholders has been increased by $7.4 million resulting in net loss per share of $4.72.

The rights, including the liquidation and dividend rights, of the holders of Series A and Series B common stock are identical, except with respect to voting. As such, the undistributed losses are allocated on a proportionate basis and the resulting net loss per share attributable to common stockholders were, therefore, the same for both Series A and Series B common stock on an individual or combined basis. The Company has treated Series A and Series B common stock as one class for net loss per share purposes.

Basic net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net loss attributable to common stockholders is computed by adjusting net losses attributable to common stockholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net loss per share attributable to common stockholders is computed by dividing the diluted net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares.

The Company’s convertible preferred stock contractually entitles the holders of such shares to participate in dividends, but contractually does not require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders since dilutive common shares are not assumed to have been issued, as their effect is anti-dilutive. The Company reported net losses attributable to common stockholders for the year ended December 31, 2019 and 2020.

Recently Adopted Accounting Pronouncements

In May 2014, the FASB issued Accounting Standards Update (“ASU”) No. 2014-09,Revenue from Contracts with Customers (Topic 606)” (“ASU 2014-09”) as modified by ASU No. 2015-14,Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date,” ASU 2016-08,Revenue from Contracts with Customers (Topic 606): Principal versus Agent Considerations (Reporting Revenue Gross versus Net),” ASU No. 2016-10,Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing,” ASU No. 2016-12,Revenue from Contracts with Customers (Topic 606): Narrow-Scope Improvements and Practical Expedients,” and ASU 2016-20,Revenue from Contracts with Customers (Topic 606): Technical Corrections and Improvements.” ASU 2014-09 supersedes existing revenue recognition standards with a single model unless those contracts are within the scope of other standards. The Company early-adopted the standard effective January 1, 2019. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

In January 2016, the FASB issued ASU 2016-01,Financial Instruments—Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). The new guidance changes the current accounting related to (i) the classification and measurement of certain equity investments, (ii) the presentation of changes in the fair value of financial liabilities measured under the fair value option that are due to instrument-specific credit risk, and (iii) certain disclosures associated with the fair value of financial instruments. Most notably, ASU 2016-01 requires that equity investments, with certain exemptions, be measured at fair value with changes in fair value recognized in net income as opposed to

 

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other comprehensive income. This guidance was effective for the Company for fiscal years beginning after December 15, 2018 and for interim periods within fiscal years beginning after December 15, 2019. The Company adopted the standard effective January 1, 2019. The adoption of this standard did not have an impact on the Company’s consolidated financial statements.

In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows: Classification of Certain Cash Receipts and Cash Payments, (Topic 230)” (“ASU 2016-15”), which amends the guidance in ASC 230 on the classification of certain cash receipts and payments in the statement of cash flows. This standard clarifies the classification of certain cash receipts and cash payments in the statement of cash flows, including debt prepayment or extinguishment costs, settlement of contingent consideration arising from a business combination, insurance settlement proceeds, and distributions from certain equity method investees. The amendments are effective for the Company for fiscal years beginning after December 15, 2018, and interim periods within fiscal years beginning after December 15, 2019. The Company adopted this standard effective January 1, 2019. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

In June 2018, the FASB issued ASU 2018-07 (Topic 718); Improvements to Non-employee Share-Based Payment Accounting (Topic 718). This standard expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from non-employees. FASB clarified that Topic 718 does not apply to shares-based payments used to effectively provide financing to the issuer or awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under ASC 606, Revenue from Contracts with Customers. The standard is effective for the Company as of January 1, 2020. Early adoption is permitted. The Company early-adopted the standard effective January 1, 2019. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

In August 2018, the FASB issued ASU 2018-13, “Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement,” (“ASU 2018-13”). The amendments in ASU 2018-13 eliminate, add, and modify certain disclosure requirements for fair value measurements. The amendments are effective for interim and annual periods beginning after December 15, 2019, with early adoption permitted for either the entirety of ASU 2018-13 or only the provisions that eliminate or modify disclosure requirements. The Company adopted the standard effective January 1, 2020. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

In November 2018, the FASB issued ASU 2018-18, “Collaborative Arrangements (Topic 808): Clarifying the Interaction Between Topic 808 and Topic 606” (“ASU 2018-18”). The amendments in ASU 2018-18 clarify that certain transactions between collaborative arrangement participants should be accounted for as revenue under ASC 606 when the collaborative arrangement participant is a customer in the context of a unit of account. The amendments under ASU 2018-18 are effective for interim and annual fiscal periods beginning after December 15, 2019, with early adoption permitted. The amendments in ASU 2018-18 should be applied retrospectively to the date of initial application of ASC 606. The Company adopted the standard effective January 1, 2020. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

Recently Issued Accounting Pronouncements

From time to time, new accounting pronouncements are issued by the FASB or other standard setting bodies that the Company adopts as of the specified effective date. The Company is an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until such time as those standards

 

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apply to private companies. The Company has elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it is (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, these financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates.

In February 2016, the (FASB) issued (ASU) 2016-02, “Leases (Topic 842)” (ASU 2016-02). Under ASU 2016-02, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both finance and operating leases. For leases with a term of 12 months or less, an entity can elect to not recognize lease assets and lease liabilities and expense the lease over a straight-line basis for the term of the lease. ASU 2016-02 will require new disclosures that depict the amount, timing, and uncertainty of cash flows pertaining to an entity’s leases. Companies are required to adopt the new standard using a modified retrospective approach for annual and interim periods beginning after December 15, 2018. In November 2019, the FASB issued guidance delaying the effective date for all entities, except for public business entities. This guidance is effective for the Company for annual periods beginning after December 15, 2021 and interim periods within fiscal years beginning after December 15, 2022. Early adoption is permitted. The Company is currently evaluating the effect that the adoption of ASU 2016-02 will have on its consolidated financial statements.

In June 2016, the FASB issued ASU 2016-13,Financial Instruments—Credit Losses (Topic 326)” (“ASU 2016-13”), which requires entities to use a current expected credit loss model (“CECL”), which is a new impairment model based on expected losses rather than incurred losses. Under this model, an entity would recognize an impairment allowance equal to its current estimate of all contractual cash flows that the entity does not expect to collect from financial assets measured at amortized cost. The entity’s estimate would consider relevant information about past events, current conditions, and reasonable and supportable forecasts, which will result in recognition of lifetime expected credit losses upon loan origination. In November 2018, the FASB issued ASU No. 2018-19,Codification Improvements to Topic 326, Financial Instruments-Credit Losses,” which narrowed the scope and changed the effective date for non-public entities for ASU 2016-13. The FASB subsequently issued supplemental guidance within ASU 2019-05,Financial Instruments-Credit Losses (Topic 326): Targeted Transition Relief” (‘‘ASU 2019-05’’) and ASU 2020-02, “Financial Instruments-Credit Losses (Topic 326) and Leases (Topic 842) (“ASU 2020-02”). ASU 2019-05 provides an option to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost basis. ASU 2020-02, as it relates to CECL, provides amendments to SEC paragraphs pursuant to SEC Staff Accounting Bulletin No. 119. In November 2019, the FASB issued guidance delaying the effective date for all entities, except for public business entities. ASU 2016-13 is effective for the Company for annual periods beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted. The Company is currently assessing the effect that the adoption of ASU 2016-13 will have on its consolidated financial statements.

In August 2018, the FASB issued ASU 2018-15,Intangibles-Goodwill and Other-Internal-Use Software: Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement that is a Service Contract” (“ASU 2018-15”), which requires implementation costs incurred by customers in cloud computing arrangements (i.e., hosting arrangements) to be capitalized under the same premises of authoritative guidance for internal-use software, and deferred over the non-cancellable term of the cloud computing arrangements plus any option renewal periods that are reasonably certain to be exercised by the customer or for which the exercise is controlled by the service provider. The guidance is effective for the Company for annual periods beginning after December 15, 2020, and interim periods beginning after December 15, 2021. Early adoption is

 

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permitted. The Company currently anticipates that the adoption of ASU 2018-15 will not have a material impact on its financial statements.

In November 2019, the FASB issued ASU 2019-11,Codification Improvements to Topic 326, Financial Instruments—Credit Losses” (“ASU 2019-11”). In May 2019, the FASB issued ASU 2019-05,Financial Instruments—Credit Losses (Topic 326): Targeted Transition Relief.” In April 2019, the FASB issued ASU 2019-04,Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments.” In November 2018, the FASB issued ASU 2018-19,Codification Improvements to Topic 326, Financial Instruments—Credit Losses.” These updates provide an option to irrevocably elect to measure certain individual financial assets at fair value instead of amortized cost and provide additional clarification and implementation guidance on certain aspects of the previously issued ASU 2016-13 and have the same effective date and transition requirements as ASU 2016-13. The effect of a prospective transition approach is to maintain the same amortized cost basis before and after the date of adoption. ASU 2016-13 is effective for the Company for annual periods beginning after December 15, 2022, including interim periods within those fiscal years. The Company is currently evaluating the effects the adoption of ASU 2019-11 will have on its consolidated financial statements.

In December 2019, the FASB issued ASU 2019-12,Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes” (“ASU 2019-12”). The amendments in ASU 2019-12 remove certain exceptions to the general principles in ASC Topic 740. The amendments also clarify and amend existing guidance to improve consistent application. The amendments are effective for the Company’s annual reporting periods beginning after December 15, 2020, with early adoption permitted. The transition method (retrospective, modified retrospective, or prospective basis) related to the amendments depends on the applicable guidance, and all amendments for which there is no transition guidance specified are to be applied on a prospective basis. The Company is currently evaluating the effects the adoption of ASU 2019-12 will have on its consolidated financial statements.

3. PREMIUMS EARNED

Direct policy premiums include premiums directly from members and premiums collected from CMS as part of Advanced Premium Tax Credit program (“APTC”). For the years ended December 31, 2019 and 2020, $563,990 and $1,368,648 were revenues received from CMS for APTC. The Company also records the impact of risk adjustment to premiums earned based on year-to-date health plan experience which are reasonably estimable (see “Risk Adjustment” below). In 2019, the Company sold its rights to some of its risk corridor claims and the effect on premiums earned was $20.0 million. The underlying claim was settled in 2020 when the Company received proceeds from CMS of $64.5 million which was partially offset by $12.1 million of legal fees and federal and state assessments (see “Risk Corridor claims” below). The following table illustrates the components of premiums earned for the years ended December 31, 2019 and 2020.

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

Premiums earned

    

Direct policy premiums

   $ 1,325,760     $ 2,287,319  

Premiums assumed

     455       299  
  

 

 

   

 

 

 

Direct and assumed premiums

     1,326,215       2,287,618  

Risk adjustment and corridor, net

     (285,070     (615,279
  

 

 

   

 

 

 

Premiums before ceded reinsurance

     1,041,145       1,672,339  

Reinsurance premiums ceded

     (572,284     (1,217,304
  

 

 

   

 

 

 

Total

   $ 468,861     $ 455,035  
  

 

 

   

 

 

 

 

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Risk Adjustment: Risk Adjustment is a program of the ACA administered federally by CMS. Generally speaking, insurance plans with younger healthier members must return some of their collected premium to a pool and insurance companies with older sicker members receive from the pool. However, the New York Department of Financial Services (“NY DFS”), initiated the imposition of a program seeking to limit these transfers (i.e., payers pay less and receivers receive less). Such limitation by NY DFS has been referred to as the “Haircut”. The Company had previously recorded a receivable $23.2 million for the Haircut as of December 31, 2019. In 2017, carriers initiated a lawsuit against the NY DFS to reverse the imposition of the Haircut since large carriers would be required to pay back some of the Risk Adjustment funds they received from CMS. In July 2020, a final decision regarding the large carriers lawsuit was issued in the large carriers’ favor. This final decision could potentially be appealed to the Supreme Court, however, the issuance of the final decision represents a significant change in facts subsequent to December 31, 2019. As a consequence, in 2019 the Company wrote off a receivable of $23.2 million and recognized a total charge of $16.1 million which was net of reinsurance of $7.2 million.

Risk Corridor claims: The ACA and the implementing regulations at 45 C.F.R. Part 153 established a temporary risk corridor (“Risk Corridor”) program covering issuers of qualified health plans in the Individual and Small Group markets for the 2014, 2015, and 2016 benefit years. However, this temporary program was defunded and the federal government did not pay out recoveries to participants, and insurance carriers had higher losses than were anticipated or priced. A class action lawsuit was filed on behalf of a number of participating insurance carriers (including the Company) to require the government to pay amounts owed to insurance carriers under the Risk Corridor temporary program. A litigation finance company paid approximately $30 million to the Company to “factor” a portion of the Company’s potential recovery receivable (Risk Corridor claim of approximately $210 million). While the $30.0 million received from the factored potential receivable has been recorded in revenue through 2019, $10.0 million in 2018 and $20.0 million in 2019, there was no existing potential recoverable amount on the Company’s books at December 31, 2019, for the Risk Corridor.

4. REINSURANCE

The Company has quota share reinsurance treaties with two reinsurers under which the reinsurer assumes an agreed percentage of the underlying policies being reinsured and shares all premiums and incurred claims accordingly. All premiums and claims ceded under the Company’s quota share arrangements are shared proportionally with its reinsurers, up to a limit specified in each agreement. The Company also receives ceding commission, which is based on a percentage of ceded premiums, and the reinsurer retains a margin. The Company’s reinsurance contracts have an ultimate net loss ratio that limits its reinsurers’ exposure and beyond which claims shall no longer be ceded out to the reinsurer. To the extent ceded premiums exceed ceded claims, commissions and a specified margin, the Company receives an experience refund.

The Company reports assumed reinsurance premiums in premiums earned on the consolidated statements of operations and comprehensive loss. Refer to Note 2. Summary of Significant Accounting Policies for more information.

 

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The following table reconciles total reinsurance premiums ceded and assumed included in premiums earned in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2019 and 2020.

 

     For the years ended
December 31,
 
     2019     2020  
    

(In thousands)

 

Reinsurance premiums

    

Reinsurance premiums ceded prior to experience refund

   $ (587,864   $ (1,308,275

Experience refund

     15,580       90,971  
  

 

 

   

 

 

 

Reinsurance premiums ceded

     (572,284     (1,217,304

Assumed reinsurance

     455       299  
  

 

 

   

 

 

 

Total

   $ (571,829   $ (1,217,005
  

 

 

   

 

 

 

The Company records claims expense net of reinsurance recoveries. The following table reconciles the total direct claims expense to the net claims expense as presented in the consolidated statement of operations and comprehensive loss for the years ended December 31, 2019 and 2020.

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

Claims incurred, net

    

Direct claims incurred

   $ 924,256     $ 1,364,432  

Private reinsurance losses ceded

     (516,144     (1,055,371

Assumed reinsurance

     147       292  
  

 

 

   

 

 

 

Total

   $ 408,259     $ 309,353  
  

 

 

   

 

 

 

The Company records other insurance costs net of ceding commission. The following table reconciles other insurance costs as presented in the consolidated statement of operations and comprehensive loss for the years ended December 31, 2019 and 2020.

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

Other insurance costs, net

    

Other insurance costs

   $ 233,442     $ 343,374  

Ceding commissions

     (65,591     (126,840
  

 

 

   

 

 

 

Total

   $ 167,851     $ 216,534  
  

 

 

   

 

 

 

 

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The Company records balances due from reinsurance programs within current assets in its consolidated balance sheets. The following table summarizes balances due from reinsurance programs at December 31, 2019 and 2020.

 

     As of December 31,  
     2019      2020  
     (In thousands)  

Balances due from reinsurance programs

     

Reinsurance ceded claim recoveries

   $ 448,748      $ 435,331  

Reinsurance ceding commissions

     49,631      41,586  

Experience refunds on reinsurance contracts

     17,685        102,476  
  

 

 

    

 

 

 

Total

   $ 516,064      $ 579,393  
  

 

 

    

 

 

 

5. INVESTMENTS

A summary of investments by major security type is as follows at December 31, 2019 and 2020:

 

     As of December 31, 2019  
     Amortized
Cost
     Unrealized
Gains
     Unrealized
Losses
    Fair Value  
     (In thousands)  

U.S. treasury and agency securities

   $ 270,259      $ —        $ (2   $ 270,257  

Corporate notes

     56,975        —          (25     56,950  

Certificate of deposit

     25,304        —          —         25,304  

Commercial paper

     10,717        —          —         10,717  
  

 

 

    

 

 

    

 

 

   

 

 

 

Total

   $ 363,255      $ —        $ (27   $ 363,228  
  

 

 

    

 

 

    

 

 

   

 

 

 

 

     As of December 31, 2020  
     Amortized
Cost
     Unrealized
Gains
     Unrealized
Losses
    Fair Value  
     (In thousands)  

U.S. treasury and agency securities

   $ 523,809      $ 562      $ (2   $ 524,369  

Corporate notes

     159,461        262        (58     159,665  

Commercial paper

     7,043                   7,043  

Certificate of deposit

     1,050                   1,050  
  

 

 

    

 

 

    

 

 

   

 

 

 

Total

   $ 691,363      $ 824      $ (60   $ 692,127  
  

 

 

    

 

 

    

 

 

   

 

 

 

At December 31, 2019 and 2020, the securities classified as current available-for-sale mature within one year or less are as follows:

 

     As of December 31, 2019  
     Number of
Securities
     Fair Value      Gross
Unrealized
Losses
 
     (In thousands)  

Investments twelve months or less

        

U.S. treasury and agency securities

     59      $ 270,257      $ (2

Corporate notes

     80        56,950        (25

Certificate of deposit

     19        25,304        —    

Commercial paper

     14        10,717        —    
  

 

 

    

 

 

    

 

 

 

Total

     172      $ 363,228      $ (27
  

 

 

    

 

 

    

 

 

 

 

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     As of December 31, 2020  
     Number of
Securities
     Fair Value      Gross
Unrealized
Losses
 
     (In thousands)  

Investments twelve months or less

        

U.S. treasury and agency securities

     51      $ 339,014      $ (2

Corporate notes

     40        19,280        (3

Commercial paper

     9        7,043        —    

Certificate of deposit

     3        1,050        —    
  

 

 

    

 

 

    

 

 

 

Total

     103      $ 366,387      $ (5
  

 

 

    

 

 

    

 

 

 

At December 31, 2019, there were no available-for-sale securities that have been in a continuous unrealized loss position for longer than twelve months. Long-term securities that mature over twelve months or more in a gross unrealized loss position are follows as:

 

     As of December 31, 2020  
     Number of
Securities
     Fair Value      Gross
Unrealized
Losses
 
     (In thousands)  

Investments over twelve months

        

U.S. treasury and agency securities

     42      $ 185,355      $ —    

Corporate notes

     189        140,384        (55
  

 

 

    

 

 

    

 

 

 

Total

     231      $ 325,739      $ (55
  

 

 

    

 

 

    

 

 

 

Net Investment Income - Net investment income for the years ended December 31, 2019 and 2020 was attributable to the following:

 

     For the years ended
December 31, 
 
     2019      2020  
     (In thousands)  

Net investment income

     

Interest income

   $ 11,122      $ 8,014  

Investment discount amortization net of premium accretion

     6,649        (2,571

Net realized gain

     481        1,239  
  

 

 

    

 

 

 

Total

   $ 18,252      $ 6,682  
  

 

 

    

 

 

 

 

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6. FAIR VALUE

In accordance with ASC 820, Fair Value Measurement, assets and liabilities measured at fair value on recurring basis as of December 31, 2019 and 2020 are as follows:

 

     As of December 31, 2019  
     Level 1      Level 2      Level 3      Total Fair
Value
Measurement
 
     (In thousands)  

Investments

           

U.S. treasury and agency securities

   $ —        $ 270,257      $ —        $ 270,257  

Corporate notes

     —          56,950        —          56,950  

Certificate of deposit

     —          25,304        —          25,304  

Commercial paper

     —          10,717        —          10,717  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ —        $ 363,228      $ —        $ 363,228  
  

 

 

    

 

 

    

 

 

    

 

 

 

Warrant liabilities

   $ —        $ —        $ 8,819      $ 8,819  
  

 

 

    

 

 

    

 

 

    

 

 

 

 

     As of December 31, 2020  
     Level 1      Level 2      Level 3      Total Fair
Value
Measurement
 
     (In thousands)  

Investments

           

U.S. treasury and agency securities

   $ —        $ 524,369      $ —      $ 524,369  

Corporate notes

     —          159,665        —        159,665  

Certificate of deposit

     —          7,043        —        7,043  

Commercial paper

     —          1,050        —        1,050  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ —        $ 692,127      $ —      $ 692,127  
  

 

 

    

 

 

    

 

 

    

 

 

 

Warrant liabilities

   $ —        $ —        $ 15,005      $ 15,005  
  

 

 

    

 

 

    

 

 

    

 

 

 

The Company classifies investments within Level 2, because the Company uses quoted market prices or alternative pricing sources that are based on market observable inputs to determine their fair value. The carrying values of restricted deposits reported on the consolidated balance sheet but not listed in the table above approximate their fair value. Cash and cash equivalents are carried at cost, which approximates fair value.

The Company classified long-term debt within Level 3 value hierarchy because the fair value of the liability is based upon a market approach with various unobservable inputs such as market price quotations, discount margins, market spreads applied, the terms and liquidity of the instrument, the financial condition, operating results and credit ratings of the issuer or underlying company, the quoted market price of publicly traded securities with similar duration and yield, time value, yield curve, default rates, as well as other measurements. As of December 31, 2020, the fair value approximated the carrying value as the debt was issued near year end and there has been little volatility in interest rates.

The Company classified warrant liabilities within Level 3 value hierarchy because the liability is based on present value calculations and external valuation models whose inputs include market interest rates, estimated operational capitalization rates, and volatilities. Fair value is determined using an option pricing model.

 

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The table below presents changes in the fair value of the Company’s Level 3 warrant liabilities as of December 31, 2019 and 2020 as follows:

 

     For the years ended
December 31,
 
             2019                      2020          
    

(In thousands)

 

Beginning balance

   $ 8,115      $ 8,819  

Vesting of warrants

     416        392  

Change in fair value

     288        4,709  

Preferred Stock Series A11 call options issued

     —          13,488  

Preferred Stock Series A11 call options exercised

     —          (12,403
  

 

 

    

 

 

 

Ending balance

   $ 8,819      $ 15,005  
  

 

 

    

 

 

 

7. REGULATION

The Company is subject to extensive regulation under both State and Federal law. Both the State and Federal regulations require, among other things, that qualified insurance companies demonstrate fiscally sound operations. Such requirements generally include maintaining sufficient levels of capital and meeting certain liquidity benchmarks in order to satisfy operating liabilities or at a minimum to have an approved financial plan towards achieving net operating surplus.

Regulatory Capital and Dividend Restrictions

Each of the Company’s health maintenance organizations (“HMO”) and insurance subsidiaries must maintain a minimum amount of statutory capital determined by statute or regulation. The minimum statutory capital requirements differ by state and are generally based on a percentage of annualized premium revenue, a percentage of annualized health care costs, a percentage of certain liabilities, a statutory minimum, risk-based capital (“RBC”) requirements or other financial ratios. Failure to maintain these requirements would trigger regulatory action by the state. Such statues, regulations and capital requirements also restrict the timing, payment and amount of dividends and other distributions that may be paid to us as the sole stockholder. Aggregate minimum required statutory capital and surplus is based on the greater of the RBC level that would trigger regulatory action or minimum requirements per state insurance regulation. At December 31, 2019 and 2020, all insurance subsidiaries individually exceeded the minimum required statutory capital and surplus requirements as well as RBC minimum required levels. The combined statutory capital and surplus of the Company’s HMO and insurance subsidiaries was $135.7 million at December 31, 2019 and $199.5 million at December 31, 2020.

Dividend restrictions vary by state, but the maximum amount of dividends which can be paid without prior approval from the applicable state is subject to restrictions relating to statutory capital, unassigned surplus and net income for the previous year. Some states require prior approval of all dividends, regardless of amount. States may disapprove any dividend that, together with other dividends paid by a subsidiary in the prior 12 months, exceeds the regulatory maximum as computed for the subsidiary based on its statutory surplus and net income. Under applicable regulatory requirements at December 31, 2020, no dividends may be paid through the end of 2021 by the Company’s HMO and insurance subsidiaries without prior approval by regulatory authorities.

Medical Loss Ratio (“MLR”) Requirements

The ACA established a minimum MLR provision that requires insurers to pay rebates to customers when the specified MLR is below the established thresholds. The Company accrues for the estimated amount of premiums to be returned retrospectively to members as an adjustment to

 

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premium revenue. In 2019, the Company’s MLR was greater than the established thresholds and, in all but one market where de minimis amount was returned to the member, no premiums were returned to the members. In 2020, the Company accrued $5.7 million of MLR rebates to be returned to members.

Premium-Based Fee on Health Insurers

As of January 1, 2015, the Company was subject to an annual fee under Section 9010 of the ACA. This health insurance industry fee is based on a ratio of an insurer’s net health insurance premiums written for the previous calendar year compared to the U.S. health insurance industry total. The assessed fee is not deductible for income tax purposes and is recorded as health insurance industry fee on the Company’s consolidated statement of operations and comprehensive loss. The fee was $19.3 million in 2020, but was not applicable for 2019 due to a one-year suspension of the fee. The fee has been permanently repealed for calendar years beginning in 2021. Refer to Note 2. Summary of Significant Accounting Policies for more information.

8. BENEFITS PAYABLE

The following tables provide information about incurred and paid health care claims development and cumulative claims frequency. The claims development information for all periods preceding the most recent reporting period is considered required unaudited supplementary information. For claims frequency information summarized below, a claim is defined as the financial settlement of a single medical event in which remuneration was paid to the servicing provider. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported and development on reported claims. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors.

The following table summarizes health care claims incurred, net of reinsurance:

Incurred Health Care Claims

Net of Reinsurance

 

     For the years ended December 31,         
     (In thousands)      Cumulative
number of
reported claims
(in thousands)
 
     Unaudited      Unaudited      Unaudited      Unaudited         
     2016      2017      2018      2019      2020  

Date of Service(*):

                 

2016

   $ 489,151      $ 474,624      $ 475,380      $ 477,818      $ 477,001      949  

2017

     —          232,738        234,176        236,699        241,957      653  

2018

     —          —          579,936        564,718        567,753     
1,740

2019

     —          —          —          418,516        412,023     
1,882

2020

                 308,370      2,657
              

 

 

    

Total

               $ 2,007,104   
              

 

 

    

 

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The following table summarizes health care claims paid, net of reinsurance:

Cumulative Paid Health Care Claims

Net of Reinsurance

 

     For the years ended December 31,  
     (In thousands)  
     Unaudited      Unaudited      Unaudited      Unaudited         
     2016      2017      2018      2019      2020  

Date of Service(*):

              

2016

   $ 402,424      $ 472,662      $ 474,977      $ 475,422      $ 475,456

2017

     —          188,804        229,992        232,702        232,567

2018

     —          —          488,531        549,684        552,075

2019

     —          —          —          359,570        388,999

2020

                 178,751
              

 

 

 

Total

                 1,827,848
              

 

 

 

Total benefits payable, net of reinsurance

               $ 179,256  
              

 

 

 

 

(*)

The years ended December 31, 2016, 2017, 2018 and 2019 are unaudited

At December 31, 2019 and 2020, total Health Care IBNR liabilities plus expected development on reported claims totaled $156.6 million and $311.9 million, respectively. Substantially all of the total Health Care IBNR liabilities plus expected development on reported claims at December 31, 2019 and 2020 relate to the respective current year.

The following table reconciles total outstanding liabilities, net of reinsurance to benefits payable in the Consolidated Balance Sheet:

 

     As of
December 31, 2019
     As of
December 31, 2020
 
     (In thousands)  

Short-duration health care costs payable, net of reinsurance

   $ 80,373      $ 179,256

Reinsurance recoverables

     76,184        132,658
  

 

 

    

 

 

 

Total benefits payable

   $ 156,557      $ 311,914
  

 

 

    

 

 

 

 

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The following tables show the components of the change in benefits payable and unallocated claims adjustment expenses (“CAE”) payable during 2019 and 2020:

 

     As of December 31, 2019  
     Benefits Payable     Unallocated Claims
Adjustment Expense
     Total  
     (In thousands)  

Benefits payable, beginning of the period

   $ 135,126     $ 2,414      $ 137,540  

Less: Reinsurance recoverable

     39,135       —          39,135  
  

 

 

   

 

 

    

 

 

 

Benefits payable, beginning of the period, net

   $ 95,991     $ 2,414      $ 98,405  
  

 

 

   

 

 

    

 

 

 

Claims incurred and CAE

       

Current year

   $ 418,516     $ 63,815      $ 482,331  

Prior years

     (10,257     —          (10,257
  

 

 

   

 

 

    

 

 

 

Total claims incurred and CAE, net

   $ 408,259     $ 63,815      $ 472,074  
  

 

 

   

 

 

    

 

 

 

Claims and CAE paid

       

Current year

   $ 359,570     $ 60,806      $ 420,376  

Prior years

     64,307       2,414        66,721  
  

 

 

   

 

 

    

 

 

 

Total claims and CAE paid, net

   $ 423,877     $ 63,220      $ 487,097  
  

 

 

   

 

 

    

 

 

 

Benefits and CAE payable, end of period, net

   $ 80,373     $ 3,009      $ 83,382  

Add: Reinsurance recoverable

     76,184       —          76,184  
  

 

 

   

 

 

    

 

 

 

Benefits and CAE payable, end of period

   $ 156,557     $ 3,009      $ 159,566  
  

 

 

   

 

 

    

 

 

 

 

     As of December 31, 2020  
     Benefits Payable      Unallocated Claims
Adjustment Expense
     Total  
     (In thousands)  

Benefits payable, beginning of the period

   $ 156,557    $ 3,009    $ 159,566

Less: Reinsurance recoverable

     76,184      —          76,184
  

 

 

    

 

 

    

 

 

 

Benefits payable, beginning of the period, net

   $ 80,373    $ 3,009    $ 83,382
  

 

 

    

 

 

    

 

 

 

Claims incurred and CAE

        

Current year

   $ 308,370    $ 59,442    $ 367,812

Prior years

     983      —          983
  

 

 

    

 

 

    

 

 

 

Total claims incurred and CAE, net

   $ 309,353    $ 59,442    $ 368,795
  

 

 

    

 

 

    

 

 

 

Claims and CAE paid

        

Current year

   $ 178,751    $ 53,933    $ 232,684

Prior years

     31,719      3,009      34,728
  

 

 

    

 

 

    

 

 

 

Total claims and CAE paid, net

   $ 210,470    $ 56,942    $ 267,412
  

 

 

    

 

 

    

 

 

 

Benefits and CAE payable, end of period, net

   $ 179,256    $ 5,509    $ 184,765

Add: Reinsurance recoverable

     132,658      —          132,658
  

 

 

    

 

 

    

 

 

 

Benefits and CAE payable, end of period

   $ 311,914    $ 5,509    $ 317,423
  

 

 

    

 

 

    

 

 

 

The provision for benefits payable attributable to prior year claims incurred developed favorably by $10.3 million in 2019 and unfavorably by $1.0 million in 2020 related to prior years. The favorable development in 2019 and 2020 is the result of ongoing analysis of recent loss development trends and claim payment patterns. Changes to original estimates are recorded in the period the additional information becomes known.

 

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Unallocated CAE - CAE are costs the Company incurs or expects to incur in connection with the adjustment and recording of health claims not subject to reinsurance. Such expenses include, but are not limited to case management, utilization review, and quality assurance and are intended to reduce the number of health services provided or the cost of such services. CAE is included in other insurance costs and the related CAE payable is included in accounts payable and accrued liabilities.

9. DEBT AND WARRANTS

Long-term debt

On October 30, 2020, the Company entered into a first lien credit loan facility (“facility agreement”) with HPS Investment Partners, LLC (“HPSIP”) whereby HPSIP agreed to provide a $150.0 million First Lien Term Loan (“Term Loan”). The Term Loan has a variable interest rate equal to 12.75%, per annum, at December 31, 2020. The Term Loan matures on October 30, 2024; provided that upon the invalidation of certain provisions of the ACA by the Supreme Court of the United States or any other federal courts that could reasonably be likely to result in a material adverse effect, upon the election of the majority lenders, the maturity of the Term Loan will be 12 months from such election, which is referred to as the “Springing Maturity Date.” Notwithstanding the Springing Maturity Date, upon certain events (including the consummation of an initial public offering satisfying certain conditions), the maturity date of the Term Loan will revert to October 30, 2024. The Term Loan is subject to a prepayment fee equal to (i) if a qualified initial public offering has occurred on or after the six-month anniversary of October 30, 2020, a sliding scale percentage ranging from 6.5% to 1% of the aggregate principal balance of the Term Loan based upon the valuation of the initial public offering and the prepayment date, or (ii) otherwise, if such prepayment occurs prior to the two-year anniversary of the closing date, a customary “make-whole,” or if such prepayment occurs thereafter 1.0%. The Term Loan will be required to be prepaid with 100% cash proceeds, subject to certain exceptions, of (i) certain asset sales, (ii), equity issuances at a valuation of less than $2.0 billion, (iii) certain debt issuances, or (iv) certain extraordinary events. The Term Loan is guaranteed by Mulberry Management Corporation and all of the Company’s future direct and indirect subsidiaries (subject to certain permitted exceptions, including exceptions guarantees that would require material governmental consents or in respect of joint venture). The Term Loan is secured by a lien on substantially all of the Company’s and the guarantors’ assets (subject to certain exceptions) and includes certain reporting requirements, conditions precedent, affirmative covenants and financial covenants. The financial covenants include requirements that the Company must maintain a minimum of gross premiums set forth by fiscal quarter (ranging from $382.1 million to $565.2 million for quarters ended December 31, 2020 and 2021, respectively), maintain a minimum weekly liquidity (average weekly balance of the Company’s unrestricted cash deposit accounts) of $60.0 million or greater, and a combined ratio set forth by fiscal quarter ranging from 106.7% commencing in the quarter ended December 31, 2022 to 97.6% commencing in the quarter ended March 31, 2024. Combined ratio is defined as the sum of (a) the ratio of medical claims to net premiums plus (b) the ratio of variable costs to net premiums plus (c) the ratio of fixed costs to net premiums. As of December 31, 2020, the unamortized discount and debt issuance costs were $7.5 million; and the Company was in compliance with all covenants.

In July 2016, the Company entered into a $45 million Senior Secured Revolving Facility (“Revolving Facility”) agreement with Barclays Bank PLC as administrative agent. The Company’s Revolving Facility agreement expired in 2019. No borrowings had been drawn under this facility.

The fair value of outstanding debt was approximately $142.5 million at December 31, 2020.

Warrants and Call Options

In connection with a loan facility entered into during 2013 (such facility was terminated in 2016), the Company issued 1,887,430 warrants to purchase Series AA preferred stock at $0.56 per share. Preferred stock of the Company has been classified outside permanent equity (see Note 10.

 

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Convertible Preferred Stock) and as such, the warrants are accounted for as liabilities and recorded at fair value, $7.5 million and $9.8 million at December 31, 2019 and 2020, respectively.

The Company has an arrangement with an integrated health system, as described in Note 1. Organization. Pursuant to an agreement under the arrangement, on February 15, 2017, the Company issued warrants to purchase up to 500,000 shares of series A8 preferred shares at $6.75 per share. As of December 31, 2019, all the warrants were vested and are exercisable through July 25, 2021. The aggregate fair value of the warrants, at date of issuance was $0.4 million. For the year ended December 31, 2019, the Company recorded $0.1 million related to the vesting of these warrants general and administrative expense. Preferred stock of the Company has been classified outside permanent equity (see Note 10. Convertible Preferred Stock) and as such, the warrants are accounted for as liabilities and recorded at fair value, $0.5 million and $1.5 million, at December 31, 2019 and 2020, respectively.

In September 2018, the Company issued a detachable warrant to purchase 1,250,000 shares of Series A9 preferred stock at $7.13. The warrants vest over a period of three years and are exercisable through January 1, 2023. At date of issuance, the aggregate fair value of the outstanding warrant was $1.2 million. For the years ended December 31, 2019 and 2020, the Company recorded $0.3 million and $0.4 million, respectively, related to the vesting of these warrants recorded in general and administrative expenses. Preferred stock of the Company has been classified outside permanent equity (see Note 10. Convertible Preferred Stock) and as such, the warrants are accounted for as liabilities and recorded at fair value, $0.8 million and $3.7 million at December 31, 2019 and 2020, respectively.

In May 2020, the Company, in connection with the sale of Series A11 preferred Stock, entered into a series of Call Option Agreements (the “Call Option Agreements”) with the Investors for the issuance of additional shares of Series A11 preferred stock up to 33% of the number of shares in the Investor’s initial purchase at the issue price of $6.02. These Call Option Agreements are non-transferrable or assignable, except to the Investors’ affiliates. During the year ended December 31, 2020, 12,390,888 shares of Series A11 preferred Stock were purchased under the Call Option Agreements. As of December 31, 2020, 38,198 shares of Series A11 preferred Stock are eligible for purchase under the terms of the Call Option Agreements. The Call Options are accounted for as liabilities and recorded at fair value of $0.05 million at December 31, 2020. The fair value of the Call Options of $13.5 million was recorded as a reduction of convertible preferred stock and an increase in warrant liability. Upon exercise of substantially all the Call Options, an entry to reduce the warrant liability and increase the convertible preferred stock of $12.4 million was recorded, which was the fair value of the Call Options on exercise.

During the years ended December 31, 2019 and 2020, the Company recorded an increase in the fair value of warrant liabilities of $0.3 million and $4.7 million, respectively, and included the corresponding charge in general and administrative expense. Fair value is determined using an option pricing model.

10. CONVERTIBLE PREFERRED STOCK

As of December 31, 2019 and 2020, the Company’s certificate of incorporation, as amended and restated, authorized the Company to issue 339,262,809 and 407,156,831 shares, respectively, of $0.0001 par value preferred stock.

The Company has issued a variety of series’ of convertible preferred stock, Series A convertible preferred stock, Series A1 convertible preferred stock, Series AA convertible preferred stock, Series AAA convertible preferred stock, Series A4 convertible preferred stock, Series A5 convertible preferred stock, Series A6 convertible preferred stock, Series A7 convertible preferred stock, Series A8 convertible preferred stock, Series A9 convertible preferred stock, Series AA-9 convertible preferred stock, Series A10 convertible preferred stock, Series A11 convertible preferred stock, Series A12

 

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convertible preferred stock, collectively referred to as “Preferred Stock”, that have been classified separately on the consolidated balance sheet. Redemption rights have not been granted to holders of Preferred Stock, except in the event of a deemed liquidation.

Upon issuance of each class of Preferred Stock, the Company assessed the embedded conversion and liquidation features of the shares and determined that such features did not require the Company to separately account for these features. The Company also concluded that a contingent beneficial conversion feature (i.e. “down round feature”) existed on the issuance date of each series of Preferred Stock. The beneficial conversion feature is not recognized before the resolution of the related contingency.

The Company’s Preferred Stock is classified outside of stockholders’ deficit on the consolidated balance sheet because the holders of such shares have liquidation rights in the event of a deemed liquidation that, in certain situations, is not solely within the control of the Company and would require the redemption of the then-outstanding Preferred Stock. The Preferred Stock is not redeemable, except in the event of a deemed liquidation at liquidation preference amounts.

As of December 31, 2019 and 2020, the Company reserved 3,637,460 and 3,675,658 shares of convertible preferred stock for the exercise of outstanding warrants, respectively.

As of the balance sheet date, preferred stock consisted of the following:

 

December 31, 2019

 

Preferred
Stock Series

   Preferred
Shares
Authorized
     Preferred
Shares Issued
     Preferred
Shares
Outstanding
     Carrying
Value
     Liquidation
Preference
     Common
Stock Issuable
Upon
Conversion
 
( $ in thousands)  

A

     41,913,800        41,913,800        41,913,800      $ 18,254      $ 18,254        41,913,800  

A1

     1,371,010        1,371,010        1,371,010        1,194        1,194        1,371,010  

AA

     24,267,440        22,379,980        22,379,980        12,450        12,450        22,379,980  

AAA

     36,109,790        36,109,790        36,109,790        20,088        20,088        36,109,790  

A4

     23,142,080        23,142,080        23,142,080        30,000        30,000        23,142,080  

A5

     29,189,760        29,189,760        29,189,760        80,000        80,000        29,189,760  

A6

     29,942,474        29,942,474        29,942,474        134,918        134,918        29,942,474  

A7

     6,265,845        6,265,845        6,265,845        32,500        32,500        6,265,845  

A8

     56,934,363        56,434,363        56,434,363        381,200        381,200        56,434,363  

A9

     24,427,793        23,177,793        23,177,793        165,624        165,624        23,177,793  

AA-9

     11,820,502        11,820,502        11,820,502        34,516        34,516        11,820,502  

A10

     53,877,952        53,877,952        53,877,952        385,000        385,000        53,877,952  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total

     339,262,809        335,625,349        335,625,349      $ 1,295,744      $ 1,295,744        335,625,349  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

 

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December 31, 2020

 

Preferred
Stock Series

   Preferred
Shares
Authorized
     Preferred
Shares Issued
     Preferred
Shares
Outstanding
     Carrying
Value
     Liquidation
Preference
     Common
Stock
Issuable Upon
Conversion
 
($ in thousands)  

A

     41,913,800        41,913,800        41,913,800      $ 18,254      $ 18,254        41,913,800  

A1

     1,371,010        1,371,010        1,371,010        1,194        1,194        1,371,010  

AA

     24,267,440        22,379,980        22,379,980        12,450        12,450        22,379,980  

AAA

     36,109,790        36,109,790        36,109,790        20,088        20,088        36,109,790  

A4

     23,142,080        23,142,080        23,142,080        30,000        30,000        23,142,080  

A5

     29,189,760        29,189,760        29,189,760        80,000        80,000        29,189,760  

A6

     29,942,474        29,942,474        29,942,474        134,918        134,918        29,942,474  

A7

     6,265,845        6,265,845        6,265,845        32,500        32,500        6,265,845  

A8

     56,934,363        56,434,363        56,434,363        381,200        381,200        56,789,877  

A9

     24,427,793        23,177,793        23,177,793        165,624        165,624        23,388,697  

AA-9

     11,820,502        11,820,502        11,820,502        34,516        34,516        11,820,502  

A10

     53,877,952        53,877,952        53,877,952        385,000        385,000        54,368,237  

A11

     49,842,333        49,678,169        49,678,169        297,927        299,012        49,678,169  

A12

     18,051,689        15,600,784        15,600,784        151,240        151,240        15,600,784  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total

     407,156,831        400,904,302        400,904,302      $ 1,744,911      $ 1,745,996        401,961,005  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

The holders of the Preferred Stock have the following rights and preferences:

Voting Rights

The holders of Preferred Stock are entitled to the number of votes equal to the number of shares of common stock into which such shares of Preferred Stock could convert (see “Conversion” below) at the record date for the determination of stockholders entitled to vote. The Series AA-9 convertible preferred stock, Series A9 convertible preferred stock and Series A10 convertible preferred stock are known as the “New Preferred Stock”, and the series of convertible preferred stock, other than the New Preferred, is collectively referred to as the “Legacy Preferred Stock”. As long as at least 37,370,484 Legacy Preferred stock remains outstanding, Legacy Preferred Stock may elect nine board directors of the Company. As long as at least 7,871,778 of Series A10 convertible preferred stock remains outstanding, Series A10 convertible preferred stock may elect one board director of the Company. The holders of Legacy Preferred Stock, Series A10 convertible preferred stock, Series A common stock, and Series B common stock, voting as a single class on an as-converted basis, are entitled to elect any remaining board directors of the Company.

Dividends

The holders of the Preferred Stock are entitled to receive noncumulative dividends in preference to any declaration or payment of dividends the Series A common stock, Series B common stock or Series C common stock when, as and if declared by the board of directors, at a rate of 8% per annum of the Original Issue Price of the respective series of preferred stock. In addition, the holders of shares of Preferred Stock are entitled to participate pro rata on an as-converted-basis of Preferred Stock to Series A common stock on any additional dividends paid to the holders of Series A common stock, Series B common stock or Series C common stock. No dividends have been declared through December 31, 2020.

Liquidation

In the event of a liquidation, voluntary or involuntary, dissolution or winding up of the Company or deemed liquidation event, the holders of the Preferred Stock will be entitled to receive (i) an amount

 

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per share equal to the applicable Original Issue Price plus (ii) any dividends declared but unpaid. In the event that proceeds are not sufficient to permit payment in full to the holders of the Preferred Stock, the proceeds will be ratably distributed among the holders of the Preferred Stock.

After payments have been made in full to the holders of Preferred Stock, then, to the extent available, the remaining assets of the Company available for distribution to its stockholders will be distributed ratably among the holders of Series A common stock, Series B common stock and Series C common stock.

Conversion

All shares of Preferred Stock, except Series A8, A9 and A10, are convertible at any time to Series A common stock on 1:1 basis at the original price per share paid to the Company, subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization with respect to the Preferred Stock. During the year ended December 31, 2020, the Company issued Series A11 convertible preferred stock at an issuance price that triggered a beneficial conversion feature, a change in the conversion ratio for Series A8, A9 and A10 convertible preferred shares. As a result, Series A8 are convertible at any time into 1.0063 shares of Series A common stock for each share of Series A8 convertible preferred stock. Series A9 and A10 are convertible at any time into 1.0091 shares of Series A common stock for each share of Series A9 or A10 convertible preferred stock. The Company recognized an increase in additional paid in capital of $7.4 million offset by a corresponding charge to accumulated deficit in recognition of the beneficial conversion feature. See Note 2. Summary of Significant Accounting Policies - Net Loss Per Share, regarding treatment of the charge to accumulated deficit as a deemed dividend and the impact to the calculation of net loss per share.

All shares of Preferred Stock are subject to an automatic conversion into shares of Series A common stock in the event of the closing of a qualified public offering.

11. COMMON STOCK

Common Stock

As of December 31, 2019 and 2020, the Company’s certificate of incorporation, as amended and restated, authorized the Company to issue 681,991,713 and 759,487,963 shares, respectively, of $0.0001 par value common stock, 602,000,000 and 680,000,000 of which have been designated Series A common stock, respectively, 69,991,713 and 69,487,963 of which have been designated Series B common stock, respectively, and 10,000,000 of which have been designated Series C common stock, collectively referred to as “Common Stock”. As of December 31, 2020, 135,768 shares of Series A common stock are reflected as issued and outstanding that are associated with the early exercise of stock options.

As of December 31, 2019 and 2020, the Company had reserved 463,704,467 and 539,987,369 shares of Series A common stock, respectively, for the conversion of the outstanding shares of convertible preferred stock, the exercise of outstanding preferred stock warrants, the exercise of outstanding stock options and the number of shares remaining available for future grant.

The holders of the Common Stock have the following rights and preferences:

Voting Rights

Each share of Series A common stock entitles the holder to one vote and each share of Series B common stock entitles the holder to ten votes and Series C common stock are not entitled to any votes

 

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on all matters submitted to a vote of the Company’s stockholders. The Series A common stock and Series B common stock, voting together as a single class and not as a separate series, are entitled to elect one board director of the Company.

Dividends

Common stockholders are entitled to receive dividends, as may be declared by the board of directors, if any, subject to the preferential dividend right of the preferred stockholders. No dividends have been declared through December 31, 2020.

12. STOCK-BASED COMPENSATION

The Company grants stock option and restricted stock awards to employees and non-employee consultants under the terms of the 2012 Stock Compensation Plan (the “Plan”) as well as outside the Plan (“Out of Plan”). All awards are subject to approval by the board of directors. Total stock-based compensation for the years ended December 31, 2019 and 2020 was $33.6 million and $35.9 million, respectively, of which $15.9 million and $17.6 million was recognized in general and administrative expenses, respectively, and $17.6 million and $18.3 million was recognized in other insurance costs, respectively.

The Company modified certain awards in conjunction with employee terminations. The modifications provided for the extension of the post-employment exercise period. For the years ended December 31, 2019 and 2020, the modifications resulted in $8.7 million and $6.4 million of stock-based compensation expenses, respectively, of which $3.5 million and $3.3 million was recognized in general and administrative expenses, respectively, and $5.2 million and $3.1 million was recognized in other insurance costs, respectively. In October 2020, the Company modified a stock option award granted to an executive for 4,300,000 shares of Series A common stock under the Plan in March 2019. The modification was applicable to 2,777,083 shares of unvested options. The modification resulted in a change in the time vesting period and added performance based vesting for 645,833 of the unvested options. As a result of the modification, the Company recorded additional stock-based compensation expense of $4.7 million for the year ended December 31, 2020, of which $2.4 million was recognized in general and administrative expenses, and $2.3 million was recognized in other insurance costs.

Total unrecognized compensation cost related to unvested share-based awards at December 31, 2019 and 2020 was $74.4 million and $104.1 million, respectively. Unvested share-based awards have 3.22 years of amortization remaining as of December 31, 2020. As of December 21, 2019 and 2020, 136.0 million and 153.8 million shares of Series A common stock, respectively, were authorized under the Plan, and 12.8 million and 6.3 million shares are still available for future issuance, respectively.

2012 Plan - Stock Option - The following tables summarize the Plan stock option award activity for the years ended December 31, 2019 and 2020:

 

     Options Outstanding  
     December 31, 2019     Weighted
Average
Exercise
Price
     Weighted
Average
Contractual
Life (in years)
     Aggregate
Intrinsic
Value
 
     ($’s in thousands, except exercise price)  

Balance - December 31, 2018

     68,717,017     $ 2.37        7.54      $ 55,102  

Options granted

     49,677,028     $ 3.22        

Options exercised

     (1,358,078   $ 0.67         $ 3,396  

Options canceled

     (6,294,539   $ 2.66         $ 3,179  
  

 

 

         

Balance - December 31, 2019

     110,741,428     $ 2.75        7.94      $ 61,678  
  

 

 

         

Options exercisable - December 31, 2019

     82,355,639     $ 2.59        7.27      $ 54,762  

 

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     Options Outstanding  
     December 31, 2020     Weighted
Average
Exercise
Price
     Weighted
Average
Contractual
Life (in years)
     Aggregate
Intrinsic
Value
 
     ($’s in thousands, except exercise price)  

Balance - December 31, 2019

     110,741,428     $ 2.75        7.94      $ 61,678  

Options granted

     31,481,265     $ 4.00        

Options exercised

     (7,841,168   $ 2.50         $ 14,181  

Options canceled

     (11,909,481   $ 3.04        
  

 

 

         

Balance - December 31, 2020

     122,472,044     $ 3.06        7.59      $ 275,112  
  

 

 

         

Options Exercisable at December 31, 2020

     76,034,763      $ 2.66         6.51       $ 201,828   

Option Valuation - The fair value of a stock option is estimated using an option-pricing model that takes into account as of the grant date the exercise price and expected life of the option, the current price of the underlying stock and its expected volatility, expected dividends on the stock, and the risk-free interest rate for the expected term of the option. The Company has used the simplified method in calculating the expected term of all option grants based on the vesting period and contractual term. Compensation costs related to share-based payment transactions are recognized in the stock-based compensation expense upon satisfaction of the vesting requirements.

The weighted average per share fair value of options on the date granted during the years ended December 31, 2019 and 2020 was $1.33 and $1.49, respectively. The following weighted average assumptions were used in estimating the grant date fair values for the years ended December 31, 2019 and 2020:

 

     For the years ended
December 31,
 
         2019             2020      

Term in years

     6.04       5.99  

Dividend Rate

     0     0

Risk free rate of return

     1.9     0.6

Volatility

     40     38

Out of Plan Options - As of December 31, 2019 and 2020, there were 874,350 vested and unexercised Out of Plan options outstanding out of an original issuance of 2,649,000 to non-employee consultants in exchange for services.

Restricted Stock Units - During the year ended December 31, 2020, the Company issued restricted stock units (“RSUs”) to two employees of the Company and a consultant to the Company. The Company recorded compensation expense of $0.5 million in the year ended December 31, 2020. The employees RSUs vest over 4 years and the consultant RSUs cliff vest after 13.5 months.

 

     Restricted Stock
Units Outstanding
 
    

 

     Weighted
Average Grant
Date Fair Value
 

Unvested RSUs at December 31, 2019

     —     

RSUs granted

     4,667,000    $ 5.27  

RSUs exercised

     —     

RSUs canceled

     —     

RSUs vested

     —     
  

 

 

    

Unvested RSUs at December 31, 2020

     4,667,000    $ 5.27  
  

 

 

    

 

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13. DEFINED CONTRIBUTION PLAN

The Company maintains a defined contribution plan under section 401(k) of the U.S. Code, which covers substantially all of the Company’s employees. The plan allows employees to contribute a portion of their pre-tax income in accordance with specific IRS guidelines. The Company matches a percentage of the employees’ contributions with certain limits to a maximum of 2% of an employee’s salary. Employees are fully vested in their contributions and the Company’s contribution. For the years ended December 31, 2019 and 2020, the Company recorded payroll contribution expense of $1.6 million and $2.1 million, respectively.

14. PROPERTY, EQUIPMENT AND CAPITALIZED SOFTWARE

The following table summarizes the balances of the Company’s property, equipment and capitalized software:

 

     As of December 31,  
     2019     2020  
     (In thousands)  

Property, equipment, and capitalized software

    

Software and hardware

   $ 27,588     $ 39,979  

Leasehold improvements

     20,364       21,995  

Property and fixtures

     1,334       1,334  
  

 

 

   

 

 

 

Property, equipment, and capitalized software

     49,286       63,308  

Less: Accumulated depreciation and amortization

     (16,210     (27,496
  

 

 

   

 

 

 

Property, equipment, and capitalized software, net

   $ 33,076     $ 35,812  
  

 

 

   

 

 

 

15. RELATED PARTY DISCLOSURES

The Company has leased office space for its corporate headquarters from New Puck, LLC. New Puck, LLC is affiliated with Joshua Kushner, who is a member of our board of directors and the sole managing member of each of the Thrive General Partners that control the Thrive Capital Funds, beneficial holders of more than 5% of our capital stock. Rent expense incurred related to these contracts for the year ended December 31, 2019 was $1.5 million, of which $1.1 million was recognized in general and administrative expenses and $0.4 million was recognized in other insurance costs. The related lease agreements expired in 2019.

The Company has entered into various technology service agreements for technology infrastructure, enterprise services and lead generation services with affiliates of Alphabet Holdings LLC, which is a beneficial holder of more than 5% of its capital stock. For the year ended December 31, 2019, the Company incurred total costs related to these agreements of $2.4 million of which $1.3 million and $1.1 million was recognized in other insurance costs and general and administrative expenses, respectively. For the year ended December 31, 2020, the Company incurred total costs related to these agreements of $2.1 million, of which $0.9 million and $1.2 million was recognized in other insurance costs and general and administrative expenses, respectively.

In August 2019, the Company repurchased 503,750 shares of its Series B common stock and 440,050 shares of its Series A common stock from its Co-Founder and Chief Executive Officer, at a purchase price of $6.4312 per share, for an aggregate purchase price of approximately $6.1 million, of which $3.1 million was recognized as compensation in general and administrative expenses and $3.0 million was attributed to the fair market value of the underlying shares and recorded as treasury stock.

 

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16. COMMITMENTS AND CONTINGENCIES

Commitments

The Company leases office space under operating leases expiring on various dates through 2032. Total rent expense for the year ended December 31, 2019 and 2020 was $9.0 million and $14.4 million, respectively. At December 31, 2020, future minimum lease payments under non-cancellable operating leases, expiring through 2032, are as follows:

 

Years Ending December 31,

   (In thousands)  

2021

   $ 12,863  

2022

     13,664  

2023

     13,564  

2024

     13,722  

2025

     13,922  

Thereafter

     48,727  
  

 

 

 

Total

   $ 116,462  
  

 

 

 

Contingencies

In the ordinary course of business, the Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include employment and contract claims and claims related to health care benefits coverage and other business practices.

The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable that a loss may be incurred, the ultimate settlement of which could be material.

17. INCOME TAXES

Oscar Health, Inc. files a consolidated federal income tax return on behalf of itself and the majority of its various operating subsidiaries. Oscar Health, Inc. files as part of a unitary return group in various states.

 

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Significant components of the income tax expense are as follow:

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

Current income tax:

    

Federal

   $ 2,219     $ 1,112  

State

     —         —    
  

 

 

   

 

 

 

Total current income tax

     2,219       1,112  
  

 

 

   

 

 

 

Deferred income tax:

    

Federal

     (426     (67

State

     —         —    
  

 

 

   

 

 

 

Total deferred tax

     (426     (67
  

 

 

   

 

 

 

Total income Tax

   $ 1,793     $ 1,045  
  

 

 

   

 

 

 

A reconciliation of the federal income tax rate and the effective income tax rate is as follows:

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

Pre-tax book loss

   $ (259,389     $ (405,780  

Income tax benefit at statutory rate

     (54,472     21.00     (85,213     21.00

State Taxes

     —         —         (15,340     3.78

Change in valuation allowance

     39,280       (15.14 )%      105,460       (25.99 )% 

Stock-based compensation adjustment

     1,241       (0.48 )%      2,173       (0.54 )% 

Return-to-provision true-up

     1,043       (0.40 )%      3,899       (0.96 )% 

Revision to estimates

     8,700       (3.35 )%      (18,108     4.46

Non-deductible salary

     5,687       (2.19 )%      3,977       (0.98 )% 

Other permanent items

     314       (0.12 )%      4,197       (1.03 )% 
  

 

 

   

 

 

   

 

 

   

 

 

 

Total income tax

   $ 1,793       (0.68 )%    $ 1,045       (0.26 )% 
  

 

 

   

 

 

   

 

 

   

 

 

 

 

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Significant components of the Company’s deferred tax assets and liabilities are as follows:

 

     As of December 31, 2019  
     2019      2020  
     (In thousands)  

Deferred Tax Assets:

     

NOL carryforwards

   $ 177,291      $ 255,028  

Premium deficiency reserves

     2,649        17,760

Stock option

     5,072      5,259

Provisions for adverse deviations

     1,344      5,785

Accrued bonus

     2,826      4,223

Start-up costs

     4,593        4,146

Unearned premium reserve

     1,060      3,099

Warrant liability

     1,852        1,787  

Deferred FICA payments

     —          1,217  

Fixed assets

     366        724  

Long-term debt interest

     —          669  

Other

     657        573  
  

 

 

    

 

 

 

Total deferred tax assets before VA

     197,710      300,270  

Valuation allowance

     191,605        296,875
  

 

 

    

 

 

 

Total Deferred Tax Asset

   $ 6,105      $ 3,395  
  

 

 

    

 

 

 

Deferred Tax Liabilities:

     

Prepaid expenses

   $ 1,645      $ 2,117

Capitalized salary and software

     3,507        276  

§481(a) Adjustment - bonus

     477        239  

Unrealized gains

     —          185  

Bond market discount

     —          44  

LRD transition liability

     50        41  
  

 

 

    

 

 

 

Total deferred tax liability

     5,679        2,902  
  

 

 

    

 

 

 

Net Deferred Tax Asset

   $ 426      $ 493  
  

 

 

    

 

 

 

President Donald Trump on December 27, 2020, signed into law the Consolidated Appropriations Act, 2021 (“the Act”). The Act modifies Notice 2020-65, issued in response to the president’s August 8, 2020, Executive Order permitting businesses to defer the employee-portion of payroll taxes incurred on wages paid between September 1, 2020, and December 31, 2020. The Act extends the date for remitting postponed taxes from the period beginning January 1, 2021, and ending on April 30, 2021, to the new period beginning on January 1, 2021, and ending on December 31, 2021. The employer, however, must still withhold and remit the applicable taxes ratably throughout the repayment period. The Company took advantage of this deferral in the amount of $5.8 million and therefore created a deferred tax asset.

On December 22, 2017, President Trump signed the Tax Cuts and Jobs Act of 2017 (“Act”) into legislation. The Act includes numerous changes in tax law, including, but not limited to a reduction in the federal income tax rate for corporations from 35% to 21% which took effect for taxable years beginning on or after January 1, 2018. We are required to recognize the effect of a change in tax rate on deferred tax assets and liabilities in the period the tax rate change was enacted. As of December 31, 2019 and 2020, the Act had no impact on tax expense or the net deferred tax asset.

On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was enacted in response to the COVID-19 pandemic. The CARES Act, among other things, permits NOL carryovers and carrybacks to offset 100% of taxable income for taxable years beginning before 2021. In addition, the CARES Act allows NOLs incurred in 2018, 2019, and 2020 to be carried back to each

 

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of the five preceding taxable years to generate a refund of previously paid income taxes. The Company is currently evaluating the impact of the CARES Act, but at present does not expect that the NOL carryback provision of the CARES Act would result in a cash benefit to The Company. The CARES Act also modified the limitation of business interest for tax years beginning in 2019 and 2020. The Company anticipates no impact or modification to the net operating loss carryover.

As of December 31, 2020, the Company has Federal net operating loss carryovers of $1.05 billion, $792.1 million which expire between 2032 and 2039 and $253.9 million which carryover indefinitely.

The Company evaluates the need for a valuation allowance considering all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies and the Company’s recent operating results. The Company established a valuation allowance of $296.9 million because it does not consider it more likely than not that these deferred tax assets will be recovered, as the Company does not have a history of positive earnings.

Pursuant to Internal Revenue Code (“IRC”), Section 382, use of the Company’s U.S. federal carryforwards may be limited in the event of a cumulative change in ownership. Based upon the Company’s analysis, operating loss carryforwards generated prior to an ownership change in 2016 are subject to annual limitations, cumulatively of $370.4 million at December 31, 2020.

In September 2019, the Internal Revenue Service issued proposed Section 382 regulations. These proposed regulations on the items of income and deductions that are included in calculating built-in gains and losses under IRC Section 382(h) would further limit the applicability of net operating losses. In January 2020, additional proposed regulations provide some transition relief by extending the applicability date of the new rules to 30 days after the publication of final regulations. These regulations would grant transition relief to taxpayers that must determine built-in gain and loss when a change in a loss corporation’s ownership occurs for purposes of the IRC Section 382. The new proposed regulations would also allow the grandfathering of certain, specified transactions.

The Company has state net operating losses from group filings of approximately $500.0 million and from standalone filings of $66.7 million. The Company established a full valuation allowance because it does not consider it more likely than not that these deferred tax assets will be recovered, as the Company does not have a history of positive earnings.

The Company has made a proactive election under IRC§280C(c)(3) to claim a reduced research tax credit. The Company is in the process of finalizing its research credit computations. The amounts and method to be utilized in calculating the research tax credit have not yet been determined. Any credit amount generated will require a full valuation allowance because it does not consider it more likely than not that these deferred tax assets will be recovered, as the Company does not have a history of positive earnings.

The Company files a consolidated federal tax return as well as consolidated New York and New York City income tax returns. The Company began operations during 2012 and has never been placed under audit. The statute of limitations has run on tax years 2014 and prior, while 2015 through 2019 are open to examination to the extent of Net Operating Losses. The Company’s Ohio entity is considered outside of the US Consolidated group and files tax returns separately. It generates a current liability and deferred tax asset.

At present, the Company has not recorded any reserve for uncertain tax benefits. The Company’s liability for unrecognized tax benefits may increase in the next 12 months. A reasonable estimate of the increase cannot be made at this time.

 

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The Company’s policy is to classify interest accrued related to unrecognized tax benefits in interest expense, included within other expenses, while penalties are included in income tax expense. The Company had no interest or penalties for the years ended December 31, 2019 and 2020.

18. CONDENSED FINANCIAL INFORMATION

Oscar Health, Inc. (the Parent Company) condensed financial statements should be read in conjunction with the Company’s consolidated financial statements. The condensed financial statements include the activity of the Parent Company and reflect its subsidiaries using the equity method of accounting. Under the equity method, the investment in consolidated subsidiaries is stated at cost plus equity in undistributed earnings of consolidated subsidiaries. The following summarizes the major categories of the Parent Company’s financial statements

 

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Condensed Balance Sheets

 

     As of December 31,  
     2019     2020  
     (In thousands, except
share data)
 

ASSETS

    

Current assets:

    

Cash and cash equivalents

   $ 45,733     $ 230,769  

Investments and restricted deposits (Note 5)

     132,060       33,652  

Investments in and advances to subsidiaries

     159,754       333,918  

Other assets

     23,444       16,966  
  

 

 

   

 

 

 

TOTAL ASSETS

   $ 360,991     $ 615,305  
  

 

 

   

 

 

 

LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT

    

Long-term debt

   $ —       $ 142,487  

Other liabilities

     10,385       23,800  
  

 

 

   

 

 

 

Total liabilities

     10,385       166,287  
  

 

 

   

 

 

 

Commitments and contingencies (Note 16)

    

Convertible preferred stock, (Series A, A1, AA, AAA, A4, A5, A6, A7, A8, A9, AA9, A10); $0.00001 par value; 339,262,809 shares authorized; 335,625,349 issued and outstanding; aggregate liquidation preference of $1,295,744 as of December 31, 2019; (Series A, A1, AA, AAA, A4, A5, A6, A7, A8, A9, AA9, A10, A11, A12); $0.00001 par value; 407,156,831 shares authorized; 400,904,302 issued and outstanding; aggregate liquidation preference of $1,745,996 as of December 31, 2020 (Note 10)

     1,295,744       1,744,911  

STOCKHOLDERS’ DEFICIT

    

Common stock, Series A, $0.00001 par value, 602,000,000 and 680,000,000 shares authorized; 17,034,585 and 24,875,753 issued and outstanding; Series B $0.00001 par value, 69,991,713 and 69,487,963 shares authorized, 69,487,963 and 69,487,963 shares issued and outstanding; as of December 31, 2019 and 2020, respectively; Series C $0.00001 par value, 10,000,000 shares authorized, no shares issued and outstanding as of December 31, 2019 and 2020 (Note 11)

     2       2  

Treasury stock (Note 15)

     (2,923     (2,923

Additional paid-in capital

     70,673       133,255  

Accumulated deficit

     (1,012,863     (1,427,106

Accumulated other comprehensive loss

     (27     879  
  

 

 

   

 

 

 

Total stockholders’ deficit

     (945,138     (1,295,893
  

 

 

   

 

 

 

TOTAL LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT

   $ 360,991     $ 615,305  
  

 

 

   

 

 

 

 

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Condensed Statements of Operations and Comprehensive Loss

 

     For the years ended
December 31,
 
     2019     2020  
     (In thousands)  

REVENUE

    

Investment income

   $ 8,996     $ 2,903  
  

 

 

   

 

 

 

Total revenue

     8,996       2,903  

EXPENSES

    

General and administrative expenses

     17,563       23,020  

Interest expense

     —         3,514  
  

 

 

   

 

 

 

Total expenses

     17,563       26,534  
  

 

 

   

 

 

 

Loss before equity in net loss of subsidiaries

     (8,567     (23,631

Equity in net loss of subsidiaries

     (252,615     (383,194
  

 

 

   

 

 

 

Net loss

     (261,182     (406,825
  

 

 

   

 

 

 

Unrealized gain on investments

     17       906  
  

 

 

   

 

 

 

Comprehensive loss

   $ (261,165   $ (405,919
  

 

 

   

 

 

 

Condensed Statements of Cash Flows

 

     For the years ended
December 31,
 
     2019     2020  

Net cash (used in)/provided by operating activities

   $ (13,200   $ 6,487  

CASH FLOWS FROM INVESTING ACTIVITIES:

    

Investments in subsidiaries

     (153,563     (511,125

Purchase of fixed maturity securities

     (440,214     (182,027

Sale of investments

     490,887       240,411  

Maturity of investments

     145,821       19,583  

Purchase of property, equipment and capitalized software

     (29,690     —    
  

 

 

   

 

 

 

Net cash provided by/(used in) investing activities

     13,241       (433,158

CASH FLOW FROM FINANCING ACTIVITIES:

    

Stock options exercised

     873       19,295  

Stock repurchase

     (2,992     —    

Convertible preferred stock and call option issuances

     —         375,671  

Exercise of convertible preferred stock call options

     —         74,581  

Proceeds from long-term debt

     —         147,000  

Payment of debt issuance costs

     —         (4,840
  

 

 

   

 

 

 

Net cash (used in)/provided by financing activities:

     (2,119     611,707  

Increase (decrease) in cash, cash equivalents and restricted cash equivalents

     (2,078     185,036  

Cash, cash equivalents, restricted cash and cash equivalents—beginning of year

     47,811       45,733  
  

 

 

   

 

 

 

Cash, cash equivalents, restricted cash and cash equivalents—end of year

   $ 45,733     $ 230,769  
  

 

 

   

 

 

 

19. SUBSEQUENT EVENTS

In connection with the preparation of the consolidated financial statements, the Company evaluated subsequent events through February 4, 2021, which was the date the consolidated financial statements were issued.

 

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            Shares

Oscar Health, Inc.

Common Stock

 

 

 

 

LOGO

 

 

Goldman Sachs & Co. LLC

Morgan Stanley

Allen & Company LLC

Wells Fargo Securities

BofA Securities

Credit Suisse

Cowen

LionTree

Ramirez & Co., Inc.

Siebert Williams Shank

 

 

 


Table of Contents

PART II

INFORMATION NOT REQUIRED IN THE PROSPECTUS

Item 13. Other expenses of issuance and distribution.

The following table sets forth all fees and expenses, other than the underwriting discounts and commissions payable solely by Oscar Health, Inc. in connection with the offer and sale of the securities being registered. All amounts shown are estimated except for the SEC registration fee, the Financial Industry Regulatory Authority, Inc., or FINRA, filing fee and the NYSE listing fee.

 

     Amount
to be
    paid    
 

SEC registration fee

   $      10,910  

FINRA filing fee

        15,500  

NYSE listing fee

                *  

Accounting fees and expenses

                *  

Legal fees and expenses

                *  

Printing and engraving expenses

                *  

Transfer agent and registrar fees

                *  

Blue sky fees and expenses

                *  

Miscellaneous expenses

                *  
  

 

 

Total

   $              *  
  

 

 

 

*

To be completed by amendment.

Item 14. Indemnification of directors and officers.

Section 102 of the DGCL permits a corporation to eliminate the personal liability of directors of a corporation to the corporation or its stockholders for monetary damages for a breach of fiduciary duty as a director, except where the director breached his or her duty of loyalty, failed to act in good faith, engaged in intentional misconduct or knowingly violated a law, authorized the payment of a dividend or approved a stock repurchase in violation of the DGCL or obtained an improper personal benefit. Our Amended Charter, which will become effective upon the closing of this offering, will provide that no director of Oscar Health, Inc. shall be personally liable to it or its stockholders for monetary damages for any breach of fiduciary duty as a director, to the fullest extent permitted by applicable law as it may be amended.

Section 145 of the DGCL provides that a corporation has the power to indemnify a director, officer, employee, or agent of the corporation, or a person serving at the request of the corporation for another corporation, partnership, joint venture, trust or other enterprise in related capacities, against expenses (including attorneys’ fees) (and, with respect to actions other than actions brought by or in the right of the corporation, judgments, fines and amounts paid in settlement) actually and reasonably incurred by the person in connection with an action, suit or proceeding to which he or she was or is a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding by reason of such position, if such person acted in good faith and in a manner he or she reasonably believed to be in or not opposed to the best interests of the corporation, and, in any criminal action or proceeding, had no reasonable cause to believe his or her conduct was unlawful, except that, in the case of actions brought by or in the right of the corporation, no indemnification shall be made with respect to any claim, issue or matter as to which such person shall have been adjudged to be liable to the corporation unless and only to the extent that the Delaware Court of Chancery or other adjudicating court determines that, despite the adjudication of liability but in view of all of the

 

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circumstances of the case, such person is fairly and reasonably entitled to indemnity for such expenses which the Delaware Court of Chancery or such other court shall deem proper.

Upon consummation of this offering, our Amended Bylaws will provide that we will indemnify and hold harmless, to the fullest extent permitted by applicable law, any person, or a Covered Person, who was or is made or is threatened to be made a party or is otherwise involved in any action, suit or proceeding, whether civil, criminal, administrative or investigative, by reason of the fact that he or she, or a person for whom he or she is the legal representative, is or was a director or officer of the Company or, while a director or officer of the Company, is or was serving at the request of the Company as a director, officer, employee or agent of another corporation or of a partnership, limited liability company, joint venture, trust, enterprise or nonprofit entity, including service with respect to employee benefit plans, against all liability and loss suffered and expenses (including attorneys’ fees, judgments, fines, ERISA excise taxes or penalties and amounts paid in settlement) reasonably incurred by such Covered Person. Notwithstanding the preceding sentence, except as otherwise provided in the Amended Bylaws, the Company shall be required to indemnify a Covered Person in connection with a proceeding (or part thereof) commenced by such Covered Person only if the commencement of such proceeding (or part thereof) by the Covered Person was authorized in the specific case by the Board of Directors.

Prior to the consummation of this offering, we intend to enter into separate indemnification agreements with each of our directors and executive officers and certain other employees. Each indemnification agreement will provide, among other things, for indemnification to the fullest extent permitted by law against any and all expenses, judgments, fines, penalties, and amounts paid in settlement of any claim. The indemnification agreements will provide for the advancement or payment of all expenses to the indemnitee and for the reimbursement to us if it is found that such indemnitee is not entitled to such indemnification under applicable law.

We maintain a general liability insurance policy that covers certain liabilities of directors and officers of our corporation arising out of claims based on acts or omissions in their capacities as directors or officers.

In any underwriting agreement we enter into in connection with the sale of common stock being registered hereby, the underwriters will agree to indemnify, under certain conditions, us, our directors, our officers and persons who control us within the meaning of the Securities Act against certain liabilities.

Item 15. Recent sales of unregistered securities.

The following sets forth information regarding all unregistered securities sold by us since January 1, 2018:

Preferred Stock Issuances

In March 2018, we issued and sold an aggregate of 23,177,793 shares of our Series A9 Preferred Stock, par value $0.00001 per share, to 31 accredited investors at a purchase price of $7.13489 per share, for an aggregate purchase price of $165,371,003.65.

In March 2018, we issued and sold an aggregate of 11,820,502 shares of our Series AA-9 Preferred Stock, par value $0.00001 per share, to 28 accredited investors at a purchase price of $2.92000 per share, for an aggregate purchase price of $34,515,865.84.

From October 2018 to December 2018, we issued and sold an aggregate of 53,877,952 shares of our Series A10 Preferred Stock, par value $0.00001 per share, to 5 accredited investors at a purchase price of $7.14578 per share, for an aggregate purchase price of $384,999,991.87.

 

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In May 2020 and June 2020, we issued and sold an aggregate of 37,287,281 shares of our Series A11 Preferred Stock, par value $0.00001 per share, to 27 accredited investors at a purchase price of $6.01898 per share, for an aggregate purchase price of $224,431,398.76. We refer to such issuances and sales collectively as the Series A11 Financing. In connection with the Series A11 Financing, each accredited investor received a right to purchase additional shares of our Series A11 Preferred Stock until March 1, 2021 in an aggregate amount up to 33% of the number of shares purchased by such accredited investor in the Series A11 Financing. Pursuant to the exercise of such rights, in November 2020 and December 2020, we issued and sold an aggregate of 12,390,888 shares of our Series A11 Preferred Stock to 20 accredited investors at a purchase price of $6.01898 per share, for an aggregate purchase price of $74,580,507.05.

In December 2020, we issued and sold an aggregate of 15,600,784 shares of our Series A12 Preferred Stock, par value $0.00001 per share, to 17 accredited investors at a purchase price of $9.69438 per share, for an aggregate purchase price of $151,239,928.39.

Warrant Issuances

In September 2018, we issued a warrant to purchase up to an aggregate of 1,250,000 shares of our Series A9 Preferred Stock to an accredited investor at an exercise price of $7.13489 per share for an aggregate exercise price of $8,918,612.50.

Option, RSU, and Common Stock Issuances

From January 1, 2018 through the date of this registration statement, we granted to our employees, officers and directors options to purchase an aggregate of 96,050,962 shares of Series A Common Stock at per share exercise prices ranging from $2.71 to $6.68, and RSUs in respect of 4,843,000 shares of Series A Common Stock, under the 2012 Plan. From January 1, 2018 through the date of this registration statement, we issued an aggregate of 21,583,070 shares of Series A Common Stock at per share purchase prices ranging from $0.14 to $4.24 pursuant to the exercise of options by our employees, officers and directors.

The issuances of the securities in the transactions described above were deemed to be exempt from registration under the Securities Act in reliance upon Section 4(a)(2) of the Securities Act and/or Rule 506, Rule 701 or Regulation S promulgated thereunder. The securities were issued directly by us and did not involve a public offering or general solicitation. The recipients of such securities represented their intentions to acquire the securities for investment purposes only and not with a view to, or for sale in connection with, any distribution thereof.

None of the transactions set forth in Item 15 involved any underwriters, underwriting discounts or commissions or any public offering. All recipients had adequate access, through their relationships with us, to information about us. The sales of these securities were made without any general solicitation or advertising.

Item 16. Exhibits and financial statements.

(a) Exhibits

The exhibits filed herewith are set forth on the Index to Exhibits filed as a part of this Registration Statement beginning on page II-6 hereof.

(b) Financial Statement Schedules

All schedules have been omitted because the information required to be set forth in the schedules is either not applicable or is shown in the financial statements or notes thereto.

 

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Item 17. Undertakings.

(a) The undersigned registrant hereby undertakes to provide to the underwriters at the closing specified in the underwriting agreement certificates in such denominations and registered in such names as required by the underwriters to permit prompt delivery to each purchaser.

(b) Insofar as indemnification for liabilities arising under the Securities Act may be permitted to directors, officers and controlling persons of the registrant pursuant to the foregoing provisions, or otherwise, the registrant has been advised that in the opinion of the SEC such indemnification is against public policy as expressed in the Securities Act and is, therefore, unenforceable. In the event that a claim for indemnification against such liabilities (other than the payment by the registrant of expenses incurred or paid by a director, officer or controlling person of the registrant in the successful defense of any action, suit or proceeding) is asserted by such director, officer or controlling person in connection with the securities being registered, the registrant will, unless in the opinion of its counsel the matter has been settled by controlling precedent, submit to a court of appropriate jurisdiction, the question whether such indemnification by it is against public policy as expressed in the Securities Act and will be governed by the final adjudication of such issue.

(c) The undersigned hereby further undertakes that:

(1) For purposes of determining any liability under the Securities Act the information omitted from the form of prospectus filed as part of this registration statement in reliance upon Rule 430A and contained in a form of prospectus filed by the registrant pursuant to Rule 424(b)(1) or (4) or 497(h) under the Securities Act shall be deemed to be part of this registration statement as of the time it was declared effective.

(2) For the purpose of determining any liability under the Securities Act each post-effective amendment that contains a form of prospectus shall be deemed to be a new registration statement relating to the securities offered therein, and the offering of such securities at that time shall be deemed to be the initial bona fide offering thereof.

(3) For the purpose of determining liability of the registrant under the Securities Act of 1933 to any purchaser in the initial distribution of the securities, the undersigned registrant undertakes that in a primary offering of securities of the undersigned registrant pursuant to this registration statement, regardless of the underwriting method used to sell the securities to the purchaser, if the securities are offered or sold to such purchaser by means of any of the following communications, the undersigned registrant will be a seller to the purchaser and will be considered to offer or sell such securities to such purchaser:

(i) Any preliminary prospectus or prospectus of the undersigned registrant relating to the offering required to be filed pursuant to Rule 424 under the Securities Act;

(ii) Any free writing prospectus relating to the offering prepared by or on behalf of the undersigned registrant or used or referred to by the undersigned registrant;

(iii) The portion of any other free writing prospectus relating to the offering containing material information about the undersigned registrant or its securities provided by or on behalf of the undersigned registrant; and

(iv) Any other communication that is an offer in the offering made by the undersigned registrant to the purchaser.

 

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INDEX TO EXHIBITS

 

Exhibit No.

    
  1.1*    Form of Underwriting Agreement.
  3.1    Thirteenth Amended and Restated Certificate of Incorporation of Mulberry Health Inc., as amended and as in effect prior to the consummation of this offering.
  3.2*    Form of Amended and Restated Certificate of Incorporation of Oscar Health, Inc., to be in effect upon the consummation of this offering.
  3.3    Third Amended and Restated Bylaws of Oscar Health, Inc., as in effect prior to the consummation of this offering.
  3.4*    Form of Amended and Restated Bylaws of Oscar Health, Inc., to be in effect upon the consummation of this offering.
  4.1*    Specimen Common Stock Certificate of Oscar Health, Inc.
  4.2    Form of Twelfth Amended and Restated Investors’ Rights Agreement, by and among Oscar Health, Inc. and certain security holders of Oscar Health, Inc., to be in effect upon the consummation of this offering.
  5.1*    Opinion of Latham & Watkins LLP.
10.1    Warrant to Purchase Shares of Preferred Stock, by and between Mulberry Health Inc. and Venture Lending & Leasing VI, LLC, dated March 20, 2013.
10.2    Warrant to Purchase Shares of Preferred Stock, by and between Mulberry Health Inc. and Venture Lending & Leasing VII, LLC, dated March 20, 2013.
10.3    Warrant to Purchase Shares of Preferred Stock, by and between Mulberry Health Inc. and Montefiore Medical Center, dated February 15, 2017.
10.4    Warrant to Purchase Shares of Preferred Stock, by and between Mulberry Health Inc. and True North Health, Inc., dated September 5, 2018.
10.5†    Mulberry Health Inc. Amended and Restated 2012 Stock Incentive Plan.
10.6†    Form of Stock Option Award Agreement (Early Exercise) under 2012 Stock Incentive Plan.
10.7†    Form of Stock Option Award Agreement (Installment Exercise) under 2012 Stock Incentive Plan.
10.8†    Stock Option Award Agreement under 2012 Stock Incentive Plan, by and between Mulberry Health Inc. and Mario Schlosser.
10.9†    Stock Option Award Agreement under 2012 Stock Incentive Plan, by and between Mulberry Health Inc. and Meghan Joyce.
10.10†    Form of Restricted Stock Unit Award Agreement under 2012 Stock Incentive Plan.
10.11†*    Oscar Health, Inc. 2021 Incentive Award Plan.
10.12†*    Form of Stock Option Award Agreement under 2021 Incentive Award Plan.
10.13†*    Form of Restricted Stock Unit Award Agreement under 2021 Incentive Award Plan.
10.14†*    Oscar Health, Inc. 2021 Employee Stock Purchase Plan.
10.15†+    Employment Offer Letter, by and between Mulberry Health Inc. and Mario Schlosser, dated November 29, 2012.

 

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Exhibit No.

    
10.16†+#    Employment Offer Letter, by and between Oscar Insurance Corporation and Joel Klein, dated January 1, 2016.
10.17†+    Employment Offer Letter, by and between Mulberry Management Corporation and Meghan Joyce, dated June 26, 2019.
10.18†*    Employment Agreement, by and between Oscar Health, Inc., Mulberry Management Corporation and Meghan Joyce, dated                         .
10.19†*    Employment Agreement, by and between Oscar Health, Inc., Mulberry Management Corporation and Joel Klein, dated                         .
10.20†+    Employment Agreement, by and between Oscar Health, Inc., Mulberry Management Corporation and R. Scott Blackley, dated December 5, 2020
10.21†+    Director Appointment Letter, by and between Oscar Health, Inc. and Jeffery Boyd, dated January 4, 2021
10.22†+    Director Appointment Letter, by and between Oscar Health, Inc. and Teri List-Stoll, dated January 15, 2021.
10.23†+    Director Appointment Letter, by and between Oscar Health, Inc. and Charles Phillips, dated January 19, 2021.
10.24†+    Director Appointment Letter, by and between Oscar Health, Inc. and David Plouffe, dated January 14, 2021.
10.25†+    Director Appointment Letter, by and between Oscar Health, Inc. and Elbert O’Neal Robinson Jr., dated January 20, 2021.
10.26†+    Director Appointment Letter, by and between Oscar Health, Inc. and Vanessa Wittman, dated January 7, 2021.
10.27†*    Director Compensation Program.
10.28    Form of Indemnification Agreement.
10.29    Credit Agreement, dated October  30, 2020, by and among Mulberry Health Inc., as borrower, the several lenders from time to time parties thereto, and HPS Investment Partners, LLC, as administrative agent.
10.30X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Corporation and Axa France Vie, dated December 21, 2017, as amended.
10.31X+    Quota Share Reinsurance Agreement, by and between Oscar Health Plan of California and Axa France Vie, dated December 21, 2017, as amended.
10.32X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Company of Texas and Axa France Vie, dated December 21, 2017, as amended.
10.33X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Company of Florida and National Indemnity Company, dated August 13, 2019, as amended.
10.34X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Company and National Indemnity Company, dated September 30, 2019.
10.35X+    Quota Share Reinsurance Agreement, by and between Oscar Health Plan of California and National Indemnity Company, dated September 30, 2019, as amended.
10.36X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Corporation and National Indemnity Company, dated December 31, 2019, as amended.

 

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Exhibit No.

    
10.37X+    Quota Share Reinsurance Agreement, by and between Oscar Insurance Company of Florida and Axa France Vie, dated January 31, 2020.
16.1    Letter Regarding Change in Accountants of Deloitte & Touche LLP.
16.2    Letter Regarding Change in Accountants of Grant Thornton LLP.
21.1    List of Subsidiaries of Oscar Health, Inc.
23.1    Consent of Grant Thornton LLP as to Oscar Health, Inc.
23.2    Consent of PricewaterhouseCoopers LLP as to Oscar Health, Inc.
23.3*    Consent of Latham & Watkins LLP (included in Exhibit 5.1).
24.1    Power of Attorney (included on signature page).

 

*

To be filed by amendment.

Indicates a management contract or compensatory plan or arrangement.

#

Certain of the schedules and attachments to this exhibit have been omitted pursuant to Regulation S-K, Item 601(a)(5). The registrant hereby undertakes to provide further information regarding such omitted materials to the Commission upon request.

+

Certain portions of this exhibit (indicated by “####”) have been redacted pursuant to Regulation S-K, Item 601(a)(6).

X

Certain portions of this exhibit (indicated by “[***]”) have been redacted pursuant to Regulation S-K, Item 601(b)(10)(iv).

 

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SIGNATURES

Pursuant to the requirements of the Securities Act of 1933, as amended, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized, in New York, New York, on this 5th day of February, 2021.

 

OSCAR HEALTH, INC.

By:    

  /s/ Mario Schlosser
 

Mario Schlosser

Chief Executive Officer

***

 

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POWER OF ATTORNEY

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Mario Schlosser and Siddhartha Sankaran, and each one of them, as his or her true and lawful attorneys-in-fact and agents, with full power of substitution and resubstitution, for him or her and in their name, place and stead, in any and all capacities, to sign any and all amendments (including post-effective amendments) to this registration statement, and to sign any registration statement for the same offering covered by this registration statement that is to be effective on filing pursuant to Rule 462(b) under the Securities Act of 1933, as amended, and all post-effective amendments thereto, and to file the same, with all exhibits thereto and other documents in connection therewith, with the Securities and Exchange Commission, granting unto said attorneys-in-fact and agents, and each of them, full power and authority to do and perform each and every act and thing requisite and necessary to be done in connection therewith, as fully to all intents and purposes as he or she might or could do in person, hereby ratifying and confirming all that said attorneys-in-fact and agents or any of them, or his or her substitute or substitutes, may lawfully do or cause to be done by virtue hereof.

Pursuant to the requirements of the Securities Act of 1933, as amended, this registration statement has been signed by the following persons in the capacities and on the date indicated.

 

Signature

 

Title

 

Date

/s/ Mario Schlosser

Mario Schlosser

 

Chief Executive Officer and Director

(Principal Executive Officer)

  February 5, 2021

/s/ Siddhartha Sankaran

Siddhartha Sankaran

 

Chief Financial Officer and Director

(Principal Financial Officer)

  February 5, 2021

/s/ Ari Fischel

Ari Fischel

 

Vice President, Finance and Accounting

(Principal Accounting Officer)

  February 5, 2021

/s/ Jeffery H. Boyd

Jeffery H. Boyd

 

Director

  February 5, 2021

/s/ Joel Cutler

Joel Cutler

  Director   February 5, 2021

/s/ Joshua Kushner

Joshua Kushner

  Director   February 5, 2021

/s/ Teri List-Stoll

Teri List-Stoll

  Director   February 5, 2021

/s/ Charles E. Phillips, Jr.

Charles E. Phillips, Jr.

  Director   February 5, 2021

/s/ David Plouffe

David Plouffe

  Director   February 5, 2021

/s/ Elbert O. Robinson, Jr.

Elbert O. Robinson, Jr.

  Director   February 5, 2021

/s/ Vanessa A. Wittman

Vanessa A. Wittman

  Director   February 5, 2021

 

II-9

Exhibit 3.1

THIRTEENTH AMENDED AND RESTATED CERTIFICATE OF INCORPORATION

OF

MULBERRY HEALTH INC.

(Pursuant to Sections 242 and 245 of the

General Corporation Law of the State of Delaware)

Mulberry Health Inc., a corporation organized and existing under and by virtue of the provisions of the General Corporation Law of the State of Delaware (the “General Corporation Law”).

DOES HEREBY CERTIFY:

FIRST: That the name of this corporation is Mulberry Health Inc. and that this corporation was originally incorporated pursuant to the General Corporation Law on October 25, 2012 under the name Mulberry Health Inc.

SECOND: That the Board of Directors of this corporation duly adopted resolutions proposing to amend and restate the Twelfth Amended and Restated Certificate of Incorporation of this corporation, declaring said amendment and restatement to be advisable and in the best interests of this corporation and its stockholders, and authorizing the appropriate officers of this corporation to solicit the consent of the stockholders therefor, which resolution setting forth the proposed amendment and restatement is as follows:

RESOLVED, that the Twelfth Amended and Restated Certificate of Incorporation of this corporation, be amended and restated in its entirety as follows:

ARTICLE I

The name of this corporation is Mulberry Health Inc.

ARTICLE II

The address of the registered office of this corporation in the State of Delaware is 251 Little Falls Drive in the City of Wilmington, 19808, County of New Castle. The name of its registered agent at such address is Corporation Service Company.

ARTICLE III

The nature of the business or purposes to be conducted or promoted is to engage in any lawful act or activity for which corporations may be organized under the General Corporation Law of the State of Delaware (the “General Corporation Law”).

ARTICLE IV

A. Authorization of Stock. This corporation is authorized to issue two classes of stock to be designated, respectively, common stock and preferred stock. The total number of


shares that this corporation is authorized to issue is one billion, one hundred sixty-six million, six hundred forty-four thousand, seven hundred ninety-four (1,166,644,794). The total number of shares of common stock authorized to be issued is seven hundred fifty-nine million, four hundred eighty-seven thousand, nine hundred sixty-three (759,487,963), par value $0.00001 per share, six hundred eighty million (680,000,000) of which are designated as “Series A Common Stock,” sixty-nine million four hundred eighty-seven thousand nine hundred sixty-three (69,487,963) of which are designated as “Series B Common Stock” and ten million (10,000,000) of which are designated as “Series C Common Stock.” The Series A Common Stock, Series B Common Stock and Series C Common Stock are sometimes referred to herein collectively as “Common Stock.” The total number of shares of preferred stock authorized to be issued is four hundred seven million, one hundred fifty-six thousand, eight hundred thirty-one (407,156,831), par value $0.00001 per share (the “Preferred Stock”), forty-one million nine hundred thirteen thousand eight hundred (41,913,800) of which are designated as “Series A Preferred Stock,” one million three hundred seventy-one thousand ten (1,371,010) of which are designated as “Series A-1 Preferred Stock,” twenty-four million two hundred sixty-seven thousand four hundred forty (24,267,440) of which are designated as “Series AA Preferred Stock,” thirty-six million one hundred nine thousand seven hundred ninety (36,109,790) of which are designated as “Series AAA Preferred Stock,” twenty-three million one hundred forty-two thousand eighty (23,142,080) of which are designated as “Series A4 Preferred Stock,” twenty-nine million one hundred eighty-nine thousand seven hundred sixty (29,189,760) of which are designated as “Series A5 Preferred Stock,” twenty-nine million nine hundred forty-two thousand four hundred seventy-four (29,942,474) of which are designated as “Series A6 Preferred Stock,” six million two hundred sixty-five thousand eight hundred forty-five (6,265,845) of which are designated as “Series A7 Preferred Stock,” fifty-six million nine hundred thirty-four thousand three hundred sixty-three (56,934,363) of which are designated as “Series A8 Preferred Stock,” eleven million eight hundred twenty thousand five hundred two (11,820,502) of which are designated as “Series AA-9 Preferred Stock,” twenty-four million four hundred twenty-seven thousand seven hundred ninety-three (24,427,793) of which are designated as “Series A9 Preferred Stock,” fifty-three million eight hundred seventy-seven thousand nine hundred fifty-two (53,877,952) of which are designated as “Series A10 Preferred Stock,” forty-nine million, eight hundred forty-two thousand, three hundred thirty-three (49,842,333) of which are designated as “Series A11 Preferred Stock” and eighteen million, fifty-one thousand, six hundred eighty-nine (18,051,689) of which are designated as “Series A12 Preferred Stock.” The Series AA-9 Preferred Stock and Series A9 Preferred Stock are sometimes referred to herein collectively as “IX Preferred” and, together with the Series A10 Preferred Stock, the Series A11 Preferred Stock and Series A12 Preferred Stock, the “New Preferred Stock.” The series of Preferred Stock other than the New Preferred Stock are sometimes referred to herein collectively as “Legacy Preferred Stock.”

B. Rights, Preferences and Restrictions of Preferred Stock. The rights, preferences, privileges and restrictions granted to and imposed on the Preferred Stock are as set forth below in this Article IV(B).

1. Dividend Provisions.

(a) The holders of shares of Preferred Stock shall be entitled to receive dividends, out of any assets legally available therefor, prior and in preference to any declaration or payment of any dividend (payable other than in Series A Common Stock, Series B Common

 

2


Stock, Series C Common Stock or other securities and rights convertible into or entitling the holder thereof to receive, directly or indirectly, additional shares of Series A Common Stock, Series B Common Stock or Series C Common Stock of this corporation) on the Series A Common Stock, Series B Common Stock or Series C Common Stock of this corporation, at the applicable Dividend Rate (as defined below), payable when, as and if declared by the Board of Directors of this corporation (the “Board of Directors”). The holders of the outstanding Preferred Stock can waive any dividend preference that such holders shall be entitled to receive under this Section 1 upon the affirmative vote or written consent of the holders of a majority of the shares of Preferred Stock then outstanding (voting together as a single class and not as separate series, and on an as-converted basis) (the “Requisite Investor Threshold”). For purposes of this subsection 1(a), “Dividend Rate” shall mean eight percent (8%) of the applicable Original Issue Price per annum for each share of Preferred Stock (with each such original price per share adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like with respect to such series of Preferred Stock).

(b) After payment of such dividends, any additional dividends or distributions shall be distributed among all holders of Series A Common Stock, Series B Common Stock, Series C Common Stock and Preferred Stock in proportion to the number of shares of Series A Common Stock, Series B Common Stock and Series C Common Stock that would be held by each such holder if all shares of Preferred Stock were converted to Series A Common Stock at the then effective Conversion Rate (as defined below).

2. Liquidation Preference.

(a) In the event of any Liquidation Event (as defined below), either voluntary or involuntary, the holders of each series of Preferred Stock shall be entitled to receive out of the proceeds or assets of this corporation available for distribution to its stockholders (the “Proceeds”), prior and in preference to any distribution of the Proceeds of such Liquidation Event to the holders of Series A Common Stock, Series B Common Stock or Series C Common Stock by reason of their ownership thereof, an amount per share equal to the sum of the applicable Original Issue Price (as defined below) for such series of Preferred Stock, plus declared but unpaid dividends on such share. If, upon the occurrence of such event, the Proceeds thus distributed among the holders of the Preferred Stock shall be insufficient to permit the payment to such holders of the full aforesaid preferential amounts, then the entire Proceeds legally available for distribution shall be distributed ratably among the holders of the Preferred Stock in proportion to the full preferential amount that each such holder is otherwise entitled to receive under this subsection (a). For purposes of this Thirteenth Amended and Restated Certificate of Incorporation (the “Restated Certificate”), “Original Issue Price” shall mean (i) with respect to the Series A Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A Preferred Stock, (ii) with respect to the Series A-1 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A-1 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A-1 Preferred Stock, (iii) with respect to the Series AA Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of

 

3


indebtedness or any combination of the foregoing for the Series AA Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series AA Preferred Stock, (iv) with respect to the Series AAA Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series AAA Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series AAA Preferred Stock, (v) with respect to the Series A4 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A4 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A4 Preferred Stock, (vi) with respect to the Series A5 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A5 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A5 Preferred Stock, (vii) with respect to the Series A6 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A6 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A6 Preferred Stock, (viii) with respect to the Series A7 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A7 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A7 Preferred Stock, (ix) with respect to the Series A8 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A8 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A8 Preferred Stock, (x) with respect to the Series AA-9 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series AA-9 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series AA-9 Preferred Stock, (xi) with respect to the Series A9 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A9 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A9 Preferred Stock, (xii) with respect to the Series A10 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A10 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A10 Preferred Stock, (xiii) with respect to the Series A11 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A11 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A11 Preferred Stock (the “A11 Purchase Agreement”), and (xiv) with respect to the Series A12 Preferred Stock, the original price per share paid to this corporation by check, wire transfer, cancellation of indebtedness or any combination of the foregoing for the Series A12 Preferred Stock in accordance with a written agreement with this corporation setting forth the purchase price per share of such Series A12 Preferred Stock (each as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like with respect to such series of Preferred Stock).

 

4


(b) Upon completion of the distribution required by subsection (a) of this Section 2, all of the remaining Proceeds available for distribution to stockholders shall be distributed among the holders of Series A Common Stock, Series B Common Stock and Series C Common Stock pro rata based on the number of shares of Series A Common Stock, Series B Common Stock and Series C Common Stock held by each.

(c) Notwithstanding the above, for purposes of determining the amount each holder of shares of Preferred Stock is entitled to receive with respect to a Liquidation Event, each such holder of shares of a series of Preferred Stock shall be deemed to have converted (regardless of whether such holder actually converted) such holder’s shares of such series into shares of Series A Common Stock immediately prior to the Liquidation Event if, as a result of an actual conversion, such holder would receive, in the aggregate, an amount greater than the amount that would be distributed to such holder if such holder did not convert such series of Preferred Stock into shares of Series A Common Stock. If any such holder shall be deemed to have converted shares of Preferred Stock into Series A Common Stock pursuant to this paragraph, then such holder shall not be entitled to receive any distribution that would otherwise be made to holders of Preferred Stock that have not converted (or have not been deemed to have converted) into shares of Series A Common Stock.

(d) (i) For purposes of this Section 2, a “Liquidation Event” shall include (A) the closing of the sale, lease, transfer, exclusive license or other disposition, in a single transaction or series of related transactions, of all or substantially all of this corporation’s assets (including, without limitation, the sale or disposition (whether by merger or otherwise) of one or more subsidiaries of this corporation if substantially all of the assets of this corporation are held by such subsidiary or subsidiaries), (B) the consummation of the merger or consolidation of this corporation with or into another entity or of a subsidiary of this corporation which is a constituent party and this corporation issues shares of its capital stock pursuant to such merger or consolidation (except a merger or consolidation in which the holders of capital stock of this corporation immediately prior to such merger or consolidation continue to hold at least 50% of the voting power of the capital stock of (i) this corporation or the surviving or resulting entity or (ii) if the surviving or resulting entity is a wholly-owned subsidiary of another corporation immediately following such merger or consolidations, the parent corporation of such surviving or resulting corporation), (C) the closing of the transfer (whether by merger, consolidation or otherwise), in one transaction or a series of related transactions, to a person or group of affiliated persons (other than an underwriter of this corporation’s securities), of this corporation’s securities if, after such closing, such person or group of affiliated persons would hold 50% or more of the outstanding voting stock of this corporation (or the surviving or acquiring entity) or (D) a liquidation, dissolution or winding up of this corporation; provided, however, that a transaction shall not constitute a Liquidation Event if its sole purpose is to change the state of this corporation’s incorporation or to create a holding company that will be owned in the same proportions by the persons who held this corporation’s securities immediately prior to such transaction. The treatment of any particular transaction or series of related transactions as a Liquidation Event may be waived by the vote or written consent of the holders

 

5


of (i) as to all series of Preferred Stock other than the Series A5 Preferred Stock, Series A6 Preferred Stock, Series A7 Preferred Stock, Series A8 Preferred Stock, Series AA-9 Preferred Stock, Series A9 Preferred Stock, Series A10 Preferred Stock and Series A11 Preferred Stock, a majority of the shares of Preferred Stock (other than shares of Series A5 Preferred Stock, Series A6 Preferred Stock, Series A7 Preferred Stock, Series A8 Preferred Stock, Series AA-9 Preferred Stock, Series A9 Preferred Stock, Series A10 Preferred Stock and Series A11 Preferred Stock) then outstanding (voting together as a single class and not as separate series, and on an as-converted basis), (ii) solely with respect to the Series A5 Preferred Stock, a majority of the shares of Series A5 Preferred Stock then outstanding, voting as a separate class, (iii) solely with respect to the Series A6 Preferred Stock, a majority of the shares of Series A6 Preferred Stock then outstanding, voting as a separate class, (iv) solely with respect to the Series A7 Preferred Stock, a majority of the shares of Series A7 Preferred Stock then outstanding, voting as a separate class, (v) solely with respect to the Series A8 Preferred Stock, at least sixty-five percent (65%) of the shares of Series A8 Preferred Stock then outstanding, voting as a separate class, (vi) solely with respect to the IX Preferred, a majority of the shares of IX Preferred then outstanding, voting together as a single class and not as separate series, and on an as-converted basis, (vii) solely with respect to the Series A10 Preferred Stock, a majority of the shares of Series A10 Preferred Stock then outstanding, voting as a separate class and (viii) solely with respect to the Series A11 Preferred Stock, the Requisite Series A11 Consent (as defined in that certain Voting Agreement by and among the Company and the stockholders party thereto, dated on or about the date hereof).

(ii) In any Liquidation Event, if Proceeds received by this corporation or its stockholders are other than cash, their value will be deemed their fair market value. Any securities shall be valued as follows:

(A) Securities not subject to investment letter or other similar restrictions on free marketability covered by (B) below:

(1) If traded on a securities exchange, the value shall be deemed to be the average of the closing prices of the securities on such exchange over the twenty (20) trading-day period ending three (3) trading days prior to the closing of the Liquidation Event;

(2) If actively traded over-the-counter, the value shall be deemed to be the average of the closing bid or sale prices (whichever is applicable) over the twenty (20) trading-day period ending three (3) trading days prior to the closing of the Liquidation Event; and

(3) If there is no active public market, the value shall be the fair market value thereof, as mutually determined in good faith by the Board of Directors and the holders constituting the Requisite Investor Threshold.

(B) The method of valuation of securities subject to investment letter or other restrictions on free marketability (other than restrictions arising solely by virtue of a stockholder’s status as an affiliate or former affiliate) shall be to make an appropriate discount from the market value determined as above in (A) (1), (2) or (3) to reflect the approximate fair market value thereof, as mutually determined in good faith by the Board of Directors and holders constituting the Requisite Investor Threshold.

 

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(C) If the Board of Directors and holders constituting the Requisite Investor Threshold cannot in good faith determine the fair market value to be determined pursuant to Sections 2(d)(ii)(A)(3) or 2(d)(ii)(B) of this Article IV(B) within fifteen (15) days of the Liquidation Event, the Board of Directors shall retain for such purposes an independent national accounting firm as a neutral and independent party (the “Independent Accountant”). If the Independent Accountant is retained, then within twenty (20) days the Independent Accountant render its decision as to the applicable fair market value, which decision shall be final and binding on, and nonappealable by, all parties hereto. The fees and expenses of the Independent Accountant shall be paid by this corporation.

(D) The foregoing methods for valuing non-cash consideration to be distributed in connection with a Liquidation Event shall, with the appropriate approval of the definitive agreements governing such Liquidation Event by the stockholders under the General Corporation Law and Section 6 of this Article IV(B), be superseded by the determination of such value set forth in the definitive agreements governing such Liquidation Event.

(iii) In the event the requirements of this Section 2 are not complied with, this corporation shall forthwith either:

(A) cause the closing of such Liquidation Event to be postponed until such time as the requirements of this Section 2 have been complied with; or

(B) cancel such transaction, in which event the rights, preferences and privileges of the holders of the Preferred Stock shall revert to and be the same as such rights, preferences and privileges existing immediately prior to the date of the first notice referred to in
subsection 2(d)(iv) hereof.

(iv) This corporation shall give each holder of record of Preferred Stock written notice of such impending Liquidation Event not later than twenty (20) days prior to the stockholders’ meeting called to approve such transaction, or twenty (20) days prior to the closing of such transaction, whichever is earlier, and shall also notify such holders in writing of the final approval of such transaction, which approval shall not be effective without first obtaining the approval of holders constituting the Requisite Investor Threshold, as described in Section 6 of this Article IV(B). The first of such notices shall describe the material terms and conditions of the impending transaction and the provisions of this Section 2, and this corporation shall thereafter give such holders prompt notice of any material changes. The transaction shall in no event take place sooner than ten (10) days after this corporation has given the first notice provided for herein or sooner than ten (10) days after this corporation has given notice of any material changes provided for herein; provided, however, that subject to compliance with the General Corporation Law such periods may be shortened or waived upon the written consent of the holders of Preferred Stock that constitute the Requisite Investor Threshold.

 

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(e) Allocation of Contingent Consideration. In the event of a deemed Liquidation Event pursuant to subsection 2(d)(i), if any portion of the consideration payable to the stockholders of this corporation is subject to contingencies (the “Additional Consideration”), the definitive agreement with respect to such deemed Liquidation Event shall provide that (a) the portion of such consideration that is not subject to any contingencies (the “Initial Consideration”) shall be allocated among the holders of capital stock of this corporation in accordance with subsections 2(a), 2(b) and 2(c) as if the Initial Consideration were the only consideration payable in connection with such deemed Liquidation Event and (b) any Additional Consideration that becomes payable to the stockholders of this corporation upon satisfaction of contingencies shall be allocated among the holders of capital stock of this corporation in accordance with subsections 2(a), 2(b) and 2(c) after taking into account the previous payment of the Initial Consideration as part of the same transaction. For purposes of this subsection (e), consideration placed into escrow or retained as holdback to be available for satisfaction of indemnification or similar obligations in connection with such Liquidation Event shall be deemed to be Additional Consideration.

3. Redemption. The Preferred Stock is not redeemable at the option of the holder thereof.

4. Conversion. The Preferred Stock may convert to Common Stock as follows:

(a) Right to Convert. Each share of Preferred Stock shall be convertible, at the option of the holder thereof, at any time after the date of issuance of such share, and without the payment of additional consideration by the holder thereof, at the office of this corporation or any transfer agent for such stock, into such number of fully paid and nonassessable shares of Series A Common Stock as is determined by dividing the applicable Original Issue Price for such series by the applicable Conversion Price for such series (the conversion rate for a series of Preferred Stock into Series A Common Stock is referred to herein as the “Conversion Rate” for such series), determined as hereafter provided, in effect on the date the certificate is surrendered for conversion. The “Conversion Price” per share for each series of Preferred Stock (which, with respect to each series of Preferred Stock as applicable, shall be referred to as the “applicable Conversion Price”) shall (i) for each series of Preferred Stock other than the Series A8 Preferred Stock, Series A9 Preferred Stock and Series A10 Preferred Stock, be the Original Issue Price applicable to such series; (ii) for the Series A8 Preferred Stock, be $6.71249 (subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization affecting such series of Preferred Stock); (iii) for the Series A9 Preferred Stock, be $7.07079 (subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization affecting such series of Preferred Stock) and (iv) for the Series A10 Preferred Stock, be $7.08106 (subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization affecting such series of Preferred Stock); provided, however, that the Conversion Price for the Preferred Stock shall be subject to adjustment as set forth in
subsection 4(d).

 

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(b) Automatic Conversion.

(i) Subject to subsection 4(b)(ii) below in respect of the Series A8 Preferred Stock, subsection 4(b)(iii) below in respect of the Series A10 Preferred Stock and subsection 4(b)(iv) below in respect of the Series A11 Preferred Stock, each share of Preferred Stock shall automatically be converted into shares of Series A Common Stock at the Conversion Rate at the time in effect for such series of Preferred Stock (and such shares may not be reissued by this corporation) immediately upon the earlier of (x) the closing of this corporation’s sale of its Common Stock in a firm commitment underwritten public offering pursuant to a registration statement under the Securities Act of 1933, as amended (the “Act”), resulting in at least $200,000,000 of gross proceeds, net of the underwriting discount and commissions, to this corporation (a “Qualified Public Offering”) or (y) the date, or the occurrence of an event, specified by vote or written consent or agreement of holders constituting (A) as to all series of Preferred Stock other than Series A8 Preferred Stock, IX Preferred, Series A10 Preferred Stock and Series A11 Preferred Stock, a majority of the shares of Preferred Stock (other than shares of Series A8 Preferred Stock, IX Preferred, Series A10 Preferred Stock and Series A11 Preferred Stock) then outstanding (voting together as a single class and not as separate series, and on an as-converted basis); provided, however, that, with respect to the automatic conversion of Series A5 Preferred Stock, Series A6 Preferred Stock or Series A7 Preferred Stock pursuant to subsection 4(b)(i)(y)(A), (1) if the automatic conversion of shares of Series A5 Preferred Stock is in connection with a Liquidation Event wherein the Proceeds to which the holders of Series A5 Preferred Stock would be entitled pursuant to the conversion of such shares of Series A5 Preferred Stock into Common Stock and payment to them as holders of Common Stock in such Liquidation Event would be lower than the Proceeds such holders would otherwise have been entitled to receive in exchange for their shares of Series A5 Preferred Stock pursuant to Section 2 of Article IV(B) hereof if no shares of Series A5 Preferred Stock were converted to Common Stock, then the approval, by vote or written consent, of holders of a majority of the shares of Series A5 Preferred Stock then outstanding, voting as a separate class, shall also be required for the conversion of Series A5 Preferred Stock; (2) if the automatic conversion of shares of Series A6 Preferred Stock is in connection with a Liquidation Event wherein the Proceeds to which the holders of Series A6 Preferred Stock would be entitled pursuant to the conversion of such shares of Series A6 Preferred Stock into Common Stock and payment to them as holders of Common Stock in such Liquidation Event would be lower than the Proceeds such holders would otherwise have been entitled to receive in exchange for their shares of Series A6 Preferred Stock pursuant to Section 2 of Article IV(B) hereof if no shares of Series A6 Preferred Stock were converted to Common Stock, then the approval, by vote or written consent, of holders of a majority of the shares of Series A6 Preferred Stock then outstanding, voting as a separate class, shall also be required for the conversion of Series A6 Preferred Stock; and (3) if the automatic conversion of shares of Series A7 Preferred Stock is in connection with a Liquidation Event wherein the Proceeds to which the holders of Series A7 Preferred Stock would be entitled pursuant to the conversion of such shares of Series A7 Preferred Stock into Common Stock and payment to them as holders of Common Stock in such Liquidation Event would be lower than the Proceeds such holders would otherwise have been entitled to receive in exchange for their shares of Series A7 Preferred Stock pursuant to Section 2 of Article IV(B) hereof if no shares of Series A7 Preferred Stock were converted to Common Stock, then the approval, by vote or written consent, of holders of a majority of the shares of Series A7 Preferred Stock then outstanding, voting as a separate class, shall also be required for the conversion of Series A7 Preferred Stock; (B) solely with respect to the conversion of the Series A8 Preferred Stock, at least sixty-five percent (65%)

 

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of the shares of Series A8 Preferred Stock then outstanding, voting as a separate class; (C) solely with respect to the conversion of the IX Preferred, a majority of the shares of IX Preferred then outstanding, voting together as a single class and on an as-converted basis; (D) solely with respect to the conversion of the Series A10 Preferred Stock, a majority of the shares of Series A10 Preferred Stock then outstanding, voting as a separate class and (E) solely with respect to the conversion of the Series A11 Preferred Stock the Requisite Series A11 Consent.

(ii) Notwithstanding subsection 4(b)(i) above, unless waived by the vote or written consent of the holders of at least sixty-five percent (65%) of the shares of Series A8 Preferred Stock then outstanding, voting as a separate class, in the event of a conversion of Preferred Stock pursuant to a Qualified Public Offering in clause (x) of subsection 4(b)(i) in which the initial public offering price to the public set forth on the cover of the registration statement for the Qualified Public Offering (the “Qualified Offering Price”) is less than the Conversion Price then in effect for the Series A8 Preferred Stock, the Conversion Rate of the Series A8 Preferred Stock shall automatically be adjusted to a Conversion Rate that would provide for, as of the closing of the Qualified Public Offering, each holder of Series A8 Preferred Stock to receive on conversion of such holder’s shares of Series A8 Preferred Stock, a number of shares of Common Stock with an aggregate value (with such value calculated based on the Qualified Offering Price) equal to the product of (x) the number of shares of Series A8 Preferred Stock held by such holder that are converted into shares of Common Stock in connection with the Qualified Public Offering multiplied by (y) the Original Issue Price of the Series A8 Preferred Stock.

(iii) Notwithstanding subsection 4(b)(i) above, unless waived by the vote or written consent of the holders of a majority of the shares of Series A10 Preferred Stock then outstanding, voting as a separate class, in the event of a conversion of Preferred Stock pursuant to a Qualified Public Offering in clause (x) of subsection 4(b)(i) in which the Qualified Offering Price is less than the Conversion Price then in effect for the Series A10 Preferred Stock, the Conversion Price of the Series A10 Preferred Stock shall automatically be adjusted as of immediately prior to the closing of such Qualified Public Offering by assuming (solely as to the Series A10 Preferred Stock) that the shares to be issued by the Company in such Qualified Public Offering are shares of “Additional Stock” (as defined in subsection 4(d)(ii)) issued as of immediately prior to the conversion of the Series A10 Preferred Stock, such that the provisions of subsection 4(d)(i) shall apply in respect of the shares issued in such Qualified Public Offering.

(iv) Notwithstanding subsection 4(b)(i) above, unless waived by the vote or written consent of the Requisite Series A11 Consent, in the event of a conversion of Preferred Stock pursuant to a Qualified Public Offering in clause (x) of subsection 4(b)(i) in which the Qualified Offering Price is less than the Conversion Price then in effect for the Series A11 Preferred Stock, the Conversion Price of the Series A11 Preferred Stock shall automatically be adjusted as of immediately prior to the closing of such Qualified Public Offering by assuming (solely as to the Series A11 Preferred Stock) that the shares to be issued by the Company in such Qualified Public Offering are shares of “Additional Stock” (as defined in subsection 4(d)(ii)) issued as of immediately prior to the conversion of the Series A11 Preferred Stock, such that the provisions of subsection 4(d)(i) shall apply in respect of the shares issued in such Qualified Public Offering.

 

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(c) Mechanics of Conversion.

(i) Before any holder of Preferred Stock shall be entitled to voluntarily convert the same into shares of Series A Common Stock, he, she or it shall surrender the certificate or certificates therefor, duly endorsed (or if such holder alleges that any such certificate has been lost, stolen or destroyed, a lost certificate affidavit and agreement reasonably acceptable to this corporation to indemnify this corporation against any claim that may be made against this corporation on account of the alleged loss, theft or destruction of such certificate), at the principal office of this corporation or of any transfer agent for the Preferred Stock, together with written notice of the election to convert all or any number of the shares of Preferred Stock represented by such certificate or certificates, any event on which such conversion is contingent (if applicable) and the name or names in which the certificate or certificates for shares of Series A Common Stock are to be issued. This corporation shall, as soon as practicable thereafter, (i) issue and deliver at such office to such holder of Preferred Stock, or to the nominee or nominees of such holder, a certificate or certificates for the number of shares of Series A Common Stock to which such holder shall be entitled as aforesaid and a certificate for the number (if any) of the shares of Preferred Stock represented by the surrendered certificate or certificates that were not converted into Series A Common Stock and (ii) pay all declared but unpaid dividends for the applicable Preferred Stock which is being converted. Such conversion shall be deemed to have been made immediately prior to the close of business on the date set forth for conversion in the written notice of the election to convert irrespective of the surrender of the shares of Preferred Stock to be converted, and the person or persons entitled to receive the shares of Series A Common Stock issuable upon such conversion shall be treated for all purposes as the record holder or holders of such shares of Series A Common Stock as of such date. If the conversion is in connection with an underwritten offering of securities registered pursuant to the Act, the conversion may, at the option of any holder tendering Preferred Stock for conversion, be conditioned upon the closing with the underwriters of the sale of securities pursuant to such offering, in which event the persons entitled to receive the Series A Common Stock upon conversion of the Preferred Stock shall not be deemed to have converted such Preferred Stock until immediately prior to the closing of such sale of securities. If the conversion is in connection with automatic conversion provisions of subsection 4(b)(ii), 4(b)(iii) and/or 4(b)(iv), such conversion shall be deemed to have been made on the conversion date described in the stockholder consent approving such conversion, and the persons entitled to receive shares of Series A Common Stock issuable upon such conversion shall be treated for all purposes as the record holders of such shares of Series A Common Stock as of such date.

(ii) All holders of record of shares of Preferred Stock shall be sent written notice of the time (the “Automatic Conversion Time”) and the place designated for automatic conversion of all such shares of Preferred Stock pursuant to this Section 4. Such notice need not be sent in advance of the occurrence of the Automatic Conversion Time. Upon receipt of such notice, each holder of shares of Preferred Stock shall surrender his, her or its certificate or certificates for all such shares (or if such holder alleges that any such certificate has been lost, stolen or destroyed, a lost certificate affidavit and agreement reasonably acceptable to this corporation to indemnify this corporation against any claim that may be made against this corporation on account of the alleged loss, theft or destruction of such certificate) to this corporation at the place designated in such notice. This corporation shall, as soon as practicable thereafter, (i) issue and deliver at such office to such holder of Preferred Stock, or to the nominee

 

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or nominees of such holder, a certificate or certificates for the number of shares of Series A Common Stock to which such holder shall be entitled as aforesaid and a certificate for the number (if any) of the shares of Preferred Stock represented by the surrendered certificate or certificates that were not converted into Series A Common Stock and (ii) pay all declared but unpaid dividends for the applicable Preferred Stock which is being converted. Such conversion shall be deemed to have been made on the date of such Automatic Conversion Time (the “Automatic Conversion Date”), and the persons entitled to receive shares of Series A Common Stock issuable upon such Automatic Conversion Date shall be treated for all purposes as the record holders of such shares of Series A Common Stock as of such date.

(iii) Such converted Preferred Stock shall be retired and cancelled and may not be reissued as shares of such series, and this corporation may thereafter take such appropriate action (without the need for stockholder action) as may be necessary to reduce the authorized number of shares of Preferred Stock accordingly.

(d) Conversion Price Adjustments of Preferred Stock for Certain Dilutive Issuances, Splits and Combinations. The Conversion Price of the Preferred Stock shall be subject to adjustment from time to time as follows:

(i) (A) If this corporation shall issue, on or after the date upon which this Restated Certificate is accepted for filing by the Secretary of State of the State of Delaware (the “Filing Date”), any Additional Stock (as defined below) without consideration or for a consideration per share less than the Conversion Price applicable to a series of Preferred Stock in effect immediately prior to the issuance of such Additional Stock, the Conversion Price for such series in effect immediately prior to each such issuance shall forthwith (except as otherwise provided in this clause (i)) be adjusted to a price (calculated to the nearest one-hundredth of one cent) determined by multiplying such Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock Outstanding (as defined below) immediately prior to such issuance plus the number of shares of Series A Common Stock that the aggregate consideration received by this corporation for such issuance would purchase at such Conversion Price; and the denominator of which shall be the number of shares of Common Stock Outstanding (as defined below) immediately prior to such issuance plus the number of shares of such Additional Stock. For purposes of this Section 4(d)(i)(A), the term “Common Stock Outstanding” shall mean and include the following: (1) outstanding Series A Common Stock, Series B Common Stock and Series C Common Stock, (2) Series A Common Stock issuable upon conversion of outstanding Preferred Stock, (3) Series A Common Stock, Series B Common Stock and Series C Common Stock issuable upon exercise of outstanding stock options and (4) Series A Common Stock, Series B Common Stock and Series C Common Stock issuable upon exercise (and, in the case of warrants to purchase Preferred Stock, conversion) of outstanding warrants. Shares described in (1) through (4) above shall be included whether vested or unvested, whether contingent or non-contingent and whether exercisable or not yet exercisable. In the event that this corporation issues or sells, or is deemed to have issued or sold, shares of Additional Stock that results in an adjustment to a Conversion Price pursuant to the provisions of this Section 4(d) (the “First Dilutive Issuance”), and this corporation then issues or sells, or is deemed to have issued or sold, shares of Additional Stock in a subsequent issuance other than the First Dilutive Issuance that would result in further adjustment to a Conversion Price (a “Subsequent Dilutive Issuance”) pursuant to the same instruments as the First Dilutive

 

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Issuance, then and in each such case upon a Subsequent Dilutive Issuance the applicable Conversion Price for the applicable series of Preferred Stock shall be reduced to the applicable Conversion Price that would have been in effect had the First Dilutive Issuance and each Subsequent Dilutive Issuance all occurred on the closing date of the First Dilutive Issuance.

(B) No adjustment of the Conversion Price for the Preferred Stock shall be made in an amount less than one hundredth of one cent per share. Except to the limited extent provided for in subsections 4(d)(i)(E)(3) and 4(d)(i)(E)(4), no adjustment of such Conversion Price pursuant to this subsection 4(d)(i) shall have the effect of increasing the Conversion Price above the Conversion Price in effect immediately prior to such adjustment.

(C) In the case of the issuance of Additional Stock for cash, the consideration shall be deemed to be the amount of cash paid therefor, excluding amounts paid or payable for accrued interest.

(D) In the case of the issuance of the Additional Stock for a consideration in whole or in part other than cash, the consideration other than cash shall be deemed to be the fair market value thereof as determined in good faith by the Board of Directors irrespective of any accounting treatment.

(E) In the case of the issuance of options to purchase or rights to subscribe for Series A Common Stock, Series B Common Stock or Series C Common Stock, securities by their terms convertible into or exchangeable for Series A Common Stock, Series B Common Stock or Series C Common Stock or options to purchase or rights to subscribe for such convertible or exchangeable securities (“Common Stock Equivalents”), the following provisions shall apply for purposes of determining the number of shares of Additional Stock issued and the consideration paid therefor:

(1) The aggregate maximum number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock deliverable upon exercise (assuming the satisfaction of any conditions to exercisability, including without limitation, the passage of time, but without taking into account potential antidilution adjustments) of such Common Stock Equivalents shall be deemed to have been issued at the time such options or rights were issued and for a consideration equal to the consideration (determined in the manner provided in subsections 4(d)(i)(C) and 4(d)(i)(D)), if any, received by this corporation upon the issuance of such Common Stock Equivalents plus the minimum exercise price provided in such Common Stock Equivalents (without taking into account potential antidilution adjustments) for the Series A Common Stock, Series B Common Stock or Series C Common Stock covered thereby.

(2) The aggregate maximum number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock deliverable upon conversion of, or in exchange (assuming the satisfaction of any conditions to convertibility or exchangeability, including, without limitation, the passage of time, but without taking into account potential antidilution adjustments) for, any such convertible or exchangeable securities or upon the exercise of options to purchase or rights to subscribe for such convertible or

 

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exchangeable securities and subsequent conversion or exchange thereof shall be deemed to have been issued at the time such securities were issued or such options or rights were issued and for a consideration equal to the consideration, if any, received by this corporation for any such securities and related options or rights (excluding any cash received on account of accrued interest or accrued dividends), plus the minimum additional consideration, if any, to be received by this corporation (without taking into account potential antidilution adjustments) upon the conversion or exchange of such securities or the exercise of any related options or rights (the consideration in each case to be determined in the manner provided in subsections 4(d)(i)(C) and 4(d)(i)(D)).

(3) In the event of any change in the number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock deliverable or in the consideration payable to this corporation upon exercise of such options or rights or upon conversion of or in exchange for such convertible or exchangeable securities, the Conversion Price of the Preferred Stock, to the extent in any way affected by or computed using such options, rights or securities, shall be recomputed to reflect such change, but no further adjustment shall be made for the actual issuance of Series A Common Stock, Series B Common Stock or Series C Common Stock or any payment of such consideration upon the exercise of any such options or rights or the conversion or exchange of such securities.

(4) Upon the expiration of any such options or rights, the termination of any such rights to convert or exchange or the expiration of any options or rights related to such convertible or exchangeable securities, the Conversion Price of the Preferred Stock, to the extent in any way affected by or computed using such options, rights or securities or options or rights related to such securities, shall be recomputed to reflect the issuance of only the number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock (and convertible or exchangeable securities that remain in effect) actually issued upon the exercise of such options or rights, upon the conversion or exchange of such securities or upon the exercise of the options or rights related to such securities.

(5) The number of shares of Additional Stock deemed issued and the consideration deemed paid therefor pursuant to subsections 4(d)(i)(E)(1) and (2) shall be appropriately adjusted to reflect any change, termination or expiration of the type described in either subsection 4(d)(i)(E)(3) or (4).

(ii) “Additional Stock” shall mean any shares of Series A Common Stock, Series B Common Stock, or Series C Common Stock issued (or deemed to have been issued pursuant to subsection 4(d)(i)(E)) by this corporation on or after the Filing Date other than:

(A) Series A Common Stock, Series B Common Stock or Series C Common Stock issued pursuant to a transaction described in subsection 4(d)(iii) hereof;

(B) Series A Common Stock issued or issuable to employees, directors, consultants and other service providers for the primary purpose of soliciting or retaining their services pursuant to plans or agreements approved by the Board of Directors;

 

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(C) Except as provided in subsection 4(b)(ii) as to the Series A8 Preferred Stock, subsection 4(b)(iii) as to the Series A10 Preferred Stock and subsection 4(b)(iv) as to the Series A11 Preferred Stock, Series A Common Stock, Series B Common Stock or Series C Common Stock issued pursuant to, or in connection with, an underwritten public offering (it being understood that, for the avoidance of doubt, Additional Stock shall not include any shares issued or deemed to be issued as a result of an increase in the Conversion Rate of the Series A8 Preferred Stock resulting from the operation of subsection 4(b)(ii) and/or as a result of a decrease in the Conversion Price of the Series A10 Preferred Stock resulting from the operation of subsection 4(b)(iii) and/or the Series A11 Preferred Stock resulting from the operation of subsection 4(b)(iv));

(D) Series A Common Stock, Series B Common Stock or Series C Common Stock issued or issuable pursuant to the conversion or exercise of convertible or exercisable securities outstanding on the Filing Date;

(E) Series A Common Stock, Series B Common Stock or Series C Common Stock issued in connection with a bona fide business acquisition by this corporation, whether by merger, consolidation, sale of assets, sale or exchange of stock or otherwise, which issuance is approved by the Board of Directors;

(F) Series A Common Stock, Series B Common Stock or Series C Common Stock issued or deemed issued pursuant to subsection 4(d)(i)(E) as a result of a decrease in the Conversion Price of any series of Preferred Stock resulting from the operation of Section 4(d);

(G) Series A Common Stock issued or issuable upon conversion of Preferred Stock issued on or after the date hereof;

(H) Series A Common Stock, Series B Common Stock or Series C Common Stock issued pursuant to any equipment leasing arrangement or debt financing arrangement, which arrangement is approved by the Board of Directors;

(I) Series A Common Stock, Series B Common Stock or Series C Common Stock issued to persons or entities with which this corporation has business relationships, provided such issuances are approved by the Board of Directors and are primarily for non-equity financing purposes;

(J) Series A Common Stock issued upon conversion of any Series B Common Stock in accordance with Section (C)(5) of Article IV;

(K) Series A Common Stock issued upon conversion of any Series C Common Stock in accordance with Section (C)(5) of Article IV

(L) Series A Common Stock issued as a dividend on the Preferred Stock; or

 

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(M) shares of any authorized but unissued Series A11 Preferred Stock designated in this Restated Certificate, including shares issued pursuant to the A11 Purchase Agreement or the Call Option Agreements (as defined in the A11 Purchase Agreement), and shares of Series A Common Stock issued or issuable upon such Series A11 Preferred Stock (such issuances listed in (A) through (M) hereof collectively referred to as “Excluded Issuances”).

(iii) In the event this corporation should at any time or from time to time after the Filing Date fix a record date for the effectuation of a split or subdivision of the outstanding shares of Series A Common Stock, Series B Common Stock or Series C Common Stock or the determination of holders of Series A Common Stock, Series B Common Stock or Series C Common Stock entitled to receive a dividend or other distribution payable in additional shares of Series A Common Stock, Series B Common Stock or Series C Common Stock or Common Stock Equivalents without payment of any consideration by such holder for the additional shares of Series A Common Stock, Series B Common Stock or Series C Common Stock or the Common Stock Equivalents (including the additional shares of Series A Common Stock, Series B Common Stock or Series C Common Stock issuable upon conversion or exercise thereof), then, as of such record date (or the date of such dividend distribution, split or subdivision if no record date is fixed), the Conversion Price of the Preferred Stock shall be proportionately decreased so that the number of shares of Series A Common Stock issuable on conversion of each share of such series of Preferred Stock shall be increased in proportion to such increase of the aggregate number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock outstanding and those issuable with respect to such Common Stock Equivalents with the number of shares issuable with respect to Common Stock Equivalents determined from time to time in the manner provided for deemed issuances in subsection 4(d)(i)(E); provided, however, that if such record date is fixed and such dividend is not paid or if such distribution is not fully made on the date fixed therefor, the Conversion Price for such series of Preferred Stock will be re-computed accordingly as of the close of business on such record date and thereafter each such Conversion Price will be adjusted pursuant to this Section 4(d)(iii) to reflect the actual payment of such dividend or distribution.

(iv) If the number of shares of Series A Common Stock, Series B Common Stock or Series C Common Stock outstanding at any time after the Filing Date is decreased by a combination of the outstanding shares of Series A Common Stock, Series B Common Stock or Series C Common Stock, then, following the record date of such combination, the Conversion Price for the Preferred Stock shall be appropriately increased so that the number of shares of Series A Common Stock issuable on conversion of each share of such series shall be decreased in proportion to such decrease in outstanding shares.

(e) Other Distributions. In the event this corporation shall declare a distribution payable in securities of other persons, evidences of indebtedness issued by this corporation or other persons, assets (excluding cash dividends) or options or rights not referred to in subsection 4(d)(iii), then, in each such case for the purpose of this subsection 4(e), the holders of the Preferred Stock shall be entitled to a proportionate share of any such distribution as though they were the holders of the number of shares of Series A Common Stock of this corporation into which their shares of Preferred Stock are convertible as of the record date fixed for the determination of the holders of Series A Common Stock of this corporation entitled to receive such distribution.

 

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(f) Merger or Recapitalizations. If at any time or from time to time there shall be a reorganization, recapitalization, reclassification, consolidation or merger in which the Series A Common Stock (but not the Preferred Stock) is converted into or exchanged for securities, cash, or other property (other than a transaction provided for elsewhere in this Section 4 or in Section 2) provision shall be made so that the holders of the Preferred Stock shall thereafter be entitled to receive, upon conversion of the Preferred Stock, the number and kind of shares of stock or other securities, cash or property to which a holder of the number of shares of Series A Common Stock deliverable upon conversion of one share of such series of Preferred Stock immediately prior to such recapitalization would have been entitled on such recapitalization. In any such case, appropriate adjustment shall be made in the application of the provisions of this Section 4 with respect to the rights of the holders of the Preferred Stock after the recapitalization to the end that the provisions of this Section 4 (including adjustment of the Conversion Price then in effect and the number of shares issuable upon conversion of the Preferred Stock) shall be applicable after that event as nearly equivalently as may be practicable. For the avoidance of doubt, nothing in this subsection (f) shall be construed as preventing the holders of Preferred Stock from seeking any appraisal rights to which they are otherwise entitled under the General Corporation Law in connection with a merger triggering an adjustment hereunder, nor shall this subsection (f) be deemed conclusive evidence of the fair value of the shares of Preferred Stock in any such appraisal proceeding.

(g) No Fractional Shares and Certificate as to Adjustments.

(i) No fractional shares shall be issued upon the conversion of any share or shares of the Preferred Stock and the aggregate number of shares of Series A Common Stock to be issued to particular stockholders, shall be rounded down to the nearest whole share and this corporation shall pay in cash the fair market value of any fractional shares as of the time when entitlement to receive such fractions is mutually determined in good faith by the Board of Directors and the holders constituting the Requisite Investor Threshold. Whether or not fractional shares would be issuable upon such conversion shall be determined on the basis of the total number of shares of Preferred Stock the holder is at the time converting into Series A Common Stock and the number of shares of Series A Common Stock issuable upon such conversion.

(ii) Upon the occurrence of each adjustment or readjustment of the Conversion Price of any series of Preferred Stock pursuant to this Section 4, this corporation, at its expense, shall promptly as reasonably practicable, but in any event not later than 15 days thereafter, compute such adjustment or readjustment in accordance with the terms hereof and prepare and furnish to each holder of each applicable series of Preferred Stock a certificate setting forth such adjustment or readjustment (including the kind and amount of securities, cash or other property into which the Preferred Stock is convertible) and showing in detail the facts upon which such adjustment or readjustment is based. This corporation shall, as promptly as practicable upon the written request at any time of any holder of any series of Preferred Stock (but in any event not later than 15 days thereafter), furnish or cause to be furnished to such holder a like certificate setting forth (A) the Conversion Price for each applicable series of Preferred Stock at the time in effect, and (B) the number of shares of Series A Common Stock and the amount, if any, of other property that at the time would be received upon the conversion of a share of each applicable series of Preferred Stock.

 

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(h) Notices of Record Date. In the event (i) of any taking by this corporation of a record of the holders of any class of securities for the purpose of determining the holders thereof who are entitled to receive any dividend or other distribution, or to receive any right to subscribe for or purchase any shares of capital stock of any class or any other securities, or to receive any other security, or (ii) of any capital reorganization of this corporation, any reclassification of Common Stock, or any Liquidation Event, this corporation shall mail to each holder of Preferred Stock, at least ten (10) days prior to the date specified therein, a notice specifying the (x) date on which any such record is to be taken for the purpose of such dividend or distribution, and the amount and character of such dividend or distribution or (y) the effective date on which such reorganization, reclassification or Liquidation Event is proposed to take place, and the time, if any is to be fixed, as of which the holders of record of Common Stock (or such other capital stock or securities at the time issuable upon the conversion of the Preferred Stock) shall be entitled to exchange their shares of Common Stock (or such other capital stock or securities) for securities or other property deliverable upon such reorganization, reclassification, or Liquidation Event, and the amount per share and character of such exchange applicable to the Preferred Stock and the Common Stock.

(i) Reservation of Stock Issuable Upon Conversion. This corporation shall at all times reserve and keep available out of its authorized but unissued shares of Series A Common Stock, solely for the purpose of effecting the conversion of the shares of the Preferred Stock, such number of its shares of Series A Common Stock as shall from time to time be sufficient to effect the conversion of all outstanding shares of the Preferred Stock; and if at any time the number of authorized but unissued shares of Series A Common Stock shall not be sufficient to effect the conversion of all then outstanding shares of the Preferred Stock, in addition to such other remedies as shall be available to the holder of such Preferred Stock, this corporation will take such corporate action as may be necessary to increase its authorized but unissued shares of Series A Common Stock to such number of shares as shall be sufficient for such purposes, including, without limitation, engaging in best efforts to obtain the requisite stockholder approval of any necessary amendment to this Restated Certificate.

(j) Waiver of Adjustment to Conversion Price. Notwithstanding anything herein to the contrary, (i) any downward adjustment of the Conversion Price of any series of Legacy Preferred Stock may be waived, either prospectively or retroactively and either generally or in a particular instance, by the consent or vote of holders of a majority of the shares of Legacy Preferred Stock then outstanding (voting together as a single class and not as separate series, and on an as-converted basis); provided, however, that any downward adjustment of the Conversion Price of the Series A8 Preferred Stock pursuant to Article IV(B), Section 4(b)(ii) may only be waived by the vote or written consent of the holders of at least sixty-five percent (65%) of the shares of Series A8 Preferred Stock then outstanding, voting as a separate class, (ii) any downward adjustment of the Conversion Price of any series of IX Preferred may be waived, either prospectively or retroactively and either generally or in a particular instance, by the consent or vote of holders of a majority of the shares of IX Preferred then outstanding (voting together as a single class and not as separate series, and on an as-converted basis); provided,

 

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however, that if a downward adjustment of the Conversion Price of the Series AA-9 Preferred Stock is waived in accordance with this subsection 4(j)(ii), then any downward adjustment of the Conversion Price of the Series A9 Preferred Stock shall also be automatically waived, (iii) any downward adjustment of the Conversion Price of the Series A10 Preferred Stock may be waived, either prospectively or retroactively and either generally or in a particular instance, by the consent or vote of holders of a majority of the shares of Series A10 Preferred Stock then outstanding, voting as a separate class and (iv) any downward adjustment of the Conversion Price of the Series A11 Preferred Stock may be waived, either prospectively or retroactively and either generally or in a particular instance, by the consent or vote of the Requisite Series A11 Consent. Any such waiver shall bind all future holders of shares of such series of Preferred Stock.

5. Voting Rights.

(a) General Voting Rights. The holder of each share of Preferred Stock shall have the right to one vote for each share of Series A Common Stock into which such Preferred Stock could be converted as of the record date for determining stockholders entitled to vote on such matter, and with respect to such vote, such holder shall have full voting rights and powers equal to the voting rights and powers of the holders of Series A Common Stock, and shall be entitled, notwithstanding any provision hereof, to notice of any stockholders’ meeting in accordance with the Bylaws of this corporation, and except as provided by law or in subsection 5(b) below with respect to the election of directors by the separate class vote of the holders of Series A Common Stock and Series B Common Stock (voting together as a single class and not as separate series), shall be entitled to vote, together with holders of Series A Common Stock and Series B Common Stock (voting together as a single class and not as separate series), with respect to any question upon which holders of Series A Common Stock and Series B Common Stock have the right to vote. Fractional votes shall not, however, be permitted and any fractional voting rights available on an as-converted basis (after aggregating all shares into which shares of Preferred Stock held by each holder could be converted) shall be rounded to the nearest whole number (with one-half being rounded upward).

(b) Voting for the Election of Directors. As long as at least 37,370,484 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Legacy Preferred Stock originally issued remain outstanding, the holders of shares of Legacy Preferred Stock shall be entitled to elect nine (9) directors of this corporation. As long as at least 7,871,778 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A10 Preferred Stock originally issued remain outstanding, the holders of shares of Series A10 Preferred Stock shall be entitled to elect one (1) director of this corporation. The holders of outstanding Series A Common Stock and Series B Common Stock (voting together as a single class and not as separate series) shall be entitled to elect one (1) director of this corporation. The holders of Legacy Preferred Stock, Series A10 Preferred Stock, Series A Common Stock and Series B Common Stock (voting together as a single class and not as separate series, and on an as-converted basis) shall be entitled to elect any remaining directors of this corporation.

Notwithstanding the provisions of Section 223(a)(1) and 223(a)(2) of the General Corporation Law, any vacancy, including newly created directorships resulting from any

 

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increase in the authorized number of directors or amendment of this Restated Certificate, and vacancies created by removal or resignation of a director, may be filled through the nomination and election by the holders of shares of Preferred Stock (voting together as a single class and not as separate series) and/or the holders of outstanding Series A Common Stock and Series B Common Stock (voting together as a single class and not as separate series), as the case may be; provided, however, that to the extent a vacancy occurs (from the removal or resignation of a director), such vacancy shall be filled by the holders of the shares of the class(es) or series of stock entitled to elect such director or directors, and such chosen director shall hold office until the next annual election and until their successors are duly elected and shall qualify, unless sooner displaced; and no such directorship may be filled by shareholders of this corporation other than by the class(es) or series of shareholders of this corporation that are entitled to elect a person to fill such directorship, voting exclusively and together as a separate class. The holders of record of the shares of Series A Common Stock, Series B Common Stock and of any other class or series of voting stock (including the Preferred Stock), exclusively and voting together as a single class, shall be entitled to elect the balance of the total number of directors of this corporation. Any director may be removed during his or her term of office, either with or without cause, by, and only by, the affirmative vote of the holders of the shares of the class or series of stock entitled to elect such director or directors, given either at a special meeting of such stockholders duly called for that purpose or pursuant to a written consent of stockholders, and any vacancy thereby created may be filled by the holders of that class or series of stock represented at the meeting or pursuant to written consent.

6. Protective Provisions.

(a) Protective Provisions Applicable to the Preferred Stock. So long as at least 58,365,771 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Preferred Stock originally issued remain outstanding, this corporation shall not, and shall cause any subsidiary of this corporation not to (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders constituting the Requisite Investor Threshold, and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

(i) consummate a Liquidation Event or effect any other merger or consolidation;

(ii) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Preferred Stock;

(iii) increase or decrease (other than in connection with a conversion and as contemplated by this Restated Certificate) the total number of authorized shares of Common Stock or Preferred Stock;

(iv) (A) create or adopt any equity incentive or employee compensation plan that has not been adopted by the Board of Directors and approved by this

 

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corporation’s stockholders prior to the Filing Date, (B) create or approve any equity compensation agreement that is not made pursuant to a plan that has been adopted by the Board of Directors and approved by this corporation’s stockholders prior to the Filing Date (such plans and agreements referenced in clauses (A) or (B) collectively, the “Equity Plans”), or (C) increase or decrease the number of shares reserved in any Equity Plans that are effective as of the Filing Date (the total number of reserved shares under all Equity Plans that are effective as of the Filing Date, as increased from time to time in accordance with clause (C), the “Maximum Service Provider Share Number”); provided, that, the issuance by this corporation of securities to independent contractors that are not natural persons, as consideration for the provision of services or otherwise (any such issuance, a “Non-Plan Grant”), on or after the Filing Date, shall not require any approval pursuant to this Section 6(a) to the extent that the sum of (1) the number of securities subject to such Non-Plan Grant, (2) the number of securities issued and outstanding under all Equity Plans as of the date of the issuance of a Non-Plan Grant and (3) the number of securities issued and outstanding under all other Non-Plan Grants, does not exceed the Maximum Service Provider Share Number; provided, further, that in the event that an issuance of securities pursuant to the Equity Plans would cause the aggregate number of securities issued and outstanding pursuant to all Non-Plan Grants and the Equity Plans, in the aggregate, to exceed the Maximum Service Provider Share Number, than such issuance shall require the approval of holders constituting the Requisite Investor Threshold;

(v) authorize or issue any equity security (including any other security convertible into or exercisable for any such equity security) having a preference over, or being on a parity with, any series of Preferred Stock with respect to dividends, liquidation or redemption (other than the issuance of any authorized but unissued shares of Preferred Stock designated in this Restated Certificate (including any security convertible into or exercisable for such shares of Preferred Stock)), or reclassify, alter or amend any existing security that is junior to or on parity with any series of Preferred Stock with respect to dividends, liquidation or redemption;

(vi) redeem, purchase or otherwise acquire (or pay into or set aside for a sinking fund for such purpose) any share or shares of Preferred Stock or Common Stock; provided, however, that this restriction shall not apply to the repurchase of shares of Common Stock (A) from employees, officers, directors, consultants or other persons performing services for this corporation or any subsidiary at cost (or, if lower, fair market value) pursuant to agreements under which this corporation has the option to repurchase such shares upon the occurrence of certain events, such as the termination of employment or service or (B) pursuant to a right of first refusal;

(vii) change the authorized number of directors of this corporation;

(viii) pay or declare any dividend on any shares of capital stock of this corporation other than dividends payable on the Common Stock solely in the form of additional shares of Common Stock;

(ix) create, or hold capital stock in, any subsidiary that is not wholly owned (either directly or through one or more other subsidiaries) by this corporation, or

 

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sell, transfer or otherwise dispose of any capital stock of any direct or indirect subsidiary of this corporation, or permit any direct or indirect subsidiary to sell, lease, transfer, exclusively license or otherwise dispose (in a single transaction or series of related transactions) of all or substantially all of the assets of such subsidiary; or

(x) take or agree or consent to take any of the foregoing actions with respect to any direct or indirect subsidiary of this corporation.

(b) Protective Provisions Applicable to the Series A8 Preferred Stock. So long as at least 9,992,969 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A8 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders of at least sixty-five percent (65%) of the shares of Series A8 Preferred Stock then outstanding, and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series A8 Preferred Stock;

(ii) redeem, purchase or otherwise acquire (or pay into or set aside for a sinking fund for such purpose) any shares of Common Stock; provided, however, that this restriction shall not apply to the repurchase of shares of Common Stock (A) from employees, officers, directors, consultants or other persons performing services for this corporation or any subsidiary at cost (or, if lower, fair market value) pursuant to agreements under which this corporation has the option to repurchase such shares upon the occurrence of certain events, such as the termination of employment or service or (B) pursuant to a right of first refusal;

(iii) pay or declare any dividend on any shares of Common Stock other than dividends payable on the Common Stock solely in the form of additional shares of Common Stock; or

(iv) increase or decrease the total number of authorized shares of Series A8 Preferred Stock.

(c) Protective Provisions Applicable to the Series AA-9 Preferred Stock. So long as at least 1,783,198 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series AA-9 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders of a majority of the shares of Series AA-9 Preferred Stock then outstanding, and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

 

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(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series AA-9 Preferred Stock; or

(ii) increase or decrease the total number of authorized shares of Series AA-9 Preferred Stock.

(d) Protective Provisions Applicable to the Series A9 Preferred Stock. So long as at least 5,377,860 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A9 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders of a majority of the shares of Series A9 Preferred Stock then outstanding, and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series A9 Preferred Stock; or

(ii) increase or decrease the total number of authorized shares of Series A9 Preferred Stock.

(e) Protective Provisions Applicable to the Series A10 Preferred Stock. So long as at least 7,871,778 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A10 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders of a majority of the shares of Series A10 Preferred Stock then outstanding, and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series A10 Preferred Stock; or

(ii) increase or decrease the total number of authorized shares of Series A10 Preferred Stock.

(f) Protective Provisions Applicable to the Series A11 Preferred Stock. So long as at least 5,607,262 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A11 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of the Requisite Series A11 Consent and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

 

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(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series A11 Preferred Stock; or

(ii) increase or decrease the total number of authorized shares of Series A11 Preferred Stock.

(g) Protective Provisions Applicable to the Series A12 Preferred Stock. So long as at least 2,707,754 shares (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like) of Series A12 Preferred Stock originally issued remain outstanding, this corporation shall not (by amendment, merger, consolidation or otherwise), without (in addition to any other vote required by law or the Restated Certificate) first obtaining the approval by vote or written consent, as provided by law, of holders of a majority of the shares of Series A12 Preferred Stock then outstanding and any such act or transaction entered into without such consent or vote shall be null and void ab initio, and of no force or effect:

(i) amend, alter or repeal any provision of this corporation’s Certificate of Incorporation or Bylaws so as to adversely alter or change the powers, preferences, rights or special privileges of the shares of Series A12 Preferred Stock; or

(ii) increase or decrease the total number of authorized shares of Series A12 Preferred Stock.

7. Status of Converted Stock. In the event any shares of Preferred Stock shall be converted pursuant to Section 4 hereof, the shares so converted shall be cancelled and shall not be issuable by this corporation. The Restated Certificate shall be appropriately amended to effect the corresponding reduction in this corporation’s authorized capital stock.

8. Notices. Any notice required by the provisions of this Article IV(B) to be given to the holders of shares of Preferred Stock shall be deemed given (i) if deposited in the United States mail, postage prepaid, and addressed to each holder of record at his, her or its address appearing on the books of this corporation, (ii) if such notice is provided by electronic transmission in a manner permitted by Section 232 of the General Corporation Law, or (iii) if such notice is provided in another manner then permitted by the General Corporation Law.

C. Common Stock. The rights, preferences, privileges and restrictions granted to and imposed on the Common Stock are as set forth below in this Article IV(C).

1. Dividend Rights. Subject to the prior rights of holders of all classes of stock at the time outstanding having prior rights as to dividends, the holders of the Common Stock shall be entitled to receive, when, as and if declared by the Board of Directors, out of any assets of this corporation legally available therefor, any dividends as may be declared from time to time by the Board of Directors.

 

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2. Liquidation Rights. Upon the liquidation, dissolution or winding up of this corporation, the assets of this corporation shall be distributed as provided in Section 2 of Article IV(B) hereof.

3. Redemption. The Common Stock is not redeemable at the option of the holder.

4. Voting Rights. Each holder of Series A Common Stock shall have the right to one (1) vote for each share of Series A Common Stock, and shall be entitled to notice of any stockholders’ meeting in accordance with the Bylaws of this corporation, and shall be entitled to vote upon such matters and in such manner as may be provided by law. Each holder of Series B Common Stock shall have the right to ten (10) votes for each share of Series B Common Stock, and shall be entitled to notice of any stockholders’ meeting in accordance with the Bylaws of this corporation, and shall be entitled to vote upon such matters and in such manner as may be provided by law. Shares of Series C Common Stock shall have no voting rights, except as otherwise required by law, including without limitation Section 242(b)(2) of the General Corporation Law. Notwithstanding the foregoing, except as otherwise required by law, (i) holders of Series A Common Stock, Series B Common Stock, and Series C Common Stock shall not be entitled to vote on any amendment to this Restated Certificate that relates solely to the terms of one or more outstanding series of Preferred Stock if the holders of such affected series are entitled, either separately or together with the holders of one or more other such series, to vote thereon pursuant to this Restated Certificate or pursuant to the General Corporation Law, and (ii) the number of authorized shares of Common Stock, Series A Common Stock, Series B Common Stock or Series C Common Stock may be increased or decreased (but not below the number of shares thereof then outstanding) by the affirmative vote of the holders of a majority of the stock of this corporation entitled to vote, irrespective of the provisions of Section 242(b)(2) of the General Corporation Law.

5. Conversion. The shares of Series B Common Stock and Series C Common Stock (collectively, the “Convertible Common Stock”) are convertible as follows:

(a) Right to Convert Series B Common Stock. Each share of Series B Common Stock shall be convertible, at the option of the holder thereof, at any time after the date of issuance of such share at the office of this corporation or any transfer agent for such stock, into one (1) fully paid and nonassessable share of Series A Common Stock.

(b) Automatic Conversion of Series B Common Stock. At any time following the closing of a Qualified Public Offering, upon any transfer, other than a Permitted Transfer (as defined below), of a share of Series B Common Stock, such share of Series B Common Stock shall automatically be converted into one (1) fully paid and nonassessable share of Series A Common Stock. “Permitted Transfer” means a transfer of Series B Common Stock by a holder (i) for estate planning purposes, either during such holder’s lifetime or on death by will or intestacy to such holder’s spouse or other member of a holder’s immediate family, or to a custodian, trustee (including a trustee of a voting trust), executor or other fiduciary for the account of the holder’s spouse or members of the holder’s immediate family, or to a trust for the holder’s own self, or a charitable remainder trust or (ii) to one or more of such holder’s Affiliates. “Affiliates” means, with respect to any person, any other person who

 

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or which, directly or indirectly, controls, is controlled by, or is under common control with such specified person, including, without limitation, any general partner, officer, director or manager of such person and any venture capital fund now or hereafter existing that is controlled by one or more general partners or managing members of, or is under common investment management with, such person.

(c) Automatic Conversion of Series C Common Stock. Each share of Series C Common Stock shall be automatically converted into one (1) share of Series A Common Stock upon the earliest to occur of (i) the closing of a Qualified Public Offering, (ii) any transfer of such share to a holder of Series A Common Stock, Series B Common Stock or Preferred Stock, which transfer has been approved by the Board of Directors, in its sole discretion, and (iii) a merger or consolidation of this corporation with or into another entity other than a merger or consolidation (x) that would result in the voting securities outstanding immediately prior thereto continuing to represent over fifty percent (50%) of the combined voting power of the voting securities of this corporation or the surviving entity or its parent corporation outstanding immediately after such merger or consolidation or (y) effected to implement a recapitalization of this corporation in which no person or entity acquires more than fifty percent (50%) of the combined voting power of this corporation’s then outstanding securities, which person or entity did not possess such voting power prior to such recapitalization. Such conversion shall be deemed to have been made immediately prior to the closing date of the public offering described in clause (i), upon the transfer described in clause (ii) and immediately prior to a merger or consolidation of the kind described in clause (iii).

(d) Mechanics of Conversion. Before any holder of Series B Common Stock shall be entitled to voluntarily convert the same into shares of Series A Common Stock pursuant to subsection (C)(5)(a), he, she or it shall surrender the certificate or certificates therefor, duly endorsed, at the office of this corporation or of any transfer agent for the Common Stock, and shall give written notice to this corporation at its principal corporate office, of the election to convert the same and shall state therein the name or names in which the certificate or certificates for shares of Series A Common Stock are to be issued. Thereupon, there shall be issued and delivered to such holder promptly at such office and in its name as provided in such written notice, a certificate or certificates for the number of shares of Series A Common Stock into which the shares of Series B Common Stock so surrendered were convertible on the date of such written notice. Upon the occurrence of an automatic conversion of Convertible Common Stock pursuant to subsection (C)(5)(b) or subsection (C)(5)(c), the holders of such Convertible Common Stock shall surrender the certificates representing such shares at the office of this corporation or any transfer agent for the Common Stock. Thereupon, there shall be issued and delivered to such holder promptly at such office and in its name as shown on such surrendered certificate or certificates, a certificate or certificates for the number of shares of Series A Common Stock into which the shares of Convertible Common Stock surrendered were convertible on the date on which such automatic conversion occurred. Notwithstanding the foregoing, such conversion shall occur automatically without the need for any further action by the holders of such shares and whether or not the certificates representing such shares are surrendered to this corporation or its transfer agent; provided, however, that this corporation shall not be obligated to issue certificates evidencing the shares of Series A Common Stock issuable upon such conversion unless the certificates evidencing such shares of Convertible Common Stock are either delivered to this corporation or its transfer agent as provided above, or the holder notifies this corporation or its transfer agent that such certificates have been lost, stolen or destroyed and executes an agreement satisfactory to this corporation to indemnify this corporation from any loss incurred by it in connection with such certificates.

 

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(e) Adjustments for Stock Splits or Combinations. If at any time or from time to time after the date of filing of this Restated Certificate with the Secretary of State of the State of Delaware (the “Effective Time”), this corporation effects a subdivision of the outstanding shares of the Series A Common Stock into a greater number of shares of Series A Common Stock without an equivalent subdivision of the outstanding shares of Convertible Common Stock, or of either the Series B Common Stock or the Series C Common Stock, then, in the event of a conversion of shares of the applicable Convertible Common Stock into shares of Series A Common Stock, such shares of Convertible Common Stock shall convert into a number of shares of Series A Common Stock that has been proportionately increased. If at any time or from time to time after the Effective Time, this corporation effects a combination of the outstanding shares of the Series A Common Stock into a smaller number of shares of Series A Common Stock without an equivalent combination of the outstanding shares of Convertible Common Stock, or of either the Series B Common Stock or the Series C Common Stock, then, in the event of a conversion of shares of the applicable Convertible Common Stock into shares of Series A Common Stock, such shares of Convertible Common Stock shall convert into a number of shares of Series A Common Stock that has been proportionately decreased. If at any time or from time to time after the Effective Time, this corporation effects a subdivision of the outstanding shares of the Preferred Stock into a greater number of shares of Preferred Stock without an equivalent subdivision of the outstanding shares of Series A Common Stock, then, in the event of a conversion of shares of Preferred Stock into shares of Series A Common Stock, the applicable Conversion Price for each such series of Preferred Stock shall proportionately increase. If at any time or from time to time after the Effective Time, this corporation effects a combination of the outstanding shares of the Preferred Stock into a smaller number of shares of Preferred Stock without an equivalent combination of the outstanding shares of Series A Common Stock, then, in the event of a conversion of shares of Preferred Stock into shares of Series A Common Stock, the applicable Conversion Price for each such series of Preferred Stock shall proportionately decrease.

(f) Record Holders. The persons entitled to shares of Series A Common Stock upon conversion of Convertible Common Stock shall be treated for all purposes as the record holders of such shares of Series A Common Stock as of the date of conversion.

(g) Reservation of Stock Issuable Upon Conversion. This corporation shall at all times reserve and keep available out of its authorized but unissued shares of Series A Common Stock, solely for the purpose of effecting the conversion of the shares of the Convertible Common Stock, such number of its shares of Series A Common Stock as shall from time to time be sufficient to effect the conversion of all outstanding shares of Convertible Common Stock; and if at any time the number of authorized but unissued shares of Series A Common Stock shall not be sufficient to effect the conversion of all then outstanding shares of Convertible Common Stock, in addition to such other remedies as shall be available to the holders of Convertible Common Stock, this corporation will take such corporate action as may, in the opinion of its counsel, be necessary to increase its authorized but unissued shares of Series A Common Stock to such number of shares as shall be sufficient for such purposes, including, without limitation, engaging in commercially reasonable efforts to obtain the requisite stockholder approval of any necessary amendment to this Restated Certificate.

 

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(h) Status of Converted Stock. In the event any shares of Convertible Common Stock shall be converted pursuant to this subsection (C)(5), the shares so converted shall be cancelled and shall not be issuable by this corporation. The Restated Certificate shall be appropriately amended to effect the corresponding reduction in this corporation’s authorized capital stock.

ARTICLE V

Except as otherwise provided in this Restated Certificate, in furtherance and not in limitation of the powers conferred by statute, the Board of Directors is expressly authorized to make, repeal, alter, amend and rescind any or all of the Bylaws of this corporation.

ARTICLE VI

The number of directors of this corporation shall be determined in the manner set forth in the Bylaws of this corporation.

ARTICLE VII

Elections of directors need not be by written ballot unless the Bylaws of this corporation shall so provide.

ARTICLE VIII

Meetings of stockholders may be held within or without the State of Delaware, as the Bylaws of this corporation may provide. The books of this corporation may be kept (subject to any provision contained in the statutes) outside the State of Delaware at such place or places as may be designated from time to time by the Board of Directors or in the Bylaws of this corporation.

ARTICLE IX

To the fullest extent permitted by law, a director of this corporation shall not be personally liable to this corporation or its stockholders for monetary damages for breach of fiduciary duty as a director. If the General Corporation Law or any other law of the State of Delaware is amended after approval by the stockholders of this Article IX to authorize corporate action further eliminating or limiting the personal liability of directors, then the liability of a director of this corporation shall be eliminated or limited to the fullest extent permitted by the General Corporation Law as so amended.

Any amendment, repeal or modification of the foregoing provisions of this Article IX by the stockholders of this corporation shall not adversely affect any right or protection of a director of this corporation existing at the time of, or increase the liability of any director of this corporation with respect to any acts or omissions of such director occurring prior to, such amendment, repeal or modification.

 

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ARTICLE X

A. Right to Indemnification of Directors and Officers. This corporation shall indemnify and hold harmless, to the fullest extent permitted by applicable law as it presently exists or may hereafter be amended, any person (an “Indemnified Person”) who was or is made or is threatened to be made a party or is otherwise involved in any action, suit or proceeding, whether civil, criminal, administrative or investigative (aProceeding”), by reason of the fact that such person, or a person for whom such person is the legal representative, is or was a director or officer of this corporation or, while a director or officer of this corporation, is or was serving at the request of this corporation as a director, officer, employee or agent of another corporation or of a partnership, joint venture, limited liability company, trust, enterprise or nonprofit entity, including service with respect to employee benefit plans, against all liability and loss suffered and expenses (including attorneys’ fees) reasonably incurred by such Indemnified Person in such Proceeding. Notwithstanding the preceding sentence, except as otherwise provided in Section C of this Article X, this corporation shall be required to indemnify an Indemnified Person in connection with a Proceeding (or part thereof) commenced by such Indemnified Person only if the commencement of such Proceeding (or part thereof) by the Indemnified Person was authorized in advance by the Board of Directors.

B. Prepayment of Expenses of Directors and Officers. This corporation shall pay the expenses (including attorneys’ fees) incurred by an Indemnified Person in defending any Proceeding in advance of its final disposition, provided, however, that, to the extent required by law, such payment of expenses in advance of the final disposition of the Proceeding shall be made only upon receipt of an undertaking by the Indemnified Person to repay all amounts advanced if it should be ultimately determined that the Indemnified Person is not entitled to be indemnified under this Article X or otherwise.

C. Claims by Directors and Officers. If a claim for indemnification or advancement of expenses under this Article X is not paid in full within 30 days after a written claim therefor by the Indemnified Person has been received by this corporation, the Indemnified Person may file suit to recover the unpaid amount of such claim and, if successful in whole or in part, shall be entitled to be paid the expense of prosecuting such claim. In any such action this corporation shall have the burden of proving that the Indemnified Person is not entitled to the requested indemnification or advancement of expenses under applicable law.

D. Indemnification of Employees and Agents. This corporation may indemnify and advance expenses to any person who was or is made or is threatened to be made or is otherwise involved in any Proceeding by reason of the fact that such person, or a person for whom such person is the legal representative, is or was an employee or agent of this corporation or, while an employee or agent of this corporation, is or was serving at the request of this corporation as a director, officer, employee or agent of another corporation or of a partnership, joint venture, limited liability company, trust, enterprise or nonprofit entity, including service with respect to employee benefit plans, against all liability and loss suffered and expenses (including attorney’s fees) reasonably incurred by such person in connection with such Proceeding. The ultimate determination of entitlement to indemnification of persons who are non-director or officer employees or agents shall be made in such manner as is determined by the Board of Directors in its sole discretion. Notwithstanding the foregoing sentence, this corporation shall not be required to indemnify a person in connection with a Proceeding initiated by such person if the Proceeding was not authorized in advance by the Board of Directors.

 

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E. Advancement of Expenses of Employees and Agents. This corporation may pay the expenses (including attorney’s fees) incurred by an employee or agent in defending any Proceeding in advance of its final disposition on such terms and conditions as may be determined by the Board of Directors.

F. Non-Exclusivity of Rights. The rights conferred on any person by this Article X shall not be exclusive of any other rights which such person may have or hereafter acquire under any statute, provision of the certificate of incorporation, these by-laws, agreement, vote of stockholders or disinterested directors or otherwise.

G. Other Indemnification. This corporation’s obligation, if any, to indemnify any person who was or is serving at its request as a director, officer or employee of another corporation, partnership, limited liability company, joint venture, trust, organization or other enterprise shall be reduced by any amount such person may collect as indemnification from such other corporation, partnership, limited liability company, joint venture, trust, organization or other enterprise.

H. Insurance. The Board of Directors may, to the full extent permitted by applicable law as it presently exists, or may hereafter be amended from time to time, authorize an appropriate officer or officers to purchase and maintain at this corporation’s expense insurance: (a) to indemnify this corporation for any obligation which it incurs as a result of the indemnification of directors, officers and employees under the provisions of this Article X; and (b) to indemnify or insure directors, officers and employees against liability in instances in which they may not otherwise be indemnified by this corporation under the provisions of this Article X.

I. Amendment or Repeal. Any repeal or modification of the foregoing provisions of this Article X shall not adversely affect any right or protection hereunder of any person in respect of any act or omission occurring prior to the time of such repeal or modification. The rights provided hereunder shall inure to the benefit of any Indemnified Person and such person’s heirs, executors and administrators.

ARTICLE XI

This corporation renounces, to the fullest extent permitted by law, any interest or expectancy of this corporation in, or in being offered an opportunity to participate in, any Excluded Opportunity. An “Excluded Opportunity” is any matter, transaction or interest that is presented to, or acquired, created or developed by, or which otherwise comes into the possession of, (i) any director of this corporation who is not an employee of this corporation or any of its subsidiaries, or (ii) any holder of Preferred Stock or any partner, member, director, stockholder, employee or agent of any such holder, other than someone who is an employee of this corporation or any of its subsidiaries (collectively, “Covered Persons”), unless such matter, transaction or interest is presented to, or acquired, created or developed by, or otherwise comes into the possession of, a Covered Person expressly and solely in such Covered Person’s capacity as a director of this corporation.

 

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*    *    *

THIRD: The foregoing amendment and restatement was approved by the holders of the requisite number of shares of said corporation in accordance with Section 228 of the General Corporation Law.

FOURTH: That this Restated Certificate, which restates and integrates and further amends the provisions of this corporation’s Twelfth Amended and Restated Certificate of Incorporation, has been duly adopted in accordance with Sections 242 and 245 of the General Corporation Law.

 

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IN WITNESS WHEREOF, this Twelfth Amended and Restated Certificate of Incorporation has been executed by a duly authorized officer of this corporation on this 15 day of December, 2020.

 

/s/ Mario Schlosser
Mario Schlosser, Chief Executive Officer


STATE OF DELAWARE

CERTIFICATE OF AMENDMENT

TO THE

THIRTEENTH AMENDED AND RESTATED CERTIFICATE OF INCORPORATION

OF

MULBERRY HEALTH INC.

Mulberry Health Inc., a corporation organized and existing under and by virtue of the General Corporation Law of the State of Delaware (the “Corporation”), DOES HEREBY CERTIFY:

 

  1.

The Thirteenth Amended and Restated Certificate of Incorporation of the Corporation is hereby amended by deleting Article I thereof and inserting the following in lieu thereof:

“ARTICLE I

The name of this corporation is Oscar Health, Inc.”

 

  2.

The foregoing amendment was duly adopted in accordance with the provisions of Section 242 of the General Corporation Law of the State of Delaware.

(signature page follows)


IN WITNESS WHEREOF, this Certificate of Amendment to the Thirteenth Amended and Restated Certificate of Incorporation has been executed by a duly authorized officer of this corporation on this 21st day of December, 2020.

 

/s/ Mario Schlosser

Mario Schlosser
Chief Executive Officer

Exhibit 3.3

THIRD AMENDED AND RESTATED BYLAWS OF

OSCAR HEALTH, INC.

(A DELAWARE CORPORATION)


TABLE OF CONTENTS

 

 

         Page  

ARTICLE I OFFICES

     1  

1.1

  Registered Office      1  

1.2

  Offices      1  

ARTICLE II MEETINGS OF STOCKHOLDERS

     1  

2.1

  Location      1  

2.2

  Timing      1  

2.3

  Notice of Meeting      1  

2.4

  Stockholders’ Records      1  

2.5

  Special Meetings      2  

2.6

  Notice of Meeting      2  

2.7

  Business Transacted at Special Meeting      2  

2.8

  Quorum; Meeting Adjournment; Presence by Remote Means      2  

2.9

  Voting Thresholds      3  

2.10

  Number of Votes Per Share      3  

2.11

  Action by Written Consent of Stockholders; Electronic Consent; Notice of Action      3  

ARTICLE III DIRECTORS

     4  

3.1

  Authorized Directors      4  

3.2

  Vacancies      4  

3.3

  Board Authority      5  

3.4

  Location of Meetings      5  

3.5

  First Meeting      5  

3.6

  Regular Meetings      5  

3.7

  Special Meetings      5  

3.8

  Quorum      6  

3.9

  Action Without a Meeting      6  

3.10

  Telephonic Meetings      6  

3.11

  Committees      6  

3.12

  Minutes of Meetings      6  

3.13

  Compensation of Directors      6  

3.14

  Removal of Directors      7  

ARTICLE IV NOTICES

     7  

4.1

  Notice      7  

4.2

  Waiver of Notice      7  

4.3

  Electronic Notice      7  

ARTICLE V OFFICERS

     8  

5.1

  Required and Permitted Officers      8  

5.2

  Appointment of Required Officers      8  

5.3

  Appointment of Permitted Officers      8  

5.4

  Officer Compensation      8  

5.5

  Term of Office; Vacancies      8  

5.6

  Chairman Presides      8  

5.7

  Absence of Chairman      9  

5.8

  Powers of President      9  

5.9

  President’s Signature Authority      9  

5.10

  Absence of President      9  

5.11

  Duties of Secretary      9  

5.12

  Duties of Assistant Secretary      9  

 

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5.13

  Duties of Treasurer      10  

5.14

  Disbursements and Financial Reports      10  

5.15

  Treasurer’s Bond      10  

5.16

  Duties of Assistant Treasurer      10  

ARTICLE VI CERTIFICATE OF STOCK

     10  

6.1

  Stock Certificates      10  

6.2

  Facsimile Signatures      11  

6.3

  Lost Certificates      11  

6.4

  Transfer of Stock      11  

6.5

  Fixing a Record Date      11  

6.6

  Registered Stockholders      12  

ARTICLE VII GENERAL PROVISIONS

     12  

7.1

  Dividends      12  

7.2

  Reserve for Dividends      12  

7.3

  Checks      12  

7.4

  Fiscal Year      12  

7.5

  Corporate Seal      12  

7.6

  Indemnification      12  

7.7

  Conflicts with Certificate of Incorporation      14  

ARTICLE VIII AMENDMENTS

     14  

ARTICLE IX LOANS TO OFFICERS

     14  

ARTICLE X STOCK TRANSFERS

     15  

10.1

  Stock Transfer Agreements      15  

10.2

  Restriction on Transfer      15  

 

ii


THIRD AMENDED AND RESTATED BYLAWS

OF

OSCAR HEALTH, INC.

ARTICLE I

OFFICES

1.1 Registered Office. The registered office shall be in the City of Wilmington, County of New Castle, State of Delaware.

1.2 Offices. The corporation may also have offices at such other places both within and without the State of Delaware as the Board of Directors may from time to time determine or the business of the corporation may require.

ARTICLE II

MEETINGS OF STOCKHOLDERS

2.1 Location. All meetings of the stockholders for the election of directors shall be held in the City of Wilmington State of Delaware, at such place as may be fixed from time to time by the Board of Directors, or at such other place either within or without the State of Delaware as shall be designated from time to time by the Board of Directors and stated in the notice of the meeting; provided, however, that the Board of Directors may, in its sole discretion, determine that the meeting shall not be held at any place, but may instead be held solely by means of remote communication as authorized by Section 211 of the Delaware General Corporations Law (“DGCL”). Meetings of stockholders for any other purpose may be held at such time and place, if any, within or without the State of Delaware, as shall be stated in the notice of the meeting or in a duly executed waiver of notice thereof, or a waiver by electronic transmission by the person entitled to notice.

2.2 Timing. Annual meetings of stockholders, commencing with the year 2012, shall be held at such date and time as shall be designated from time to time by the Board of Directors and stated in the notice of the meeting, at which they shall elect by a plurality vote a Board of Directors, and transact such other business as may properly be brought before the meeting.

2.3 Notice of Meeting. Written notice of any stockholder meeting stating the place, if any, date and hour of the meeting, the means of remote communication, if any, by which stockholders and proxyholders may be deemed to be present in person and vote at such meeting, shall be given to each stockholder entitled to vote at such meeting not fewer than ten (10) nor more than sixty (60) days before the date of the meeting.

2.4 Stockholders’ Records. The officer who has charge of the stock ledger of the corporation shall prepare and make, at least ten (10) days before every meeting of stockholders, a complete list of the stockholders entitled to vote at the meeting, arranged in alphabetical order, and showing the address (but not the electronic address or other electronic contact information) of each stockholder and the number of shares registered in the name of each

 


stockholder. Such list shall be open to the examination of any stockholder, for any purpose germane to the meeting for a period of at least 10 days prior to the meeting: (i) on a reasonably accessible electronic network, provided that the information required to gain access to such list is provided with the notice of the meeting, or (ii) during ordinary business hours, at the principal place of business of the corporation. In the event that the corporation determines to make the list available on an electronic network, the corporation may take reasonable steps to ensure that such information is available only to stockholders of the corporation. If the meeting is to be held at a place, then the list shall be produced and kept at the time and place of the meeting during the whole time thereof, and may be inspected by any stockholder who is present. If the meeting is to be held solely by means of remote communication, then the list shall also be open to the examination of any stockholder during the whole time of the meeting on a reasonably accessible electronic network, and the information required to access such list shall be provided with the notice of the meeting.

2.5 Special Meetings. Special meetings of the stockholders, for any purpose or purposes, unless otherwise prescribed by statute or by the certificate of incorporation, may be called by the president and shall be called by the president or secretary at the request in writing of a majority of the Board of Directors, or at the request in writing of stockholders owning at least fifty percent 50% in amount of the entire capital stock of the corporation issued and outstanding and entitled to vote. Such request shall state the purpose or purposes of the proposed meeting.

2.6 Notice of Meeting. Written notice of a special meeting stating the place, date and hour of the meeting and the purpose or purposes for which the meeting is called, shall be given not fewer than ten (10) nor more than sixty (60) days before the date of the meeting, to each stockholder entitled to vote at such meeting. The means of remote communication, if any, by which stockholders and proxyholders may be deemed to be present in person and vote at such meeting shall also be provided in the notice.

2.7 Business Transacted at Special Meeting. Business transacted at any special meeting of stockholders shall be limited to the purposes stated in the notice.

2.8 Quorum; Meeting Adjournment; Presence by Remote Means.

(a) Quorum; Meeting Adjournment. The holders of a majority of the stock issued and outstanding and entitled to vote thereat, present in person or represented by proxy, shall constitute a quorum at all meetings of the stockholders for the transaction of business except as otherwise provided by statute or by the certificate of incorporation. If, however, such quorum shall not be present or represented at any meeting of the stockholders, the stockholders entitled to vote thereat, present in person or represented by proxy, shall have power to adjourn the meeting from time to time, without notice other than announcement at the meeting, until a quorum shall be present or represented. At such adjourned meeting at which a quorum shall be present or represented, any business may be transacted that might have been transacted at the meeting as originally notified. If the adjournment is for more than thirty (30) days, or if after the adjournment a new record date is fixed for the adjourned meeting, a notice of the adjourned meeting shall be given to each stockholder of record entitled to vote at the meeting.

 

2


(b) Presence by Remote Means. If authorized by the Board of Directors in its sole discretion, and subject to such guidelines and procedures as the Board of Directors may adopt, stockholders and proxyholders not physically present at a meeting of stockholders may, by means of remote communication:

(i) participate in a meeting of stockholders; and

(ii) be deemed present in person and vote at a meeting of stockholders whether such meeting is to be held at a designated place or solely by means of remote communication, provided that (i) the corporation shall implement reasonable measures to verify that each person deemed present and permitted to vote at the meeting by means of remote communication is a stockholder or proxyholder, (ii) the corporation shall implement reasonable measures to provide such stockholders and proxyholders a reasonable opportunity to participate in the meeting and to vote on matters submitted to the stockholders, including an opportunity to read or hear the proceedings of the meeting substantially concurrently with such proceedings, and (iii) if any stockholder or proxyholder votes or takes other action at the meeting by means of remote communication, a record of such vote or other action shall be maintained by the corporation.

2.9 Voting Thresholds. When a quorum is present at any meeting, the vote of the holders of a majority of the stock having voting power present in person or represented by proxy shall decide any question brought before such meeting, unless the question is one upon which by express provision of the statutes or of the certificate of incorporation, a different vote is required, in which case such express provision shall govern and control the decision of such question.

2.10 Number of Votes Per Share. Unless otherwise provided in the certificate of incorporation, each stockholder shall at every meeting of the stockholders be entitled to one vote by such stockholder or by proxy for each share of the capital stock having voting power held by such stockholder, but no proxy shall be voted on after three years from its date, unless the proxy provides for a longer period.

2.11 Action by Written Consent of Stockholders; Electronic Consent; Notice of Action.

(a) Action by Written Consent of Stockholders. Unless otherwise provided by the certificate of incorporation, any action required or permitted to be taken at any annual or special meeting of the stockholders may be taken without a meeting, without prior notice and without a vote, if a consent in writing setting forth the action so taken, is signed in a manner permitted by law by the holders of outstanding stock having not less than the number of votes that would be necessary to authorize or take such action at a meeting at which all shares entitled to vote thereon were present and voted. Written stockholder consents shall bear the date of signature of each stockholder who signs the consent in the manner permitted by law and shall be delivered to the corporation as provided in subsection (b) below. No written consent shall be effective to take the action set forth therein unless, within sixty (60) days of the earliest dated consent delivered to the corporation in the manner provided above, written consents signed by a sufficient number of stockholders to take the action set forth therein are delivered to the corporation in the manner provided above.

 

 

3


(b) Electronic Consent. A telegram, cablegram or other electronic transmission consenting to an action to be taken and transmitted by a stockholder or proxyholder, or a person or persons authorized to act for a stockholder or proxyholder, shall be deemed to be written, signed and dated for the purposes of this section, provided that any such telegram, cablegram or other electronic transmission sets forth or is delivered with information from which the corporation can determine (1) that the telegram, cablegram or other electronic transmission was transmitted by the stockholder or proxyholder or by a person or persons authorized to act for the stockholder or proxyholder and (2) the date on which such stockholder or proxyholder or authorized person or persons transmitted such telegram, cablegram or electronic transmission. The date on which such telegram, cablegram or electronic transmission is transmitted shall be deemed to be the date on which such consent was signed. No consent given by telegram, cablegram or other electronic transmission shall be deemed to have been delivered until such consent is reproduced in paper form and until such paper form is delivered to the corporation by delivery to its registered office in the State of Delaware, its principal place of business or an officer or agent of the corporation having custody of the book in which proceedings of meetings of stockholders are recorded. Delivery made to a corporation’s registered office shall be made by hand or by certified or registered mail, return receipt requested. Notwithstanding the foregoing limitations on delivery, consents given by telegram, cablegram or other electronic transmission may be otherwise delivered to the principal place of business of the corporation or to an officer or agent of the corporation having custody of the book in which proceedings of meetings of stockholders are recorded if, to the extent and in the manner provided by resolution of the Board of Directors of the corporation.

(c) Notice of Action. Prompt notice of any action taken pursuant to this Section 2.11 shall be provided to the stockholders in accordance with Section 228(e) of the DGCL.

ARTICLE III DIRECTORS

3.1 Authorized Directors. The number of directors that shall constitute the whole Board of Directors shall be determined by resolution of the Board of Directors or by the stockholders at the annual meeting of the stockholders, except as provided in Section 3.2 of this Article, and each director elected shall hold office until his successor is elected and qualified. Directors need not be stockholders.

3.2 Vacancies. Unless otherwise provided in the corporation’s certificate of incorporation, as it may be amended, vacancies and newly created directorships resulting from any increase in the authorized number of directors shall be filled by the class of shareholders of the company entitled to fill such directorship pursuant to the terms of the corporation’s certificate of incorporation, as it may be amended, and such chosen shall hold office until the next annual election and until their successors are duly elected and shall qualify, unless sooner displaced; and no such directorship may be filled by shareholders of the corporation other than by the shareholders of the corporation that are entitled to elect a person to fill such directorship, voting exclusively and as a separate class.

 

 

4


3.3 Board Authority. The business of the corporation shall be managed by or under the direction of its Board of Directors, which may exercise all such powers of the corporation and do all such lawful acts and things as are not by statute or by the certificate of incorporation or by these bylaws directed or required to be exercised or done by the stockholders.

3.4 Location of Meetings. The Board of Directors of the corporation may hold meetings, both regular and special, either within or without the State of Delaware.

3.5 First Meeting. The first meeting of each newly elected Board of Directors shall be held at such time and place as shall be fixed by the vote of the stockholders at the annual meeting and no notice of such meeting shall be necessary to the newly elected directors in order to legally constitute the meeting, provided a quorum shall be present. In the event of the failure of the stockholders to fix the time or place of such first meeting of the newly elected Board of Directors, or in the event such meeting is not held at the time and place so fixed by the stockholders, the meeting may be held at such time and place as shall be specified in a notice given as hereinafter provided for special meetings of the Board of Directors, or as shall be specified in a written waiver signed by all of the directors.

3.6 Regular Meetings. Regular meetings of the Board of Directors may be held without notice at such time and at such place as shall from time to time be determined by the Board of Directors.

3.7 Special Meetings. Special meetings of the Board of Directors may be called by the president upon notice to each director; special meetings shall be called by the president or secretary in like manner and on like notice on the written request of two (2) directors unless the Board of Directors consists of only one director, in which case special meetings shall be called by the president or secretary in like manner and on like notice on the written request of the sole director. Notice of any special meeting shall be given to each director at his business or residence in writing, or by telegram, facsimile transmission, telephone communication or electronic transmission (provided, with respect to electronic transmission, that the director has consented to receive the form of transmission at the address to which it is directed). If mailed, such notice shall be deemed adequately delivered when deposited in the United States mails so addressed, with postage thereon prepaid, at least five (5) days before such meeting. If by telegram, such notice shall be deemed adequately delivered when the telegram is delivered to the telegraph company at least twenty-four (24) hours before such meeting. If by facsimile transmission or other electronic transmission, such notice shall be transmitted at least twenty- four (24) hours before such meeting. If by telephone, the notice shall be given at least twelve (12) hours prior to the time set for the meeting. Neither the business to be transacted at, nor the purpose of, any regular or special meeting of the Board of Directors need be specified in the notice of such meeting, except for amendments to these bylaws as provided under Section 8.1 of Article VIII hereof. A meeting may be held at any time without notice if all the directors are present (except as otherwise provided by law) or if those not present waive notice of the meeting in writing, either before or after such meeting.

 

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3.8 Quorum. At all meetings of the Board of Directors a majority of the directors shall constitute a quorum for the transaction of business and any act of a majority of the directors present at any meeting at which there is a quorum shall be an act of the Board of Directors, except as may be otherwise specifically provided by statute or by the certificate of incorporation. If a quorum is not present at any meeting of the Board of Directors, the directors present thereat may adjourn the meeting from time to time, without notice other than announcement at the meeting, until a quorum shall be present.

3.9 Action Without a Meeting. Unless otherwise restricted by the certificate of incorporation or these bylaws, any action required or permitted to be taken at any meeting of the Board of Directors or of any committee thereof may be taken without a meeting if all members of the Board of Directors or committee, as the case may be, consent thereto in writing or by electronic transmission, and the writing, writings, electronic transmission or transmissions are filed with the minutes of proceedings of the Board of Directors or committee.

3.10 Telephonic Meetings. Unless otherwise restricted by the certificate of incorporation or these bylaws, members of the Board of Directors or any committee designated by the Board of Directors may participate in a meeting of the Board of Directors or any committee, by means of conference telephone or other means of communication by which all persons participating in the meeting can hear each other, and such participation shall constitute presence in person at the meeting.

3.11 Committees. The Board of Directors may designate one or more committees, each committee to consist of one or more of the directors of the corporation. The Board of Directors may designate one or more directors as alternate members of any committee, who may replace any absent or disqualified member at any meeting of the committee.

In the absence or disqualification of a member of a committee, the member or members thereof present at any meeting and not disqualified from voting, whether or not he or she or they constitute a quorum, may unanimously appoint another member of the Board of Directors to act at the meeting in the place of any such absent or disqualified member.

Any such committee, to the extent provided in the resolution of the Board of Directors, shall have and may exercise all the powers and authority of the Board of Directors in the management of the business and affairs of the corporation, and may authorize the seal of the corporation to be affixed to all papers which may require it, but no such committee shall have the power or authority in reference to the following matters: (i) approving or adopting, or recommending to the stockholders, any action or matter expressly required by the DGCL to be submitted to stockholders for approval or (ii) adopting, amending or repealing any provision of these bylaws.

3.12 Minutes of Meetings. Each committee shall keep regular minutes of its meetings and report the same to the Board of Directors when required.

3.13 Compensation of Directors. Unless otherwise restricted by the certificate of incorporation or these bylaws, the Board of Directors shall have the authority to fix the compensation of directors. The directors may be paid their expenses, if any, of attendance at

 

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each meeting of the Board of Directors and may be paid a fixed sum for attendance at each meeting of the Board of Directors or a stated salary as director. No such payment shall preclude any director from serving the corporation in any other capacity and receiving compensation therefor. Members of special or standing committees may be allowed like compensation for attending committee meetings.

3.14 Removal of Directors. Unless otherwise provided by the certificate of incorporation or these bylaws, any director or the entire Board of Directors may be removed, with or without cause, by the holders of a majority of shares entitled to vote at an election of directors.

ARTICLE IV

NOTICES

4.1 Notice. Unless otherwise provided in these bylaws, whenever, under the provisions of the statutes or of the certificate of incorporation or of these bylaws, notice is required to be given to any director or stockholder, it shall not be construed to mean personal notice, but such notice may be given in writing, by mail, addressed to such director or stockholder, at his address as it appears on the records of the corporation, with postage thereon prepaid, and such notice shall be deemed to be given at the time when the same shall be deposited in the United States mail. Notice to directors may also be given by telegram.

4.2 Waiver of Notice. Whenever any notice is required to be given under the provisions of the statutes or of the certificate of incorporation or of these bylaws, a waiver thereof in writing, signed by the person or persons entitled to said notice, whether before or after the time stated therein, shall be deemed equivalent thereto.

4.3 Electronic Notice.

(a) Electronic Transmission. Without limiting the manner by which notice otherwise may be given effectively to stockholders and directors, any notice to stockholders or directors given by the corporation under any provision of the DGCL, the certificate of incorporation or these bylaws shall be effective if given by a form of electronic transmission consented to by the stockholder or director to whom the notice is given. Any such consent shall be revocable by the stockholder or director by written notice to the corporation. Any such consent shall be deemed revoked if (1) the corporation is unable to deliver by electronic transmission two consecutive notices given by the corporation in accordance with such consent and (2) such inability becomes known to the secretary or an assistant secretary of the corporation or to the transfer agent, or other person responsible for the giving of notice; provided, however, the inadvertent failure to treat such inability as a revocation shall not invalidate any meeting or other action.

(b) Effective Date of Notice. Notice given pursuant to subsection (a) of this section shall be deemed given: (1) if by facsimile telecommunication, when directed to a number at which the stockholder or director has consented to receive notice; (2) if by electronic mail, when directed to an electronic mail address at which the stockholder or director has consented to receive notice; (3) if by a posting on an electronic network together with separate

 

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notice to the stockholder or director of such specific posting, upon the later of (i) such posting and (ii) the giving of such separate notice; and (4) if by any other form of electronic transmission, when directed to the stockholder or director. An affidavit of the secretary or an assistant secretary or of the transfer agent or other agent of the corporation that the notice has been given by a form of electronic transmission shall, in the absence of fraud, be prima facie evidence of the facts stated therein.

(c) Form of Electronic Transmission. For purposes of these bylaws, “electronic transmission” means any form of communication, not directly involving the physical transmission of paper, that creates a record that may be retained, retrieved, and reviewed by a recipient thereof, and that may be directly reproduced in paper form by such a recipient through an automated process.

ARTICLE V OFFICERS

5.1 Required and Permitted Officers. The officers of the corporation shall be chosen by the Board of Directors and shall be a president, treasurer and a secretary. The Board of Directors may elect from among its members a Chairman of the Board and a Vice- Chairman of the Board. The Board of Directors may also choose one or more vice-presidents, assistant secretaries and assistant treasurers. Any number of offices may be held by the same person, unless the certificate of incorporation or these bylaws otherwise provide.

5.2 Appointment of Required Officers. The Board of Directors at its first meeting after each annual meeting of stockholders shall choose a president, a treasurer, and a secretary and may choose vice-presidents.

5.3 Appointment of Permitted Officers. The Board of Directors may appoint such other officers and agents as it shall deem necessary who shall hold their offices for such terms and shall exercise such powers and perform such duties as shall be determined from time to time by the Board of Directors.

5.4 Officer Compensation. The salaries of all officers and agents of the corporation shall be fixed by the Board of Directors.

5.5 Term of Office; Vacancies. The officers of the corporation shall hold office until their successors are chosen and qualify. Any officer elected or appointed by the Board of Directors may be removed at any time by the affirmative vote of a majority of the Board of Directors. Any vacancy occurring in any office of the corporation shall be filled by the Board of Directors.

THE CHAIRMAN OF THE BOARD

5.6 Chairman Presides. The Chairman of the Board, if any, shall preside at all meetings of the Board of Directors and of the stockholders at which he or she shall be present. he or she shall have and may exercise such powers as are, from time to time, assigned to him by the Board of Directors and as may be provided by law.

 

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5.7 Absence of Chairman. In the absence of the Chairman of the Board, the Vice-Chairman of the Board, if any, shall preside at all meetings of the Board of Directors and of the stockholders at which he or she shall be present. He or she shall have and may exercise such powers as are, from time to time, assigned to him by the Board of Directors and as may be provided by law.

THE PRESIDENT AND VICE-PRESIDENTS

5.8 Powers of President. The president shall be the chief executive officer of the corporation; in the absence of the Chairman and Vice-Chairman of the Board he or she shall preside at all meetings of the stockholders and the Board of Directors; he or she shall have general and active management of the business of the corporation and shall see that all orders and resolutions of the Board of Directors are carried into effect.

5.9 President’s Signature Authority. The president shall execute bonds, mortgages and other contracts requiring a seal, under the seal of the corporation, except where required or permitted by law to be otherwise signed and executed and except where the signing and execution thereof shall be expressly delegated by the Board of Directors to some other officer or agent of the corporation.

5.10 Absence of President. In the absence of the president or in the event of his inability or refusal to act, the vice-president, if any, (or in the event there be more than one vice-president, the vice-presidents in the order designated by the directors, or in the absence of any designation, then in the order of their election) shall perform the duties of the president, and when so acting, shall have all the powers of and be subject to all the restrictions upon the president. The vice-presidents shall perform such other duties and have such other powers as the Board of Directors may from time to time prescribe.

THE SECRETARY AND ASSISTANT SECRETARY

5.11 Duties of Secretary. The secretary shall attend all meetings of the Board of Directors and all meetings of the stockholders and record all the proceedings of the meetings of the corporation and of the Board of Directors in a book to be kept for that purpose and shall perform like duties for the standing committees when required. He or she shall give, or cause to be given, notice of all meetings of the stockholders and special meetings of the Board of Directors, and shall perform such other duties as may be prescribed by the Board of Directors or president, under whose supervision he or she shall be. He or she shall have custody of the corporate seal of the corporation and he or she, or an assistant secretary, shall have authority to affix the same to any instrument requiring it and when so affixed, it may be attested by his signature or by the signature of such assistant secretary. The Board of Directors may give general authority to any other officer to affix the seal of the corporation and to attest the affixing by his signature.

5.12 Duties of Assistant Secretary. The assistant secretary, or if there be more than one, the assistant secretaries in the order determined by the Board of Directors (or if there be no such determination, then in the order of their election) shall, in the absence of the secretary or in the event of his inability or refusal to act, perform the duties and exercise the powers of the secretary and shall perform such other duties and have such other powers as the Board of Directors may from time to time prescribe.

 

 

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THE TREASURER AND ASSISTANT TREASURERS

5.13 Duties of Treasurer. The treasurer shall have the custody of the corporate funds and securities and shall keep full and accurate accounts of receipts and disbursements in books belonging to the corporation and shall deposit all moneys and other valuable effects in the name and to the credit of the corporation in such depositories as may be designated by the Board of Directors.

5.14 Disbursements and Financial Reports. He or she shall disburse the funds of the corporation as may be ordered by the Board of Directors, taking proper vouchers for such disbursements, and shall render to the president and the Board of Directors, at its regular meetings or when the Board of Directors so requires, an account of all his transactions as treasurer and of the financial condition of the corporation.

5.15 Treasurer’s Bond. If required by the Board of Directors, the treasurer shall give the corporation a bond (which shall be renewed every six years) in such sum and with such surety or sureties as shall be satisfactory to the Board of Directors for the faithful performance of the duties of his office and for the restoration to the corporation, in case of his death, resignation, retirement or removal from office, of all books, papers, vouchers, money and other property of whatever kind in his possession or under his control belonging to the corporation.

5.16 Duties of Assistant Treasurer. The assistant treasurer, or if there shall be more than one, the assistant treasurers in the order determined by the Board of Directors (or if there be no such determination, then in the order of their election) shall, in the absence of the treasurer or in the event of the treasurer’s inability or refusal to act, perform the duties and exercise the powers of the treasurer and shall perform such other duties and have such other powers as the Board of Directors may from time to time prescribe.

ARTICLE VI

CERTIFICATE OF STOCK

6.1 Stock Certificates. Every holder of stock in the corporation shall be entitled to have a certificate, signed by or in the name of the corporation by, the Chairman or Vice-Chairman of the Board of Directors, or the president or a vice-president and the treasurer or an assistant treasurer, or the secretary or an assistant secretary of the corporation, certifying the number of shares owned by him in the corporation.

Certificates may be issued for partly paid shares and in such case upon the face or back of the certificates issued to represent any such partly paid shares, the total amount of the consideration to be paid therefor, and the amount paid thereon shall be specified.

If the corporation shall be authorized to issue more than one class of stock or more than one series of any class, the powers, designations, preferences and relative participating, optional or other special rights of each class of stock or series thereof and the

 

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qualification, limitations or restrictions of such preferences and/or rights shall be set forth in full or summarized on the face or back of the certificate which the corporation shall issue to represent such class or series of stock, provided that, except as otherwise provided in Section 202 of the DGCL, in lieu of the foregoing requirements, there may be set forth on the face or back of the certificate which the corporation shall issue to represent such class or series of stock, a statement that the corporation will furnish without charge to each stockholder who so requests the powers, designations, preferences and relative participating, optional or other special rights of each class of stock or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights.

6.2 Facsimile Signatures. Any or all of the signatures on the certificate may be facsimile. In the event that any officer, transfer agent or registrar who has signed or whose facsimile signature has been placed upon a certificate shall have ceased to be such officer, transfer agent or registrar before such certificate is issued, the certificate may be issued by the corporation with the same effect as if such officer, transfer agent or registrar were still acting as such at the date of issue.

6.3 Lost Certificates. The Board of Directors may direct a new certificate or certificates to be issued in place of any certificate or certificates theretofore issued by the corporation alleged to have been lost, stolen or destroyed upon such shareholder delivering a lost certificate affidavit and agreement reasonably acceptable to this corporation to indemnify the corporation against any claim that may be made against the corporation on account of the alleged loss, theft or destruction of such certificate. When authorizing such issuance of a new certificate or certificates, the Board of Directors may, in its discretion and as a condition precedent to the issuance, require the owner of such lost, stolen or destroyed certificate or certificates, or his legal representative, to advertise the same in such manner as it shall require and/or to give the corporation a bond in such sum as it may direct as indemnity against any claim that may be made against the corporation with respect to the certificate alleged to have been lost, stolen or destroyed.

6.4 Transfer of Stock. Subject to the terms of Article X, upon surrender to the corporation or the transfer agent of the corporation of a certificate for shares duly endorsed or accompanied by proper evidence of succession, assignation or authority to transfer, it shall be the duty of the corporation to issue a new certificate to the person entitled thereto, cancel the old certificate and record the transaction upon its books.

6.5 Fixing a Record Date. In order that the corporation may determine the stockholders entitled to notice of or to vote at any meeting of stockholders or any adjournment thereof, or to express consent to corporate action in writing without a meeting, or entitled to receive payment of any dividend or other distribution or allotment of any rights, or entitled to exercise any rights in respect of any change, conversion or exchange of stock or for the purpose of any other lawful action, the Board of Directors may fix a record date which shall not be more than sixty (60) nor less than ten (10) days before the date of such meeting, nor more than sixty (60) days prior to any other action. A determination of stockholders of record entitled to notice of or to vote at a meeting of stockholders shall apply to any adjournment of the meeting; provided, however, that the Board of Directors may fix a new record date for the adjourned meeting.

 

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6.6 Registered Stockholders. The corporation shall be entitled to recognize the exclusive right of a person registered on its books as the owner of shares to receive dividends, to vote as such owner, to hold liable for calls and assessments a person registered on its books as the owner of shares and shall not be bound to recognize any equitable or other claim to or interest in such share or shares on the part of any other person, whether or not it shall have express or other notice thereof, except as otherwise provided by the laws of Delaware.

ARTICLE VII

GENERAL

PROVISIONS

7.1 Dividends. Dividends upon the capital stock of the corporation, if any, subject to the provisions of the certificate of incorporation, may be declared by the Board of Directors at any regular or special meeting, pursuant to law. Dividends may be paid in cash, in property or in shares of the capital stock, subject to the provisions of the certificate of incorporation.

7.2 Reserve for Dividends. Before payment of any dividend, there may be set aside out of any funds of the corporation available for dividends such sum or sums as the directors from time to time, in their sole discretion, think proper as a reserve or reserves to meet contingencies, or for equalizing dividends, or for repairing or maintaining any property of the corporation, or for such other purposes as the directors think conducive to the interests of the corporation, and the directors may modify or abolish any such reserve in the manner in which it was created.

7.3 Checks. All checks or demands for money and notes of the corporation shall be signed by such officer or officers or such other person or persons as the Board of Directors may from time to time designate.

7.4 Fiscal Year. The fiscal year of the corporation shall be fixed by resolution of the Board of Directors.

7.5 Corporate Seal. The Board of Directors may adopt a corporate seal having inscribed thereon the name of the corporation, the year of its organization and the words “Corporate Seal, Delaware.” The seal may be used by causing it or a facsimile thereof to be impressed or affixed or otherwise reproduced.

7.6 Indemnification.

(a) Right to Indemnification of Directors and Officers. The corporation shall indemnify and hold harmless, to the fullest extent permitted by applicable law as it presently exists or may hereafter be amended, any person (an “Indemnified Person”) who was or is made or is threatened to be made a party or is otherwise involved in any action, suit or proceeding, whether civil, criminal, administrative or investigative (a “Proceeding”), by reason of the fact that such person, or a person for whom such person is the legal representative, is or was a director or officer of the corporation or, while a director or officer of the corporation, is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation or of a partnership, joint venture, limited liability company, trust, enterprise or nonprofit entity, including service with respect to employee benefit plans, against all liability and

 

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loss suffered and expenses (including attorneys” fees) reasonably incurred by such Indemnified Person in such Proceeding. Notwithstanding the preceding sentence, except as otherwise provided in subsection (c) of this Section 7.6, the corporation shall be required to indemnify an Indemnified Person in connection with a Proceeding (or part thereof) commenced by such Indemnified Person only if the commencement of such Proceeding (or part thereof) by the Indemnified Person was authorized in advance by the Board of Directors.

(b) Prepayment of Expenses of Directors and Officers. The corporation shall pay the expenses (including attorneys” fees) incurred by an Indemnified Person in defending any Proceeding in advance of its final disposition, provided, however, that, to the extent required by law, such payment of expenses in advance of the final disposition of the Proceeding shall be made only upon receipt of an undertaking by the Indemnified Person to repay all amounts advanced if it should be ultimately determined that the Indemnified Person is not entitled to be indemnified under this Section 7.6 or otherwise.

(c) Claims by Directors and Officers. If a claim for indemnification or advancement of expenses under this Section 7.6 is not paid in full within 30 days after a written claim therefor by the Indemnified Person has been received by the corporation, the Indemnified Person may file suit to recover the unpaid amount of such claim and, if successful in whole or in part, shall be entitled to be paid the expense of prosecuting such claim. In any such action the corporation shall have the burden of proving that the Indemnified Person is not entitled to the requested indemnification or advancement of expenses under applicable law.

(d) Indemnification of Employees and Agents. The corporation may indemnify and advance expenses to any person who was or is made or is threatened to be made or is otherwise involved in any Proceeding by reason of the fact that such person, or a person for whom such person is the legal representative, is or was an employee or agent of the corporation or, while an employee or agent of the corporation, is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation or of a partnership, joint venture, limited liability company, trust, enterprise or nonprofit entity, including service with respect to employee benefit plans, against all liability and loss suffered and expenses (including attorney’s fees) reasonably incurred by such person in connection with such Proceeding. The ultimate determination of entitlement to indemnification of persons who are non-director or officer employees or agents shall be made in such manner as is determined by the Board of Directors in its sole discretion. Notwithstanding the foregoing sentence, the corporation shall not be required to indemnify a person in connection with a Proceeding initiated by such person if the Proceeding was not authorized in advance by the Board of Directors.

(e) Advancement of Expenses of Employees and Agents. The corporation may pay the expenses (including attorney’s fees) incurred by an employee or agent in defending any Proceeding in advance of its final disposition on such terms and conditions as may be determined by the Board of Directors.

(f) Non-Exclusivity of Rights. The rights conferred on any person by this Section 7.6 shall not be exclusive of any other rights which such person may have or hereafter acquire under any statute, provision of the certificate of incorporation, these by-laws, agreement, vote of stockholders or disinterested directors or otherwise.

 

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(g) Other Indemnification. The corporation’s obligation, if any, to indemnify any person who was or is serving at its request as a director, officer or employee of another corporation, partnership, limited liability company, joint venture, trust, organization or other enterprise shall be reduced by any amount such person may collect as indemnification from such other corporation, partnership, limited liability company, joint venture, trust, organization or other enterprise.

(h) Insurance. The Board of Directors may, to the full extent permitted by applicable law as it presently exists, or may hereafter be amended from time to time, authorize an appropriate officer or officers to purchase and maintain at the corporation’s expense insurance: (a) to indemnify the corporation for any obligation which it incurs as a result of the indemnification of directors, officers and employees under the provisions of this Section 7.6; and (b) to indemnify or insure directors, officers and employees against liability in instances in which they may not otherwise be indemnified by the corporation under the provisions of this Article Tenth.

(i) Amendment or Repeal. Any repeal or modification of the foregoing provisions of this Section 7.6 shall not adversely affect any right or protection hereunder of any person in respect of any act or omission occurring prior to the time of such repeal or modification. The rights provided hereunder shall inure to the benefit of any Indemnified Person and such person’s heirs, executors and administrators.

CERTIFICATE OF INCORPORATION GOVERNS

7.7 Conflicts with Certificate of Incorporation. In the event of any conflict between the provisions of the corporation’s certificate of incorporation and these bylaws, the provisions of the certificate of incorporation shall govern.

ARTICLE VIII

AMENDMENTS

8.1 Subject to the provisions of the certificate of incorporation, these bylaws may be altered, amended or repealed, or new bylaws may be adopted by the stockholders or by the Board of Directors, when such power is conferred upon the Board of Directors by the certificate of incorporation at any regular meeting of the stockholders or of the Board of Directors or at any special meeting of the stockholders or of the Board of Directors if notice of such alteration, amendment, repeal or adoption of new bylaws be contained in the notice of such special meeting. If the power to adopt, amend or repeal bylaws is conferred upon the Board of Directors by the certificate of incorporation, it shall not divest or limit the power of the stockholders to adopt, amend or repeal bylaws.

 

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ARTICLE IX

LOANS TO OFFICERS

9.1 The corporation may lend money to, or guarantee any obligation of or otherwise assist any officer or other employee of the corporation or of its subsidiaries, including any officer or employee who is a director of the corporation or its subsidiaries, whenever, in the judgment of the Board of Directors, such loan, guarantee or assistance may reasonably be expected to benefit the corporation. The loan, guarantee or other assistance may be with or without interest and may be unsecured or secured in such manner as the Board of Directors shall approve, including, without limitation, a pledge of shares of stock of the corporation. Nothing in these bylaws shall be deemed to deny, limit or restrict the powers of guaranty or warranty of the corporation at common law or under any statute.

ARTICLE X

STOCK TRANSFERS

10.1 Stock Transfer Agreements. The corporation shall have the power to enter into and perform any agreement with any number of stockholders of any one or more classes of stock of the corporation to restrict the transfer of shares of stock of the corporation of any one or more classes owned by such stockholders in any manner not prohibited by the DGCL or the certificate of incorporation, as it may be amended and/or restated from time to time.

10.2 Restriction on Transfer.

(a) Restriction on Transfer. No stockholder of the corporation (a “Stockholder”) may sell, assign, transfer, pledge, encumber or in any manner dispose of (“Transfer”) any share of stock of the corporation (a “Share”), whether voluntarily or by operation of law, or by gift or otherwise, other than by means of a Permitted Transfer (as defined below). If any provision(s) of any agreement(s) currently in effect by and between the corporation and any Stockholder (the “Stockholder Agreement(s)”) conflicts with this Section 10.2 of these bylaws, this Section 10.2 shall govern, and the remaining provision(s) of the Stockholder Agreement(s) that do not conflict with this Section 10.2 shall continue in full force and effect.

(b) Permitted Transfers. For purposes of this Section 10.2, a “Permitted Transfer” shall mean any of the following:

(i) any Transfer by a Stockholder of any or all of such Stockholder’s Shares to the corporation;

(ii) any Transfer by a Stockholder of any or all of such Stockholder’s Shares to such Stockholder’s Immediate Family (as defined below) or a trust for the benefit of such Stockholder or such Stockholder’s Immediate Family;

(iii) any Transfer by a Stockholder of any or all of such Stockholder’s Shares effected pursuant to such Stockholder’s will or the laws of intestate succession;

(iv) if a Stockholder is a partnership, limited liability company, or corporation, any Transfer by such Stockholder of any or all of such Stockholder’s Shares to the partners, members, retired partners, retired members, stockholders, and/or Affiliates (as defined below) of such Stockholder; provided that no Stockholder may Transfer any of such Stockholder’s Shares to a Special Purpose Entity (as defined below) pursuant to this subsection (iv);

 

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(v) any Transfer by a Stockholder and its Affiliates of at least five hundred thousand (500,000) shares of the corporation’s preferred stock (appropriately adjusted for any stock split, dividend, combination or other recapitalization of the corporation’s preferred stock effected after March 15, 2013) in one transaction or a series of related transactions to a single transferee and its Affiliates which (A) is made pursuant to a form of stock transfer agreement approved by the Board of Directors, (B) is not made on a Private Market Exchange (as defined below), (C) is not made to a Named Competitor (as defined below) and (D) is not made to a Special Purpose Entity; and/or

(vi) any Transfer of Shares approved by the Board of Directors.

Notwithstanding the foregoing, and for the avoidance of doubt, if a Permitted Transfer is approved pursuant to subsection (vi) of this Section 10.2(b) and the Shares of the transferring party are subject to rights of first refusal or co-sale rights pursuant to a Stockholder Agreement (the “ROFR and Co-Sale Rights”), the persons and/or entities entitled to the ROFR and Co-Sale Rights shall be permitted to exercise their respective ROFR and Co-Sale Rights in conjunction with that specific Permitted Transfer without any additional approval of the Board of Directors.

(c) Certain Definitions. For purposes of this Section 10.2:

(i) “Affiliate” shall mean any person or entity who or which, directly or indirectly, controls, is controlled by, or is under common control with the relevant Stockholder, including, without limitation, any general partner, managing partner, officer or director of such Stockholder or any venture capital fund now or hereafter existing that is controlled by one or more general partners or managing members of, or shares the same management company with, such Stockholder.

(ii) “Immediate Family” shall mean any child, stepchild, grandchild or other lineal descendant, any parent, stepparent, grandparent or other ancestor, any spouse, former spouse, sibling, niece, nephew, uncle, aunt, mother-in-law, father-in-law, son-in- law, daughter-in-law, brother-in-law or sister-in-law, including adoptive relationships, or any Spousal Equivalent.

(iii) “Named Competitor” shall mean any person or entity engaged in activities directly competitive with the then current and proposed products and services of the corporation, or any affiliate of such person or entity, as set forth on a list approved in good faith by the Board of Directors. The Board of Directors shall update the list of Named Competitors within thirty (30) days after June 30 and December 31 of each year; provided that if such list has not been prepared in such period, the most recent list so prepared will remain in effect.

(iv) “Private Market Exchange” shall mean any private marketplace or securities exchange, including, without limitation, SecondMarket or SharesPost, the activities of which have not been ruled, and which has not been endorsed, as compliant with applicable securities law by a court of competent jurisdiction or appropriate regulatory authority to the corporation’s reasonable satisfaction.

 

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(v) “Special Purpose Entity” shall mean an entity that holds or would hold only Shares or has or would have a class or series of security holders with beneficial interests primarily in Shares (including for such purpose an entity that holds cash and/or cash equivalents intended to purchase Shares); provided that no entity directly holding Shares as of January 31, 2013 shall be deemed a Special Purpose Entity.

(vi) “Spousal Equivalent” shall mean an individual who: (A) is in an exclusive, continuous, committed relationship with the relevant Stockholder, has been in that relationship for the twelve (12) months prior to the relevant date and intends to be in that relationship indefinitely; (B) has no such relationship with any other person and is not married to any other person; (C) shares a principal residence with the relevant Stockholder; (D) is at least 18 years of age and legally and mentally competent to consent to contract; (E) is not related by blood to the relevant stockholder to a degree of kinship that would prevent marriage from being recognized under the law of the state in which the individual and the relevant Stockholder reside; and (F) is jointly responsible with the relevant Stockholder for each other’s common welfare and financial obligations; provided that any Stockholder who wishes to Transfer stock to a Spousal Equivalent under Section 10.2(b)(ii) above must provide proof of (i) a joint mortgage, (ii) a joint lease or (iii) a joint bank account, in each case held by both the Stockholder and their Spousal Equivalent.

(d) Void Transfers. Any Transfer of Shares shall be null and void unless the terms, conditions and provisions of this Section 10.2 are strictly observed and followed.

(e) Termination of Restriction on Transfer. The foregoing restriction on transfer shall lapse upon the earlier of (i) immediately prior to the consummation of a Liquidation Event (as such term is defined in the certificate of incorporation, as it may be amended and/or restated from time to time), or (ii) immediately prior to the corporation’s first firm commitment underwritten public offering of its securities pursuant to a registration statement under the Securities Act of 1933, as amended.

(f) Legends. The certificates representing shares of stock of the corporation shall bear on their face the following legend so long as the foregoing restriction on transfer remains in effect:

“THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE BYLAWS OF THE CORPORATION. COPIES OF THE BYLAWS OF THE CORPORATION MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE CORPORATION.”

* * * * * * *

 

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CERTIFICATE OF SECRETARY

OF OSCAR HEALTH, INC.

The undersigned certifies:

1. That the undersigned is the duly elected and acting Secretary of Oscar Health, Inc., a Delaware corporation (the “Corporation”); and

2. That the bylaws attached hereto constitute the Third Amended and Restated Bylaws of the Corporation as duly adopted by the Board of Directors on December 21st, 2020.

IN WITNESS WHEREOF, I have hereunto subscribed my name this 21st day of December 2020.

 

/s/ Harold Greenberg

Harold Greenberg
Corporate Secretary

Exhibit 4.2

TWELFTH AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT

This TWELFTH AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT (the “Agreement”) is made by and among Oscar Health, Inc. (formerly Mulberry Health Inc.), a Delaware corporation (the “Company”), the investors listed on Schedule A hereto, each of which is herein referred to as an “Investor” and collectively as the “Investors”, and the holders of Class B Common Stock (as defined below) listed on Schedule B hereto, each of which is herein referred to as a “Common Holder” and collectively as the “Common Holders”.

RECITALS

WHEREAS, immediately prior to the pricing of the Initial Offering, certain of the Investors held Preferred Stock (the “Existing Investors”), which will be on or prior to the Effective Time, converted to, reclassified as and/or exchanged for Class A Common Stock of the Company and/or Class B Common Stock of the Company, as applicable, in connection with the Initial Offering, and such Existing Investors possess, prior to the Effective Time, information rights, rights of first offer and other rights pursuant to that certain Eleventh Amended and Restated Investors’ Rights Agreement dated as of December 17, 2020 by and among the Company, such Existing Investors and the Common Holders (the “Prior Agreement”);

WHEREAS, in connection with the Initial Offering, the undersigned, representing the requisite parties necessary to amend and restate the Prior Agreement, desire to amend and restate the Prior Agreement and to accept the rights created pursuant hereto in lieu of the rights created under the Prior Agreement.

NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties hereto hereby agree that the Prior Agreement shall be superseded and replaced in its entirety by this Agreement, and further agree as follows:

 

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1. Definitions. For purposes of this Agreement:

(a) The term “1934 Act” means the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder.

(b) The term “Act” means the Securities Act of 1933, as amended, and the rules and regulations promulgated thereunder.

(c) The term “Affiliate” means, with respect to (i) any Person, any other Person who or which, directly or indirectly, controls, is controlled by, or is under common control with such specified Person, including, without limitation, any general partner, officer, director or manager of such Person and any venture capital fund or institutional investor now or hereafter existing that is controlled by one or more general partners, managing members or management companies of, or is under common investment management with, such Person, and (ii) in the case of a Fidelity Investor, an investment company registered under the Investment Company Act advised or sub-advised by Fidelity or any affiliated investment advisor of Fidelity, one or more mutual fund, pension fund, pooled investment vehicle or institutional client advised or sub-advised by Fidelity or any affiliated investment advisor of Fidelity, in each case, registered under the Investment Advisers Act of 1940. Notwithstanding anything to the contrary in (but without limiting) the foregoing, (A) each Wellington Investor shall be deemed to be an “Affiliate” of each other Wellington Investor, (B) an entity that is an “Affiliate” of a Wellington Investor shall not be deemed to be an “Affiliate” of any other Wellington Investor unless such entity is a Wellington Investor (and, for the avoidance of doubt, an “Affiliate” of such entity shall not be deemed an “Affiliate” of any Wellington Investor solely by virtue of being an “Affiliate” of such entity), (C) each Fidelity Investor shall be deemed to be an “Affiliate” of each other Fidelity Investor, and (D) an entity that is an “Affiliate” of a Fidelity Investor shall not be deemed to be an “Affiliate” of any other Fidelity Investor unless such entity is a Fidelity Investor (and, for the avoidance of doubt, an “Affiliate” of such entity shall not be deemed an “Affiliate” of any Fidelity Investor solely by virtue of being an “Affiliate” of such entity).

(d) The term “Board” means the Company’s Board of Directors, as constituted from time to time.

(e) The term “Class A Common Stock” means shares of Class A Common Stock of the Company, par value $0.00001.

(f) The term “Class B Common Stock” means shares of Class B Common Stock of the Company, par value $0.00001.

(g) The term “Fidelity” means Fidelity Management & Research Company.

(h) The term “Fidelity Investor” means Fidelity and any Investor advised or sub-advised by Fidelity.

(i) The term “Form S-3” means such form under the Act as in effect on the date hereof or any registration form under the Act subsequently adopted by the SEC that permits inclusion or incorporation of substantial information by reference to other documents filed by the Company with the SEC.

 

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(j) The term “Free Writing Prospectus” means a free-writing prospectus, as defined in Rule 405.

(k) The term “Holder” means any Person owning or having the right to acquire Registrable Securities or any assignee thereof in accordance with Section 2.10 of this Agreement.

(l) The term “Initial Offering” means the Company’s first firm commitment underwritten public offering of its Common Stock or other equity securities to the public under the Act, to be consummated at the Effective Time.

(m) The term “Investment Company Act” means the Investment Company Act of 1940, as amended, and the rules and regulations promulgated thereunder.

(n) The term “Khosla Ventures” means Khosla Ventures IV, LP, Khosla Ventures IV (CF), LP and their respective Affiliates.

(o) The term “Person” shall mean any individual, corporation, partnership, trust, limited liability company, association or other entity.

(p) The term “Preferred Stock” means (i) the Series A Preferred Stock, (ii) the Series A-1 Preferred Stock, (iii) the Series AA Preferred Stock, (iv) the Series AAA Preferred Stock, (v) the Series A4 Preferred Stock, (vi) the Series A5 Preferred Stock, (vii) the Series A6 Preferred Stock, (viii) the Series A7 Preferred Stock, (ix) the Series A8 Preferred Stock, (x) the Series A9 Preferred Stock, (xi) the Series AA-9 Preferred Stock, (xii) the Series A10 Preferred Stock, (xiii) the Series A11 Preferred Stock and (xiv) the Series A12 Preferred Stock.

(q) The terms “register,” “registered,” and “registration” refer to a registration effected by preparing and filing a registration statement or similar document in compliance with the Act, and the declaration or ordering of effectiveness of such registration statement or document.

(r) The term “Registrable Securities” means (i) the shares of Class A Common Stock issued prior to the Effective Date in connection with the conversion and reclassification of the Preferred Stock for the Initial Offering (and the shares of Class A Common Stock issued or issuable upon the conversion of Class B Common Stock issued prior to the Effective Date in connection with the conversion and reclassification of the Preferred Stock for the Initial Offering), (ii) the shares of Class A Common Stock issuable or issued upon the conversion of shares of Class B Common Stock originally issued to the Common Holders as Series B Common Stock (as defined in the Prior Certificate) on or prior to the date of the Prior Agreement; provided, however, that such shares of Class A Common Stock issuable or issued upon the conversion of Class B Common Stock (as described in clause (ii)) shall not be deemed Registrable Securities for the purposes of Sections 2.1, 2.3, 2.11 and 4.7 except to the extent such shares of Class A Common Stock issuable or issued upon the conversion of Class B Common Stock are also Registrable Securities pursuant to clause (iv) of this definition, (iii) the Class A Common Stock

 

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(formerly Common Stock) issued upon conversion of the Preferred Stock issued upon exercise of the VLL Warrants in connection with the Initial Offering; provided, however, that such shares of Class A Common Stock issued to the holders of the VLL Warrants shall not be deemed Registrable Securities for the purposes of Sections 2.1, 2.11 and 4.7, (iv) shares of Class A Common Stock (which were formerly Common Stock under the Prior Certificate), including shares of Class A Common Stock issued or issuable upon the conversion of Class B Common Stock, acquired by an Investor pursuant to a Stock Transfer Agreement dated as of April 13, 2015 among the Company, such Investor and the other parties thereto, and (v) any Class A Common Stock or Class B Common Stock issued as (or issuable upon the conversion or exercise of any warrant, right or other security that is issued as) a dividend or other distribution with respect to, or in exchange for, or in replacement of, the shares referenced in (i), (ii), (iii) or (iv) above, excluding in all cases, however, any Registrable Securities sold by a Person in a transaction in which his, her or its rights under Section 2 of this Agreement are not assigned. In addition, the number of shares of Registrable Securities outstanding shall equal the aggregate of the number of shares of Class A Common Stock or Class B Common Stock outstanding that are, and the number of shares of Class A Common Stock or Class B Common Stock issuable pursuant to then exercisable or convertible securities that are, Registrable Securities.

(s) The term “Restated Certificate” shall mean the Company’s Amended and Restated Certificate of Incorporation, as amended and/or restated from time to time.

(t) The term “Rule 144” shall mean Rule 144 under the Act.

(u) The term “Rule 144(b)(1)(i)” shall mean subsection (b)(1)(i) of Rule 144 under the Act as it applies to Persons who have held shares for more than one (1) year.

(v) The term “Rule 405” shall mean Rule 405 under the Act.

(w) The term “SEC” shall mean the Securities and Exchange Commission.

(x) The term “VLL” shall mean, collectively, Venture Lending & Leasing, VI, LLC and Venture Lending & Leasing VII, LLC.

(y) The term “VLL Warrants” shall mean the warrants issued to Venture Lending & Leasing, VI, LLC and Venture Lending & Leasing VII, LLC, and their respective assigns, dated March 20, 2013.

(z) The term “Wellington” shall mean Wellington Management Company LLP, and any affiliated or successor investment advisor or subadvisor thereof to the Wellington Investors.

(aa) The term “Wellington Investors” shall mean those Investors, or permitted transferees of Registrable Securities held by Wellington Investors, that are advisory or subadvisory clients of Wellington.

2. Registration Rights. The Company covenants and agrees as follows:

 

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2.1 Request for Registration.

(a) Subject to the conditions of this Section 2.1, if the Company shall receive at any time after six (6) months after the effective date of the registration statement for the Initial Offering, a written request from the Holders of at least fifty percent (50%) of the Registrable Securities then outstanding (for purposes of this Section 2.1, the “Initiating Holders”) that the Company file a registration statement under the Act covering the registration of Registrable Securities with an anticipated aggregate offering price of at least $50,000,000, then the Company shall, within ten (10) days of the receipt thereof, give written notice of such request to all Holders, and subject to the limitations of this Section 2.1, use its commercially reasonable efforts to effect, as soon as practicable, the registration under the Act of all Registrable Securities that the Holders request to be registered in a written request received by the Company within twenty (20) days of the mailing of the Company’s notice pursuant to this Section 2.1(a).

(b) If the Initiating Holders intend to distribute the Registrable Securities covered by their request by means of an underwriting, they shall so advise the Company as a part of their request made pursuant to this Section 2.1, and the Company shall include such information in the written notice referred to in Section 2.1(a). In such event the right of any Holder to include its Registrable Securities in such registration shall be conditioned upon such Holder’s participation in such underwriting and the inclusion of such Holder’s Registrable Securities in the underwriting (unless otherwise mutually agreed by a majority in interest of the Initiating Holders and such Holder) to the extent provided herein. All Holders proposing to distribute their securities through such underwriting shall enter into an underwriting agreement in customary form with the underwriter or underwriters selected for such underwriting by the Company (which underwriter or underwriters shall be reasonably acceptable to those Initiating Holders holding a majority of the Registrable Securities then held by all Initiating Holders). Notwithstanding any other provision of this Section 2.1, if the underwriter advises the Company that marketing factors require a limitation on the number of securities underwritten (including Registrable Securities), then the Company shall so advise all Holders of Registrable Securities that would otherwise be underwritten pursuant hereto, and the number of shares that may be included in the underwriting shall be allocated to the Holders of such Registrable Securities pro rata based on the number of Registrable Securities held by all such Holders (including the Initiating Holders). In no event shall any Registrable Securities be excluded from such underwriting unless all other securities are first excluded. Any Registrable Securities excluded or withdrawn from such underwriting shall be withdrawn from the registration.

(c) Notwithstanding the foregoing, the Company shall not be required to effect a registration pursuant to this Section 2.1:

(i) in any particular jurisdiction in which the Company would be required to execute a general consent to service of process in effecting such registration, unless the Company is already subject to service in such jurisdiction and except as may be required under the Act; or

(ii) after the Company has effected two (2) registrations pursuant to this Section 2.1, and such registrations have been declared or ordered effective; or

 

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(iii) during the period starting with the date sixty (60) days prior to the Company’s good faith estimate of the date of the filing of and ending on a date one hundred eighty (180) days following the effective date of a Company-initiated registration subject to Section 2.2 below; provided that the Company is actively employing in good faith its commercially reasonable efforts to cause such registration statement to become effective; or

(iv) if the Initiating Holders propose to dispose of Registrable Securities that may be registered on Form S-3 pursuant to Section 2.3 hereof; or

(v) if the Company shall furnish to Holders requesting a registration statement pursuant to this Section 2.1 a certificate signed by the Company’s Chief Executive Officer or Chairman of the Board stating that in the good faith judgment of the Board, it would be seriously detrimental to the Company and its stockholders for such registration statement to be effected or remain effective at such time, in which event the Company shall have the right to defer such filing for a period of not more than ninety (90) days after receipt of the request of the Initiating Holders; provided that such right shall be exercised by the Company not more than once in any twelve (12) month period.

2.2 Company Registration.

(a) If (but without any obligation to do so) the Company proposes to register (including for this purpose a registration effected by the Company for stockholders other than the Holders) any of its stock or other securities under the Act in connection with the public offering of such securities (other than (i) a registration relating to a demand pursuant to Section 2.1 of this Agreement, (ii) a registration relating solely to the sale of securities of participants in a Company stock plan, (iii) a registration relating to a corporate reorganization or transaction under Rule 145 of the Act, (iv) a registration on any form that does not include substantially the same information as would be required to be included in a registration statement covering the sale of the Registrable Securities, or (v) a registration in which the only Common Stock being registered is Common Stock issuable upon conversion of debt securities that are also being registered), the Company shall, at such time, promptly give each Holder written notice of such registration. Upon the written request of each Holder given within twenty (20) days after mailing of such notice by the Company in accordance with Section 4.5 of this Agreement, the Company shall, subject to the provisions of Section 2.2(c) of this Agreement, use its commercially reasonable efforts to cause to be registered under the Act all of the Registrable Securities that each such Holder requests to be registered.

(b) Right to Terminate Registration. The Company shall have the right to terminate or withdraw any registration initiated by it under this Section 2.2 prior to the effectiveness of such registration whether or not any Holder has elected to include securities in such registration. The expenses of such withdrawn registration shall be borne by the Company in accordance with Section 2.6 hereof.

(c) Underwriting Requirements. In connection with any offering involving an underwriting of shares of the Company’s capital stock, the Company shall not be required under this Section 2.2 to include any of the Holders’ securities in such underwriting unless they accept the terms of the underwriting as agreed upon between the Company and the

 

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underwriters selected by the Company (or by other Persons entitled to select the underwriters) and enter into an underwriting agreement in customary form with such underwriters, and then only in such quantity as the underwriters determine in their sole discretion will not jeopardize the success of the offering by the Company. If the total amount of securities, including Registrable Securities, requested by stockholders to be included in such offering exceeds the amount of securities sold other than by the Company that the underwriters determine in their sole discretion is compatible with the success of the offering, then the Company shall be required to include in the offering only that number of such securities, including Registrable Securities, that the underwriters determine in their sole discretion will not jeopardize the success of the offering. In the event that the underwriters determine that less than all of the Registrable Securities requested to be registered can be included in such offering, then the Registrable Securities that are included in such offering shall be apportioned pro rata among the selling Holders based on the number of Registrable Securities held by all selling Holders or in such other proportions as shall mutually be agreed to by all such selling Holders. Notwithstanding the foregoing, in no event shall (i) any Registrable Securities be excluded from such offering unless all other stockholders’ securities have been first excluded from the offering, (ii) the amount of securities of the selling Holders included in the offering be reduced below twenty percent (20%) of the total amount of securities included in such offering, or (iii) any securities held by a Common Holder be included in such offering if any Registrable Securities held by any Holder other than a Common Holder (and that such Holder has requested to be registered) are excluded from such offering. For purposes of the preceding sentence concerning apportionment, for any selling stockholder that is a Holder of Registrable Securities and that is a venture capital fund, partnership, limited liability company, or corporation, the affiliated venture capital funds, partners, members, retired partners, retired members, and stockholders of such Holder, or the estates and family members of any such partners, members and retired partners and any trusts for the benefit of any of the foregoing Persons shall be deemed to be a single “selling Holder,” and any pro rata reduction with respect to such “selling Holder” shall be based upon the aggregate amount of Registrable Securities owned by all such related entities and individuals.

(d) Registrations effected pursuant to this Section 2.2 shall not be counted as requests for registration effected pursuant to Section 2.1 of this Agreement.

2.3 Form S-3 Registration. In case the Company shall receive from the Holders of at least thirty percent (30%) of the Registrable Securities (for purposes of this Section 2.3, the “S-3 Initiating Holders”) a written request or requests that the Company effect a registration on Form S-3 and any related qualification or compliance with respect to all or a part of the Registrable Securities owned by such Holder or Holders, the Company shall:

(a) promptly give written notice of the proposed registration, and any related qualification or compliance, to all other Holders; and

(b) use its commercially reasonable efforts to effect, as soon as practicable, such registration and all such qualifications and compliances as may be so requested and as would permit or facilitate the sale and distribution of all or such portion of such Holders’ Registrable Securities as are specified in such request, together with all or such portion of the Registrable Securities of any other Holders joining in such request as are specified in a written request given within twenty (20) days after receipt of such written notice from the Company; provided, however, that the Company shall not be obligated to effect any such registration, qualification or compliance, pursuant to this Section 2.3:

 

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(i) if Form S-3 is not available for such offering by the Holders;

(ii) if the Holders, together with the holders of any other securities of the Company entitled to inclusion in such registration, propose to sell Registrable Securities and such other securities (if any) at an aggregate price to the public (net of any underwriters’ discounts or commissions) of less than $5,000,000;

(iii) if the Company shall furnish to all Holders requesting a registration statement pursuant to this Section 2.3 a certificate signed by the Company’s Chief Executive Officer or Chairman of the Board stating that in the good faith judgment of the Board, it would be seriously detrimental to the Company and its stockholders for such registration statement to be effected at such time, in which event the Company shall have the right to defer such filing for a period of not more than ninety (90) days after receipt of the request of the S-3 Initiating Holders; provided that such right shall be exercised by the Company not more than once in any twelve (12) month period;

(iv) if the Company has, within the twelve (12) month period preceding the date of such request, already effected two (2) registrations on Form S-3 pursuant to this Section 2.3;

(v) in any particular jurisdiction in which the Company would be required to qualify to do business or to execute a general consent to service of process in effecting such registration, qualification or compliance, unless the Company is already subject to service in such jurisdiction;

(vi) if the Company, within thirty (30) days of receipt of the request of such S-3 Initiating Holders, gives notice to such S-3 Initiating Holders of its bona fide intention to effect the filing of a registration statement with the SEC within one hundred twenty (120) days of receipt of such request (other than a registration effected solely to qualify an employee benefit plan or to effect a business combination pursuant to Rule 145); provided that the Company is actively employing in good faith its commercially reasonable efforts to cause such registration statement to become effective; or

(vii) during the period starting with the date thirty (30) days prior to the Company’s good faith estimate of the date of the filing of and ending on a date ninety (90) days following the effective date of a Company-initiated registration subject to Section 2.2 of this Agreement; provided that the Company is actively employing in good faith its commercially reasonable efforts to cause such registration statement to become effective.

(c) If the S-3 Initiating Holders intend to distribute the Registrable Securities covered by their request by means of an underwriting, they shall so advise the Company as a part of their request made pursuant to this Section 2.3 and the Company shall include such information in the written notice referred to in Section 2.3(a). The provisions of Section 2.1(b) of this Agreement shall be applicable to such request (with the substitution of Section 2.3 for references to Section 2.1).

 

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(d) Subject to the foregoing, the Company shall file a registration statement covering the Registrable Securities and other securities so requested to be registered as soon as practicable after receipt of the request or requests of the S-3 Initiating Holders. Registrations effected pursuant to this Section 2.3 shall not be counted as requests for registration effected pursuant to Section 2.1 of this Agreement.

2.4 Obligations of the Company. Whenever required under this Section 2 to effect the registration of any Registrable Securities, the Company shall, as expeditiously as reasonably possible:

(a) prepare and file with the SEC a registration statement with respect to such Registrable Securities and use its commercially reasonable efforts to cause such registration statement to become effective, and, upon the request of the Holders of a majority of the Registrable Securities registered thereunder, keep such registration statement effective for a period of up to one hundred twenty (120) days or, if earlier, until the distribution contemplated in the registration statement has been completed;

(b) prepare and file with the SEC such amendments and supplements to such registration statement and the prospectus used in connection with such registration statement as may be necessary to comply with the provisions of the Act with respect to the disposition of all securities covered by such registration statement;

(c) furnish to the Holders such number of copies of a prospectus, including a preliminary prospectus and any Free Writing Prospectus, in conformity with the requirements of the Act, and such other documents as they may reasonably request in order to facilitate the disposition of Registrable Securities owned by them;

(d) use its commercially reasonable efforts to register and qualify the securities covered by such registration statement under such other securities or Blue Sky laws of such jurisdictions as shall be reasonably requested by the Holders; provided that the Company shall not be required in connection therewith or as a condition thereto to qualify to do business or to file a general consent to service of process in any such states or jurisdictions, unless the Company is already subject to service in such jurisdiction;

(e) in the event of any underwritten public offering, enter into and perform its obligations under an underwriting agreement, in usual and customary form, with the managing underwriter of such offering;

(f) notify each Holder of Registrable Securities covered by such registration statement at any time when a prospectus or Free Writing Prospectus (to the extent prepared by or on behalf of the Company) relating thereto is required to be delivered under the Act of the happening of any event as a result of which the prospectus included in such registration statement, as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the circumstances then existing, and, at the request of any such Holder,

 

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the Company will, as soon as reasonably practicable, file and furnish to all such Holders a supplement or amendment to such prospectus or Free Writing Prospectus (to the extent prepared by or on behalf of the Company) so that, as thereafter delivered to the purchasers of such Registrable Securities, such prospectus will not contain an untrue statement of a material fact or omit to state any fact necessary to make the statements therein not misleading in light of the circumstances under which they were made;

(g) cause all such Registrable Securities registered pursuant to this Section 2 to be listed on a national exchange or trading system and on each securities exchange and trading system on which similar securities issued by the Company are then listed;

(h) provide a transfer agent and registrar for all Registrable Securities registered pursuant to this Agreement and a CUSIP number for all such Registrable Securities, in each case not later than the effective date of such registration;

(i) promptly make available for inspection by the selling Holders, any managing underwriter(s) participating in any disposition pursuant to such registration statement, and any attorney or accountant or other agent retained by any such underwriter or selected by the selling Holders, all financial and other records, pertinent corporate documents, and properties of the Company, and cause the Company’s officers, directors, employees, and independent accountants to supply all information reasonably requested by any such seller, underwriter, attorney, accountant, or agent, in each case, as necessary or advisable to verify the accuracy of the information in such registration statement and to conduct appropriate due diligence in connection therewith;

(j) notify each selling Holder, promptly after the Company receives notice thereof, of the time when such registration statement has been declared effective or a supplement to any prospectus forming a part of such registration statement has been filed; and

(k) after such registration statement becomes effective, notify each selling Holder of any request by the SEC that the Company amend or supplement such registration statement or prospectus.

Notwithstanding the provisions of this Section 2, the Company shall be entitled to postpone or suspend, for a reasonable period of time, the filing, effectiveness or use of, or trading under, any registration statement if the Company shall determine that any such filing or the sale of any securities pursuant to such registration statement would in the good faith judgment of the Board:

(i) materially impede, delay or interfere with any material pending or proposed financing, acquisition, corporate reorganization or other similar transaction involving the Company for which the Board has authorized negotiations;

(ii) materially and adversely impair the consummation of any pending or proposed material offering or sale of any class of securities by the Company; or

(iii) require disclosure of material nonpublic information that, if disclosed at such time, would be materially harmful to the interests of the Company and its stockholders; provided, however, that during any such period all executive officers and directors of the Company are also prohibited from selling securities of the Company (or any security of any of the Company’s subsidiaries or affiliates).

 

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In the event of the suspension of effectiveness of any registration statement pursuant to this Section 2.4, the applicable time period during which such registration statement is to remain effective shall be extended by that number of days equal to the number of days the effectiveness of such registration statement was suspended.

2.5 Information from Holder. It shall be a condition precedent to the obligations of the Company to take any action pursuant to this Section 2 with respect to the Registrable Securities of any selling Holder that such Holder shall furnish to the Company such information regarding itself, the Registrable Securities held by it, and the intended method of disposition of such securities as shall be reasonably required to effect the registration of such Holder’s Registrable Securities.

2.6 Expenses of Registration. All expenses other than underwriting discounts and commissions incurred in connection with registrations, filings or qualifications pursuant to Sections 2.1, 2.2 and/or 2.3 of this Agreement, including, without limitation, all registration, filing and qualification fees, printers’ and accounting fees, fees and disbursements of counsel for the Company and the reasonable fees and disbursements of one counsel for the selling Holders shall be borne by the Company. Notwithstanding the foregoing, the Company shall not be required to pay for any expenses of any registration proceeding begun pursuant to Section 2.1 of this Agreement if the registration request is subsequently withdrawn at the request of the Holders of a majority of the Registrable Securities to be registered (in which case all participating Holders shall bear such expenses pro rata based upon the number of Registrable Securities that were to be included in the withdrawn registration) unless, in the case of a registration requested under Section 2.1 of this Agreement, the Holders of a majority of the Registrable Securities agree to forfeit their right to one demand registration pursuant to Section 2.1 of this Agreement and; provided, however, that if at the time of such withdrawal, the Holders have learned of a material adverse change in the condition, business or prospects of the Company from that known to the Holders at the time of their request and have withdrawn the request with reasonable promptness following disclosure by the Company of such material adverse change, then the Holders shall not be required to pay any of such expenses and shall retain all, and not forfeit any, of their rights pursuant to Section 2.1 of this Agreement. All expenses incurred in connection with a registration requested pursuant to Section 2.3 of this Agreement, including, without limitation, all registration, filing, qualification, printer’s and accounting fees and the reasonable fees and disbursements of counsel for the selling Holder or Holders and counsel for the Company, shall be borne pro rata by the Holder or Holders participating in such registration effected pursuant to Section 2.3 of this Agreement.

2.7 Delay of Registration. No Holder shall have any right to obtain or seek an injunction restraining or otherwise delaying any such registration as the result of any controversy that might arise with respect to the interpretation or implementation of this Section 2.

2.8 Indemnification. In the event any Registrable Securities are included in a registration statement under this Section 2:

 

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(a) To the extent permitted by law, the Company will indemnify and hold harmless each Holder, the partners, members, officers, directors and equity holders of each Holder, legal counsel and accountants for each Holder, any underwriter (as defined in the Act) for such Holder and each Person, if any, who controls such Holder or underwriter within the meaning of the Act or the 1934 Act, against any losses, claims, damages or liabilities (joint or several) to which any of the foregoing Persons may become subject under the Act, the 1934 Act, any state securities laws or any rule or regulation promulgated under the Act, the 1934 Act or any state securities laws, insofar as such losses, claims, damages, or liabilities (or actions or proceedings, whether commenced or threatened, in respect thereof) arise out of or are based upon any of the following statements, omissions or violations (collectively, a “Violation”): (i) any untrue or alleged untrue statement of a material fact contained in such registration statement, including any preliminary prospectus, final prospectus, or Free Writing Prospectus contained therein or any amendments or supplements thereto, any issuer information (as defined in Rule 433 of the Act) filed or required to be filed pursuant to Rule 433(d) under the Act or any other document incident to such registration prepared by or on behalf of the Company or used or referred to by the Company, (ii) the omission or alleged omission of a material fact required to be stated in such registration statement, or necessary to make the statements therein not misleading or (iii) any violation or alleged violation by the Company of the Act, the 1934 Act, any state securities laws or any rule or regulation promulgated under the Act, the 1934 Act or any state securities laws, and the Company will reimburse each such Holder, underwriter, controlling Person or other aforementioned Person or any Person intended to be indemnified pursuant to this Section 2.8(a) for any legal or other expenses reasonably incurred by such Person in connection with investigating or defending any such loss, claim, damage, liability, action or proceeding as such expenses are incurred; provided, however, that the indemnity agreement contained in this Section 2.8(a) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability, action or proceeding if such settlement is effected without the consent of the Company (which consent shall not be unreasonably withheld), nor shall the Company be liable in any such case for any such loss, claim, damage, liability, action or proceeding to the extent that it arises out of or is based upon a Violation that occurs in reliance upon, and in conformity with, written information furnished expressly for use in connection with such registration by any such Holder, underwriter, controlling Person or other aforementioned Person.

(b) To the extent permitted by law, each selling Holder, severally and not jointly, will indemnify and hold harmless the Company, each of its directors, each of its officers who has signed the registration statement, each Person, if any, who controls the Company within the meaning of the Act, legal counsel and accountants for the Company, any underwriter, any other Holder selling securities in such registration statement and any controlling Person of any such underwriter or other Holder, against any losses, claims, damages or liabilities (joint or several) to which any of the foregoing Persons may become subject, under the Act, the 1934 Act, any state securities laws or any rule or regulation promulgated under the Act, the 1934 Act or any state securities laws, insofar as such losses, claims, damages or liabilities (or actions or proceedings, whether commenced or threatened, in respect thereof) arise out of or are based upon any Violation, in each case to the extent (and only to the extent) that such Violation occurs in reliance upon and in conformity with written information furnished by such Holder expressly for use in connection with such registration; and each such Holder will reimburse any Person intended to be indemnified pursuant to this Section 2.8(b) for any legal or other expenses reasonably incurred by such Person in connection with investigating or defending any such loss, claim, damage, liability, action or

 

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proceeding as such expenses are incurred; provided, however, that the indemnity agreement contained in this Section 2.8(b) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability, action or proceeding if such settlement is effected without the consent of the Holder (which consent shall not be unreasonably withheld), and provided that in no event shall any indemnity under this Section 2.8(b) exceed the net proceeds from the offering received by such Holder.

(c) Promptly after receipt by an indemnified party under this Section 2.8 of notice of the commencement of any action or proceeding (including any governmental action or proceeding) for which a party may be entitled to indemnification, such indemnified party will, if a claim in respect thereof is to be made against any indemnifying party under this Section 2.8, deliver to the indemnifying party a written notice of the commencement thereof and the indemnifying party shall have the right to participate in and, to the extent the indemnifying party so desires, jointly with any other indemnifying party similarly noticed, to assume the defense thereof with counsel mutually satisfactory to the parties; provided, however, that an indemnified party (together with all other indemnified parties that may be represented without conflict by one counsel) shall have the right to retain one (1) separate counsel, with the fees and expenses to be paid by the indemnifying party, if representation of such indemnified party by the counsel retained by the indemnifying party would be inappropriate due to actual or potential differing interests between such indemnified party and any other party represented by such counsel in such proceeding. The failure to deliver written notice to the indemnifying party within a reasonable time of the commencement of any such action or proceeding, if materially prejudicial to its ability to defend such action or proceeding, shall relieve such indemnifying party of liability to the indemnified party under this Section 2.8 to the extent of such material prejudice, but the omission to so deliver written notice to the indemnifying party will not relieve such indemnifying party of any liability that it may have to any indemnified party otherwise than under this Section 2.8.

(d) If the indemnification provided for in this Section 2.8 is held by a non-appealable order from a court of competent jurisdiction to be unavailable to an indemnified party with respect to any loss, liability, claim, damage or expense referred to herein, then the indemnifying party, in lieu of indemnifying such indemnified party hereunder, shall contribute to the amount paid or payable by such indemnified party as a result of such loss, liability, claim, damage or expense in such proportion as is appropriate to reflect the relative fault of the indemnifying party on the one hand and the indemnified party on the other hand in connection with the statements or omissions that resulted in such loss, liability, claim, damage or expense, as well as any other relevant equitable considerations; provided, however, that (i) no contribution by any Holder, when combined with any amounts paid by such Holder pursuant to Section 2.8(b), shall exceed the net proceeds from the offering received by such Holder and (ii) no Person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Act) will be entitled to contribution from any Person who was not guilty of such fraudulent misrepresentation; and provided further that in no event shall a Holder’s liability pursuant to this Section 2.8(d), when combined with the amounts paid or payable by such Holder pursuant to Section 2.8(b), exceed the proceeds from the offering received by such Holder (net of any expenses paid by such Holder). The relative fault of the indemnifying party and the indemnified party shall be determined by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or the omission or alleged omission to state a material fact relates to information supplied by the indemnifying party or by the indemnified party and the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission.

 

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(e) Notwithstanding the foregoing, to the extent that the provisions on indemnification and contribution contained in the underwriting agreement entered into in connection with the underwritten public offering are in conflict with the foregoing provisions, the provisions in the underwriting agreement shall control.

(f) The obligations of the Company and Holders under this Section 2.8 shall survive the completion of any offering of Registrable Securities in a registration statement under this Section 2 and otherwise.

2.9 Reports Under the 1934 Act. With a view to making available to the Holders the benefits of Rule 144 and any other rule or regulation of the SEC that may at any time permit a Holder to sell securities of the Company to the public without registration or pursuant to a registration on Form S-3, the Company agrees to:

(a) make and keep adequate and current public information available, as those terms are understood and defined in Rule 144, at all times after the effective date of the Initial Offering;

(b) file with the SEC in a timely manner all reports and other documents required of the Company under the Act and the 1934 Act; and

(c) furnish to any Holder, so long as the Holder owns any Registrable Securities, forthwith upon request (i) a written statement by the Company that it has complied with the reporting requirements of Rule 144 (at any time after ninety (90) days after the effective date of the first registration statement filed by the Company), the Act and the 1934 Act (at any time after it has become subject to such reporting requirements), or that it qualifies as a registrant whose securities may be resold pursuant to Form S-3 (at any time after it so qualifies), (ii) a copy of the most recent annual or quarterly report of the Company and such other reports and documents so filed by the Company and (iii) such other information as may be reasonably requested to avail any Holder of any rule or regulation of the SEC that permits the selling of any such securities without registration or pursuant to such form.

2.10 Assignment of Registration Rights. The rights to cause the Company to register Registrable Securities pursuant to this Section 2 may be assigned (but only with all related obligations) (1) by a Holder to a transferee or assignee of such securities (a) who is an Affiliate, subsidiary, parent, partner, limited partner, retired partner, member, retired member, or equity holder of a Holder, (b) who is a Holder’s family member or trust for the benefit of an individual Holder, (c) [Reserved], or (d) who, after such assignment or transfer, holds at least one million (1,000,000) shares of Registrable Securities (appropriately adjusted for any stock split, dividend, combination or other recapitalization, including in connection with the Initial Offering), or (2) by a Fidelity Investor pursuant to a merger or reorganization of such Fidelity Investor; provided: (i) the Company is, within a reasonable time after such transfer, furnished with written notice of the name and address of such transferee or assignee and the securities with respect to which such registration rights are being assigned; (ii) such transferee or assignee agrees in writing to be bound

 

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by and subject to the terms and conditions of this Agreement, including, without limitation, the provisions of Section 2.12 of this Agreement; and (iii) such assignment shall be effective only if immediately following such transfer the further disposition of such securities by the transferee or assignee is restricted under the Act.

2.11 Limitations on Subsequent Registration Rights. From and after the date of this Agreement, the Company shall not, without the prior written consent of the Investors holding at least seventy percent (70%) of the Registrable Securities originally held by Investors (not including shares of Class B Common Stock originally held by Thrive Capital Partners III, L.P. or its Affiliates (“Thrive”)) enter into any agreement with any holder or prospective holder of any securities of the Company that would allow such holder or prospective holder (a) to include any of such securities in any registration filed under Section 2.1, Section 2.2 or Section 2.3 of this Agreement, unless under the terms of such agreement, such holder or prospective holder may include such securities in any such registration only to the extent that the inclusion of such securities will not reduce the amount of the Registrable Securities of the Holders that are included or (b) to demand registration of their securities.

2.12 “Market Stand-Off Agreement.

(a) Each Holder hereby agrees that it will not, without the prior written consent of the managing underwriter, during the period commencing on the date of the final prospectus relating to the Initial Offering and ending on the date specified by the Company and the managing underwriter (such period not to exceed one hundred eighty (180) days or such shorter time as may be agreed between the relevant Holder and the managing underwriter in a stand-alone lock-up agreement entered into on or prior to the date hereof) (the “Lock- Up Period”) (i) lend, offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any option, right or warrant to purchase, or otherwise transfer or dispose of, directly or indirectly, any shares of Class A Common Stock or any securities convertible into or exercisable or exchangeable for Class A Common Stock held immediately prior to the effectiveness of the registration statement for the Initial Offering (the “Restricted Securities”), or (ii) enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences of ownership of the Restricted Securities, whether any such transaction described in clause (i) or (ii) above is to be settled by delivery of Class A Common Stock or other securities, in cash or otherwise. The foregoing provisions of this Section 2.12 (A) shall apply only to the Initial Offering, (B) shall not apply to the sale of any shares to an underwriter pursuant to an underwriting agreement, (C) shall not apply to shares acquired by a Holder in the Initial Offering or in open market transactions on or after the effective date of the registration statement for the Initial Offering; provided that, in either case, no filing with the SEC on Form 4 or Form 5 in accordance with Section 16(a) of the 1934 Act is required, and (D) shall be applicable to the Holders only if all executive officers and directors of the Company and stockholders individually owning more than one percent (1%) of the Company’s outstanding Class A Common Stock (after giving effect to conversion into Class A Common Stock of all outstanding securities exchangeable or convertible into shares of Class A Common Stock) (each, a “1% Stockholder”) are subject to the same restrictions. The underwriters in connection with the Initial Offering are intended third-party beneficiaries of this Section 2.12 and shall have the right, power and authority to enforce the provisions hereof as though they were a party hereto.

 

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If, prior to the expiration of the Lock-Up Period, the underwriters consent to the release of any Restricted Securities held by any executive officers or directors of the Company or 1% Stockholders from the restrictions set forth in this Section 2.12 (any such release, a “Triggering Release” and, such parties receiving such release, the “Triggering Release Parties”), then a number of the Restricted Securities held by each Investor who is a Major Investor (as defined below) on the date hereof, regardless of whether such Investor fails to hold a sufficient number of shares of Registrable Securities to constitute a “Major Investor” hereunder at any point in the future (each such Investor, a “Lock-Up Major Investor”) shall also be released from the restrictions set forth in this Section 2.12, such number of Restricted Securities being the total number of Restricted Securities held by such Lock-Up Major Investor on the date of the Triggering Release multiplied by a fraction, the numerator of which shall be the number of Restricted Securities released pursuant to the Triggering Release and the denominator of which shall be the total number of Restricted Securities held by the Triggering Release Parties on such date.

In order to enforce the foregoing covenant, the Company may impose stop-transfer instructions with respect to the Registrable Securities of each Holder (and the shares or securities of every other Person subject to the foregoing restriction) until the end of such period.

(b) Each Holder agrees that a legend reading substantially as follows shall be placed on all certificates representing all shares or securities of the Company of each Holder (and the shares or securities of every other Person subject to the restriction contained in this Section 2.12):

THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO A LOCK-UP PERIOD AFTER THE EFFECTIVE DATE OF THE ISSUER’S REGISTRATION STATEMENT FILED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AS SET FORTH IN AN AGREEMENT BETWEEN THE COMPANY AND THE ORIGINAL HOLDER OF THESE SECURITIES, A COPY OF WHICH MAY BE OBTAINED AT THE ISSUER’S PRINCIPAL OFFICE. SUCH LOCK-UP PERIOD IS BINDING ON TRANSFEREES OF THESE SHARES.

Notwithstanding the foregoing, upon expiration of the Lock-up Period, the Company shall be obligated to reissue promptly unlegended certificates at the request of any Holder in connection with a sale of Registrable Securities by a Holder pursuant to Rule 144 if the Holder shall have obtained an opinion of counsel (which counsel may be counsel to the Company) reasonably acceptable to the Company to the effect that the securities proposed to be disposed of may lawfully be so disposed of without registration, qualification and legend.

2.13 Termination of Registration Rights. No Holder shall be entitled to exercise any right provided for in this Section 2: (a) after five (5) years following the consummation of the Initial Offering, (b) as to any Holder, such earlier time after the Initial Offering at which such Holder (i) can sell all shares held by it in compliance with Rule 144(b)(1)(i) or (ii) holds one percent (1%) or less of the Company’s outstanding Common Stock and all Registrable Securities held by such Holder (together with any Affiliate of the Holder with whom such Holder must aggregate its sales under Rule 144) can be sold in any three (3) month period without registration in compliance with Rule 144 or (c) after the consummation of a Liquidation Event, as that term is

 

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defined in the Thirteenth Amended and Restated Certificate of Incorporation of the Company filed with the Delaware Secretary of State on December 16, 2020 (“Prior Certificate”), in which the consideration received by the Investors is in the form of cash and/or securities of an issuer whose securities are listed on an internationally recognized securities exchange and wherein the securities constituting such consideration will become freely saleable within 180 days of the closing of such Liquidation Event (“Marketable Securities”).

3. Covenants of the Company.

3.1 Regulatory Compliance and Filings. The Company shall take, and shall cause its subsidiaries to take, all requisite action to ensure compliance with applicable regulatory laws and regulations, including, without limitation, the submission of filings with applicable city, county, state, federal and regulatory agencies and obtaining permits necessary for the conduct of its business.

3.2 Confidentiality. Each Investor agrees, severally and not jointly, that such Investor will keep confidential and will not disclose, divulge, or use for any purpose (other than to monitor its investment in the Company) any information obtained pursuant to this Agreement or otherwise as a stockholder of the Company which the Company identifies in writing as being proprietary or confidential and such Investor acknowledges that it will not, unless otherwise required by law or the rules of any national securities exchange, association or marketplace, disclose such information without the prior written consent of the Company except such information that (a) was in the public domain prior to the time it was furnished to such Investor, is or becomes (through no willful improper action or inaction by such Investor) generally available to the public, (c) was in its possession or known by such Investor without restriction prior to receipt from the Company, (d) was rightfully disclosed to such Investor by a third party without restriction or (e) was independently developed without any use of the Company’s confidential information. Notwithstanding the foregoing, (1) each Investor that is a limited partnership or limited liability company may disclose such proprietary or confidential information to any former partners or members who retained an economic interest in such Investor, current or prospective partner of the partnership or any subsequent partnership under common investment management, limited partner, general partner, member or management company of such Investor (or any employee or representative of any of the foregoing) and (2) each Investor may disclose such proprietary or confidential information to any Affiliate of such Investor or to legal counsel, accountants or representatives for such Investor who are under an ethical or similar contractual restriction regarding the confidentially of such information (each of the foregoing Persons referenced in clauses (1) and (2), a “Permitted Disclosee”). Furthermore, nothing contained herein shall prevent any Investor or any Permitted Disclosee from (i) entering into any business, entering into any agreement with a third party, or investing in or engaging in investment discussions with any other company (whether or not competitive with the Company); provided that such Investor or Permitted Disclosee does not, except as permitted in accordance with this Section 3.2, disclose or otherwise make use of any proprietary or confidential information of the Company in connection with such activities, or (ii) making any disclosures required by law, rule, regulation or court or other governmental order, including, without limitation, with respect to any Investor that is a registered investment company within the meaning of the Investment Company Act, disclosures consistent with such Investor’s required investment reporting practices.

 

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3.3 Successor Indemnification. If the Company or any of its successors or assignees consolidates with or merges into any other Person and is not the continuing or surviving corporation or entity of such consolidation or merger, then to the extent necessary, proper provision shall be made so that the successors and assignees of the Company assume the obligations of the Company with respect to indemnification of members of the Board as in effect immediately before such transaction, whether such obligations are contained in the Company’s Bylaws, as may be amended and/or restated from time to time, its Restated Certificate, or elsewhere, as the case may be.

4. Miscellaneous.

4.1 Successors and Assigns. Except as otherwise provided herein, the terms and conditions of this Agreement shall inure to the benefit of and be binding upon the respective successors and assigns of the parties (including, without limitation, permitted transferees of any shares of Registrable Securities). Nothing in this Agreement, express or implied, is intended to confer upon any party other than the parties hereto or their respective successors and assigns any rights, remedies, obligations or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement.

4.2 Governing Law. This Agreement shall be governed by and construed in accordance with the General Corporation Law of the State of Delaware as to matter within the scope thereof, and as to all other matters shall be governed by and construed in accordance with the internal laws of the State of New York, without regard to conflicts of law principles thereof.

4.3 Counterparts; Facsimile. This Agreement may be executed by electronic signature and in two (2) or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one (1) and the same instrument. Counterparts may be delivered via facsimile, electronic mail (including pdf or any electronic signature complying with the U.S. federal ESIGN Act of 2000, e.g., www.docusign.com) or other transmission method, and any counterpart so delivered shall be deemed to have been duly and validly delivered and be valid and effective for all purposes.

4.4 Titles and Subtitles. The titles and subtitles used in this Agreement are used for convenience only and are not to be considered in construing or interpreting this Agreement.

4.5 Notices. All notices and other communications given or made pursuant hereto shall be in writing and shall be deemed effectively given upon the earlier to occur of actual receipt or: (a) upon personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient; if not sent during normal business hours, then on the next business day, (c) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (d) one (1) day after deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt. All communications shall be sent to the respective parties at the address listed on the applicable signature page hereto and to the other parties at the addresses set forth on Schedule A or Schedule B, as applicable (or at such other addresses as shall be specified by notice given in accordance with this Section 4.5). If notice is given to the Company, it shall be sent to the address on the Company’s signature page; a copy (which shall not constitute notice) shall also be given to Latham & Watkins LLP, 885 Third Avenue, New York, NY 10022, Attention: Peter Handrinos, Esq. and Keith Halverstam, Esq.

 

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4.6 Expenses. If any action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys’ fees, costs and necessary disbursements in addition to any other relief to which such party may be entitled.

4.7 Entire Agreement; Amendments and Waivers. This Agreement (including the exhibits and schedules hereto, if any) constitutes the full and entire understanding and agreement among the parties with regard to the subjects hereof and thereof. The Prior Agreement is hereby amended and restated in its entirety and shall be of no further force or effect. Any term of this Agreement may be amended and the observance of any term of this Agreement may be waived (either generally or in a particular instance and either retroactively or prospectively) only with the written consent of the Company and the Investors holding a majority of the Registrable Securities originally held by Investors as of the date hereof (not including shares of Class B Common Stock originally held by Thrive); provided, however, that this Agreement may not be amended or terminated and the observance of any term hereof may not be waived with respect to any Investor or Common Holder without the written consent of such Investor or Common Holder, unless such amendment, termination or waiver applies to all Investors or Common Holders, as the case may be, in the same fashion. Notwithstanding anything to the contrary contained herein:

(a) for so long as any Wellington Investor holds any shares of Registrable Securities, the definition of “Affiliate” as it relates to a Wellington Investor, and the definitions of “Wellington” and “Wellington Investors,” may not be amended, terminated or waived without the prior written consent of such Wellington Investor;

(b) for so long as any Fidelity Investor holds any shares of Registrable Securities, the definition of “Affiliate” as it relates to a Fidelity Investor, and the definition “Fidelity Investor,” Section 4.12(b), 4.15 and this clause (b) may not be amended, terminated or waived without the prior written consent of such Fidelity Investor;

(c) for so long as any Fidelity Investor holds any shares of Registrable Securities, any rights provided or granted to, or any obligations imposed upon, any Fidelity Investor under Section 2.10 and this clause (c) may be amended or waived (either generally or in a particular instance) in a manner that adversely affects any Fidelity Investor only with the written consent of such Fidelity Investor; and

(d) for so long as any Lock-Up Major Investor holds shares of Registrable Securities, any rights provided or granted to, or any obligations imposed upon, any Lock-Up Major Investor under Section 2.12 and this clause (d) may be amended or waived (either generally or in a particular instance) in a manner that adversely affects any Lock-Up Major Investor only with the written consent of such Lock-Up Major Investor.

Except as expressly set forth herein, any amendment or waiver effected in accordance with this paragraph shall be binding upon each holder of any Registrable Securities, each future holder of all such Registrable Securities and the Company.

 

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4.8 Severability. Whenever possible, each provision of this Agreement shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Agreement shall be held to be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidating the remainder of such provision or the remaining provisions of this Agreement.

4.9 Aggregation of Stock. All shares of Registrable Securities held or acquired by a Holder’s Affiliates or other affiliated entities (including affiliated venture capital funds or venture capital funds under common investment management) or Persons shall be aggregated together for the purpose of determining the availability of any rights of such Holder under this Agreement.

4.10 [Reserved.]

4.11 Delays or Omissions. No delay or omission to exercise any right, power or remedy accruing to any party under this Agreement, upon any breach or default of any other party under this Agreement, shall impair any such right, power or remedy of such non-breaching or non-defaulting party nor shall it be construed to be a waiver of any such breach or default, or an acquiescence therein, or of or in any similar breach or default thereafter occurring; nor shall any waiver of any single breach or default be deemed a waiver of any other breach or default theretofore or thereafter occurring. Any waiver, permit, consent or approval of any kind or character on the part of any party of any breach or default under this Agreement, or any waiver on the part of any party of any provisions or conditions of this Agreement, must be in writing and shall be effective only to the extent specifically set forth in such writing. All remedies, either under this Agreement or by law or otherwise afforded to any party, shall be cumulative and not alternative.

4.12 Acknowledgment.

(a) The Company acknowledges that the Investors are in the business of venture capital investing and therefore review the business plans and related proprietary information of many enterprises, including enterprises which may have products or services which compete directly or indirectly with those of the Company. Nothing in this Agreement shall preclude or in any way restrict the Investors from investing or participating in any particular enterprise whether or not such enterprise has products or services which compete with those of the Company.

(b) The Company hereby acknowledges that Fidelity and the Fidelity Investors are professional investment managers and/or funds, and as such, invest in numerous portfolio companies, some of which may be deemed competitive with the Company’s business (as conducted or proposed to be conducted). The Company hereby agrees that, to the extent permitted under applicable law, neither the Fidelity Investors nor their respective Affiliates shall be liable to the Company for any claim arising out of, or based upon, (i) the investment by the Fidelity Investors or any of their respective Affiliates in any entity competitive to the Company, or (ii) actions taken by any advisor, partner, officer or other representative of a Fidelity Investor or any of its Affiliates to assist any such competitive company, whether or not such action was taken as a board member of such competitive company, or otherwise; provided, however, that the foregoing shall not relieve the Fidelity Investors, from liability associated with the unauthorized disclosure of the Company’s confidential information.

 

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4.13 Dispute Resolution. The parties (a) hereby irrevocably and unconditionally submit to the jurisdiction of the federal and state courts located in the State of New York, County of New York, for the purpose of any suit, action or other proceeding arising out of or based upon this Agreement, (b) agree not to commence any suit, action or other proceeding arising out of or based upon this Agreement except in the federal and state courts located in the State of New York, County of New York, and (c) hereby waive, and agree not to assert, by way of motion, as a defense, or otherwise, in any such suit, action or proceeding, any claim that it is not subject personally to the jurisdiction of the above-named courts, that its property is exempt or immune from attachment or execution, that the suit, action or proceeding is brought in an inconvenient forum, that the venue of the suit, action or proceeding is improper or that this Agreement or the subject matter hereof may not be enforced in or by such court.

4.14 WAIVER OF JURY TRIAL. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, EACH PARTY HEREBY WAIVES ITS RIGHTS TO A JURY TRIAL OF ANY CLAIM OR CAUSE OF ACTION BASED UPON OR ARISING OUT OF THIS AGREEMENT, THE OTHER TRANSACTION DOCUMENTS, THE SECURITIES OR THE SUBJECT MATTER HEREOF OR THEREOF. THE SCOPE OF THIS WAIVER IS INTENDED TO BE ALL-ENCOMPASSING OF ANY AND ALL DISPUTES THAT MAY BE FILED IN ANY COURT AND THAT RELATE TO THE SUBJECT MATTER OF THIS TRANSACTION, INCLUDING, WITHOUT LIMITATION, CONTRACT CLAIMS, TORT CLAIMS (INCLUDING NEGLIGENCE), BREACH OF DUTY CLAIMS, AND ALL OTHER COMMON LAW AND STATUTORY CLAIMS. THIS SECTION HAS BEEN FULLY DISCUSSED BY EACH OF THE PARTIES HERETO AND THESE PROVISIONS WILL NOT BE SUBJECT TO ANY EXCEPTIONS. EACH PARTY HERETO HEREBY FURTHER WARRANTS AND REPRESENTS THAT SUCH PARTY HAS REVIEWED THIS WAIVER WITH ITS LEGAL COUNSEL, AND THAT SUCH PARTY KNOWINGLY AND VOLUNTARILY WAIVES ITS JURY TRIAL RIGHTS TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW FOLLOWING CONSULTATION WITH LEGAL COUNSEL.

4.15 Massachusetts Business Trust. A copy of the Agreement and Declaration of Trust of each Investor affiliated with Fidelity, or any affiliate thereof, is on file with the Secretary of State of the Commonwealth of Massachusetts and notice is hereby given that this Agreement is executed on behalf of the trustees of such Investor or any affiliate thereof as trustees and not individually and that the obligations of this Agreement are not binding on any of the trustees, officers or stockholders of such Investor or any affiliate thereof individually but are binding only upon such Investor or any affiliate thereof and its assets and property.

4.16 Effective Time. This Agreement shall become, and be in full force and effect, immediately upon consummation of the Initial Offering (the “Effective Time”); provided that if the Initial Offering is not consummated on or prior to June 1, 2021, this Agreement shall not become effective and the Prior Agreement shall continue to remain effective. For the avoidance of doubt, the Prior Agreement shall continue to remain effective until the Effective Time.

[Remainder of page intentionally left blank]

 

 

21


IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

 

      OSCAR HEALTH, INC.
      By:    
      Name:  
      Title:  
    Address:  

75 Varick Street

New York, NY 10013

SIGNATURE PAGE TO

TWELFTH AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT


IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

 

INVESTOR:
By:    
Name:  
Title:  

SIGNATURE PAGE TO

TWELFTH AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT


SCHEDULE A

SCHEDULE OF INVESTORS

 

General Catalyst Group VI, L.P.   Red Swan Ventures II, L.P.
Thrive Capital Partners III, L.P.   TGS Oscar LLC
Thrive Capital Partners II, L.P.   Velos Partners Fund I, LP
Claremount TW, L.P.   Boehler 2013 Irrevocable Trust
Khosla Ventures IV, LP   Davis Smith
Khosla Ventures IV (CF), LP   Doug Evans
The Founders Fund IV, LP   Kimball Thomas
The Founders Fund IV Principals Fund, LP   Barry S. Sternlicht
The Founders Fund V, LP  

The Board of Trustees of the Leland

Stanford Junior University (DAPER I)

The Founders Fund V Principals Fund, LP   Jesse Derris
The Founders Fund V Entrepreneurs Fund, LP   Stanley F. Druckenmiller
Formation8 Partners Fund I, L.P.   Kenneth G. Langone
Venture Lending & Leasing VI, LLC   Mousserena, L.P.
Venture Lending & Leasing VII, LLC   Invemed Associates, LLC
Winkelried Investment Partners, L.P.   Kevin Warsh
A-Grade Investments II, LLC   Gerald Kerner
Longload Limited   Breyer Capital L.L.C.
The Systrom Children’s Remainder Trust   F8 Oscar SPV, L.P.
Lerer Ventures III, LP   Hadley Harbor Master Investors (Cayman) L.P.1
Lerer Ventures III-A, LLC   Star Noble Holdings Limited
F8 Oscar II SPV, L.P.   Broad Street Principal Investments, L.L.C.
Lerer Ventures III-B, LP   Glynn Partners III, L.P.
SV Angel IV LP   Roxy Link Limited
Joseph T. Lonsdale   Yunfeng Investment GP, Ltd.
Gary Vaynerchuk   Golden Bell Partners Fund I, LP
Aaron Levie   JAWS Equity Owner 4, LLC

 

1 

The stock certificates representing the shares that this Investor holds are registered in the name of its nominee, Italianflare & Co.


Blumenthal Family Holdings LLC  

The Marc R. Benioff Revocable Trust U/A/D

12/3/2004

Box Group LLC   CapitalG 2015 LP
Gilboa Family Holdings LLC   Google Ventures 2014, L.P.

Community Foundation of the CSRA, Press

On Fund

  Industry Ventures Secondary VIII, LP

Fidelity Mt. Vernon Street Trust: Fidelity

Series Growth Company Fund2

 

Industry Ventures Special Opportunities Fund

III-A, LP

Fidelity Growth Company Commingled Pool3  

Fidelity Mt. Vernon Street Trust: Fidelity

Growth Company Fund4

Fidelity Securities Fund: Fidelity Blue Chip

Growth Fund5

 

FIAM Target Date Blue Chip Growth

Commingled Pool6

Fidelity Blue Chip Growth Commingled Pool7  

Fidelity Securities Fund: Fidelity Series Blue

Chip Growth Fund8

Fidelity Contrafund: Fidelity Advisor New

Insights Fund9

 

Industry Ventures Special Opportunities Fund

III-B, LP

Fidelity Contrafund: Fidelity Contrafund10   Fidelity Contrafund Commingled Pool11

Fidelity Contrafund: Fidelity Advisor New

Insights Fund—Sub A12

 

 

2 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, WAVELENGTH + CO fbo Fidelity Mt. Vernon Street Trust: Fidelity Series Growth Company Fund.

3 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Growth Company Commingled Pool.

4 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Powhatan & Co., LLC fbo Fidelity Mt. Vernon Street Trust: Fidelity Growth Company Fund.

5 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, M Gardiner & Co fbo Fidelity Securities Fund: Fidelity Blue Chip Growth Fund.

6 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, FLAPPER CO fbo FIAM Target Date Blue Chip Growth Commingled Pool.

7 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Blue Chip Growth Commingled Pool.

8 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Wavechart & Co fbo Fidelity Securities Fund: Fidelity Series Blue Chip Growth Fund.

9 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Contrafund: Fidelity Advisor New Insights Fund.

10 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Contrafund: Fidelity Contrafund.

11 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Contrafund Commingled Pool.

12 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Contrafund: Fidelity Advisor New Insights Fund—Sub A.


Fidelity Contrafund: Fidelity Series

Opportunistic Insights Fund13

  Convoy Technologies Limited
WX Ventures LLC   Mount Hopkins Investment Limited
Domino Way Limited   8VC Opal SPV, L.P.
DRJ Development Limited   Glynn Partners IV, L.P.
GRCLT LLC   Venture Lending & Leasing VIII, LLC
WTI Equity Opportunity Fund I, L.P.   Lakestar II LP
David Clark   Alpha Mulberry Investment, LLC
TAG Technologies Limited   Anthony Charles Lynton Blair
Joseph Gebbia Revocable Trust   Sunbeam Holdings Ltd.

Alex Rodriguez Revocable Trust Dated

January 5, 1998

  HS Investments 1 Limited
HS Investments (OS) Limited   Elgin Technology Holding No. 2 Limited
HJ Revocable Trust  

Community Foundation of the CSRA, Press On

Fund

Miriam Klein Sternlicht Revocable Trust   The Founders Fund VI, LP
The Founders Fund VI Principals Fund, LP   The Founders Fund VI Entrepreneurs Fund, LP
Napoleon Ta   Pai Family Trust

Neil Ruthven and Julia Ruthven, Trustees of

the Ruthven Family Trust, Dated October 1,

2012

  John Luttig
8VC Co-Invest Fund I, L.P.   Verily Life Sciences LLC
Thrive Capital Partners V, L.P.   Claremount V Associates, L.P.

University of Virginia Investment

Management Company

  Vanderbilt University
CapitalG LP   Alphabet Holdings LLC
Venture Lending & Leasing IX, LLC   Thrive Capital Partners VI Growth, L.P.
Claremount VI Associates, L.P.  

General Catalyst Group X – Growth Venture,

L.P.

Khosla Ventures VI, LP   The Founders Fund VI, LP
The Founders Fund VI Principals Fund, LP   The Founders Fund VI Entrepreneurs Fund, LP
Lakestar Growth I LP   Coatue Growth Fund IV LP
The Schiehallion Fund Limited   Warman Investments Pty Limited
Host-Plus Pty Limited   Interventure Equity Investments Limited

The Board of Trustees of the Saskatchewan

Healthcare Employees’ Pension Plan

 

The States of Jersey Public Employees

Contributory Retirement Scheme

Vision Super Pty Limited   The Founders Fund Growth, LP

The Founders Fund Growth Principals Fund,

LP

  Khosla Ventures, LLC
Osmosis DF Investments, LLC   Reinvent Capital Fund GP LLC
Tiger Global PIP XII-14 LLC   CN2T Capital, LLC
Matias Van Thienen   Everett Randle
Keith L. Halverstam   VP Company Investments 2018, LLC
Dikigoros Holdings LLC  

 

13 

The stock certificate representing the Shares that this Investor is purchasing hereunder will be registered in the name of its nominee, Mag & Co fbo Fidelity Contrafund: Fidelity Series Opportunistic Insights Fund.


SCHEDULE B

SCHEDULE OF COMMON HOLDERS

SIENA PIZZO-SCHLOSSER DYNASTY TRUST

NOAH PIZZO-SCHLOSSER DYNASTY TRUST

PIZZO-SCHLOSSER FAMILY DYNASTY TRUST

PIZZO-SCHLOSSER 2020 GRAT AND SPOUSAL TRUST

THRIVE CAPITAL PARTNERS III, L.P.

THRIVE CAPITAL PARTNERS II, L.P.

CLAREMOUNT TW, L.P.

Exhibit 10.1

THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE AND DISTRIBUTION THEREOF, AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”) OR ANY STATE SECURITIES LAWS. SUCH SECURITIES MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR AN OPINION OF COUNSEL IN A FORM REASONABLY ACCEPTABLE TO COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED DUE TO AN EXEMPTION THEREFROM UNDER SAID ACT AND ANY APPLICABLE STATE SECURITIES LAWS.

Date of Issuance: March 20, 2013

WARRANT TO PURCHASE

SHARES OF PREFERRED STOCK OF

MULBERRY HEALTH INC.

(Void after September 30, 2023)

This certifies that VENTURE LENDING & LEASING VI, LLC, a Delaware limited liability company, or assigns (“Holder”), for value received, is entitled to purchase from MULBERRY HEALTH INC., a Delaware corporation (“Company”), the Applicable Number (hereinafter defined) of fully paid and nonassessable shares of Company’s Next Round Stock (hereinafter defined), for cash, at a purchase price per share hereinafter determined (the “Stock Purchase Price”). Holder may also exercise this Warrant on a cashless or “net issuance” basis as described in Section 1(b) below, and this Warrant shall be deemed to have been exercised in full on such basis on the Expiration Date, to the extent not fully exercised prior to such date. This Warrant is issued in connection with that certain Loan and Security Agreement and Supplement thereto, both of even date herewith (as amended, restated and supplemented from time to time, the “Loan Agreement” and the “Supplement”, respectively), between Company, as borrower, and Holder’s subsidiary, Venture Lending & Leasing VI, Inc., as lender (“Lender”). Capitalized terms used herein and not otherwise defined in this Warrant shall have the meaning(s) ascribed to them in the Loan Agreement and the Supplement, unless the context would otherwise require.

The “Applicable Number” of shares of Next Round Stock purchasable hereunder shall be the number obtained by dividing (A) the sum of (i) $183,750, plus (ii) the product of (x) 0.0525 and (y) the aggregate original principal amount of the Loans advanced to Company by Lender under the First Tranche (hereinafter defined) of Lender’s Commitment, plus (iii) the product of (x) 0.105 and (y) the aggregate original principal amount of the Loans advanced to Company by Lender under the Second Tranche (hereinafter defined) of Lender’s Commitment (such sum sometimes referred to herein as the “Coverage Amount”), by (B) the Stock Purchase Price. The Stock Purchase Price shall be equal to the Next Round Price (hereinafter defined). If in any case the Applicable Number includes a fraction, the fraction shall be adjusted to the closest integral number. For purposes of this Warrant: the “First Tranche” of Lender’s Commitment means $3,500,000; and the “Second Tranche” of Lender’s Commitment means $1,500,000. For clarity, the parties agree that Borrowing Requests for Loans shall be applied initially against the First Tranche of Lender’s Commitment until the First Tranche has been fully funded; and then such Borrowing Requests for Loans shall be applied against the Second Tranche of Lender’s Commitment until the earlier of (i) the date the Second Tranche has been fully funded and (ii) the Termination Date for Lender’s Commitment has occurred.


The “Next Round Price” is the lowest price per share paid by an investor for Company’s equity securities issued in the Next Round (hereinafter defined) (the “Next Round Stock”), including for this purpose the value of all consideration given by an investor for such equity securities and specifically including any discounts afforded to investors and stockholders of Company upon conversion of any convertible promissory notes held by such investors and stockholders in connection with the Next Round or otherwise. The “Next Round” means the next bona fide round of equity financing after the date hereof in which Company sells or issues shares of its securities, and includes (and Holder shall be entitled to receive) any options, warrants, or other convertible securities or similar consideration issued or delivered to investors in connection with such equity financing in such round; provided that the Next Round excludes (i) any additional sales of Company’s Series A Preferred Stock and (ii) any sales of Series A-1 Preferred Stock to General Catalyst Group VI, L.P., or its affiliates, pursuant to that certain Call Option Agreement dated as of February 19, 2013.

As soon as reasonably practicable after the occurrence or non-occurrence of the latest event or condition necessary to determine (i) the Coverage Amount, (ii) the actual number and type of shares of Company’s stock issuable upon exercise of this Warrant, or (iii) the Stock Purchase Price, if applicable, Company shall deliver a supplement to this Warrant (subsequent to a request by Holder therefor), in substantially the form of Exhibit “A” attached hereto, specifying the total number and series of shares of Next Round Stock issuable hereunder after giving effect to the foregoing calculations, and otherwise completed with such quantity and price terms and other information as have been determined as a result of the occurrence or non-occurrence of such events or conditions. The provisions of such supplement, once completed and executed, shall control the interpretation and exercise of this Warrant; provided, however, that the failure of Company to deliver such supplement shall not affect the rights of the Holder of this Warrant to receive the number and type of shares of Next Round Stock as set forth herein.

Subject to Section 4.3, this Warrant may be exercised at any time or from time to time up to and including 5:00 p.m. (Pacific time) on September 30, 2023 (the “Expiration Date”), upon surrender to Company at its principal office at 295 Lafayette Street, 7th Floor, New York, NY 10012 (or at such other location as Company may advise Holder in writing) of this Warrant properly endorsed with the Form of Subscription attached hereto duly completed and signed and upon payment in cash or by check of the aggregate Stock Purchase Price for the number of shares for which this Warrant is being exercised determined in accordance with the provisions hereof. The Stock Purchase Price and the number of shares purchasable hereunder are subject to further adjustment as provided in Section 4 of this Warrant.

Notwithstanding anything to the contrary above, in the event that Company has satisfied the conditions precedent in Section 4.1, Section 4.2(a), Section 4.2(c), Section 4.2(d), Section 4.2(e) and Section 4.2(g) of the Loan Agreement and Lender fails or refuses to make any Loan under its Commitment then this Warrant shall be surrendered to Company by Holder for cancellation.

 

2


This Warrant is subject to the following terms and conditions:

1. Exercise; Issuance of Certificates; Payment for Shares.

(a) Unless an election is made pursuant to clause (b) of this Section 1, this Warrant shall be exercisable at the option of Holder, at any time or from time to time, on or before the Expiration Date for all or any portion of the shares of Next Round Stock (but not for a fraction of a share) which may be purchased hereunder for the Stock Purchase Price multiplied by the number of shares to be purchased. In the event, however, that pursuant to Company’s Certificate of Incorporation, as amended and restated from time to time (the “Charter”), an event causing automatic conversion of Company’s Next Round Stock shall have occurred prior to the exercise of this Warrant, in whole or in part, then this Warrant shall be exercisable for the number of shares of Common Stock of Company into which the Next Round Stock not purchased upon any prior exercise of this Warrant would have been so converted (and, where the context requires, reference to “Next Round Stock” shall be deemed to be or include such Common Stock, as may be appropriate). Company agrees that the shares of Next Round Stock purchased under this Warrant shall be and are deemed to be issued to Holder hereof as the record owner of such shares as of the close of business on the date on which the form of subscription shall have been delivered and payment made for such shares. Subject to the provisions of Section 2, certificates for the shares of Next Round Stock so purchased, together with any other securities or property to which Holder hereof is entitled upon such exercise, shall be delivered to Holder hereof by Company at Company’s expense within a reasonable time after the rights represented by this Warrant have been so exercised. Except as provided in clause (b) of this Section 1, in case of a purchase of less than all the shares which may be purchased under this Warrant, Company shall cancel this Warrant and execute and deliver a new Warrant or Warrants of like tenor for the balance of the shares purchasable under this Warrant surrendered upon such purchase to Holder hereof within a reasonable time. Each stock certificate so delivered shall be in such denominations of Next Round Stock as may be requested by Holder hereof and shall be registered in the name of such Holder or such other name as shall be designated by such Holder, subject to the limitations contained in Section 2.

(b) Holder, in lieu of exercising this Warrant by the cash payment of the Stock Purchase Price pursuant to clause (a) of this Section 1, may elect, at any time on or before the Expiration Date, to surrender this Warrant and receive that number of shares of Next Round Stock computed using the following formula:

 

   X =    Y (A – B)   
     

 

Where:   X    =    the number of shares of Next Round Stock to be issued to Holder.
  Y    =    the number of shares of Next Round Stock that Holder would otherwise have been entitled to purchase hereunder pursuant to Section 1(a) (or the applicable lesser number of shares in the case of a partial exercise of this Warrant).
  A    =    the Per Share Price (as defined in Section 1(c) below) of one (1)share of Next Round Stock at the time the net issuance electionunder this Section 1(b) is made.
  B    =    the Stock Purchase Price then in effect.

Election to exercise under this Section 1(b) may be made by delivering a signed form of subscription to Company via facsimile, to be followed by delivery of this Warrant. Notwithstanding anything to the contrary contained in this Warrant, if as of the close of business on the last business day preceding the Expiration Date this Warrant remains unexercised as to all or a portion of the shares of Next Round Stock purchasable hereunder, then effective as 9:00 a.m. (Pacific time) on the Expiration Date, Holder shall be deemed, automatically and without need for notice to Company, to have elected to exercise this Warrant in full pursuant to the provisions of this Section 1(b), and upon surrender of this Warrant shall be entitled to receive that number of shares of Next Round Stock computed using the above formula, provided that the application of such formula as of the Expiration Date yields a positive number for “X”.

(c) For purposes of Section 1(b), “Per Share Price” means:

(i) If this Warrant is exercised on the date of Company’s initial public offering of Common Stock, and if Company’s registration statement relating to such public offering has been declared effective by the Securities and Exchange Commission, then the Per Share Price shall be the product of (A) the initial “Price to Public” of the Common Stock specified in the final prospectus with respect to the offering, and (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible at the date of calculation.

(ii) If this Warrant is exercised after, and not on the date of Company’s initial public offering of Common Stock, and if Company’s Common Stock is traded on a securities exchange or actively traded over-the-counter:

 

 

3


(1) If Company’s Common Stock is traded on a securities exchange, the Per Share Price shall be deemed to be the product of (A) the closing price of Company’s Common Stock as quoted on any exchange, as published on Yahoo! Finance (or a successor thereto or equivalent publisher) for the trading day immediately prior to the date of Holder’s election hereunder and, (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible on such date.

(2) If Company’s Common Stock is actively traded over-the-counter, the Per Share Price shall be deemed to be the product of (A) the closing bid or sales price, whichever is applicable, of Company’s Common Stock for the trading day immediately prior to the date of Holder’s election hereunder and (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible on such date.

(iii) If neither (i) nor (ii) is applicable, the Per Share Price shall be determined in good faith by the Board of Directors of Company based on relevant facts and circumstances at the time of the net exercise under Section 1(b), including in the case of a Change of Control (as defined in Section 4.3 hereof) the consideration receivable by the holders of the Next Round Stock in such Change of Control and the liquidation preference (including any declared but unpaid dividends), if any, then applicable to the Next Round Stock.

 

4


2. Limitation on Transfer.

(a) This Warrant and the Next Round Stock shall not be transferable except upon the conditions specified in this Section 2, which conditions are intended to ensure compliance with the provisions of the Securities Act. Each holder of this Warrant or the Next Round Stock issuable hereunder will cause any proposed transferee of the Warrant or Next Round Stock to agree to take and hold such securities subject to the provisions and upon the conditions specified in this Section 2. Notwithstanding the foregoing and any other provision of this Section 2, Holder may freely transfer all or part of this Warrant or the shares issuable upon exercise of this Warrant (or the securities issuable, directly or indirectly, upon conversion of the shares, if any), at Holder’s expense, at any time to any lender transferee of a portion of the loan commitment of Lender under the Loan Agreement, by giving Company notice of the portion of the Warrant being transferred setting forth the name, address and taxpayer identification number of the transferee, executing appropriate transfer documentation and surrendering this Warrant to Company for reissuance to the transferees(s) (and Holder, if applicable).

(b) Each certificate representing (i) this Warrant, (ii) the Next Round Stock, (iii) shares of Company’s Common Stock issued upon conversion of the Next Round Stock and (iv) any other securities issued in respect to the Next Round or Common Stock issued upon conversion of the Next Round upon any stock split, stock dividend, recapitalization, merger, consolidation or similar event, shall (unless otherwise permitted by the provisions of this Section 2 or unless such securities have been registered under the Securities Act or sold under Rule 144) be stamped or otherwise imprinted with a legend substantially in the following form (in addition to any legend required under applicable state securities laws):

THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE AND DISTRIBUTION THEREOF, AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OR ANY STATE SECURITIES LAWS. SUCH SECURITIES MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR AN OPINION OF COUNSEL IN A FORM REASONABLY ACCEPTABLE TO COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED DUE TO AN EXEMPTION THEREFROM UNDER SAID ACT AND ANY APPLICABLE STATE SECURITIES LAWS.

(c) Holder of this Warrant and each person to whom this Warrant is subsequently transferred represents and warrants to Company (by acceptance of such transfer) that it will not transfer this Warrant (or securities issuable upon exercise hereof unless a registration statement under the Securities Act was in effect with respect to such securities at the time of issuance thereof) except pursuant to (i) an effective registration statement under the Securities Act, (ii) Rule 144 under the Securities Act (or any other rule under the Securities Act relating to the disposition of securities), or (iii) an opinion of counsel, reasonably satisfactory to counsel for Company, that an exemption from such registration is available.

 

5


3. Shares to be Fully Paid; Reservation of Shares. Company covenants and agrees that all shares of Next Round Stock which may be issued upon the exercise of the rights represented by this Warrant will, upon issuance, be duly authorized, validly issued, fully paid and nonassessable and free from all preemptive rights of any stockholder and free of all taxes, liens and charges with respect to the issue thereof. Company further covenants and agrees that during the period within which the rights represented by this Warrant may be exercised, Company will at all times have authorized and reserved, for the purpose of issue or transfer upon exercise of the subscription rights evidenced by this Warrant, a sufficient number of shares of authorized but unissued Next Round Stock, or other securities and property, when and as required to provide for the exercise of the rights represented by this Warrant. Company will take all such action as may be necessary to assure that such shares of Next Round Stock may be issued as provided herein without violation of any applicable law or regulation, or of any requirements of any domestic securities exchange upon which the Next Round Stock may be listed. Company will not take any action which would result in any adjustment of the Stock Purchase Price (as described in Section 4 hereof) (i) if the total number of shares of Next Round Stock issuable after such action upon exercise of all outstanding warrants, together with all shares of Next Round Stock then outstanding and all shares of Next Round Stock then issuable upon exercise of all options and upon the conversion of all convertible securities then outstanding, would exceed the total number of shares of Next Round Stock then authorized by Company’s Charter, (ii) if the total number of shares of Common Stock issuable after such action upon the conversion of all such shares of Next Round Stock together with all shares of Common Stock then outstanding and then issuable upon exercise of all options and upon the conversion of all convertible securities then outstanding would exceed the total number of shares of Common Stock then authorized by Company’s Charter or (iii) if the par value per share of the Next Round Stock would exceed the Stock Purchase Price.

4. Adjustment of Stock Purchase Price and Number of Shares. The Stock Purchase Price and the number of shares purchasable upon the exercise of this Warrant shall be subject to adjustment from time to time upon the occurrence of certain events described in this Section 4, provided, however, that no adjustment will be made pursuant to this Section 4 to the extent such adjustment would be duplicative of any adjustment set forth in the Company’s Certificate of Incorporation as in effect on the date of such adjustment. Upon each adjustment of the Stock Purchase Price, Holder of this Warrant shall thereafter be entitled to purchase, at the Stock Purchase Price resulting from such adjustment, the number of shares obtained by multiplying the Stock Purchase Price in effect immediately prior to such adjustment by the number of shares purchasable pursuant hereto immediately prior to such adjustment, and dividing the product thereof by the Stock Purchase Price resulting from such adjustment.

4.1 Subdivision or Combination of Stock. In case Company shall at any time subdivide its outstanding shares of Next Round Stock into a greater number of shares, the Stock Purchase Price in effect immediately prior to such subdivision shall be proportionately reduced, and conversely, in case the outstanding shares of Next Round Stock of Company shall be combined into a smaller number of shares, the Stock Purchase Price in effect immediately prior to such combination shall be proportionately increased.

 

6


4.2 Dividends in Next Round Stock, Other Stock, Property, Reclassification. If at any time or from time to time the holders of Next Round Stock (or any shares of stock or other securities at the time receivable upon the exercise of this Warrant) shall have received or become entitled to receive, without payment therefor,

(a) Next Round Stock, or any shares of stock or other securities whether or not such securities are at any time directly or indirectly convertible into or exchangeable for Next Round Stock, or any rights or options to subscribe for, purchase or otherwise acquire any of the foregoing by way of dividend or other distribution,

(b) any cash paid or payable otherwise than as a cash dividend, or

(c) Next Round Stock or other or additional stock or other securities or property (including cash) by way of spin off, split-up, reclassification, combination of shares or similar corporate rearrangement, (other than shares of Next Round Stock issued as a stock split, adjustments in respect of which shall be covered by the terms of Section 4.1 above),

Then, subject to Section 4.3, and in each such case, Holder hereof shall, upon the exercise of this Warrant, be entitled to receive, in addition to the number of shares of Next Round Stock receivable thereupon, and without payment of any additional consideration therefor, the amount of stock and other securities and property (including cash in the cases referred to in clauses (b) and (c) above) which such Holder would hold on the date of such exercise had it been the holder of record of such Next Round Stock as of the date on which holders of Next Round Stock received or became entitled to receive such shares and/or all other additional stock and other securities and property.

4.3 Change of Control; IPO.

(a) In the event of a Change of Control (as hereinafter defined) in which the sole consideration payable to Company’s stockholders consists of equity securities of a privately-held company then this Warrant shall be automatically exchanged for a number of shares of Company’s securities, such number of shares being equal to the maximum number of shares issuable pursuant to the terms hereof (after taking into account all adjustments described herein) had Holder elected to exercise this Warrant immediately prior to the closing of such Change of Control and purchased all such shares pursuant to the cash exercise provision set forth in Section 1(a) hereof (as opposed to the cashless exercise provision set forth in Section 1(b)). Company acknowledges and agrees that Holder shall not be required to make any additional payment (cash or otherwise) for such shares as further consideration for their issuance pursuant to the terms of the preceding sentence. “Change of Control” shall mean any sale, license, or other disposition of all or substantially all of the assets of Company, any reorganization, consolidation, merger or other transaction involving Company where the holders of Company’s securities before the transaction beneficially own less than 50% of the outstanding voting securities of the surviving entity after the transaction. This Warrant shall terminate upon Holder’s receipt of the number of shares of Company’s equity securities described in this Section 4.3.

(b) In the event of (i) a Change of Control, other than of the type described in the first sentence of Section 4.3(a), or (ii) the consummation of a sale of Company’s securities pursuant to a registration statement filed by Company under the Securities Act (or pursuant to the laws of the jurisdiction in which the initial public offering is completed), in connection with the first firm commitment underwritten offering of Company’s securities to the

 

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general public that occurs after the date this Warrant is issued (“IPO”), Holder agrees to exercise this Warrant in accordance with Section 1(a) or Section 1(b) immediately prior to the closing of such transaction (and if Holder has not exercised prior to such time then this Warrant shall be deemed exercised in accordance with Section 1(b) immediately prior to the closing of such transaction). This Warrant shall terminate upon Holder’s receipt of the number of shares of Company’s equity securities described in this Section 4.3(b).

4.4 Sale or Issuance Below Purchase Price. The other antidilution rights applicable to the shares of Next Round Stock purchasable hereunder are set forth in Company’s Charter. Company shall promptly provide Holder hereof with any restatement, amendment, modification or waiver of the Charter promptly after the same has been made.

4.5 Notice of Adjustment. Upon any adjustment of the Stock Purchase Price, and/or any increase or decrease in the number of shares purchasable upon the exercise of this Warrant, Company shall give written notice thereof, by first class mail, postage prepaid, addressed to the registered holder of this Warrant at the address of such holder as shown on the books of Company. The notice, which may be substantially in the form of Exhibit “A” attached hereto, shall be signed by Company’s chief financial officer or officer substantially responsible for accounting and shall state the Stock Purchase Price resulting from such adjustment and the increase or decrease, if any, in the number of shares purchasable at such price upon the exercise of this Warrant, setting forth in reasonable detail the method of calculation and the facts upon which such calculation is based.

4.6 Other Notices. If at any time:

(a) Company shall declare any cash dividend upon its Next Round Stock;

(b) Company shall declare any dividend upon its Next Round Stock payable in stock or make any special dividend or other distribution to the holders of its Next Round Stock;

(c) Company shall offer for subscription pro rata to the holders of its Next Round Stock any additional shares of stock in connection with a Down Round or additional shares of stock of any class or other rights;

(d) there shall be any capital reorganization or reclassification of the capital stock of Company, or consolidation or merger of Company with, or sale of all or substantially all of its assets to, another entity;

(e) there shall be a voluntary or involuntary dissolution, liquidation or winding-up of Company; or

(f) Company shall take or propose to take any other action, notice of which is actually provided to holders of the Next Round Stock;

 

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then, in any one or more of said cases, Company shall give, by first class mail, postage prepaid, addressed to Holder of this Warrant at the address of such Holder as shown on the books of Company, (i) at least 20 days’ prior written notice of the date on which the books of Company shall close or a record shall be taken for such dividend, distribution or subscription rights or for determining rights to vote in respect of any such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action and (ii) in the case of any such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action, at least 20 days’ written notice of the date when the same shall take place. Any notice given in accordance with the foregoing clause (i) shall also specify, in the case of any such dividend, distribution or subscription rights, the date on which the holders of Next Round Stock shall be entitled thereto. Any notice given in accordance with the foregoing clause (ii) shall also specify the date on which the holders of Next Round Stock shall be entitled to exchange their Next Round Stock for securities or other property deliverable upon such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action as the case may be.

4.7 Certain Events. If any change in the outstanding Next Round Stock of Company or any other event occurs as to which the other provisions of this Section 4 are not strictly applicable or if strictly applicable would not fairly effect the adjustments to this Warrant in accordance with the essential intent and principles of such provisions, then the Board of Directors of Company shall make in good faith an adjustment in the number and class of shares issuable under this Warrant, the Stock Purchase Price and/or the application of such provisions, in accordance with such essential intent and principles, so as to protect such purchase rights as aforesaid. The adjustment shall be such as will give Holder of this Warrant upon exercise for the same aggregate Stock Purchase Price the total number, class and kind of shares as Holder would have owned had this Warrant been exercised prior to the event and had Holder continued to hold such shares until after the event requiring adjustment.

5. Issue Tax. The issuance of certificates for shares of Next Round Stock upon the exercise of this Warrant shall be made without charge to Holder of this Warrant for any issue tax in respect thereof; provided, however, that Company shall not be required to pay any tax which may be payable in respect of any transfer involved in the issuance and delivery of any certificate in a name other than that of the then Holder of this Warrant being exercised.

6. Closing of Books. Company will at no time close its transfer books against the transfer of this Warrant or of any shares of Next Round Stock issued or issuable upon the exercise of this Warrant in any manner which interferes with the timely exercise of this Warrant.

7. No Voting or Dividend Rights; Limitation of Liability. Nothing contained in this Warrant shall be construed as conferring upon Holder hereof the right to vote or to consent as a stockholder in respect of meetings of stockholders for the election of directors of Company or any other matters or any rights whatsoever as a stockholder of Company. No dividends or interest shall be payable or accrued in respect of this Warrant or the interest represented hereby or the shares purchasable hereunder until, and only to the extent that, this Warrant shall have been exercised. No provisions hereof, in the absence of affirmative action by Holder to purchase shares of Next Round Stock, and no mere enumeration herein of the rights or privileges of Holder hereof, shall give rise to any liability of such Holder for the Stock Purchase Price or as a stockholder of Company, whether such liability is asserted by Company or by its creditors.

 

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8. [Reserved].

9. Registration Rights. Holder hereof shall be entitled, with respect to the shares of Next Round Stock issued upon exercise hereof or the shares of Common Stock or other securities issued upon conversion of such Next Round Stock, as the case may be, to all of the “piggyback” and “S-3” registration rights granted by Company to the investors who purchase Next Round Stock to the same extent and on the same terms and conditions as possessed by such investors. Company shall take such action as may be reasonably necessary to assure that the granting of such registration rights to Holder does not violate the provisions of any of Company’s charter documents or rights of prior grantees of registration rights.

10. Rights and Obligations Survive Exercise of Warrant. The rights and obligations of Company, of Holder of this Warrant and of the holder of shares of Next Round Stock issued upon exercise of this Warrant, contained in Sections 6, 9, 18.7 and 19 shall survive the exercise of this Warrant. Notwithstanding the foregoing, the rights contained in Sections 6, 9, 18.7 and 19 shall terminate upon Holder’s entry into an Amended and Restated Investors’ Rights Agreement with Company and be superseded by the rights set forth therein.

11. Modification and Waiver. This Warrant and any provision hereof may be changed, waived, discharged or terminated only by an instrument in writing signed by the party against which enforcement of the same is sought.

12. Notices. Any notice, request or other document required or permitted to be given or delivered to Holder hereof or Company shall be deemed to have been given (i) upon receipt if delivered personally or by courier (ii) upon confirmation of receipt if by telecopy or (iii) three business days after deposit in the US mail, with postage prepaid and certified or registered, to each such Holder at its address as shown on the books of Company or to Company at the address indicated therefor in the opening paragraphs of this Warrant.

13. Survival of Certain Obligations. All of the covenants and agreements of Company shall inure to the benefit of the successors and assigns of Holder hereof. Company will, at the time of the exercise of this Warrant, in whole or in part, upon request of Holder hereof but at Company’s expense, acknowledge in writing its continuing obligation to Holder hereof in respect of any rights (including, without limitation, any right to registration of the shares of Common Stock) to which Holder hereof shall continue to be entitled after such exercise in accordance with this Warrant; provided, that the failure of Holder hereof to make any such request shall not affect the continuing obligation of Company to Holder hereof in respect of such rights.

14. Descriptive Headings and Governing Law. The descriptive headings of the several sections and paragraphs of this Warrant are inserted for convenience only and do not constitute a part of this Warrant. This Warrant shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the laws of the State of California.

15. Lost Warrants or Stock Certificates. Company represents and warrants to Holder hereof that upon receipt of evidence reasonably satisfactory to Company of the loss, theft, destruction, or mutilation of any Warrant or stock certificate and, in the case of any such loss, theft or destruction, upon receipt of an indemnity reasonably satisfactory to Company, or in the case of any such mutilation upon surrender and cancellation of such Warrant or stock certificate, Company at its expense will make and deliver a new Warrant or stock certificate, of like tenor, in lieu of the lost, stolen, destroyed or mutilated Warrant or stock certificate.

 

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16. Fractional Shares. No fractional shares shall be issued upon exercise of this Warrant. Company shall, in lieu of issuing any fractional share, pay the holder entitled to such fraction a sum in cash equal to such fraction multiplied by the then effective Stock Purchase Price.

17. Representations of Holder. With respect to this Warrant, Holder represents and warrants to Company as follows:

17.1 Experience. It is experienced in evaluating and investing in companies engaged in businesses similar to that of Company; it understands that investment in this Warrant involves substantial risks; it has made detailed inquiries concerning Company, its business and services, its officers and its personnel; the officers of Company have made available to Holder any and all written information it has requested; the officers of Company have answered to Holder’s satisfaction all inquiries made by it; in making this investment it has relied upon information made available to it by Company; and it has such knowledge and experience in financial and business matters that it is capable of evaluating the merits and risks of investment in Company and it is able to bear the economic risk of that investment.

17.2 Investment. It is acquiring this Warrant for investment for its own account and not with a view to, or for resale in connection with, any distribution thereof. It understands that this Warrant, the shares of Next Round Stock issuable upon exercise thereof and the shares of Common Stock issuable upon conversion of the Next Round Stock, have not been registered under the Securities Act, nor qualified under applicable state securities laws.

17.3 Rule 144. It acknowledges that this Warrant, the Next Round Stock and the Common Stock must be held indefinitely unless they are subsequently registered under the Securities Act or an exemption from such registration is available. It has been advised or is aware of the provisions of Rule 144 promulgated under the Securities Act.

17.4 Access to Data. It has had an opportunity to discuss Company’s business, management and financial affairs with Company’s management and has had the opportunity to inspect Company’s facilities.

17.5 Accredited Investor. It is an “accredited investor” within the meaning of Regulation D promulgated under the Securities Act.

18. Additional Representations and Covenants of Company. Company hereby represents, warrants and agrees as follows:

18.1 Corporate Power. Company has all requisite corporate power and corporate authority to issue this Warrant and to carry out and perform its obligations hereunder.

18.2 Authorization. All corporate action on the part of Company, its directors and stockholders necessary for the authorization, execution, delivery and performance by Company of this Warrant has been taken. This Warrant is a valid and binding obligation of Company, enforceable in accordance with its terms.

 

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18.3 Offering. Subject in part to the truth and accuracy of Holder’s representations set forth in Section 17 hereof, the offer, issuance and sale of this Warrant is, and the issuance of Next Round Stock upon exercise of this Warrant and the issuance of Common Stock upon conversion of the Next Round Stock will be exempt from the registration requirements of the Securities Act, and are exempt from the qualification requirements of any applicable state securities laws; and neither Company nor anyone acting on its behalf will take any action hereafter that would cause the loss of such exemptions.

18.4 Listing; Stock Issuance. Company shall secure and maintain the listing of the Next Round Stock issuable upon exercise of this Warrant and the shares of Common Stock or other securities issuable upon conversion of such Next Round Stock upon each securities exchange or over-the-counter market upon which securities of the same class or series issued by Company are listed, if any. Upon exercise of this Warrant, Company will use its best efforts to cause stock certificates representing the shares of Next Round Stock purchased pursuant to the exercise to be issued in the names of Holder, its nominees or assignees, as appropriate at the time of such exercise. Upon conversion of the shares of Next Round Stock into shares of Common Stock, Company will issue the Common Stock in the names of Holder, its nominees or assignees, as appropriate.

18.5 Charter Documents. Company has provided Holder with true and complete copies of Company’s Charter, By-Laws, and each Certificate of Designation or other charter document setting, forth any rights, preferences and privileges of Company’s capital stock, each as amended and in effect on the date of issuance of this Warrant.

18.6 Intentionally Omitted.

18.7 Financial and Other Reports. From time to time up to the Expiration Date, Company shall furnish to Holder (i) within 30 days of delivery to Company’s Board of Directors after the close of each fiscal year of Company, a balance sheet and statement of changes in financial position at and as of the end of such fiscal year, together with a statement of income for such fiscal year, in the same form as such annual financial statements are furnished to Company’s Board of Directors; (ii) within 45 days after the close of each fiscal quarter of Company, an unaudited balance sheet and statement of cash flows at and as of the end of such quarter, together with an unaudited statement of income for such quarter and a capitalization table; and (iii) promptly after the closing of each equity financing consummated by Company after the date this Warrant has been issued, a copy of the term sheet for such equity financing (if any), a post-closing capitalization table and other information relating to the valuation of Company. In addition, Company agrees to provide Holder at any time and from time to time with such information as Holder may reasonably request for purposes of Holder’s compliance with regulatory, accounting and reporting requirements applicable to Holder (e.g., Fair Value Accounting Standard 157), including any 409A valuation reports, as well as information with respect to whether the securities issuable upon the exercise hereof constitute “qualified small business stock” for purposes of Section 1202(c) of the Internal Revenue Code and Section 18152.5 of the California Revenue and Taxation Code. Notwithstanding the foregoing, Company shall not be required to furnish to Holder the financial information described in this Section 18.7 in the event such financial information has been previously delivered to Lender pursuant to the Loan Agreement.

 

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19. Right to Purchase Securities in Future Financings. If in connection with the Next Round the investors who purchase Next Round Stock are granted pro rata investment rights then in connection with any equity or convertible debt securities that Company may from time to time propose to offer or sell after the Next Round, Company hereby grants to Holder the right to invest up to such amount of cash as is required to enable Holder to purchase that number of any equity or convertible debt securities as will enable Holder to own or acquire immediately after completion of such offering the same percentage of the securities of Company (on a fully diluted basis) as Holder owned and/or had the right to purchase (including under this Warrant, under any other warrant instrument held by Holder or any affiliate of Holder or otherwise with respect to any securities owned by Holder or any affiliate of Holder) immediately prior to commencement of such offering. Holder shall not have any obligation to purchase Company’s securities in any such future sale(s). In the event Holder exercises its purchase right set forth hereunder, Holder shall not have any obligation to purchase such securities, except pursuant to those definitive purchase documents executed by other purchasers in connection with the applicable offering. For avoidance of doubt, the right granted herein shall apply to all future sales of Company’s equity and convertible debt securities consummated by Company after the date hereof, excluding (i) any additional sales of Company’s Series A Preferred Stock, (ii) any sales of Series A-l Preferred Stock to General Catalyst Group VI, L.P., or its affiliates, pursuant to that certain Call Option Agreement dated as of February 19, 2013, and (iii) any sales of Next Round Stock. The right to purchase securities in future sales by Company thereof described in this Section 19 shall survive the payment and satisfaction of all of Company’s Obligations to Lender, notwithstanding anything to the contrary set forth in any other Loan Document executed or delivered by Company or Lender after the date hereof. Subject to compliance with applicable securities laws, Holder shall be entitled to apportion the rights hereby granted to it among itself and any affiliate of Holder in such proportions as Holder deems appropriate.

[Remainder of this page intentionally left blank; signature page follows]

 

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IN WITNESS WHEREOF, Company has caused this Warrant to be duly executed by its officer, thereunto duly authorized as of the date of issuance set forth on the first page hereof.

 

MULBERRY HEALTH INC.
By:  

/s/ Sina Kevin Nazemi

Name:   Sina Kevin Nazemi
Title:   Co-CEO

 

 

[Signature Page to VLL6 Warrant]


FORM OF SUBSCRIPTION

(To be signed only upon exercise of Warrant)

To: ____________________

 

The undersigned, the holder of the within Warrant, hereby irrevocably elects to exercise the purchase right represented by such Warrant for, and to purchase thereunder, (1) See Below _____________ (____) shares (the “Shares”) of Stock of _____________ and herewith makes payment of _____________ Dollars ($______) therefor, and requests that the certificates for such shares be issued in the name of, and delivered to, _____________, whose address is _____________.

 

The undersigned hereby elects to convert _____________ percent (__%) of the value of the Warrant pursuant to the provisions of Section 1(b) of the Warrant.

The undersigned acknowledges that it has reviewed the representations and warranties contained in Section 17 of this Warrant and by its signature below hereby makes such representations and warranties to Company.

 

Dated  

 

Holder:  

 

By:  

 

Its:  

 

(Address)  

 

 

 

(1)

Insert here the number of shares called for on the face of the Warrant (or, in the case of a partial exercise, the portion thereof as to which the Warrant is being exercised), in either case without making any adjustment for additional Next Round Stock or any other stock or other securities or property or cash which, pursuant to the adjustment provisions of the Warrant, may be issuable upon exercise.

 


ASSIGNMENT

FOR VALUE RECEIVED, the undersigned, the holder of the within Warrant, hereby sells, assigns and transfers all of the rights of the undersigned under the within Warrant, with respect to the number of shares of Next Round Stock covered thereby set forth herein below, unto:

 

Name of Assignee

 

Address

 

No. of Shares

 

Dated  

 

Holder:  

 

By:  

 

Its:  

 


EXHIBIT “A”

[On letterhead of Company]

Reference is hereby made to that certain Warrant dated March 20, 2013, issued by MULBERRY HEALTH INC., a Delaware corporation (the “Company”), to VENTURE LENDING & LEASING VI, LLC, a Delaware limited liability company (the “Holder”).

[IF APPLICABLE] The Warrant provides that the actual number and type of shares of Company’s capital stock issuable upon exercise of the Warrant and the initial exercise price per share are to be determined by reference to one or more events or conditions subsequent to the issuance of the Warrant. Such events or conditions have now occurred or lapsed, and Company wishes to confirm the actual number of shares issuable and the initial exercise price. The provisions of this Supplement to Warrant are incorporated into the Warrant by this reference, and shall control the interpretation and exercise of the Warrant.

[IF APPLICABLE] Notice is hereby given pursuant to Section 4.5 of the Warrant that the following adjustment(s) have been made to the Warrant: [describe adjustments, setting forth details regarding method of calculation and facts upon which calculation is based].

This certifies that Holder is entitled to purchase from Company _____________ (_____________) fully paid and nonassessable shares of Company’s _____________ Stock at a price of __________________________ Dollars ($_________) per share. The applicable Stock Purchase Price and the number of shares purchasable under the Warrant remain subject to adjustment as provided in Section 4 of the Warrant.

Executed this __ day of _____________, 20__.

 

MULBERRY HEALTH INC.
By:  

 

Name:  

 

Title:  

 

Exhibit 10.2

THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE AND DISTRIBUTION THEREOF, AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”) OR ANY STATE SECURITIES LAWS. SUCH SECURITIES MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR AN OPINION OF COUNSEL IN A FORM REASONABLY ACCEPTABLE TO COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED DUE TO AN EXEMPTION THEREFROM UNDER SAID ACT AND ANY APPLICABLE STATE SECURITIES LAWS.

Date of Issuance: March 20, 2013

WARRANT TO PURCHASE

SHARES OF PREFERRED STOCK OF

MULBERRY HEALTH INC.

(Void after September 30, 2023)

This certifies that VENTURE LENDING & LEASING VII, LLC, a Delaware limited liability company, or assigns (“Holder”), for value received, is entitled to purchase from MULBERRY HEALTH INC., a Delaware corporation (“Company”), the Applicable Number (hereinafter defined) of fully paid and nonassessable shares of Company’s Next Round Stock (hereinafter defined), for cash, at a purchase price per share hereinafter determined (the “Stock Purchase Price”). Holder may also exercise this Warrant on a cashless or “net issuance” basis as described in Section 1(b) below, and this Warrant shall be deemed to have been exercised in full on such basis on the Expiration Date, to the extent not fully exercised prior to such date. This Warrant is issued in connection with that certain Loan and Security Agreement and Supplement thereto, both of even date herewith (as amended, restated and supplemented from time to time, the “Loan Agreement” and the “Supplement”, respectively), between Company, as borrower, and Holder’s subsidiary, Venture Lending & Leasing VII, Inc., as lender (“Lender”). Capitalized terms used herein and not otherwise defined in this Warrant shall have the meaning(s) ascribed to them in the Loan Agreement and the Supplement, unless the context would otherwise require.

The “Applicable Number” of shares of Next Round Stock purchasable hereunder shall be the number obtained by dividing (A) the sum of (i) $183,750, plus (ii) the product of (x) 0.0525 and (y) the aggregate original principal amount of the Loans advanced to Company by Lender under the First Tranche (hereinafter defined) of Lender’s Commitment, plus (iii) the product of (x) 0.105 and (y) the aggregate original principal amount of the Loans advanced to Company by Lender under the Second Tranche (hereinafter defined) of Lender’s Commitment (such sum sometimes referred to herein as the “Coverage Amount”), by (B) the Stock Purchase Price. The Stock Purchase Price shall be equal to the Next Round Price (hereinafter defined). If in any case the Applicable Number includes a fraction, the fraction shall be adjusted to the closest integral number. For purposes of this Warrant: the “First Tranche” of Lender’s Commitment means $3,500,000; and the “Second Tranche” of Lender’s Commitment means $1,500,000. For clarity, the parties agree that Borrowing Requests for Loans shall be applied initially against the First Tranche of Lender’s Commitment until the First Tranche has been fully funded; and then such Borrowing Requests for Loans shall be applied against the Second Tranche of Lender’s Commitment until the earlier of (i) the date the Second Tranche has been fully funded and (ii) the Termination Date for Lender’s Commitment has occurred.

The “Next Round Price” is the lowest price per share paid by an investor for Company’s equity securities issued in the Next Round (hereinafter defined) (the “Next Round Stock”), including for this purpose the value of all consideration given by an investor for such equity securities and specifically including any discounts afforded to investors and stockholders of Company upon conversion of any convertible promissory notes held by such investors and stockholders in connection with the Next Round or otherwise. The “Next Round” means the next bona fide round of equity financing after the date hereof in which Company sells or issues shares of its securities, and includes (and Holder shall be entitled to receive) any options, warrants, or other convertible

 


securities or similar consideration issued or delivered to investors in connection with such equity financing in such round; provided that the Next Round excludes (i) any additional sales of Company’s Series A Preferred Stock and (ii) any sales of Series A-1 Preferred Stock to General Catalyst Group VI, L.P., or its affiliates, pursuant to that certain Call Option Agreement dated as of February 19, 2013.

As soon as reasonably practicable after the occurrence or non-occurrence of the latest event or condition necessary to determine (i) the Coverage Amount, (ii) the actual number and type of shares of Company’s stock issuable upon exercise of this Warrant, or (iii) the Stock Purchase Price, if applicable, Company shall deliver a supplement to this Warrant (subsequent to a request by Holder therefor), in substantially the form of Exhibit “A” attached hereto, specifying the total number and series of shares of Next Round Stock issuable hereunder after giving effect to the foregoing calculations, and otherwise completed with such quantity and price terms and other information as have been determined as a result of the occurrence or non-occurrence of such events or conditions. The provisions of such supplement, once completed and executed, shall control the interpretation and exercise of this Warrant; provided, however, that the failure of Company to deliver such supplement shall not affect the rights of the Holder of this Warrant to receive the number and type of shares of Next Round Stock as set forth herein.

Subject to Section 4.3, this Warrant may be exercised at any time or from time to time up to and including 5:00 p.m. (Pacific time) on September 30, 2023 (the “Expiration Date”), upon surrender to Company at its principal office at 295 Lafayette Street, 7th Floor, New York, NY 10012 (or at such other location as Company may advise Holder in writing) of this Warrant properly endorsed with the Form of Subscription attached hereto duly completed and signed and upon payment in cash or by check of the aggregate Stock Purchase Price for the number of shares for which this Warrant is being exercised determined in accordance with the provisions hereof. The Stock Purchase Price and the number of shares purchasable hereunder are subject to further adjustment as provided in Section 4 of this Warrant.

Notwithstanding anything to the contrary above, in the event that Company has satisfied the conditions precedent in Section 4.1, Section 4.2(a), Section 4.2(c), Section 4.2(d), Section 4.2(e) and Section 4.2(g) of the Loan Agreement and Lender fails or refuses to make any Loan under its Commitment then this Warrant shall be surrendered to Company by Holder for cancellation.

This Warrant is subject to the following terms and conditions:

1. Exercise; Issuance of Certificates; Payment for Shares.

(a) Unless an election is made pursuant to clause (b) of this Section 1, this Warrant shall be exercisable at the option of Holder, at any time or from time to time, on or before the Expiration Date for all or any portion of the shares of Next Round Stock (but not for a fraction of a share) which may be purchased hereunder for the Stock Purchase Price multiplied by the number of shares to be purchased. In the event, however, that pursuant to Company’s Certificate of Incorporation, as amended and restated from time to time (the “Charter”), an event causing automatic conversion of Company’s Next Round Stock shall have occurred prior to the exercise of this Warrant, in whole or in part, then this Warrant shall be exercisable for the number of shares of Common Stock of Company into which the Next Round Stock not purchased upon any prior exercise of this Warrant would have been so converted (and, where the context requires, reference to “Next Round Stock” shall be deemed to be or include such Common Stock, as may be appropriate). Company agrees that the shares of Next Round Stock purchased under this Warrant shall be and are deemed to be issued to Holder hereof as the record owner of such shares as of the close of business on the date on which the form of subscription shall have been delivered and payment made for such shares. Subject to the provisions of Section 2, certificates for the shares of Next Round Stock so purchased, together with any other securities or property to which Holder hereof is entitled upon such exercise, shall be delivered to Holder hereof by Company at Company’s expense within a reasonable time after the rights represented by this Warrant have been so exercised. Except as provided in clause (b) of this Section 1, in case of a purchase of less than all the shares which may be purchased under this Warrant, Company shall cancel this Warrant and execute and deliver a new Warrant or Warrants of like tenor for the balance of the shares purchasable under this Warrant surrendered upon such purchase to Holder hereof within a reasonable time. Each stock certificate so delivered shall be in such denominations of Next Round Stock as may be requested by Holder hereof and shall be registered in the name of such Holder or such other name as shall be designated by such Holder, subject to the limitations contained in Section 2.

 

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(b) Holder, in lieu of exercising this Warrant by the cash payment of the Stock Purchase Price pursuant to clause (a) of this Section 1, may elect, at any time on or before the Expiration Date, to surrender this Warrant and receive that number of shares of Next Round Stock computed using the following formula:

 

   X =    Y (A – B)   
     

 

Where:   X    =    the number of shares of Next Round Stock to be issued to Holder.
  Y    =    the number of shares of Next Round Stock that Holder would otherwise have been entitled to purchase hereunder pursuant to Section 1(a) (or the applicable lesser number of shares in the case of a partial exercise of this Warrant).
  A    =    the Per Share Price (as defined in Section 1(c) below) of one (1) share of Next Round Stock at the time the net issuance election under this Section 1(b) is made.
  B    =    the Stock Purchase Price then in effect.

Election to exercise under this Section 1(b) may be made by delivering a signed form of subscription to Company via facsimile, to be followed by delivery of this Warrant. Notwithstanding anything to the contrary contained in this Warrant, if as of the close of business on the last business day preceding the Expiration Date this Warrant remains unexercised as to all or a portion of the shares of Next Round Stock purchasable hereunder, then effective as 9:00 a.m. (Pacific time) on the Expiration Date, Holder shall be deemed, automatically and without need for notice to Company, to have elected to exercise this Warrant in full pursuant to the provisions of this Section 1(b), and upon surrender of this Warrant shall be entitled to receive that number of shares of Next Round Stock computed using the above formula, provided that the application of such formula as of the Expiration Date yields a positive number for “X”.

(c) For purposes of Section 1(b), “Per Share Price” means:

(i) If this Warrant is exercised on the date of Company’s initial public offering of Common Stock, and if Company’s registration statement relating to such public offering has been declared effective by the Securities and Exchange Commission, then the Per Share Price shall be the product of (A) the initial “Price to Public” of the Common Stock specified in the final prospectus with respect to the offering, and (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible at the date of calculation.

(ii) If this Warrant is exercised after, and not on the date of Company’s initial public offering of Common Stock, and if Company’s Common Stock is traded on a securities exchange or actively traded over-the-counter:

(1) If Company’s Common Stock is traded on a securities exchange, the Per Share Price shall be deemed to be the product of (A) the closing price of Company’s Common Stock as quoted on any exchange, as published on Yahoo! Finance (or a successor thereto or equivalent publisher) for the trading day immediately prior to the date of Holder’s election hereunder and, (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible on such date.

 

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(2) If Company’s Common Stock is actively traded over-the-counter, the Per Share Price shall be deemed to be the product of (A) the closing bid or sales price, whichever is applicable, of Company’s Common Stock for the trading day immediately prior to the date of Holder’s election hereunder and (B) the number of shares of Common Stock into which each share of Next Round Stock exercised is convertible on such date.

(iii) If neither (i) nor (ii) is applicable, the Per Share Price shall be determined in good faith by the Board of Directors of Company based on relevant facts and circumstances at the time of the net exercise under Section 1(b), including in the case of a Change of Control (as defined in Section 4.3 hereof) the consideration receivable by the holders of the Next Round Stock in such Change of Control and the liquidation preference (including any declared but unpaid dividends), if any, then applicable to the Next Round Stock.

2. Limitation on Transfer.

(a) This Warrant and the Next Round Stock shall not be transferable except upon the conditions specified in this Section 2, which conditions are intended to ensure compliance with the provisions of the Securities Act. Each holder of this Warrant or the Next Round Stock issuable hereunder will cause any proposed transferee of the Warrant or Next Round Stock to agree to take and hold such securities subject to the provisions and upon the conditions specified in this Section 2. Notwithstanding the foregoing and any other provision of this Section 2, Holder may freely transfer all or part of this Warrant or the shares issuable upon exercise of this Warrant (or the securities issuable, directly or indirectly, upon conversion of the shares, if any), at Holder’s expense, at any time to any lender transferee of a portion of the loan commitment of Lender under the Loan Agreement, by giving Company notice of the portion of the Warrant being transferred setting forth the name, address and taxpayer identification number of the transferee, executing appropriate transfer documentation and surrendering this Warrant to Company for reissuance to the transferees(s) (and Holder, if applicable).

(b) Each certificate representing (i) this Warrant, (ii) the Next Round Stock, (iii) shares of Company’s Common Stock issued upon conversion of the Next Round Stock and (iv) any other securities issued in respect to the Next Round or Common Stock issued upon conversion of the Next Round upon any stock split, stock dividend, recapitalization, merger, consolidation or similar event, shall (unless otherwise permitted by the provisions of this Section 2 or unless such securities have been registered under the Securities Act or sold under Rule 144) be stamped or otherwise imprinted with a legend substantially in the following form (in addition to any legend required under applicable state securities laws):

THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE AND DISTRIBUTION THEREOF, AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OR ANY STATE SECURITIES LAWS. SUCH SECURITIES MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR AN OPINION OF COUNSEL IN A FORM REASONABLY ACCEPTABLE TO COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED DUE TO AN EXEMPTION THEREFROM UNDER SAID ACT AND ANY APPLICABLE STATE SECURITIES LAWS.

(c) Holder of this Warrant and each person to whom this Warrant is subsequently transferred represents and warrants to Company (by acceptance of such transfer) that it will not transfer this Warrant (or securities issuable upon exercise hereof unless a registration statement under the Securities Act was in effect with respect to such securities at the time of issuance thereof) except pursuant to (i) an effective registration statement under the Securities Act, (ii) Rule 144 under the Securities Act (or any other rule under the Securities Act relating to the disposition of securities), or (iii) an opinion of counsel, reasonably satisfactory to counsel for Company, that an exemption from such registration is available.

3. Shares to be Fully Paid; Reservation of Shares. Company covenants and agrees that all shares of Next Round Stock which may be issued upon the exercise of the rights represented by this Warrant will, upon issuance, be duly authorized, validly issued, fully paid and nonassessable and free from all preemptive rights of any stockholder and free of all taxes, liens and charges with respect to the issue thereof. Company further

 

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covenants and agrees that during the period within which the rights represented by this Warrant may be exercised, Company will at all times have authorized and reserved, for the purpose of issue or transfer upon exercise of the subscription rights evidenced by this Warrant, a sufficient number of shares of authorized but unissued Next Round Stock, or other securities and property, when and as required to provide for the exercise of the rights represented by this Warrant. Company will take all such action as may be necessary to assure that such shares of Next Round Stock may be issued as provided herein without violation of any applicable law or regulation, or of any requirements of any domestic securities exchange upon which the Next Round Stock may be listed. Company will not take any action which would result in any adjustment of the Stock Purchase Price (as described in Section 4 hereof) (i) if the total number of shares of Next Round Stock issuable after such action upon exercise of all outstanding warrants, together with all shares of Next Round Stock then outstanding and all shares of Next Round Stock then issuable upon exercise of all options and upon the conversion of all convertible securities then outstanding, would exceed the total number of shares of Next Round Stock then authorized by Company’s Charter, (ii) if the total number of shares of Common Stock issuable after such action upon the conversion of all such shares of Next Round Stock together with all shares of Common Stock then outstanding and then issuable upon exercise of all options and upon the conversion of all convertible securities then outstanding would exceed the total number of shares of Common Stock then authorized by Company’s Charter or (iii) if the par value per share of the Next Round Stock would exceed the Stock Purchase Price.

4. Adjustment of Stock Purchase Price and Number of Shares. The Stock Purchase Price and the number of shares purchasable upon the exercise of this Warrant shall be subject to adjustment from time to time upon the occurrence of certain events described in this Section 4, provided, however, that no adjustment will be made pursuant to this Section 4 to the extent such adjustment would be duplicative of any adjustment set forth in the Company’s Certificate of Incorporation as in effect on the date of such adjustment. Upon each adjustment of the Stock Purchase Price, Holder of this Warrant shall thereafter be entitled to purchase, at the Stock Purchase Price resulting from such adjustment, the number of shares obtained by multiplying the Stock Purchase Price in effect immediately prior to such adjustment by the number of shares purchasable pursuant hereto immediately prior to such adjustment, and dividing the product thereof by the Stock Purchase Price resulting from such adjustment.

4.1 Subdivision or Combination of Stock. In case Company shall at any time subdivide its outstanding shares of Next Round Stock into a greater number of shares, the Stock Purchase Price in effect immediately prior to such subdivision shall be proportionately reduced, and conversely, in case the outstanding shares of Next Round Stock of Company shall be combined into a smaller number of shares, the Stock Purchase Price in effect immediately prior to such combination shall be proportionately increased.

4.2 Dividends in Next Round Stock, Other Stock, Property, Reclassification. If at any time or from time to time the holders of Next Round Stock (or any shares of stock or other securities at the time receivable upon the exercise of this Warrant) shall have received or become entitled to receive, without payment therefor,

(a) Next Round Stock, or any shares of stock or other securities whether or not such securities are at any time directly or indirectly convertible into or exchangeable for Next Round Stock, or any rights or options to subscribe for, purchase or otherwise acquire any of the foregoing by way of dividend or other distribution,

(b) any cash paid or payable otherwise than as a cash dividend, or

(c) Next Round Stock or other or additional stock or other securities or property (including cash) by way of spin off, split-up, reclassification, combination of shares or similar corporate rearrangement, (other than shares of Next Round Stock issued as a stock split, adjustments in respect of which shall be covered by the terms of Section 4.1 above),

 

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Then, subject to Section 4.3, and in each such case, Holder hereof shall, upon the exercise of this Warrant, be entitled to receive, in addition to the number of shares of Next Round Stock receivable thereupon, and without payment of any additional consideration therefor, the amount of stock and other securities and property (including cash in the cases referred to in clauses (b) and (c) above) which such Holder would hold on the date of such exercise had it been the holder of record of such Next Round Stock as of the date on which holders of Next Round Stock received or became entitled to receive such shares and/or all other additional stock and other securities and property.

4.3 Change of Control; IPO.

(a) In the event of a Change of Control (as hereinafter defined) in which the sole consideration payable to Company’s stockholders consists of equity securities of a privately-held company then this Warrant shall be automatically exchanged for a number of shares of Company’s securities, such number of shares being equal to the maximum number of shares issuable pursuant to the terms hereof (after taking into account all adjustments described herein) had Holder elected to exercise this Warrant immediately prior to the closing of such Change of Control and purchased all such shares pursuant to the cash exercise provision set forth in Section 1(a) hereof (as opposed to the cashless exercise provision set forth in Section 1(b)). Company acknowledges and agrees that Holder shall not be required to make any additional payment (cash or otherwise) for such shares as further consideration for their issuance pursuant to the terms of the preceding sentence. “Change of Control” shall mean any sale, license, or other disposition of all or substantially all of the assets of Company, any reorganization, consolidation, merger or other transaction involving Company where the holders of Company’s securities before the transaction beneficially own less than 50% of the outstanding voting securities of the surviving entity after the transaction. This Warrant shall terminate upon Holder’s receipt of the number of shares of Company’s equity securities described in this Section 4.3.

(b) In the event of (i) a Change of Control, other than of the type described in the first sentence of Section 4.3(a), or (ii) the consummation of a sale of Company’s securities pursuant to a registration statement filed by Company under the Securities Act (or pursuant to the laws of the jurisdiction in which the initial public offering is completed), in connection with the first firm commitment underwritten offering of Company’s securities to the general public that occurs after the date this Warrant is issued (“IPO”), Holder agrees to exercise this Warrant in accordance with Section 1(a) or Section 1(b) immediately prior to the closing of such transaction (and if Holder has not exercised prior to such time then this Warrant shall be deemed exercised in accordance with Section 1(b) immediately prior to the closing of such transaction). This Warrant shall terminate upon Holder’s receipt of the number of shares of Company’s equity securities described in this Section 4.3(b).

4.4 Sale or Issuance Below Purchase Price. The other antidilution rights applicable to the shares of Next Round Stock purchasable hereunder are set forth in Company’s Charter. Company shall promptly provide Holder hereof with any restatement, amendment, modification or waiver of the Charter promptly after the same has been made.

4.5 Notice of Adjustment. Upon any adjustment of the Stock Purchase Price, and/or any increase or decrease in the number of shares purchasable upon the exercise of this Warrant, Company shall give written notice thereof, by first class mail, postage prepaid, addressed to the registered holder of this Warrant at the address of such holder as shown on the books of Company. The notice, which may be substantially in the form of Exhibit “A attached hereto, shall be signed by Company’s chief financial officer or officer substantially responsible for accounting and shall state the Stock Purchase Price resulting from such adjustment and the increase or decrease, if any, in the number of shares purchasable at such price upon the exercise of this Warrant, setting forth in reasonable detail the method of calculation and the facts upon which such calculation is based.

4.6 Other Notices. If at any time:

(a) Company shall declare any cash dividend upon its Next Round Stock;

(b) Company shall declare any dividend upon its Next Round Stock payable in stock or make any special dividend or other distribution to the holders of its Next Round Stock;

 

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(c) Company shall offer for subscription pro rata to the holders of its Next Round Stock any additional shares of stock in connection with a Down Round or additional shares of stock of any class or other rights;

(d) there shall be any capital reorganization or reclassification of the capital stock of Company, or consolidation or merger of Company with, or sale of all or substantially all of its assets to, another entity;

(e) there shall be a voluntary or involuntary dissolution, liquidation or winding-up of Company; or

(f) Company shall take or propose to take any other action, notice of which is actually provided to holders of the Next Round Stock;

then, in any one or more of said cases, Company shall give, by first class mail, postage prepaid, addressed to Holder of this Warrant at the address of such Holder as shown on the books of Company, (i) at least 20 days’ prior written notice of the date on which the books of Company shall close or a record shall be taken for such dividend, distribution or subscription rights or for determining rights to vote in respect of any such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action and (ii) in the case of any such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action, at least 20 days’ written notice of the date when the same shall take place. Any notice given in accordance with the foregoing clause, (i) shall also specify, in the case of any such dividend, distribution or subscription rights, the date on which the holders of Next Round Stock shall be entitled thereto. Any notice given in accordance with the foregoing clause (ii) shall also specify the date on which the holders of Next Round Stock shall be entitled to exchange their Next Round Stock for securities or other property deliverable upon such reorganization, reclassification, consolidation, merger, sale, dissolution, liquidation or winding-up, or other action as the case may be.

4.7 Certain Events. If any change in the outstanding Next Round Stock of Company or any other event occurs as to which the other provisions of this Section 4 are not strictly applicable or if strictly applicable would not fairly effect the adjustments to this Warrant in accordance with the essential intent and principles of such provisions, then the Board of Directors of Company shall make in good faith an adjustment in the number and class of shares issuable under this Warrant, the Stock Purchase Price and/or the application of such provisions, in accordance with such essential intent and principles, so as to protect such purchase rights as aforesaid. The adjustment shall be such as will give Holder of this Warrant upon exercise for the same aggregate Stock Purchase Price the total number, class and kind of shares as Holder would have owned had this Warrant been exercised prior to the event and had Holder continued to hold such shares until after the event requiring adjustment.

5. Issue Tax. The issuance of certificates for shares of Next Round Stock upon the exercise of this Warrant shall be made without charge to Holder of this Warrant for any issue tax in respect thereof; provided, however, that Company shall not be required to pay any tax which may be payable in respect of any transfer involved in the issuance and delivery of any certificate in a name other than that of the then Holder of this Warrant being exercised.

6. Closing of Books. Company will at no time close its transfer books against the transfer of this Warrant or of any shares of Next Round Stock issued or issuable upon the exercise of this Warrant in any manner which interferes with the timely exercise of this Warrant.

7. No Voting or Dividend Rights; Limitation of Liability. Nothing contained in this Warrant shall be construed as conferring upon Holder hereof the right to vote or to consent as a stockholder in respect of meetings of stockholders for the election of directors of Company or any other matters or any rights whatsoever as a stockholder of Company. No dividends or interest shall be payable or accrued in respect of this Warrant or the interest represented hereby or the shares purchasable hereunder until, and only to the extent that, this Warrant shall have been exercised. No provisions hereof, in the absence of affirmative action by Holder to purchase shares of Next Round Stock, and no mere enumeration herein of the rights or privileges of Holder hereof, shall give rise to any liability of such Holder for the Stock Purchase Price or as a stockholder of Company, whether such liability is asserted by Company or by its creditors.

 

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8. [Reserved].

9. Registration Rights. Holder hereof shall be entitled, with respect to the shares of Next Round Stock issued upon exercise hereof or the shares of Common Stock or other securities issued upon conversion of such Next Round Stock, as the case may be, to all of the “piggyback” and “S-3” registration rights granted by Company to the investors who purchase Next Round Stock to the same extent and on the same terms and conditions as possessed by such investors. Company shall take such action as may be reasonably necessary to assure that the granting of such registration rights to Holder does not violate the provisions of any of Company’s charter documents or rights of prior grantees of registration rights.

10. Rights and Obligations Survive Exercise of Warrant. The rights and obligations of Company, of Holder of this Warrant and of the holder of shares of Next Round Stock issued upon exercise of this Warrant, contained in Sections 6, 9, 18.7 and 19 shall survive the exercise of this Warrant. Notwithstanding the foregoing, the rights contained in Sections 6, 9, 18.7 and 19 shall terminate upon Holder’s entry into an Amended and Restated Investors’ Rights Agreement with Company and be superseded by the rights set forth therein.

11. Modification and Waiver. This Warrant and any provision hereof may be changed, waived, discharged or terminated only by an instrument in writing signed by the party against which enforcement of the same is sought.

12. Notices. Any notice, request or other document required or permitted to be given or delivered to Holder hereof or Company shall be deemed to have been given (i) upon receipt if delivered personally or by courier (ii) upon confirmation of receipt if by telecopy or (iii) three business days after deposit in the US mail, with postage prepaid and certified or registered, to each such Holder at its address as shown on the books of Company or to Company at the address indicated therefor in the opening paragraphs of this Warrant.

13. Survival of Certain Obligations. All of the covenants and agreements of Company shall inure to the benefit of the successors and assigns of Holder hereof. Company will, at the time of the exercise of this Warrant, in whole or in part, upon request of Holder hereof but at Company’s expense, acknowledge in writing its continuing obligation to Holder hereof in respect of any rights (including, without limitation, any right to registration of the shares of Common Stock) to which Holder hereof shall continue to be entitled after such exercise in accordance with this Warrant; provided, that the failure of Holder hereof to make any such request shall not affect the continuing obligation of Company to Holder hereof in respect of such rights.

14. Descriptive Headings and Governing Law. The descriptive headings of the several sections and paragraphs of this Warrant are inserted for convenience only and do not constitute a part of this Warrant. This Warrant shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the laws of the State of California.

15. Lost Warrants or Stock Certificates. Company represents and warrants to Holder hereof that upon receipt of evidence reasonably satisfactory to Company of the loss, theft, destruction, or mutilation of any Warrant or stock certificate and, in the case of any such loss, theft or destruction, upon receipt of an indemnity reasonably satisfactory to Company, or in the case of any such mutilation upon surrender and cancellation of such Warrant or stock certificate, Company at its expense will make and deliver a new Warrant or stock certificate, of like tenor, in lieu of the lost, stolen, destroyed or mutilated Warrant or stock certificate.

16. Fractional Shares. No fractional shares shall be issued upon exercise of this Warrant. Company shall, in lieu of issuing any fractional share, pay the holder entitled to such fraction a sum in cash equal to such fraction multiplied by the then effective Stock Purchase Price.

 

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17. Representations, of Holder. With respect to this Warrant, Holder represents and warrants to Company as follows:

17.1 Experience. It is experienced in evaluating and investing in companies engaged in businesses similar to that of Company; it understands that investment in this Warrant involves substantial risks; it has made detailed inquiries concerning Company, its business and services, its officers and its personnel; the officers of Company have made available to Holder any and all written information it has requested; the officers of Company have answered to Holder’s satisfaction all inquiries made by it; in making this investment it has relied upon information made available to it by Company; and it has such knowledge and experience in financial and business matters that it is capable of evaluating the merits and risks of investment in Company and it is able to bear the economic risk of that investment.

17.2 Investment. It is acquiring this Warrant for investment for its own account and not with a view to, or for resale in connection with, any distribution thereof. It understands that this Warrant, the shares of Next Round Stock issuable upon exercise thereof and the shares of Common Stock issuable upon conversion of the Next Round Stock, have not been registered under the Securities Act, nor qualified under applicable state securities laws.

17.3 Rule 144. It acknowledges that this Warrant, the Next Round Stock and the Common Stock must be held indefinitely unless they are subsequently registered under the Securities Act or an exemption from such registration is available. It has been advised or is aware of the provisions of Rule 144 promulgated under the Securities Act.

17.4 Access to Data. It has had an opportunity to discuss Company’s business, management and financial affairs with Company’s management and has had the opportunity to inspect Company’s facilities.

17.5 Accredited Investor. It is an “accredited investor” within the meaning of Regulation D promulgated under the Securities Act.

18. Additional Representations and Covenants of Company. Company hereby represents, warrants and agrees as follows:

18.1 Corporate Power. Company has all requisite corporate power and corporate authority to issue this Warrant and to carry out and perform its obligations hereunder.

18.2 Authorization. All corporate action on the part of Company, its directors and stockholders necessary for the authorization, execution, delivery and performance by Company of this Warrant has been taken. This Warrant is a valid and binding obligation of Company, enforceable in accordance with its terms.

18.3 Offering. Subject in part to the truth and accuracy of Holder’s representations set forth in Section 17 hereof, the offer, issuance and sale of this Warrant is, and the issuance of Next Round Stock upon exercise of this Warrant and the issuance of Common Stock upon conversion of the Next Round Stock will be exempt from the registration requirements of the Securities Act, and are exempt from the qualification requirements of any applicable state securities laws; and neither Company nor anyone acting on its behalf will take any action hereafter that would cause the loss of such exemptions.

18.4 Listing; Stock Issuance. Company shall secure and maintain the listing of the Next Round Stock issuable upon exercise of this Warrant and the shares of Common Stock or other securities issuable upon conversion of such Next Round Stock upon each securities exchange or over-the-counter market upon which securities of the same class or series issued by Company are listed, if any. Upon exercise of this Warrant, Company will use its best efforts to cause stock certificates representing the shares of Next Round Stock purchased pursuant to the exercise to be issued in the names of Holder, its nominees or assignees, as appropriate at the time of such exercise. Upon conversion of the shares of Next Round Stock into shares of Common Stock, Company will issue the Common Stock in the names of Holder, its nominees or assignees, as appropriate.

 

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18.5 Charter Documents. Company has provided Holder with true and complete copies of Company’s Charter, By-Laws, and each Certificate of Designation or other charter document setting, forth any rights, preferences and privileges of Company’s capital stock, each as amended and in effect on the date of issuance of this Warrant.

18.6 Intentionally Omitted.

18.7 Financial and Other Reports. From time to time up to the Expiration Date, Company shall furnish to Holder (i) within 30 days of delivery to Company’s Board of Directors after the close of each fiscal year of Company, a balance sheet and statement of changes in financial position at and as of the end of such fiscal year, together with a statement of income for such fiscal year, in the same form as such annual financial statements are furnished to Company’s Board of Directors; (ii) within 45 days after the close of each fiscal quarter of Company, an unaudited balance sheet and statement of cash flows at and as of the end of such quarter, together with an unaudited statement of income for such quarter and a capitalization table; and (iii) promptly after the closing of each equity financing consummated by Company after the date this Warrant has been issued, a copy of the term sheet for such equity financing (if any), a post-closing capitalization table and other information relating to the valuation of Company. In addition, Company agrees to provide Holder at any time and from time to time with such information as Holder may reasonably request for purposes of Holder’s compliance with regulatory, accounting and reporting requirements applicable to Holder (e.g., Fair Value Accounting Standard 157), including any 409A valuation reports, as well as information with respect to whether the securities issuable upon the exercise hereof constitute “qualified small business stock” for purposes of Section 1202(c) of the Internal Revenue Code and Section 18152.5 of the California Revenue and Taxation Code. Notwithstanding the foregoing, Company shall not be required to furnish to Holder the financial information described in this Section 18.7 in the event such financial information has been previously delivered to Lender pursuant to the Loan Agreement.

19. Right to Purchase Securities in Future Financings. If in connection with the Next Round the investors who purchase Next Round Stock are granted pro rata investment rights then in connection with any equity or convertible debt securities that Company may from time to time propose to offer or sell after the Next Round, Company hereby grants to Holder the right to invest up to such amount of cash as is required to enable Holder to purchase that number of any equity or convertible debt securities as will enable Holder to own or acquire immediately after completion of such offering the same percentage of the securities of Company (on a fully diluted basis) as Holder owned and/or had the right to purchase (including under this Warrant, under any other warrant instrument held by Holder or any affiliate of Holder or otherwise with respect to any securities owned by Holder or any affiliate of Holder) immediately prior to commencement of such offering. Holder shall not have any obligation to purchase Company’s securities in any such future sale(s). In the event Holder exercises its purchase right set forth hereunder, Holder shall not have any obligation to purchase such securities, except pursuant to those definitive purchase documents executed by other purchasers in connection with the applicable offering. For avoidance of doubt, the right granted herein shall apply to all future sales of Company’s equity and convertible debt securities consummated by Company after the date hereof, excluding (i) any additional sales of Company’s Series A Preferred Stock, (ii) any sales of Series A-1 Preferred Stock to General Catalyst Group VI, L.P., or its affiliates, pursuant to that certain Call Option Agreement dated as of February 19, 2013, and (iii) any sales of Next Round Stock. The right to purchase securities in future sales by Company thereof described in this Section 19 shall survive the payment and satisfaction of all of Company’s Obligations to Lender, notwithstanding anything to the contrary set forth in any other Loan Document executed or delivered by Company or Lender after the date hereof. Subject to compliance with applicable securities laws, Holder shall be entitled to apportion the rights hereby granted to it among itself and any affiliate of Holder in such proportions as Holder deems appropriate.

[Remainder of this page intentionally left blank; signature page follows]

 

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IN WITNESS WHEREOF, Company has caused this Warrant to be duly executed by its officer, thereunto duly authorized as of the date of issuance set forth on the first page hereof.

 

MULBERRY HEALTH INC.
By:  

/s/ Sina Kevin Nazemi

Name:   Sina Kevin Nazemi
Title:   Co-CEO

 

 

[Signature Page to VLL7 Warrant]


FORM OF SUBSCRIPTION

(To be signed only upon exercise of Warrant)

To:                                                                  

 

The undersigned, the holder of the within Warrant, hereby irrevocably elects to exercise the purchase right represented by such Warrant for, and to purchase thereunder, (1) See Below                 (            ) shares (the “Shares”) of Stock of                 and herewith makes payment of                                  Dollars ($_________) therefor, and requests that the certificates for such shares be issued in the name of, and delivered to, , whose address is.

 

The undersigned hereby elects to convert ________ percent (    %) of the value of the Warrant pursuant to the provisions of Section 1(b) of the Warrant.

The undersigned acknowledges that it has reviewed the representations and warranties contained in Section 17 of this Warrant and by its signature below hereby makes such representations and warranties to Company.

 

Dated  

 

Holder:  

 

By:  

 

Its:  

 

 

(Address)  

 

 

 

(1)

Insert here the number of shares called for on the face of the Warrant (or, in the case of a partial exercise, the portion thereof as to which the Warrant is being exercised), in either case without making any adjustment for additional Next Round Stock or any other stock or other securities or property or cash which, pursuant to the adjustment provisions of the Warrant, may be issuable upon exercise.


ASSIGNMENT

FOR VALUE RECEIVED, the undersigned, the holder of the within Warrant, hereby sells, assigns and transfers all of the rights of the undersigned under the within Warrant, with respect to the number of shares of Next Round Stock covered thereby set forth herein below, unto:

 

Name of Assignee

 

Address

 

No. of Shares

 

Dated  

 

Holder:  

 

By:  

 

Its:  

 


EXHIBIT “A”

[On letterhead of Company]

Reference is hereby made to that certain Warrant dated March 20, 2013, issued by MULBERRY HEALTH INC., a Delaware corporation (the “Company”), to VENTURE LENDING & LEASING VII, LLC, a Delaware limited liability company (the “Holder”).

[IF APPLICABLE] The Warrant provides that the actual number and type of shares of Company’s capital stock issuable upon exercise of the Warrant and the initial exercise price per share are to be determined by reference to one or more events or conditions subsequent to the issuance of the Warrant. Such events or conditions have now occurred or lapsed, and Company wishes to confirm the actual number of shares issuable and the initial exercise price. The provisions of this Supplement to Warrant are incorporated into the Warrant by this reference, and shall control the interpretation and exercise of the Warrant.

[IF APPLICABLE] Notice is hereby given pursuant to Section 4.5 of the Warrant that the following adjustment(s) have been made to the Warrant: [describe adjustments, setting forth details regarding method of calculation and facts upon which calculation is based].

This certifies that Holder is entitled to purchase from Company ________________________________ (                         ) fully paid and nonassessable shares of Company’s Stock at a price of _______________________ Dollars ($                    ) per share. The applicable Stock Purchase Price and the number of shares purchasable under the Warrant remain subject to adjustment as provided in Section 4 of the Warrant.

Executed this          day of                             , 20___.

 

MULBERRY HEALTH, INC.
By:  

 

Name:  

 

Title:  

 

Exhibit 10.3

THIS WARRANT AND THE SECURITIES ISSUABLE UPON THEEXERCISE HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED. THEY MAY NOT BE SOLD,OFFERED FOR SALE, PLEDGED, HYPOTHECATED, OR OTHERWISETRANSFERRED EXCEPT PURSUANT TO AN EFFECTIVEREGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933,AS AMENDED, OR AN OPINION OF COUNSEL SATISFACTORY TO THE COMPANY THAT REGISTRATION IS NOT REQUIRED UNDER SUCH ACT OR UNLESS SOLD PURSUANT TO RULE 144 UNDER SUCH ACT.

 

Date of Issuance
February 15, 2017
   Void after
July 25, 2021

MULBERRY HEALTH INC.

WARRANT TO PURCHASE SHARES OF PREFERRED STOCK

This Warrant is issued to Montefiore Medical Center or its assigns (the “Holder”) by Mulberry Health Inc., a Delaware corporation (the “Company”), in consideration of the premises and mutual promises made to the Company and/or its affiliates in that certain Facility Participation Agreement, dated July 25, 2016 (the “Facility Participation Agreement”).

1. Purchase of Shares.

(a) Number of Warrant Shares. Subject to the terms and conditions set forth herein, the Holder shall be entitled, upon surrender of this Warrant at the principal office of the Company (or at such other place as the Company shall notify the Holder in writing), to purchase from the Company up to 500,000 shares of the Company’s Series A8 Preferred Stock (the “Warrant Shares”).

(b) Vesting of Warrant Shares. This Warrant shall vest and become exercisable (during the Exercise Period (as defined below), unless earlier terminated or voided) with respect to (i) 166,666 Warrant Shares on July 25, 2017, (ii) an additional 166,666 Warrant Shares on July 25, 2018, and (iii) an additional 166,667 Warrant Shares on July 25, 2019(each of (i) through (iii), a “Vesting Date”), subject to, as of each such Vesting Date, (A) the Company’s reasonable satisfaction with the continued performance by the Facility (as defined in the Facility Participation Agreement) of its obligations under the Facility Participation Agreement, (B) the absence of any claims by the Company against the Facility and/or its affiliates and (C) the Facility Participation Agreement continuing to be in full force and effect at all times through such Vesting Date. If, on any such Vesting Date, any of the aforementioned conditions are not fulfilled, then the Warrant shall not become exercisable with respect to the Warrant Shares for which the Warrant would otherwise become exercisable on such Vesting Date, and the Warrant shall be deemed cancelled and void with respect to such Warrant Shares.


Notwithstanding the foregoing, if prior to July 25, 2019, (a) the Company consummates a Corporate Transaction, or has the registration statement for its Initial Public Offering declared effective by the United States Securities and Exchange Commission, and (b) as of the date of such consummation or effectiveness, as applicable (the “Transaction Date”), (i) the Company is reasonably satisfied with the continued performance by the Facility (as defined in the Facility Participation Agreement) of its obligations under the Facility Participation Agreement, (ii) there are then no any claims by the Facility outstanding against the Company and/or its affiliates and (iii) the Facility Participation Agreement shall have continued to be in full force and effect at all times through such Transaction Date, then this Warrant shall immediately become fully vested and exercisable with respect to all Warrant Shares in respect of which this Warrant has not then been deemed cancelled or void pursuant to the preceding paragraph.

(c) Exercise Price. The purchase price for the Warrant Shares issuable pursuant to this Section 1 shall be $6.75475 per share, subject to adjustment as provided in Section 7 (the “Exercise Price”).

2. Exercise Period.

(a) Subject to the terms and conditions set forth herein, this Warrant shall be exercisable only during the term commencing on the date hereof and ending at 5:00 p.m., Eastern Standard Time, on July 25, 2021 (the “Exercise Period”); provided, however, that, unless exercised as set forth in Section 4, this Warrant shall no longer be exercisable as to any Warrant Shares and shall become null and void immediately upon the consummation of a Corporate Transaction or Initial Public Offering. In the event of a Corporate Transaction or an Initial Public Offering during the Exercise Period, the Company shall notify the Holder at least ten (10) days prior to the consummation of such Corporate Transaction or Initial Public Offering.

(b) For purposes of this Warrant:“Corporate Transaction” shall mean any transaction defined as a “Liquidation Event” in the Company’s Ninth Amended and Restated Certificate of Incorporation, as may be amended and/or restated from time to time; and

(ii) “Initial Public Offering” shall mean the Company’s first firm commitment underwritten public offering of its Common Stock under the Act.

3. Method of Exercise.

(a) Subject to the terms and conditions set forth herein, while this Warrant remains outstanding and exercisable in accordance with Section 2 above, the Holder may exercise, in whole or in part (except for a Net Exercise as set forth in Section 4), the Warrant by:

(i) the surrender of the Warrant, together with a duly executed copy of the Notice of Exercise attached hereto, to the Secretary of the Company at its principal office (or at such other place as the Company shall notify the Holder in writing); and

(ii) the payment to the Company of an amount equal to the aggregate Exercise Price for the number of Warrant Shares being purchased.

(b) Each exercise of this Warrant shall be deemed to have been effected immediately prior to the close of business on the day on which this Warrant is surrendered to the Company as provided in Section 3(a) above. At such time, the person or persons in whose name or names any certificate for the Warrant Shares shall be issuable upon such exercise as provided in Section 3(c) below shall be deemed to have become the holder or holders of record of the Warrant Shares represented by such certificate.


(c) As soon as practicable after the exercise of this Warrant in whole or in part, the Company at its expense will cause to be issued in the name of, and delivered to, the Holder, or as the Holder (upon payment by the Holder of any applicable transfer taxes) may direct:

(i) a certificate or certificates for the number of Warrant Shares to which the Holder shall be entitled, and

(ii) in case such exercise is in part only, a new warrant or warrants (dated the date hereof) of like tenor, calling in the aggregate on the face or faces thereof for the number of Warrant Shares equal to the number of such Warrant Shares called for on the face of this Warrant minus the number of Warrant Shares purchased by the Holder upon all exercises made in accordance with Section 3(a) above or Section 4 below.

(d) Notwithstanding the provisions of Section 2 if the Holder has not exercised this Warrant prior to the closing of a Corporate Transaction or an Initial Public Offering, this Warrant shall automatically be deemed to be exercised in full in the manner set forth in Section 4, without any further action on behalf of the Holder, immediately prior to such closing.

4. Net Exercise.

(a) In the event of a Corporate Transaction or the Initial Public Offering, the Holder shall, upon the surrender of the Warrant, together with a duly executed copy of the Notice of Exercise attached hereto, to the Secretary of the Company at its principal office (or at such other place as the Company shall notify the Holder in writing), not less than two (2) days prior to the consummation of such Corporate Transaction or Initial Public Offering (a “Net Exercise”), receive a number of Warrant Shares computed using the following formula:

 

   X =    Y (A – B)   
     

Where

 

X =

   The number of Warrant Shares to be issued to the Holder.

Y =

   The number of Warrant Shares purchasable under this Warrant.

A =

   The fair market value of one (1) Warrant Share (at the date of such calculation).

B =

   The Exercise Price (as adjusted to the date of such calculations).

The Warrant shall be deemed to have been exercised in full upon such Net Exercise.


(b) For purposes of this Section 4, the fair market value of a Warrant Share shall mean (i) in the event of a Corporate Transaction, the fair market value of the consideration per share received by holders of the same class as the Warrant Shares in connection with such Corporate Transaction and (ii) in the event of the Initial Public Offering, the product of (A) the per share offering price to the public of the Initial Public Offering, and (B) the number of shares of Common Stock into which each Warrant Share is convertible at the time of such exercise or, if the Warrant Shares are shares of Common Stock, one.

(c) Any Net Exercise effected pursuant to this Section 4 shall be contingent upon and deemed to occur immediately prior to, the consummation of such Corporate Transaction or Initial Public Offering. The Holder may elect to withdraw such Net Exercise by separate written notice to the Company if no Corporate Transaction or Initial Public Offering occurs within thirty (30) days of the written notice provided by Holder pursuant to Section 4(a).

5. Covenants of the Company.

(a) Notices of Record Date. In the event of any taking by the Company of a record of the holders of any class of securities for the purpose of determining the holders thereof who are entitled to receive any dividend (other than a cash dividend which is the same as cash dividends paid in previous quarters or a stock dividend) or other distribution, the Company shall mail to the Holder, at least ten (10) days prior to such record date, a notice specifying the date on which any such record is to be taken for the purpose of such dividend or distribution.

(b) Covenants as to Warrant Shares. The Company covenants and agrees that all Warrant Shares that may be issued upon the exercise of the rights represented by this Warrant will, upon issuance in accordance with the terms hereof, be validly issued and outstanding, fully paid and nonassessable, and free from all taxes, liens and charges with respect to the issuance thereof. The Company further covenants and agrees that the Company will at all times during the Exercise Period have authorized and reserved, free from preemptive rights, a sufficient number of shares of its Series A8 Preferred Stock and Common Stock to provide for the exercise of the rights represented by this Warrant. If at any time during the Exercise Period the number of authorized but unissued shares of Series A8 Preferred Stock and Common Stock shall not be sufficient to permit exercise of this Warrant, the Company will take such corporate action as may, in the opinion of its counsel, be necessary to increase its authorized but unissued shares of Series A8 Preferred Stock and Common Stock to such number of shares as shall be sufficient for such purposes.

6. Representations, Warranties and Additional Agreements of the Holder. In connection with the transactions provided for herein, the Holder hereby represents and warrants to the Company that:Authorization. This Warrant constitutes the Holder’s valid and legally binding obligation, enforceable in accordance with its terms, except as may be limited by (i) applicable bankruptcy, insolvency, reorganization, or similar laws relating to or affecting the enforcement of creditors’ rights and (ii) laws relating to the availability of specific performance, injunctive relief or other equitable remedies. The Holder represents that it has full power and authority to enter into this Warrant.


(b) Purchase Entirely for Own Account. The Holder acknowledges that this Warrant is made with the Holder in reliance upon the Holder’s representation to the Company that this Warrant, the Warrant Shares and any Common Stock issuable upon conversion of the Warrant Shares (collectively, the “Securities”) will be acquired for investment for the Holder’s own account, not as a nominee or agent, and not with a view to the resale or distribution of any part thereof, and that the Holder has no present intention of selling, granting any participation in, or otherwise distributing the same. By executing this Warrant, the Holder further represents that the Holder does not have any contract, undertaking, agreement or arrangement with any person to sell, transfer or grant participations to such person or to any third person, with respect to the Securities.

(c) Disclosure of Information. The Holder acknowledges that it has received all the information it considers necessary or appropriate for deciding whether to acquire the Securities. The Holder further represents that it has had an opportunity to ask questions and receive answers from the Company regarding the terms and conditions of the offering of the Securities.

(d) Investment Experience. The Holder is an investor in securities of companies in the development stage and acknowledges that it is able to fend for itself, can bear the economic risk of its investment and has such knowledge and experience in financial or business matters that it is capable of evaluating the merits and risks of the investment in the Securities. If other than an individual, the Holder also represents it has not been organized solely for the purpose of acquiring the Securities.

(e) Accredited Investor. The Holder is an “accredited investor” within the meaning of Rule 501 of Regulation D promulgated under the Securities Act of 1933, as presently in effect (the “Act”).

(f) Restricted Securities. The Holder understands that the Securities are characterized as “restricted securities” under the federal securities laws inasmuch as they are being acquired from the Company in a transaction not involving a public offering and that under such laws and applicable regulations such securities may be resold without registration under the Act only in certain limited circumstances. The Holder represents that it is familiar with Rule 144 promulgated under the Act, as presently in effect, and understands the resale limitations imposed thereby and by the Act.

(g) Bad Actor Representations and Covenants. The Holder hereby represents and warrants to the Company that the Holder has not been convicted of any of the felonies or misdemeanors or has been subject to any of the orders, judgments, decrees or other conditions set forth in Rule 506(d) of Regulation D promulgated by the SEC. The Holder covenants to provide immediate written notice to the Company in the event the Holder is convicted of any felony or misdemeanor or becomes subject to any order, judgment, decree or other condition set forth in Rule 506(d) of Regulation D promulgated by the SEC, as may be amended from time to time. The Holder covenants to provide such information to the Company as the Company may reasonably request in order to comply with the disclosure obligations set forth in Rule 506(e) of Regulation D promulgated by the SEC, as may be amended from time to time.


7. Adjustment of Exercise Price and Number of Warrant Shares. The number and kind of Warrant Shares purchasable upon exercise of this Warrant and the Exercise Price shall be subject to adjustment from time to time as follows:

(a) Subdivisions, Combinations and Other Issuances. If the Company shall at any time after the issuance but prior to the expiration of this Warrant subdivide its Series A8 Preferred Stock, by split-up or otherwise, or combine its Preferred Stock, including the Series A8 Preferred Stock, or issue additional shares of its Preferred Stock or Common Stock as a dividend with respect to any shares of its Series A8 Preferred Stock, the number of Warrant Shares issuable on the exercise of this Warrant shall forthwith be proportionately increased in the case of a subdivision or stock dividend, or proportionately decreased in the case of a combination. Appropriate adjustments shall also be made to the Exercise Price payable per share, but the aggregate Exercise Price payable for the total number of Warrant Shares purchasable under this Warrant (as adjusted) shall remain the same. Any adjustment under this Section 7(a) shall become effective at the close of business on the date the subdivision or combination becomes effective, or as of the record date of such dividend, or in the event that no record date is fixed, upon the making of such dividend.

(b) Reclassification, Reorganization and Consolidation. In case of any reclassification, capital reorganization or change in the capital stock of the Company (other than as a result of a subdivision, combination or stock dividend provided for in Section 7(a) above), then, as a condition of such reclassification, reorganization or change, lawful provision shall be made, and duly executed documents evidencing the same from the Company or its successor shall be delivered to the Holder, so that the Holder shall have the right at any time prior to the expiration of this Warrant to purchase, at a total price equal to that payable upon the exercise of this Warrant, the kind and amount of shares of stock and other securities or property receivable in connection with such reclassification, reorganization or change by a holder of the same number and type of securities as were purchasable as Warrant Shares by the Holder immediately prior to such reclassification, reorganization or change. In any such case appropriate provisions shall be made with respect to the rights and interest of the Holder so that the provisions hereof shall thereafter be applicable with respect to any shares of stock or other securities or property deliverable upon exercise hereof, and appropriate adjustments shall be made to the Exercise Price per Warrant Share payable hereunder, provided the aggregate Exercise Price shall remain the same.

(c) Notice of Adjustment. When any adjustment is required to be made in the number or kind of shares purchasable upon exercise of the Warrant, or in the Exercise Price, the Company shall promptly notify the Holder of such event and of the number of Warrant Shares or other securities or property thereafter purchasable upon exercise of this Warrant.

8. No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise of this Warrant, but in lieu of such fractional shares the Company shall make a cash payment therefor on the basis of the Exercise Price then in effect.

9. No Stockholder Rights. Prior to exercise of this Warrant, the Holder shall not be entitled to any rights of a stockholder with respect to the Warrant Shares, including (without limitation) the right to vote such Warrant Shares, receive dividends or other distributions thereon, exercise preemptive rights or be notified of stockholder meetings, and except as otherwise provided in this Warrant, the Holder shall not be entitled to any stockholder notice or other communication concerning the business or affairs of the Company.


10. Agreement to be Bound. The Holder agrees, as a condition to any exercise of this Warrant not made pursuant to Section 4, to be bound by and comply with the terms and conditions of the Company’s Seventh Amended and Restated Voting Agreement, dated as of January 20, 2016 and as amended from time to time, by and among the Company and the other parties thereto (the “Voting Agreement”), as an “Investor” thereunder with respect to any Warrant Shares issued in connection with the exercise of this Warrant, including without limitation, (a) all applicable restrictions, agreements and notice requirements pursuant to the Voting Agreement with respect to such Warrant Shares and (b) the voting and drag-along provisions contained in the Voting Agreement. Holder agrees and acknowledges that, in addition to, and not in limitation of, the foregoing restrictions, any Warrant Shares issued in connection with the exercise of this Warrant shall be subject to the restrictions in Article X of the Company’s Second Amended and Restated Bylaws.

11. “Market Stand-Off” Agreement.The Holder hereby agrees that it will not, without the prior written consent of the managing underwriter, during the period commencing on the date of the final prospectus relating to the Initial Public Offering and ending on the date specified by the Company and the managing underwriter (such period not to exceed one hundred eighty (180) days) (the “Lock-Up Period”) (i) lend, offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any option, right or warrant to purchase, or otherwise transfer or dispose of, directly or indirectly, any shares of Common Stock or any securities convertible into or exercisable or exchangeable for Common Stock held immediately prior to the effectiveness of the registration statement for such offering (the “Restricted Securities”), or (ii) enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences of ownership of the Restricted Securities, whether any such transaction described in clause (i) or (ii) above is to be settled by delivery of Common Stock or other securities, in cash or otherwise. The foregoing provisions of this Section 11 (A) shall apply only to the Initial Public Offering, (B) shall not apply to the sale of any shares to an underwriter pursuant to an underwriting agreement, and (C) shall not apply to shares acquired by the Holder in the Initial Public Offering or in open market transactions on or after the effective date of the registration statement for the Initial Public Offering; provided that, in either case, no filing with the SEC on Form 4 or Form 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, is required. The underwriters in connection with the Initial Public Offering are intended third-party beneficiaries of this Section 11 and shall have the right, power and authority to enforce the provisions hereof as though they were a party hereto. The Holder further agrees to execute such agreements as may be reasonably requested by the underwriters in the Initial Public Offering that are consistent with this Section 11 or that are necessary to give further effect thereto.


(b) The Holder agrees that a legend reading substantially as follows shall be placed on all stock certificates representing all shares or securities of the Company of the Holder:

THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO A LOCK-UP PERIOD AFTER THE EFFECTIVE DATE OF THE ISSUER’S REGISTRATION STATEMENT FILED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AS SET FORTH IN AN AGREEMENT BETWEEN THE COMPANY AND THE ORIGINAL HOLDER OF THESE SECURITIES, A COPY OF WHICH MAY BE OBTAINED AT THE ISSUER’S PRINCIPAL OFFICE. SUCH LOCK-UP PERIOD IS BINDING ON TRANSFEREES OF THESE SHARES.

Notwithstanding the foregoing, the Company shall be obligated to reissue promptly unlegended certificates at the request of the Holder if the Company has completed its Initial Public Offering or in connection with a sale of Registrable Securities by the Holder pursuant to Rule 144 and the Holder shall have obtained an opinion of counsel (which counsel may be counsel to the Company) reasonably acceptable to the Company to the effect that the securities proposed to be disposed of may lawfully be so disposed of without registration, qualification and legend.

12. Governing Law. This Warrant shall be governed by and construed in accordance with the General Corporation Law of the State of Delaware as to matter within the scope thereof, and as to all other matters shall be governed by and construed in accordance with the internal laws of the State of New York, without regard to conflicts of law principles thereof.

13. Successors and Assigns. The terms and provisions of this Warrant shall inure to the benefit of, and be binding upon, the Company and the holders hereof and their respective successors and assigns.

14. Titles and Subtitles. The titles and subtitles used in this Warrant are used for convenience only and are not to be considered in construing or interpreting this Warrant.

15. Notices. All notices and other communications given or made pursuant hereto shall be in writing and shall be deemed effectively given: (a) upon personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient, and if not so confirmed, then on the next business day, (c) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (d) one (1) day after deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt. All communications shall be sent to the respective parties at the applicable address set forth on the signature page hereto.

16. Entire Agreement: Amendments and Waivers. This Warrant and the other documents expressly delivered pursuant hereto constitute the full and entire understanding and agreement between the parties with regard to the subjects hereof and thereof. Any term of this Warrant may be amended and the observance of any term of this Warrant may be waived (either generally or in a particular instance and either retroactively or prospectively), with the written consent of the Company and the Holder. Any waiver or amendment effected in accordance with this Section 16 shall be binding upon each party to this Warrant.


17. Severability. If any provision of this Warrant is held to be unenforceable under applicable law, such provision shall be excluded from this Warrant and the balance of the Warrant shall be interpreted as if such provision were so excluded and shall be enforceable in accordance with its terms.

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IN WITNESS WHEREOF, the parties have executed this Warrant as of the date written above.

 

MULBERRY HEALTH INC.
By:  

/s/ Mario Schlosser

Name:  Mario Schlosser
Title: Chief Executive Officer
Address:

 

 

 

ACKNOWLEDGED AND AGREED:
MONTEFIORE MEDICAL CENTER
By:  

/s/ Colleen Blye

Name: Colleen Blye
Title: Executive Vice President, CFO

 

Address:
Montefiore Medical Center
111 East 210th Street
Bronx, NY 10467

 

SIGNATURE PAGE TO WARRANT


NOTICE OF EXERCISE

MULBERRY HEALTH INC.

Attention: Corporate Secretary

The undersigned hereby elects to purchase, pursuant to the provisions of the Warrant, as follows:

 

  ____________ shares of the Company’s Series A8 Preferred Stock pursuant to the terms of the attached Warrant, and tenders herewith payment in cash of the Exercise Price of such Warrant Shares in full, together with all applicable transfer taxes, if any.

  Net Exercise the attached Warrant with respect to ___________ shares of the Company’s Series A8 Preferred Stock.

The undersigned hereby represents and warrants that the representations and warranties in Section 6 of the Warrant are true and correct as of the date hereof.

 

 

      MONTEFIORE MEDICAL CENTER:
Date:                                              By:  

 

  Address:  

 

   

 

 

Name in which shares should be registered:

 

 

SIGNATURE PAGE TO WARRANT


ASSIGNMENT FORM

(To assign the foregoing Warrant, execute

this form and supply required information.

Do not use this form to purchase shares.)

FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to

 

Name:  

 

  (Please Print)
Address:  

 

  (Please Print)

 

Dated:                                                   
Holder’s     
Signature:  

 

  
Holder’s     
Address:  

 

  

NOTE: The signature to this Assignment Form must correspond with the name as it appears on the face of the Warrant. Officers of corporations and those acting in a fiduciary or other representative capacity should provide proper evidence of authority to assign the foregoing Warrant.

Exhibit 10.4

THIS WARRANT AND THE SECURITIES ISSUABLE UPON THE EXERCISE HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED. THEY MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED, HYPOTHECATED, OR OTHERWISE TRANSFERRED EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR AN OPINION OF COUNSEL SATISFACTORY TO THE COMPANY THAT REGISTRATION IS NOT REQUIRED UNDER SUCH ACT OR UNLESS SOLD PURSUANT TO RULE 144 UNDER SUCH ACT.

 

Date of Issuance    Void after
September 5, 2018    January 1, 2023

MULBERRY HEALTH INC.

WARRANT TO PURCHASE SHARES OF PREFERRED STOCK

This Warrant is issued to True North Health, Inc. or its assigns (the “Holder”) by Mulberry Health Inc., a Delaware corporation (the “Company”), in consideration of the premises and mutual promises made to the Company and/or its affiliates in that certain Provider Agreement, dated January 1, 2014, as amended (the “Provider Agreement”).

1. Purchase of Shares.

(a) Number of Warrant Shares. Subject to the terms and conditions set forth herein, the Holder shall be entitled, upon surrender of this Warrant at the principal office of the Company (or at such other place as the Company shall notify the Holder in writing), to purchase from the Company up to 1,250,000 shares of the Company’s Series A9 Preferred Stock (the “Warrant Shares”).

(b) Vesting of Warrant Shares. This Warrant shall vest and become exercisable (during the Exercise Period (as defined below), unless earlier terminated or voided) with respect to (i) 416,666 Warrant Shares on November 1, 2018, (ii) an additional 416,667 Warrant Shares on January 1, 2020, and (iii) an additional 416,667 Warrant Shares on January 1, 2021 (each of (i) through (iii), a “Vesting Date”), subject to, as of each such Vesting Date, (A) the absence of any uncured material breach of the Provider Agreement by Northwell (as defined in the Provider Agreement) of its obligations under the Provider Agreement, and (B) the Provider Agreement being in full force and effect as of such Vesting Date. If, on any such Vesting Date, any of the aforementioned conditions are not fulfilled, then the Warrant shall not become exercisable with respect to the Warrant Shares for which the Warrant would otherwise become exercisable on such Vesting Date, and the Warrant shall be deemed cancelled and void with respect to such Warrant Shares.

Notwithstanding the foregoing, if prior to January 1, 2021, (a) the Company consummates a Corporate Transaction, or has the registration statement for its Initial Public Offering declared effective by the United States Securities and Exchange Commission, and (b) as of the date of such consummation or effectiveness, as applicable (the “Transaction Date”), (i) the absence of any uncured material breach of the Provider Agreement by Northwell (as defined in the Provider


Agreement) of its obligations under the Provider Agreement, (ii) there are no then outstanding claims by Northwell against the Company and/or its affiliates, with the exception of any accounts receivable claims or contractual dispute claims in connection with or arising from the Provider Agreement and (iii) the Provider Agreement being in full force and effect as of such Transaction Date, then this Warrant shall immediately become fully vested and exercisable with respect to all Warrant Shares in respect of which this Warrant has not then been deemed cancelled or void pursuant to the preceding paragraph.

(c) Exercise Price. The purchase price for the Warrant Shares issuable pursuant to this Section 1 shall be $7.13489 per share, subject to adjustment as provided in Section 7 (the “Exercise Price”).

2. Exercise Period.

(a) Subject to the terms and conditions set forth herein, this Warrant shall be exercisable only during the term commencing on the date hereof and ending at 5:00 p.m., Eastern Standard Time, on January 1, 2023 (the “Exercise Period”); provided, however, that, unless exercised as set forth in Section 3 or 4, this Warrant shall no longer be exercisable as to any Warrant Shares and shall become null and void immediately upon the consummation of a Corporate Transaction or Initial Public Offering. In the event of a Corporate Transaction or an Initial Public Offering during the Exercise Period, the Company shall notify the Holder at least ten (10) days prior to the consummation of such Corporate Transaction or Initial Public Offering.

(b) For purposes of this Warrant:

(i) “Corporate Transaction” shall mean any transaction defined as a “Liquidation Event” in the Company’s Tenth Amended and Restated Certificate of Incorporation, as may be amended and/or restated from time to time; and

(ii) “Initial Public Offering” shall mean the Company’s first firm commitment underwritten public offering of its Common Stock under the Act.

3. Method of Exercise.

(a) Subject to the terms and conditions set forth herein, while this Warrant remains outstanding and exercisable in accordance with Section 2 above, the Holder may exercise, in whole or in part (except for a Net Exercise as set forth in Section 4), the Warrant by:

(i) the surrender of the Warrant, together with a duly executed copy of the Notice of Exercise attached hereto, to the Secretary of the Company at its principal office (or at such other place as the Company shall notify the Holder in writing); and

(ii) the payment to the Company of an amount equal to the aggregate Exercise Price for the number of Warrant Shares being purchased.

(b) Each exercise of this Warrant shall be deemed to have been effected immediately prior to the close of business on the day on which this Warrant is surrendered to the Company as provided in Section 3(a) above. At such time, the person or persons in whose name or names any certificate for the Warrant Shares shall be issuable upon such exercise as provided in Section 3(c) below shall be deemed to have become the holder or holders of record of the Warrant Shares represented by such certificate.

 

2


(c) As soon as practicable after the exercise of this Warrant in whole or in part, the Company at its expense will cause to be issued in the name of, and delivered to, the Holder, or as the Holder (upon payment by the Holder of any applicable transfer taxes) may direct:

(i) a certificate or certificates for the which the Holder shall be entitled, and

(ii) in case such exercise is in part only, a new warrant or warrants (dated the date hereof) of like tenor, calling in the aggregate on the face or faces thereof for the number of Warrant Shares equal to the number of such Warrant Shares called for on the face of this Warrant minus the number of Warrant Shares purchased by the Holder upon all exercises made in accordance with Section 3(a) above or Section 4 below.

(d) The Company will pay all documentary stamp or other issuance taxes, if any, attributable to the issuance or delivery of Warrant Shares upon the exercise of this Warrant; provided, however, that the Company shall not be required to pay any tax or taxes which may be payable in respect of any transfer involved in the issuance or delivery of any Warrants or Warrant certificates or Warrant Shares in a name other than that of the then Holder as reflected upon the books of the Company.

(e) Notwithstanding the provisions of Section 2 if the Holder has not exercised this Warrant prior to the closing of a Corporate Transaction or an Initial Public Offering, this Warrant shall automatically be exercised in full in the manner set forth in Section 4, without any further action on behalf of the Holder, immediately prior to such closing. Notwithstanding the foregoing, the Holder may, by written notice to the Company not more than six (6) days following the delivery of the notice to Holder by the Company pursuant to Section 2(a), elect not to have this Warrant automatically Net Exercised, in which case, this Warrant shall no longer be exercisable as to any Warrant Shares and shall become null and void immediately upon the consummation of a Corporate Transaction or Initial Public Offering.

4. Net Exercise.

(a) In lieu of exercising this Warrant for cash, the Holder, upon the surrender of the Warrant, together with a duly executed copy of the Notice of Exercise attached hereto, to the Secretary of the Company at its principal office (or at such other place as the Company shall notify the Holder in writing) (a “Net Exercise”), may elect to receive a number of Warrant Shares computed using the following formula:

 

   X =    Y (A – B)   
     

 

3


Where

 

  X =

The number of Warrant Shares to be issued to the Holder.

 

  Y =

The number of Warrant Shares purchasable under this Warrant.

 

  A =

The fair market value of one (1) Warrant Share (at the date of such calculation).

 

  B =

The Exercise Price (as adjusted to the date of such calculations).

If the Holder Net Exercises, then the Holder shall have the rights described in Sections 3(b) – 3(d).

(b) For purposes of this Section 4, the fair market value of a Warrant Share shall mean (i) in the event of a Corporate Transaction, the fair market value of the consideration per share received by holders of the same class as the Warrant Shares in connection with such Corporate Transaction, (ii) in the event of the Initial Public Offering, the product of (A) the per share offering price to the public of the Initial Public Offering, and (B) the number of shares of Common Stock into which each Warrant Share is convertible at the time of such exercise or, if the Warrant Shares are shares of Common Stock, one, and (iii) in the event of any other Net Exercise, (X) if the Warrant Shares are traded on a securities exchange, the average of the closing prices of the Warrant Shares on such exchange over the twenty (20) trading-day period ending three (3) trading days prior to the date of determination of the fair market value; (Y) if the Warrant Shares are actively traded over-the-counter, the average of the closing bid or sale prices (whichever is applicable) over the twenty (20) trading-day period ending three (3) trading days prior to the date of determination of the fair market value; or (Z) if there is no active public market for the Warrant Shares, the fair market value thereof, as mutually determined in good faith by the Board of Directors.

(c) Any Net Exercise effected in connection with a Corporate Transaction or Initial Public Offering pursuant to Section 3(e) shall be contingent upon and deemed to occur immediately prior to, the consummation of such Corporate Transaction or Initial Public Offering. For the avoidance of doubt and notwithstanding the foregoing in Section 4(a), the Holder shall not be required to deliver the Warrant or the Notice of Exercise in connection with any automatic Net Exercise pursuant to Section 3(e).

5. Covenants of the Company.

(a) Notices of Record Date. In the event of any taking by the Company of a record of the holders of any class of securities for the purpose of determining the holders thereof who are entitled to receive any dividend (other than a cash dividend which is the same as cash dividends paid in previous quarters or a stock dividend) or other distribution, the Company shall mail to the Holder, at least ten (10) days prior to such record date, a notice specifying the date on which any such record is to be taken for the purpose of such dividend or distribution.

(b) Covenants as to Warrant Shares. The Company represents, covenants and agrees that (i) this Warrant is, and any warrant issued in substitution for or replacement of this Warrant shall be, upon issuance, duly authorized and validly issued, and (ii) all Warrant Shares that may be issued upon the exercise of the rights represented by this Warrant will, upon issuance in accordance with the terms hereof, be validly issued and outstanding, fully paid and nonassessable, issued without violation of any preemptive or similar rights of any stockholder of the Company, and free from all taxes, liens and charges with respect to the issuance thereof. The Company further covenants and agrees that the Company will at all times during the Exercise

 

4


Period have authorized and reserved, free from preemptive rights, a sufficient number of shares of its Series A9 Preferred Stock and Common Stock to provide for the exercise of the rights represented by this Warrant. If at any time during the Exercise Period the number of authorized but unissued shares of Series A9 Preferred Stock and Common Stock shall not be sufficient to permit exercise of this Warrant, the Company will take such corporate action as may, in the opinion of its counsel, be necessary to increase its authorized but unissued shares of Series A9 Preferred Stock and Common Stock to such number of shares as shall be sufficient for such purposes.

(c) No Impairment. Except and to the extent consented to by the Holder, the Company will not, by amendment of its Charter or through any reorganization, reclassification, transfer of assets, consolidation, merger, dissolution, liquidation, issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms to be observed or performed hereunder by the Company , but will at all times in good faith assist in the carrying out of all the provisions of this Warrant and in the taking of all such action as may be necessary or appropriate in order to protect the rights of the Holder against impairment.

6. Representations, Warranties and Additional Agreements of the Holder. In connection with the transactions provided for herein, the Holder hereby represents and warrants to the Company that:

(a) Authorization. This Warrant constitutes the Holder’s valid and legally binding obligation, enforceable in accordance with its terms, except as may be limited by (i) applicable bankruptcy, insolvency, reorganization, or similar laws relating to or affecting the enforcement of creditors’ rights and (ii) laws relating to the availability of specific performance, injunctive relief or other equitable remedies. The Holder represents that it has full power and authority to enter into this Warrant.

(b) Purchase Entirely for Own Account. The Holder acknowledges that this Warrant is made with the Holder in reliance upon the Holder’s representation to the Company that this Warrant, the Warrant Shares and any Common Stock issuable upon conversion of the Warrant Shares (collectively, the “Securities”) will be acquired for investment for the Holder’s own account, not as a nominee or agent, and not with a view to the resale or distribution of any part thereof, and that the Holder has no present intention of selling, granting any participation in, or otherwise distributing the same. By executing this Warrant, the Holder further represents that the Holder does not have any contract, undertaking, agreement or arrangement with any person to sell, transfer or grant participations to such person or to any third person, with respect to the Securities.

(c) Disclosure of Information. The Holder acknowledges that it has received all the information it considers necessary or appropriate for deciding whether to acquire the Securities. The Holder further represents that it has had an opportunity to ask questions and receive answers from the Company regarding the terms and conditions of the offering of the Securities.

(d) Investment Experience. The Holder is an investor in securities of companies in the development stage and acknowledges that it is able to fend for itself, can bear the economic risk of its investment and has such knowledge and experience in financial or business matters that it is capable of evaluating the merits and risks of the investment in the Securities. If other than an individual, the Holder also represents it has not been organized solely for the purpose of acquiring the Securities.

 

5


(e) Accredited Investor. The Holder is “accredited investor” within the meaning of Rule 501 of Regulation D promulgated under the Securities Act of 1933, as presently in effect (the “Act”).

(f) Restricted Securities. The Holder understands that the Securities are characterized as “restricted securities” under the federal securities laws inasmuch as they are being acquired from the Company in a transaction not involving a public offering and that under such laws and applicable regulations such securities may be resold without registration under the Act only in certain limited circumstances. The Holder represents that it is familiar with Rule 144 promulgated under the Act, as presently in effect, and understands the resale limitations imposed thereby and by the Act.

(g) Bad Actor Representations and Covenants. The Holder hereby represents and warrants to the Company that the Holder has not been convicted of any of the felonies or misdemeanors or has been subject to any of the orders, judgments, decrees or other conditions set forth in Rule 506(d) of Regulation D promulgated by the SEC. The Holder covenants to provide immediate written notice to the Company in the event the Holder is convicted of any felony or misdemeanor or becomes subject to any order, judgment, decree or other condition set forth in Rule 506(d) of Regulation D promulgated by the SEC, as may be amended from time to time. The Holder covenants to provide such information to the Company as the Company may reasonably request in order to comply with the disclosure obligations set forth in Rule 506(e) of Regulation D promulgated by the SEC, as may be amended from time to time.

7. Adjustment of Exercise Price and Number of Warrant Shares. The number and kind of Warrant Shares purchasable upon exercise of this Warrant and the Exercise Price shall be subject to adjustment from time to time as follows:

(a) Subdivisions, Combinations and Other Issuances. If the Company shall at any time after the issuance but prior to the expiration of this Warrant subdivide its Series A9 Preferred Stock, by split-up or otherwise, or combine its Preferred Stock, including the Series A9 Preferred Stock, or issue additional shares of its Preferred Stock or Common Stock as a dividend with respect to any shares of its Series A9 Preferred Stock, the number of Warrant Shares issuable on the exercise of this Warrant shall forthwith be proportionately increased in the case of a subdivision or stock dividend, or proportionately decreased in the case of a combination. Appropriate adjustments shall also be made to the Exercise Price payable per share, but the aggregate Exercise Price payable for the total number of Warrant Shares purchasable under this Warrant (as adjusted) shall remain the same. Any adjustment under this Section 7(a) shall become effective at the close of business on the date the subdivision or combination becomes effective, or as of the record date of such dividend, or in the event that no record date is fixed, upon the making of such dividend.

 

6


(b) Reclassification, Reorganization and Consolidation. In case of any reclassification, capital reorganization or change in the capital stock of the Company (other than as a result of a subdivision, combination or stock dividend provided for in Section 7(a) above), then, as a condition of such reclassification, reorganization or change, lawful provision shall be made, and duly executed documents evidencing the same from the Company or its successor shall be delivered to the Holder, so that the Holder shall have the right at any time prior to the expiration of this Warrant to purchase, at a total price equal to that payable upon the exercise of this Warrant, the kind and amount of shares of stock and other securities or property receivable in connection with such reclassification, reorganization or change by a holder of the same number and type of securities as were purchasable as Warrant Shares by the Holder immediately prior to such reclassification, reorganization or change. In any such case appropriate provisions shall be made with respect to the rights and interest of the Holder so that the provisions hereof shall thereafter be applicable with respect to any shares of stock or other securities or property deliverable upon exercise hereof, and appropriate adjustments shall be made to the Exercise Price per Warrant Share payable hereunder, provided the aggregate Exercise Price shall remain the same.

(c) Notice of Adjustment. When any adjustment is required to be made in the number or kind of shares purchasable upon exercise of the Warrant, or in the Exercise Price, the Company shall promptly notify the Holder of such event and of the number of Warrant Shares or other securities or property thereafter purchasable upon exercise of this Warrant.

8. No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise of this Warrant, but in lieu of such fractional shares the Company shall make a cash payment therefor on the basis of the Exercise Price then in effect.

9. No Stockholder Rights. Prior to exercise of this Warrant, the Holder shall not be entitled to any rights of a stockholder with respect to the Warrant Shares, including (without limitation) the right to vote such Warrant Shares, receive dividends or other distributions thereon, exercise preemptive rights or be notified of stockholder meetings, and except as otherwise provided in this Warrant, the Holder shall not be entitled to any stockholder notice or other communication concerning the business or affairs of the Company. Nothing contained in this Warrant shall be determined as imposing any liabilities on the Holder to purchase any securities whether such liabilities are asserted by the Company or by creditors or stockholders of the Company or otherwise.

10. Agreement to be Bound. The Holder agrees, as a condition to any exercise of this Warrant not made pursuant to Section 3(e) in connection with an Initial Public Offering, to be bound by and comply with the terms and conditions of the Company’s Eighth Amended and Restated Voting Agreement, dated as of March 23, 2018 and as amended from time to time, by and among the Company and the other parties thereto (the “Voting Agreement”), as an “Investor” thereunder with respect to any Warrant Shares issued in connection with the exercise of this Warrant, including without limitation, (a) all applicable restrictions, agreements and notice requirements pursuant to the Voting Agreement with respect to such Warrant Shares and (b) the voting and drag-along provisions contained in the Voting Agreement. Holder agrees and acknowledges that, in addition to, and not in limitation of, the foregoing restrictions, any Warrant Shares issued in connection with the exercise of this Warrant shall be subject to the restrictions in Article X of the Company’s Second Amended and Restated Bylaws. Additionally, as a condition to any exercise of this Warrant not made pursuant to Section 3(e) in connection with a Corporate Transaction, the Holder shall execute a counterpart signature page to the Company’s Eighth Amended and Restated Investors’ Rights Agreement among the Company and certain other parties thereto dated as of March 23, 2018 (as amended from time to time, the “Investors’ Rights Agreement”) and (ii) shall execute a counterpart signature page to the Company’s Eighth Amended and Restated Right of First Refusal and Co-Sale Agreement among the Company and certain other parties thereto dated as of March 23, 2018 (as amended from time to time, the “ROFR Agreement”).

 

7


11. “Market Stand-Off Agreement.

(a) The Holder hereby agrees that it will not, without the prior written consent of the managing underwriter, during the period commencing on the date of the final prospectus relating to the Initial Public Offering and ending on the date specified by the Company and the managing underwriter (such period not to exceed one hundred eighty (180) days) (the “Lock-Up Period”) (i) lend, offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any option, right or warrant to purchase, or otherwise transfer or dispose of, directly or indirectly, any shares of Common Stock or any securities convertible into or exercisable or exchangeable for Common Stock held immediately prior to the effectiveness of the registration statement for such offering (the “Restricted Securities”), or (ii) enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences of ownership of the Restricted Securities, whether any such transaction described in clause (i) or (ii) above is to be settled by delivery of Common Stock or other securities, in cash or otherwise. The foregoing provisions of this Section 11 (A) shall apply only to the Initial Public Offering, (B) shall not apply to the sale of any shares to an underwriter pursuant to an underwriting agreement, and (C) shall not apply to shares acquired by the Holder in the Initial Public Offering or in open market transactions on or after the effective date of the registration statement for the Initial Public Offering; provided that, in either case, no filing with the SEC on Form 4 or Form 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, is required. The underwriters in connection with the Initial Public Offering are intended third-party beneficiaries of this Section 11 and shall have the right, power and authority to enforce the provisions hereof as though they were a party hereto. The Holder further agrees to execute such agreements as may be reasonably requested by the underwriters in the Initial Public Offering that are consistent with this Section 11 or that are necessary to give further effect thereto.

(b) The Holder agrees that a legend reading substantially as follows shall be placed on all stock certificates representing all shares or securities of the Company of the Holder:

THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO A LOCK-UP PERIOD AFTER THE EFFECTIVE DATE OF THE ISSUER’S REGISTRATION STATEMENT FILED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AS SET FORTH IN AN AGREEMENT BETWEEN THE COMPANY AND THE ORIGINAL HOLDER OF THESE SECURITIES, A COPY OF WHICH MAY BE OBTAINED AT THE ISSUER’S PRINCIPAL OFFICE. SUCH LOCK-UP PERIOD IS BINDING ON TRANSFEREES OF THESE SHARES.

Notwithstanding the foregoing, the Company shall be obligated to reissue promptly unlegended certificates at the request of the Holder if the Company has completed its Initial Public Offering or in connection with a sale of Registrable Securities by the Holder pursuant to Rule 144 and the Holder shall have obtained an opinion of counsel (which counsel may be counsel to the Company) reasonably acceptable to the Company to the effect that the securities proposed to be disposed of may lawfully be so disposed of without registration, qualification and legend.

 

8


12. Governing Law. This Warrant shall be governed by and construed in accordance with the General Corporation Law of the State of Delaware as to matter within the scope thereof, and as to all other matters shall be governed by and construed in accordance with the internal laws of the State of New York, without regard to conflicts of law principles thereof.

13. Successors and Assigns. The terms and provisions of this Warrant shall inure to the benefit of, and be binding upon, the Company and the holders hereof and their respective successors and assigns.

14. Titles and Subtitles. The titles and subtitles used in this Warrant are used for convenience only and are not to be considered in construing or interpreting this Warrant.

15. Notices. All notices and other communications given or made pursuant hereto shall be in writing and shall be deemed effectively given: (a) upon personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient, and if not so confirmed, then on the next business day, (c) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (d) one (1) day after deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt. All communications shall be sent to the respective parties at the applicable address set forth on the signature page hereto.

16. Entire Agreement; Amendments and Waivers. This Warrant and the other documents expressly delivered pursuant hereto constitute the full and entire understanding and agreement between the parties with regard to the subjects hereof and thereof. Any term of this Warrant may be amended and the observance of any term of this Warrant may be waived (either generally or in a particular instance and either retroactively or prospectively), with the written consent of the Company and the Holder. Any waiver or amendment effected in accordance with this Section 16 shall be binding upon each party to this Warrant.

17. Severability. If any provision of this Warrant is held to be unenforceable under applicable law, such provision shall be excluded from this Warrant and the balance of the Warrant shall be interpreted as if such provision were so excluded and shall be enforceable in accordance with its terms.

18. Transfer of Warrant. Subject to compliance with applicable federal and state securities laws and any agreements between the Holder and the Company and subject to Section 11, this Warrant and all rights hereunder are transferable in whole or in part by the Holder to a wholly-owned subsidiary of the Holder or an affiliate under common control with the Holder. Within a reasonable time after the Company’s receipt of an executed Assignment Form in the form attached hereto, the transfer shall be recorded on the books of the Company upon the surrender of this Warrant, properly endorsed, to the Company at its principal offices, and the payment to the Company of all transfer taxes and other governmental charges imposed on such transfer. In the event of a partial transfer, the Company shall issue to the Holder and the new holders such number of new warrants as appropriate.

 

9


19. Loss or Destruction of Warrant. Subject to the terms and conditions hereof, upon receipt by the Company of evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant and, in the case of loss, theft or destruction, of such bond or indemnification as the Company may reasonably require, and, in the case of such mutilation, upon surrender and cancellation of this Warrant, the Company will execute and deliver a new Warrant of like tenor.

[Remainder of this page intentionally left blank]

 

10


IN WITNESS WHEREOF, the parties have executed this Warrant as of the date first written above.

 

MULBERRY HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title:   Chief Executive Officer
Address

 

 

 

ACKNOWLEDGED AND AGREED:
TRUE NORTH HEALTH, INC.
By:  

/s/ Richard T. Miller

Name:    Richard T. Miller
Title: EVP & Chief Business Strategy Officer

Address:

True North Health, Inc. c/o

Northwell Health, Inc.

2000 Marcus Avenue

New Hyde Park, NY 10042

Attention: Richard T. Miller

Email: ####

Fax:

With a copy to (which shall not constitute notice):

True North Health, Inc. c/o

Northwell Health, Inc.

2000 Marcus Avenue

New Hyde Park, NY 10042

Attention: Laurence Kraemer, Chief Legal Officer and General Counsel

Email: ####

 

SIGNATURE PAGE TO WARRANT


NOTICE OF EXERCISE

MULBERRY HEALTH INC.

Attention: Corporate Secretary

The undersigned hereby elects to purchase, pursuant to the provisions of the Warrant, as follows:

 

   shares of the Company’s Series A9 Preferred Stock pursuant to the terms of the attached Warrant, and tenders herewith payment in cash of the Exercise Price of such Warrant Shares in full, together with all applicable transfer taxes, if any.

   Net Exercise the attached Warrant with respect to _____________ shares of the Company’s Series A9 Preferred Stock.

The undersigned hereby represents and warrants that the representations and warranties in Section 6 of the Warrant are true and correct as of the date hereof.

 

      TRUE NORTH HEALTH, INC.
Date:                                 By:  

 

  Address:  

 

   

 

     

 

Name in which shares should be registered:

 

 

12


ASSIGNMENT FORM

(To assign the foregoing Warrant, execute this form and supply

required information. Do not use this form to purchase shares.)

FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to

 

Name:  

 

  (Please Print)
Address:  

 

  (Please Print)

 

Dated:                                                              
Holder’s    
Signature:  

 

 
Holder’s    
Address:  

 

 

NOTE: The signature to this Assignment Form must correspond with the name as it appears on the face of the Warrant. Officers of corporations and those acting in a fiduciary or other representative capacity should provide proper evidence of authority to assign the foregoing Warrant.

 

13

Exhibit 10.5

MULBERRY HEALTH INC.

2012 STOCK PLAN

ADOPTED ON DECEMBER 6, 2012 AMENDED

AND RESTATED ON OCTOBER 8, 2020


CONTENTS

 

         Page  

SECTION 1.

  ESTABLISHMENT AND PURPOSE      1  

SECTION 2.

  ADMINISTRATION      1  

(a)

  Committees of the Board of Directors      1  

(b)

  Authority of the Board of Directors      1  

SECTION 3.

  ELIGIBILITY      1  

(a)

  General Rule      1  

(b)

  Ten-Percent Stockholders      1  

SECTION 4.

  STOCK SUBJECT TO PLAN      2  

(a)

  Basic Limitation      2  

(b)

  Additional Shares      2  

SECTION 5.

  TERMS AND CONDITIONS OF AWARDS OR SALES      2  

(a)

  Stock Grant or Purchase Agreement      2  

(b)

  Duration of Offers and Nontransferability of Rights      2  

(c)

  Purchase Price      2  

SECTION 6.

  TERMS AND CONDITIONS OF OPTIONS      2  

(a)

  Stock Option Agreement      2  

(b)

  Number of Shares      3  

(c)

  Exercise Price      3  

(d)

  Exercisability      3  

(e)

  Basic Term      3  

(f)

  Termination of Service (Except by Death)      3  

(g)

  Leaves of Absence      4  

(h)

  Death of Optionee      4  

(i)

  Pre-Exercise Restrictions on Transfer of Options or Shares      4  

(j)

  No Rights as a Stockholder      5  

(k)

  Modification, Extension and Assumption of Options      5  

(l)

  Company’s Right to Cancel Certain Options      5  

SECTION 7.

  TERMS AND CONDITIONS OF RESTRICTED STOCK UNITS      5  

(a)

  Restricted Stock Unit Agreement      5  

(b)

  Payment for Restricted Stock Units      5  

(c)

  Vesting Conditions      5  

(d)

  Forfeiture      5  

(e)

  Voting and Dividend Rights      6  

(f)

  Form and Time of Settlement of Restricted Stock Units      6  

(g)

  Death of Recipient      6  

(h)

  Creditors’ Rights      6  

 

i


(i)

  Modification, Extension and Assumption of Restricted Stock Units      6  

(j)

  Restrictions on Transfer of Restricted Stock Units      6  

SECTION 8.

  PAYMENT FOR SHARES      6  

(a)

  General Rule      6  

(b)

  Services Rendered      7  

(c)

  Promissory Note      7  

(d)

  Surrender of Stock      7  

(e)

  Exercise/Sale      7  

(f)

  Net Exercise      7  

(g)

  Other Forms of Payment      7  

SECTION 9.

  ADJUSTMENT OF SHARES      7  

(a)

  General      7  

(b)

  Corporate Transactions      8  

(c)

  Reservation of Rights      9  

SECTION 10.

  PRE-EXERCISE INFORMATION REQUIREMENT      9  

(a)

  Application of Requirement      9  

(b)

  Scope of Requirement      9  

SECTION 11.

  MISCELLANEOUS PROVISIONS      10  

(a)

  Securities Law Requirements      10  

(b)

  No Retention Rights      10  

(c)

  Treatment as Compensation      10  

(d)

  Governing Law      10  

(e)

  Conditions and Restrictions on Shares      10  

(f)

  Tax Matters      10  

SECTION 12.

  DURATION AND AMENDMENTS; STOCKHOLDER APPROVAL      11  

(a)

  Term of the Plan      11  

(b)

  Right to Amend or Terminate the Plan      11  

(c)

  Effect of Amendment or Termination      11  

(d)

  Stockholder Approval      11  

SECTION 13.

  DEFINITIONS      12  

 

ii


MULBERRY HEALTH INC. 2012 STOCK PLAN

SECTION 1. ESTABLISHMENT AND PURPOSE.

The purpose of this Plan is to offer persons selected by the Company an opportunity to acquire a proprietary interest in the success of the Company, or to increase such interest, by acquiring Shares of the Company’s Stock. The Plan provides for the direct award or sale of Shares, the grant of Options to purchase Shares and the grant of Restricted Stock Units to acquire Shares. Options granted under the Plan may be ISOs intended to qualify under Code Section 422 or Nonstatutory Options which are not intended to so qualify.

Capitalized terms are defined in Section 13.

SECTION 2. ADMINISTRATION.

(a) Committees of the Board of Directors. The Plan may be administered by one or more Committees. Each Committee shall consist, as required by applicable law, of one or more members of the Board of Directors who have been appointed by the Board of Directors. Each Committee shall have such authority and be responsible for such functions as the Board of Directors has assigned to it. If no Committee has been appointed, the entire Board of Directors shall administer the Plan. Any reference to the Board of Directors in the Plan or an Award Agreement shall be construed as a reference to the Committee (if any) to whom the Board of Directors has assigned a particular function.

(b) Authority of the Board of Directors. Subject to the provisions of the Plan, the Board of Directors shall have full authority and discretion to take any actions it deems necessary or advisable for the administration of the Plan. Notwithstanding anything to the contrary in the Plan, with respect to the terms and conditions of awards granted to Participants outside the United States, the Board of Directors may vary from the provisions of the Plan to the extent it determines it necessary and appropriate to do so; provided that it may not vary from those Plan terms requiring stockholder approval pursuant to Section 12(d) below. All decisions, interpretations and other actions of the Board of Directors shall be final and binding on all Participants and all persons deriving their rights from a Participant.

SECTION 3. ELIGIBILITY.

(a) General Rule. Only Employees, Outside Directors and Consultants shall be eligible for the grant of Awards under the Plan.1 Only Employees shall be eligible for the grant of ISOs.

(b) Ten-Percent Stockholders. A person who owns more than 10% of the total combined voting power of all classes of outstanding stock of the Company, its Parent or any of its Subsidiaries shall not be eligible for the grant of an ISO unless (i) the Exercise Price is at least 110% of the Fair Market Value of a Share on the Date of Grant and (ii) such ISO by its terms is not exercisable after the expiration of five years from the Date of Grant. For purposes of this Subsection (b), in determining stock ownership, the attribution rules of Code Section 424(d) shall be applied.

 

1 

Note that special considerations apply if the Company proposes to grant awards to an Employee or Consultant of a Parent company.


SECTION 4. STOCK SUBJECT TO PLAN.

(a) Basic Limitation. Exhibit A sets forth the maximum number of Shares that may be issued under the Plan, subject to Subsection (b) below and Section 9(a). All of these Shares may be issued upon the exercise of ISOs. The number of Shares that are subject to Options or other rights outstanding at any time under the Plan may not exceed the number of Shares that then remain available for issuance under the Plan. The Company, during the term of the Plan, shall at all times reserve and keep available sufficient Shares to satisfy the requirements of the Plan. Shares offered under the Plan may be authorized but unissued Shares or treasury Shares.

(b) Additional Shares. In the event that Shares previously issued under the Plan are reacquired by the Company, such Shares shall be added to the number of Shares then available for issuance under the Plan. In the event that Shares that otherwise would have been issuable under the Plan are withheld by the Company in payment of the Purchase Price, Exercise Price or withholding taxes, such Shares shall remain available for issuance under the Plan. In the event that an outstanding Option, Restricted Stock Unit or other right for any reason expires or is canceled, the Shares allocable to the unexercised or unsettled portion of such Option, Restricted Stock Unit or other right shall be added to the number of Shares then available for issuance under the Plan.

SECTION 5. TERMS AND CONDITIONS OF AWARDS OR SALES.

(a) Stock Grant or Purchase Agreement. Each award of Shares under the Plan shall be evidenced by a Stock Grant Agreement between the Grantee and the Company. Each sale of Shares under the Plan (other than upon exercise of an Option) shall be evidenced by a Stock Purchase Agreement between the Purchaser and the Company. Such award or sale shall be subject to all applicable terms and conditions of the Plan and may be subject to any other terms and conditions which are not inconsistent with the Plan and which the Board of Directors deems appropriate for inclusion in a Stock Grant Agreement or Stock Purchase Agreement. The provisions of the various Stock Grant Agreements and Stock Purchase Agreements entered into under the Plan need not be identical.

(b) Duration of Offers and Nontransferability of Rights. Any right to purchase Shares under the Plan (other than an Option) shall automatically expire if not exercised by the Purchaser within 30 days (or such other period as may be specified in the Award Agreement) after the grant of such right was communicated to the Purchaser by the Company. Such right is not transferable and may be exercised only by the Purchaser to whom such right was granted.

(c) Purchase Price. The Board of Directors shall determine the Purchase Price of Shares to be offered under the Plan at its sole discretion. The Purchase Price shall be payable in a form described in Section 8.

SECTION 6. TERMS AND CONDITIONS OF OPTIONS.

(a) Stock Option Agreement. Each grant of an Option under the Plan shall be evidenced by a Stock Option Agreement between the Optionee and the Company. The Option shall be subject to all applicable terms and conditions of the Plan and may be subject to any other terms and conditions that are not inconsistent with the Plan and that the Board of Directors deems appropriate for inclusion in a Stock Option Agreement. The provisions of the various Stock Option Agreements entered into under the Plan need not be identical.

 

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(b) Number of Shares. Each Stock Option Agreement shall specify the number of Shares that are subject to the Option and shall provide for the adjustment of such number in accordance with Section 9. The Stock Option Agreement shall also specify whether the Option is an ISO or a Nonstatutory Option.

(c) Exercise Price. Each Stock Option Agreement shall specify the Exercise Price. The Exercise Price of an Option shall not be less than 100% of the Fair Market Value of a Share on the Date of Grant, and in the case of an ISO a higher percentage may be required by Section 3(b). Subject to the preceding sentence, the Exercise Price shall be determined by the Board of Directors at its sole discretion. The Exercise Price shall be payable in a form described in Section 8. This Subsection (c) shall not apply to an Option granted pursuant to an assumption of, or substitution for, another option in a manner that complies with Code Section 424(a) (whether or not the Option is an ISO).

(d) Exercisability. Each Stock Option Agreement shall specify the date when all or any installment of the Option is to become exercisable. No Option shall be exercisable unless the Optionee (i) has delivered an executed copy of the Stock Option Agreement to the Company or (ii) otherwise agrees to be bound by the terms of the Stock Option Agreement. The Board of Directors shall determine the exercisability provisions of the Stock Option Agreement at its sole discretion.

(e) Basic Term. The Stock Option Agreement shall specify the term of the Option. The term shall not exceed 10 years from the Date of Grant, and in the case of an ISO, a shorter term may be required by Section 3(b). Subject to the preceding sentence, the Board of Directors at its sole discretion shall determine when an Option is to expire.

(f) Termination of Service (Except by Death). If an Optionee’s Service terminates for any reason other than the Optionee’s death, then the Optionee’s Options shall expire on the earliest of the following dates:

(i) The expiration date determined pursuant to Subsection (e) above;

(ii) The date three months after the termination of the Optionee’s Service for any reason other than Disability, or such earlier or later date as the Board of Directors may determine (but in no event earlier than 30 days after the termination of the Optionee’s Service); or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability, or such later date as the Board of Directors may determine.

The Optionee may exercise all or part of the Optionee’s Options at any time before the expiration of such Options under the preceding sentence, but only to the extent that such Options had become exercisable before the Optionee’s Service terminated (or became exercisable as a result of the termination) and the underlying Shares had vested before the

 

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Optionee’s Service terminated (or vested as a result of the termination). The balance of such Options shall lapse when the Optionee’s Service terminates. In the event that the Optionee dies after the termination of the Optionee’s Service but before the expiration of the Optionee’s Options, all or part of such Options may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired such Options directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that such Options had become exercisable before the Optionee’s Service terminated (or became exercisable as a result of the termination) and the underlying Shares had vested before the Optionee’s Service terminated (or vested as a result of the termination).

(g) Leaves of Absence. For purposes of Subsection (f) above, Service shall be deemed to continue while the Optionee is on a bona fide leave of absence, if such leave was approved by the Company in writing and if continued crediting of Service for this purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company).

(h) Death of Optionee. If an Optionee dies while the Optionee is in Service, then the Optionee’s Options shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (e) above; or

(ii) The date 12 months after the Optionee’s death, or such earlier or later date as the Board of Directors may determine (but in no event earlier than six months after the Optionee’s death).

All or part of the Optionee’s Options may be exercised at any time before the expiration of such Options under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired such Options directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that such Options had become exercisable before the Optionee’s death (or became exercisable as a result of the death) and the underlying Shares had vested before the Optionee’s death (or vested as a result of the Optionee’s death). The balance of such Options shall lapse when the Optionee dies.

(i) Pre-Exercise Restrictions on Transfer of Options or Shares. An Option shall be transferable by the Optionee only by (i) a beneficiary designation, (ii) a will or (iii) the laws of descent and distribution, except as provided in the next sentence. If the applicable Stock Option Agreement so provides, a Nonstatutory Option shall also be transferable by gift or domestic relations order to a Family Member of the Optionee. An ISO may be exercised during the lifetime of the Optionee only by the Optionee or by the Optionee’s guardian or legal representative. In addition, an Option shall comply with all conditions of Rule 12h-1(f)(1) under the Exchange Act until the Company becomes subject to the reporting requirements of Section 13 or 15(d) of the Exchange Act. Such conditions include, without limitation, the transferability restrictions set forth in Rule 12h-1(f)(1)(iv) and (v) under the Exchange Act, which shall apply to an Option and, prior to exercise, to the Shares to be issued upon exercise of such Option during the period commencing on the Date of Grant and ending on the earlier of (i) the date when the Company becomes subject to the reporting requirements of Section 13 or 15(d) of the Exchange Act or (ii) the date when the Company makes a determination that it will cease to rely on the exemption afforded by Rule 12h-1(f)(1) under the Exchange Act. During such period, an Option and, prior to exercise, the Shares to be issued upon exercise of such Option shall be restricted as to any pledge, hypothecation or other transfer by the Optionee, including any short position, any “put equivalent position” (as defined in Rule 16a-1(h) under the Exchange Act) or any “call equivalent position” (as defined in Rule 16a-1(b) under the Exchange Act).

 

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(j) No Rights as a Stockholder. An Optionee, or a transferee of an Optionee, shall have no rights as a stockholder with respect to any Shares covered by the Optionee’s Option until such person becomes entitled to receive such Shares by filing a notice of exercise and paying the Exercise Price pursuant to the terms of such Option.

(k) Modification, Extension and Assumption of Options. Within the limitations of the Plan, the Board of Directors may modify, extend or assume outstanding Options or may accept the cancellation of outstanding Options (whether granted by the Company or another issuer) in return for the grant of new Options or a different type of award for the same or a different number of Shares and at the same or a different Exercise Price (if applicable). The foregoing notwithstanding, no modification of an Option shall, without the consent of the Optionee, impair the Optionee’s rights or increase the Optionee’s obligations under such Option.

(l) Companys Right to Cancel Certain Options. Any other provision of the Plan or a Stock Option Agreement notwithstanding, the Company shall have the right at any time to cancel an Option that was not granted in compliance with Rule 701 under the Securities Act. Prior to canceling such Option, the Company shall give the Optionee not less than 30 days’ notice in writing. If the Company elects to cancel such Option, it shall deliver to the Optionee consideration with an aggregate Fair Market Value equal to the excess of (i) the Fair Market Value of the Shares subject to such Option as of the time of the cancellation over (ii) the Exercise Price of such Option. The consideration may be delivered in the form of cash or cash equivalents, in the form of Shares, or a combination of both. If the consideration would be a negative amount, such Option may be cancelled without the delivery of any consideration.

SECTION 7. TERMS AND CONDITIONS OF RESTRICTED STOCK UNITS

(a) Restricted Stock Unit Agreement. Each grant of Restricted Stock Units under the Plan shall be evidenced by a Restricted Stock Unit Agreement between the recipient and the Company. Such Restricted Stock Units shall be subject to all applicable terms and conditions of the Plan and may be subject to any other terms and conditions that are not inconsistent with the Plan and which the Board of Directors deems appropriate for inclusion in a Restricted Stock Unit Agreement. The provisions of the various Restricted Stock Unit Agreements entered into under the Plan need not be identical.

(b) Payment for Restricted Stock Units. No cash consideration shall be required of the recipient in connection with the grant of Restricted Stock Units.

(c) Vesting Conditions. Each Restricted Stock Unit Agreement shall specify the vesting requirements applicable to the Restricted Stock Units subject thereto, which the Board of Directors shall determine in its sole discretion.

(d) Forfeiture. Unless a Restricted Stock Unit Agreement provides otherwise, upon termination of the recipient’s Service and upon such other times specified in the Restricted Stock Unit Agreement, any unvested Restricted Stock Units shall be forfeited to the Company.

 

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(e) Voting and Dividend Rights. The holders of Restricted Stock Units shall have no voting rights. Prior to settlement or forfeiture, any Restricted Stock Unit granted under the Plan may, at the discretion of the Board of Directors, carry with it a right to dividend equivalents. Such right entitles the holder to be credited with an amount equal to all cash dividends paid on one Share while the Restricted Stock Unit is outstanding. Dividend equivalents may be converted into additional Restricted Stock Units. Settlement of dividend equivalents may be made in the form of cash, in the form of Shares, or in a combination of both. Prior to distribution, any dividend equivalents that are not paid shall be subject to the same conditions and restrictions as the Restricted Stock Units to which they attach.

(f) Form and Time of Settlement of Restricted Stock Units. Settlement of vested Restricted Stock Units may be made in the form of (i) cash, (ii) Shares or (iii) any combination of both, as determined by the Board of Directors. The actual number of Restricted Stock Units eligible for settlement may be larger or smaller than the number included in the original award, based on predetermined performance factors. Vested Restricted Stock Units shall be settled in such manner and at such time(s) as specified in the Restricted Stock Unit Agreement. Until Restricted Stock Units are settled, the number of Shares represented by such Restricted Stock Units shall be subject to adjustment pursuant to Section 9.

(g) Death of Recipient. Any Restricted Stock Units that become distributable after the Participant’s death shall be distributed to the Participant’s estate or to any person who has acquired such Restricted Stock Units directly from the recipient by beneficiary designation, bequest or inheritance.

(h) Creditors Rights. A holder of Restricted Stock Units shall have no rights other than those of a general creditor of the Company. Restricted Stock Units represent an unfunded and unsecured obligation of the Company, subject to the terms and conditions of the applicable Restricted Stock Unit Agreement.

(i) Modification, Extension and Assumption of Restricted Stock Units. Within the limitations of the Plan, the Board of Directors may modify, extend or assume outstanding restricted stock units (whether granted by the Company or a different issuer). The foregoing notwithstanding, no modification of a Restricted Stock Unit shall, without the consent of the Participant, impair the Participant’s rights or increase the Participant’s obligations under such Restricted Stock Unit.

(j) Restrictions on Transfer of Restricted Stock Units. A Restricted Stock Unit shall be transferable by the Participant only by (i) a beneficiary designation, (ii) a will or (iii) the laws of descent and distribution, except as provided in the next sentence. In addition, if the Board of Directors so provides, in a Restricted Stock Unit Agreement or otherwise, a Restricted Stock Unit shall also be transferable to the extent permitted by Rule 701 under the Securities Act.

SECTION 8. PAYMENT FOR SHARES.

(a) General Rule. The entire Purchase Price or Exercise Price of Shares issued under the Plan shall be payable in cash or cash equivalents at the time when such Shares are purchased, except as otherwise provided in this Section 8. In addition, the Board of Directors in its sole discretion may also permit payment through any of the methods described in (b) through (g) below.

 

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(b) Services Rendered. Shares may be awarded under the Plan in consideration of services rendered to the Company, a Parent or a Subsidiary prior to the award.

(c) Promissory Note. All or a portion of the Purchase Price or Exercise Price (as the case may be) of Shares issued under the Plan may be paid with a full-recourse promissory note. The Shares shall be pledged as security for payment of the principal amount of the promissory note and interest thereon. The interest rate payable under the terms of the promissory note shall not be less than the minimum rate (if any) required to avoid the imputation of additional interest under the Code. Subject to the foregoing, the Board of Directors (at its sole discretion) shall specify the term, interest rate, amortization requirements (if any) and other provisions of such note.

(d) Surrender of Stock. All or any part of the Exercise Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when the Option is exercised.

(e) Exercise/Sale. If the Stock is publicly traded, all or part of the Exercise Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company.

(f) Net Exercise. An Option may permit exercise through a “net exercise” arrangement pursuant to which the Company will reduce the number of Shares issued upon exercise by the largest whole number of Shares having an aggregate Fair Market Value (determined by the Board of Directors as of the exercise date) that does not exceed the aggregate Exercise Price or the sum of the aggregate Exercise Price plus all or a portion of the minimum amount required to be withheld under applicable tax law (with the Company accepting from the Optionee payment of cash or cash equivalents to satisfy any remaining balance of the aggregate Exercise Price and, if applicable, any additional withholding obligation not satisfied through such reduction in Shares); provided that to the extent Shares subject to an Option are withheld in this manner, the number of Shares subject to the Option following the net exercise will be reduced by the sum of the number of Shares withheld and the number of Shares delivered to the Optionee as a result of the exercise.

(g) Other Forms of Payment. To the extent that an Award Agreement so provides, the Purchase Price or Exercise Price of Shares issued under the Plan may be paid in any other form permitted by the Delaware General Corporation Law, as amended.

SECTION 9. ADJUSTMENT OF SHARES.

(a) General. In the event of a subdivision of the outstanding Stock, a declaration of a dividend payable in Shares, a combination or consolidation of the outstanding Stock into a lesser number of Shares, a reclassification, or any other increase or decrease in the number of issued shares of Stock effected without receipt of consideration by the Company, proportionate adjustments shall automatically be made, as applicable, in each of (i) the number and kind of Shares available for future grants under Section 4, (ii) the number and kind of Shares covered by each outstanding Option, Award of Restricted Stock Units and any outstanding and unexercised right to purchase Shares that has not yet expired pursuant to Section 5(b), (iii) the Exercise Price under each outstanding Option and the Purchase Price applicable to any unexercised stock purchase right described in clause (ii) above, and (iv) any

 

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repurchase price that applies to Shares granted under the Plan pursuant to the terms of a Company repurchase right under the applicable Award Agreement. In the event of a declaration of an extraordinary dividend payable in a form other than Shares in an amount that has a material effect on the Fair Market Value of the Stock, a recapitalization, a spin-off, or a similar occurrence, the Board of Directors at its sole discretion may make appropriate adjustments in one or more of the items listed in clauses (i) through (iv) above; provided, however, that the Board of Directors shall in any event make such adjustments (x) to the extent such event constitutes an Equity Restructuring and (y) as may be required by Section 25102(o) of the California Corporations Code. No fractional Shares shall be issued under the Plan as a result of an adjustment under this Section 9(a), although the Board of Directors in its sole discretion may make a cash payment in lieu of fractional Shares.

(b) Corporate Transactions. In the event that the Company is a party to a merger or consolidation, or in the event of a sale of all or substantially all of the Company’s stock or assets, all Shares acquired under the Plan and all Awards outstanding on the effective date of the transaction shall be treated in the manner described in the definitive transaction agreement (or, in the event the transaction does not entail a definitive agreement to which the Company is party, in the manner determined by the Board of Directors in its capacity as administrator of the Plan, with such determination having final and binding effect on all parties), which agreement or determination need not treat all Awards (or all portions of an Award) in an identical manner. The treatment specified in the transaction agreement may include (without limitation) one or more of the following with respect to each outstanding Award:

(i) Continuation of the Award by the Company (if the Company is the surviving corporation).

(ii) Assumption of the Option by the surviving corporation or its parent in a manner that complies with Code Section 424(a) (whether or not the Option is an ISO).

(iii) Substitution by the surviving corporation or its parent of a new option for the Option in a manner that complies with Code Section 424(a) (whether or not the Option is an ISO).

(iv) Cancellation of the Award and a payment to the Participant with respect to each Share subject to the portion of the Award that is vested as of the transaction date equal to the excess of (A) the value, as determined by the Board of Directors in its absolute discretion, of the property (including cash) received by the holder of a share of Stock as a result of the transaction, over (if applicable) (B) the per-Share Exercise Price of the Award (such excess, the “Spread”). Such payment shall be made in the form of cash, cash equivalents, or securities of the surviving corporation or its parent having a value equal to the Spread. In addition, any escrow, holdback, earn-out or similar provisions in the transaction agreement may apply to such payment to the same extent and in the same manner as such provisions apply to the holders of Stock. If the Spread applicable to an Award is zero or a negative number, then the Award may be cancelled without making a payment to the Participant.

(v) Cancellation of the Option without the payment of any consideration; provided that the Optionee shall be notified of such treatment and given an opportunity to exercise the Option (to the extent the Option is vested or becomes

 

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vested as of the effective date of the transaction) during a period of not less than five (5) business days preceding the effective date of the transaction, unless (A) a shorter period is required to permit a timely closing of the transaction and (B) such shorter period still offers the Optionee a reasonable opportunity to exercise the Option. Any exercise of the Option during such period may be contingent upon the closing of the transaction.

(vi) Suspension of the Optionee’s right to exercise the Option during a limited period of time preceding the closing of the transaction if such suspension is administratively necessary to permit the closing of the transaction.

(vii) Termination of any right the Optionee has to exercise the Option prior to vesting in the Shares subject to the Option (i.e., “early exercise”), such that following the closing of the transaction the Option may only be exercised to the extent it is vested.

For the avoidance of doubt, the Board of Directors has discretion to accelerate, in whole or part, the vesting and exercisability of an Award in connection with a corporate transaction covered by this Section 9(b).

(c) Reservation of Rights. Except as provided in Section 7(e) or this Section 9, a Participant shall have no rights by reason of (i) any subdivision or consolidation of shares of stock of any class, (ii) the payment of any dividend or (iii) any other increase or decrease in the number of shares of stock of any class. Any issuance by the Company of shares of stock of any class, or securities convertible into shares of stock of any class, shall not affect, and no adjustment by reason thereof shall be made with respect to, the number or Exercise Price of Shares subject to an Award. The grant of an Award pursuant to the Plan shall not affect in any way the right or power of the Company to make adjustments, reclassifications, reorganizations or changes of its capital or business structure, to merge or consolidate or to dissolve, liquidate, sell or transfer all or any part of its business or assets.

SECTION 10. PRE-EXERCISE INFORMATION REQUIREMENT.

(a) Application of Requirement. This Section 10 shall apply only during a period that (i) commences when the Company begins to rely on the exemption described in Rule 12h-1(f)(1) under the Exchange Act, as determined by the Company in its sole discretion, and (ii) ends on the earlier of (A) the date when the Company ceases to rely on such exemption, as determined by the Company in its sole discretion, or (B) the date when the Company becomes subject to the reporting requirements of Section 13 or 15(d) of the Exchange Act. In addition, this Section 10 shall in no event apply to an Optionee after he or she has fully exercised all of his or her Options.

(b) Scope of Requirement. The Company shall provide to each Participant the information described in Rule 701(e)(3), (4) and (5) under the Securities Act. Such information shall be provided at six-month intervals, and the financial statements included in such information shall not be more than 180 days old. The foregoing notwithstanding, the Company shall not be required to provide such information unless the Participant has agreed in writing, on a form prescribed by the Company, to keep such information confidential.

 

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SECTION 11. MISCELLANEOUS PROVISIONS.

(a) Securities Law Requirements. Shares shall not be issued under the Plan unless, in the opinion of counsel acceptable to the Board of Directors, the issuance and delivery of such Shares comply with (or are exempt from) all applicable requirements of law, including (without limitation) the Securities Act, the rules and regulations promulgated thereunder, state securities laws and regulations, and the regulations of any stock exchange or other securities market on which the Company’s securities may then be traded. The Company shall not be liable for a failure to issue Shares as a result of such requirements.

(b) No Retention Rights. Nothing in the Plan or in any right or Award granted under the Plan shall confer upon the Participant any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Participant) or of the Participant, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

(c) Treatment as Compensation. Any compensation that an individual earns or is deemed to earn under this Plan shall not be considered a part of his or her compensation for purposes of calculating contributions, accruals or benefits under any other plan or program that is maintained or funded by the Company, a Parent or a Subsidiary.

(d) Governing Law. The Plan and all awards, sales and grants under the Plan shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

(e) Conditions and Restrictions on Shares. Shares issued under the Plan shall be subject to such forfeiture conditions, rights of repurchase, rights of first refusal, other transfer restrictions and such other terms and conditions as the Board of Directors may determine. Such conditions and restrictions shall be set forth in the applicable Award Agreement and shall apply in addition to any restrictions that may apply to holders of Shares generally. In addition, Shares issued under the Plan shall be subject to conditions and restrictions imposed either by applicable law or by Company policy, as adopted from time to time, designed to ensure compliance with applicable law or laws with which the Company determines in its sole discretion to comply including in order to maintain any statutory, regulatory or tax advantage.

(f) Tax Matters.

(i) As a condition to the award, grant, issuance, vesting, purchase, exercise, settlement or transfer of any Award, or Shares issued pursuant to any Award, granted under this Plan, the Participant shall make such arrangements as the Board of Directors may require or permit for the satisfaction of any federal, state, local or foreign withholding tax obligations that may arise in connection with such event. The Board of Directors in its sole discretion may permit the satisfaction of such withholding obligations through any of the methods described in Section 8 (b) through (g).

(ii) Unless otherwise expressly set forth in an Award Agreement, it is intended that Awards shall be exempt from Code Section 409A, and any ambiguity in the terms of an Award Agreement and the Plan shall be interpreted consistently with this intent. To the extent an Award is not exempt from Code Section 409A (any such

 

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award, a “409A Award”), any ambiguity in the terms of such Award and the Plan shall be interpreted in a manner that to the maximum extent permissible supports the Award’s compliance with the requirements of that statute. Notwithstanding anything to the contrary permitted under the Plan, in no event shall a modification of an Award not already subject to Code Section 409A, or any subsequent action taken with respect to such Award, be given effect if such modification or action would cause the Award to become subject to Code Section 409A unless the parties explicitly acknowledge and consent to the modification or action as one having that effect. A 409A Award shall be subject to such additional rules and requirements as specified by the Board of Directors from time to time in order for it to comply with the requirements of Code Section 409A. In this regard, if any amount under a 409A Award is payable upon a “separation from service” to an individual who is considered a “specified employee” (as each term is defined under Code Section 409A), then no such payment shall be made prior to the date that is the earlier of (i) six months and one day after the Participant’s separation from service or (ii) the Participant’s death, but only to the extent such delay is necessary to prevent such payment from being subject to Section 409A(a)(1). In addition, if a transaction subject to Section 9(b) constitutes a payment event with respect to any 409A Award, then the transaction with respect to such award must also constitute a “change in control event” as defined in Treasury Regulation Section 1.409A-3(i)(5) to the extent required by Code Section 409A.

(iii) Neither the Company nor any member of the Board of Directors shall have any liability to a Participant in the event an Award held by the Participant fails to achieve its intended characterization under applicable tax law.

SECTION 12. DURATION AND AMENDMENTS; STOCKHOLDER APPROVAL.

(a) Term of the Plan. The Plan, as set forth herein, shall become effective on the date of its adoption by the Board of Directors, subject to approval of the Company’s stockholders under Subsection (d) below. The Plan shall terminate automatically 10 years after the later of (i) the date when the Board of Directors adopted the Plan or (ii) the date when the Board of Directors approved the most recent increase in the number of Shares reserved under Section 4 that was also approved by the Company’s stockholders. The Plan may be terminated on any earlier date pursuant to Subsection (b) below.

(b) Right to Amend or Terminate the Plan. Subject to Subsection (d) below, the Board of Directors may amend, suspend or terminate the Plan at any time and for any reason.

(c) Effect of Amendment or Termination. No Shares shall be issued or sold and no Award granted under the Plan after the termination thereof, except upon exercise or settlement of an Award granted under the Plan prior to such termination. The termination of the Plan, or any amendment thereof, shall not affect any Share previously issued or any Award previously granted under the Plan.

(d) Stockholder Approval. To the extent required by applicable law, the Plan will be subject to approval of the Company’s stockholders within 12 months of its adoption date. To the extent required by applicable law, any amendment of the Plan will be subject to the approval of the Company’s stockholders within 12 months of the amendment date if it (i) increases the number of Shares available for issuance under the Plan (except as provided in Section 9), or (ii) materially changes the class of persons who are eligible for the grant of ISOs. In addition, an amendment effecting any other material change to the Plan terms will be subject to approval of the Company’s stockholder only if required by applicable law. Stockholder approval shall not be required for any other amendment of the Plan.

 

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SECTION 13. DEFINITIONS.

(a) “Award” means any award granted under the Plan, including as an Option, an award of Restricted Stock Units or the grant or sale of Shares pursuant to Section 5 of the Plan.

(b) “Award Agreement” means a Restricted Stock Unit Agreement, Stock Grant Agreement, Stock Option Agreement or Stock Purchase Agreement or such other agreement evidencing an Award under the Plan.

(c) “Board of Directors” means the Board of Directors of the Company, as constituted from time to time.

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

(e) “Committee” means a committee of the Board of Directors, as described in Section 2(a).

(f) “Company” means Mulberry Health Inc., a Delaware corporation.

(g) “Consultant” means a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent2 or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

(h) “Date of Grant” means the date of grant specified in the Award Agreement, which date shall be the later of (i) the date on which the Board of Directors resolved to grant the Award or (ii) the first day of the Participant’s Service.

(i) “Disability” means that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(j) “Employee” means any individual who is a common-law employee of the Company, a Parent3 or a Subsidiary.

(k) “Equity Restructuring” means as determined by the Board of Directors, a non-reciprocal transaction between the Company and its stockholders that affects the shares of Stock (or other securities of the Company) or the share price of Stock (or other securities of the Company) and causes a change in the per share value of the Stock underlying outstanding Awards.

 

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Note that special considerations apply if the Company proposes to grant awards to consultant or advisor of a Parent company.

3 

Note that special considerations apply if the Company proposes to grant awards to an Employee of a Parent company.

 

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(l) “Exchange Act” means the Securities Exchange Act of 1934, as amended.

(m) “Exercise Price” means the amount for which one Share may be purchased upon exercise of an Option, as specified by the Board of Directors in the applicable Stock Option Agreement.

(n) “Fair Market Value” means the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

(o) “Family Member” means (i) any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, former spouse, sibling, niece, nephew, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law, including adoptive relationships, (ii) any person sharing the Optionee’s household (other than a tenant or employee), (iii) a trust in which persons described in Clause (i) or (ii) have more than 50% of the beneficial interest, (iv) a foundation in which persons described in Clause (i) or (ii) or the Optionee control the management of assets and (v) any other entity in which persons described in Clause (i) or (ii) or the Optionee own more than 50% of the voting interests.

(p) “Grantee” means a person to whom the Board of Directors has awarded Shares under the Plan.

(q) “ISO” means an Option that qualifies as an incentive stock option as described in Code Section 422(b). Notwithstanding its designation as an ISO, an Option that does not qualify as an ISO under applicable law shall be treated for all purposes as a Nonstatutory Option.

(r) “Nonstatutory Option” means an Option that does not qualify as an incentive stock option as described in Code Section 422(b) or 423(b).

(s) “Option” means an ISO or Nonstatutory Option granted under the Plan and entitling the holder to purchase Shares.

(t) “Optionee” means a person who holds an Option.

(u) “Outside Director” means a member of the Board of Directors who is not an Employee.

(v) “Parent” means any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain. A corporation that attains the status of a Parent on a date after the adoption of the Plan shall be considered a Parent commencing as of such date.

(w) “Participant” means the holder of an outstanding Award.

(x) “Plan” means this Mulberry Health Inc. 2012 Stock Plan, as amended.

 

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(y) “Purchase Price” means the consideration for which one Share may be acquired under the Plan (other than upon exercise of an Option), as specified by the Board of Directors.

(z) “Purchaser” means a person to whom the Board of Directors has offered the right to purchase Shares under the Plan (other than upon exercise of an Option).

(aa) “Restricted Stock Unit” means a bookkeeping entry representing the equivalent of one Share, as awarded under the Plan.

(bb) “Restricted Stock Unit Agreement” means the agreement between the Company and the recipient of a Restricted Stock Unit that contains the terms, conditions and restrictions pertaining to such Restricted Stock Unit.

(cc) “Securities Act” means the Securities Act of 1933, as amended.

(dd) “Service” means service as an Employee, Outside Director or Consultant.

(ee) “Share” means one share of Stock, as adjusted in accordance with Section 9 (if applicable).

(ff) “Stock” means the Series A Common Stock of the Company.

(gg) “Stock Grant Agreement” means the agreement between the Company and a Grantee who is awarded Shares under the Plan that contains the terms, conditions and restrictions pertaining to the award of such Shares.

(hh) “Stock Option Agreement” means the agreement between the Company and an Optionee that contains the terms, conditions and restrictions pertaining to the Optionee’s Option.

(ii) “Stock Purchase Agreement” means the agreement between the Company and a Purchaser who purchases Shares under the Plan that contains the terms, conditions and restrictions pertaining to the purchase of such Shares.

(jj) “Subsidiary” means any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain. A corporation that attains the status of a Subsidiary on a date after the adoption of the Plan shall be considered a Subsidiary commencing as of such date.

 

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EXHIBIT A

SCHEDULE OF SHARES RESERVED FOR ISSUANCE UNDER THE PLAN

 

Date of Board Approval

  

Date of Stockholder
Approval

  

Number of Shares

Added

  

Cumulative
Number of Shares

December 6, 2012

      Not Applicable    1,250,000

February 14, 2013

   February 15, 2013    45,401    1,295,401

March 21, 2013

   March 21, 2013    1,254,999    2,550,400

August 22, 2013

   August 27, 2013    774,720    3,325,120

December 23, 2013

   December 23, 2013    522,580    3,847,700

May 2, 2014

   May 2, 2014    480,188    4,327,888

July 10, 2014

   July 14, 2014    10:1 Stock Split    43,278,880

April 13, 2015

   April 13, 2015    10,870,007    54,148,887

August 14, 2015

   August 14, 2015    3,881,232    58,030,119

February 15, 2017

   February 15, 2017    6,000,000    64,030,119

May 10, 2017

   May 10, 2017    13,000,000    77,030,119

December 6, 2017

   December 8, 2017    11,500,000    88,530,119

March 23, 2018

   March 23, 2018    -8,335,846    80,194,273

August 10, 2018

   August 10, 2018    13,500,000    93,694,273

October 24, 2019

   November 11, 2019    42,337,100    136,031,373

May 22, 2020

   May 22, 2020    17,735,692    153,767,065

 

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Exhibit 10.6

MULBERRY HEALTH INC. 2012 STOCK PLAN

NOTICE OF STOCK OPTION GRANT (EARLY EXERCISE)

The Optionee has been granted the following option to purchase shares of the Series A Common Stock of Mulberry Health Inc.:

 

Name of Optionee:    «Name»
Total Number of Shares:    «TotalShares»
Type of Option:   

«ISO» Incentive Stock Option (ISO)

 

«NSO» Nonstatutory Stock Option (NSO)

Exercise Price per Share:    $ «PricePerShare»
Date of Grant:    «DateGrant»
Date Exercisable:    This option may be exercised at any time after the Date of Grant for all or any part of the Shares subject to this option.
Vesting Commencement Date:    «VestComDate»
Vesting Schedule:    The Right of Repurchase shall lapse with respect to the first «Percent»% of the Shares subject to this option when the Optionee completes «CliffPeriod» months of continuous Service beginning with the Vesting Commencement Date set forth above. The Right of Repurchase shall lapse with respect to an additional «Fraction»% of the Shares subject to this option when the Optionee completes each month of continuous Service thereafter.
Expiration Date:    «ExpDate». This option expires earlier if the Optionee’s Service terminates earlier, as provided in Section 6 of the Stock Option Agreement, or if the Company engages in certain corporate transactions, as provided in Section 8(b) of the Plan.

By signing below, the Optionee and the Company agree that this option is granted under, and governed by the terms and conditions of, the 2012 Stock Plan and the Stock Option Agreement. Both of these documents are attached to, and made a part of, this Notice of Stock Option Grant. Section 14 of the Stock Option Agreement includes important acknowledgements of the Optionee.

 

OPTIONEE:     MULBERRY HEALTH INC.

 

    By:  

 

    Title:  

 


THE OPTION GRANTED PURSUANT TO THIS AGREEMENT AND THE SHARES ISSUABLE UPON THE EXERCISE THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC. 2012 STOCK PLAN:

STOCK OPTION AGREEMENT (EARLY EXERCISE)

SECTION 1. GRANT OF OPTION.

(a) Option. On the terms and conditions set forth in the Notice of Stock Option Grant and this Agreement, the Company grants to the Optionee on the Date of Grant the option to purchase at the Exercise Price the number of Shares set forth in the Notice of Stock Option Grant. The Exercise Price is agreed to be at least 100% of the Fair Market Value per Share on the Date of Grant (110% of Fair Market Value if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies). This option is intended to be an ISO or an NSO, as provided in the Notice of Stock Option Grant.

(b) $100,000 Limitation. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it shall be deemed to be an NSO to the extent (and only to the extent) required by the $100,000 annual limitation under Section 422(d) of the Code.

(c) Stock Plan and Defined Terms. This option is granted pursuant to the Plan, a copy of which the Optionee acknowledges having received. The provisions of the Plan are incorporated into this Agreement by this reference. Capitalized terms are defined in Section 15 of this Agreement.

SECTION 2. RIGHT TO EXERCISE.

(a) Exercisability. Subject to Subsection (b) below and the other conditions set forth in this Agreement, all or part of this option may be exercised prior to its expiration at the time or times set forth in the Notice of Stock Option Grant. Shares purchased by exercising this option may be subject to the Right of Repurchase under Section 7.

(b) Stockholder Approval. Any other provision of this Agreement notwithstanding, no portion of this option shall be exercisable at any time prior to the approval of the Plan by the Company’s stockholders.


SECTION 3. NO TRANSFER OR ASSIGNMENT OF OPTION.

Except as otherwise provided in this Agreement, this option and the rights and privileges conferred hereby shall not be sold, pledged or otherwise transferred (whether by operation of law or otherwise) and shall not be subject to sale under execution, attachment, levy or similar process.

SECTION 4. EXERCISE PROCEDURES.

(a) Notice of Exercise. The Optionee or the Optionee’s representative may exercise this option by giving written notice to the Company pursuant to Section 13(c). The notice shall specify the election to exercise this option, the number of Shares for which it is being exercised and the form of payment. The person exercising this option shall sign the notice. In the event that this option is being exercised by the representative of the Optionee, the notice shall be accompanied by proof (satisfactory to the Company) of the representative’s right to exercise this option. The Optionee or the Optionee’s representative shall deliver to the Company, at the time of giving the notice, payment in a form permissible under Section 5 for the full amount of the Purchase Price. In the event of a partial exercise of this option, Shares shall be deemed to have been purchased in the order in which they vest in accordance with the Notice of Stock Option Grant.

(b) Issuance of Shares. After receiving a proper notice of exercise, the Company shall cause to be issued one or more certificates evidencing the Shares for which this option has been exercised. Such Shares shall be registered (i) in the name of the person exercising this option, (ii) in the names of such person and his or her spouse as community property or as joint tenants with the right of survivorship or (iii) with the Company’s consent, in the name of a revocable trust. In the case of Restricted Shares, the Company shall cause such certificates to be deposited in escrow under Section 7(c). In the case of other Shares, the Company shall cause such certificates to be delivered to or upon the order of the person exercising this option.

(c) Withholding Taxes. In the event that the Company determines that it is required to withhold any tax as a result of the exercise of this option, the Optionee, as a condition to the exercise of this option, shall make arrangements satisfactory to the Company to enable it to satisfy all withholding requirements. The Optionee shall also make arrangements satisfactory to the Company to enable it to satisfy any withholding requirements that may arise in connection with the vesting or disposition of Shares purchased by exercising this option.

SECTION 5. PAYMENT FOR STOCK.

(a) Cash. All or part of the Purchase Price may be paid in cash or cash equivalents.

(b) Surrender of Stock. At the discretion of the Board of Directors, all or any part of the Purchase Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when this option is exercised.

 

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(c) Exercise/Sale. All or part of the Purchase Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company. However, payment pursuant to this Subsection (c) shall be permitted only if (i) Stock then is publicly traded and (ii) such payment does not violate applicable law.

SECTION 6. TERM AND EXPIRATION.

(a) Basic Term. This option shall in any event expire on the expiration date set forth in the Notice of Stock Option Grant, which date is 10 years after the Date of Grant (five years after the Date of Grant if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies).

(b) Termination of Service (Except by Death). If the Optionee’s Service terminates for any reason other than death, then this option shall expire on the earliest of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) above;

(ii) The date three months after the termination of the Optionee’s Service for any reason other than Disability; or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability.

The Optionee may exercise all or part of this option at any time before its expiration under the preceding sentence, but only to the extent that this option is exercisable for vested Shares on or before the date when the Optionee’s Service terminates. When the Optionee’s Service terminates, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable and with respect to any Restricted Shares. In the event that the Optionee dies after termination of Service but before the expiration of this option, all or part of this option may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option was exercisable for vested Shares on or before the date when the Optionee’s Service terminated.

(c) Death of the Optionee. If the Optionee dies while in Service, then this option shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (a) above; or

(ii) The date 12 months after the Optionee’s death.

 

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All or part of this option may be exercised at any time before its expiration under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option is exercisable for vested Shares on or before the date of the Optionee’s death. When the Optionee dies, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable and with respect to any Restricted Shares.

(d) Part-Time Employment and Leaves of Absence. If the Optionee commences working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant. If the Optionee goes on a leave of absence, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant in accordance with the Company’s leave of absence policy or the terms of such leave. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while the Optionee is on a bona fide leave of absence, if (i) such leave was approved by the Company in writing and (ii) continued crediting of Service for such purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company). Service shall be deemed to terminate when such leave ends, unless the Optionee immediately returns to active work.

(e) Notice Concerning ISO Treatment. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it ceases to qualify for favorable tax treatment as an ISO to the extent that it is exercised:

(i) More than three months after the date when the Optionee ceases to be an Employee for any reason other than death or permanent and total disability (as defined in Section 22(e)(3) of the Code);

(ii) More than 12 months after the date when the Optionee ceases to be an Employee by reason of permanent and total disability (as defined in Section 22(e)(3) of the Code); or

(iii) More than three months after the date when the Optionee has been on a leave of absence for 90 days, unless the Optionee’s reemployment rights following such leave were guaranteed by statute or by contract.

SECTION 7. RIGHT OF REPURCHASE.

(a) Scope of Repurchase Right. Until they vest in accordance with the Notice of Stock Option Grant and Subsection (b) below, the Shares acquired under this Agreement shall be Restricted Shares and shall be subject to the Company’s Right of Repurchase. The Company, however, may decline to exercise its Right of Repurchase or may exercise its Right of Repurchase only with respect to a portion of the Restricted Shares. The Company may exercise its Right of Repurchase only during the Repurchase Period following the termination of the Optionee’s Service, but the Right of Repurchase may be exercised automatically under Subsection (d) below. If the Right of Repurchase is exercised, the Company shall pay the Optionee an amount equal to the lower of (i) the Exercise Price of each Restricted Share being repurchased or (ii) the Fair Market Value of such Restricted Share at the time the Right of Repurchase is exercised.

 

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(b) Lapse of Repurchase Right. The Right of Repurchase shall lapse with respect to the Restricted Shares in accordance with the vesting schedule set forth in the Notice of Stock Option Grant.

(c) Escrow. Upon issuance, the certificate(s) for Restricted Shares shall be deposited in escrow with the Company to be held in accordance with the provisions of this Agreement. Any additional or exchanged securities or other property described in Subsection (f) below shall immediately be delivered to the Company to be held in escrow. All ordinary cash dividends on Restricted Shares (or on other securities held in escrow) shall be paid directly to the Optionee and shall not be held in escrow. Restricted Shares, together with any other assets held in escrow under this Agreement, shall be (i) surrendered to the Company for repurchase upon exercise of the Right of Repurchase or the Right of First Refusal or (ii) released to the Optionee upon his or her request to the extent that the Shares have ceased to be Restricted Shares (but not more frequently than once every six months). In any event, all Shares that have ceased to be Restricted Shares, together with any other vested assets held in escrow under this Agreement, shall be released within 90 days after the earlier of (i) the termination of the Optionee’s Service or (ii) the lapse of the Right of First Refusal.

(d) Exercise of Repurchase Right. The Company shall be deemed to have exercised its Right of Repurchase automatically for all Restricted Shares as of the commencement of the Repurchase Period, unless the Company during the Repurchase Period notifies the holder of the Restricted Shares pursuant to Section 13(c) that it will not exercise its Right of Repurchase for some or all of the Restricted Shares. The Company shall pay to the holder of the Restricted Shares the purchase price determined under Subsection (a) above for the Restricted Shares being repurchased. Payment shall be made in cash or cash equivalents and/or by canceling indebtedness to the Company incurred by the Optionee in the purchase of the Restricted Shares. The certificate(s) representing the Restricted Shares being repurchased shall be delivered to the Company.

(e) Termination of Rights as Stockholder. If the Right of Repurchase is exercised in accordance with this Section 7 and the Company makes available the consideration for the Restricted Shares being repurchased, then the person from whom the Restricted Shares are repurchased shall no longer have any rights as a holder of the Restricted Shares (other than the right to receive payment of such consideration). Such Restricted Shares shall be deemed to have been repurchased pursuant to this Section 7, whether or not the certificate(s) for such Restricted Shares have been delivered to the Company or the consideration for such Restricted Shares has been accepted.

(f) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Restricted Shares shall immediately be subject to the Right of Repurchase. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to

 

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the number and/or class of the Restricted Shares. Appropriate adjustments shall also be made to the price per share to be paid upon the exercise of the Right of Repurchase, provided that the aggregate purchase price payable for the Restricted Shares shall remain the same. In the event of a merger or consolidation of the Company with or into another entity or any other corporate reorganization, the Right of Repurchase may be exercised by the Company’s successor.

(g) Transfer of Restricted Shares. The Optionee shall not transfer, assign, encumber or otherwise dispose of any Restricted Shares without the Company’s written consent, except as provided in the following sentence. The Optionee may transfer Restricted Shares to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Restricted Shares, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(h) Assignment of Repurchase Right. The Board of Directors may freely assign the Company’s Right of Repurchase, in whole or in part. Any person who accepts an assignment of the Right of Repurchase from the Company shall assume all of the Company’s rights and obligations under this Section 7.

SECTION 8. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. In the event that the Optionee proposes to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If the Optionee desires to transfer Shares acquired under this Agreement, the Optionee shall give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by the Optionee and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Subsection (b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, the Optionee may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which the Optionee is bound. Any proposed transfer on terms and conditions different from those described in the Transfer Notice, as well as any subsequent proposed transfer by the Optionee,

 

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shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Subsection (a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 8 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 8.

(d) Termination of Right of First Refusal. Any other provision of this Section 8 notwithstanding, in the event that the Stock is readily tradable on an established securities market when the Optionee desires to transfer Shares, the Company shall have no Right of First Refusal, and the Optionee shall have no obligation to comply with the procedures prescribed by Subsections (a) and (b) above.

(e) Permitted Transfers. This Section 8 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Shares acquired under this Agreement, either under this Subsection (e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 8, then after such time the person from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

 

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(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall assume all of the Company’s rights and obligations under this Section 8.

SECTION 9. LEGALITY OF INITIAL ISSUANCE.

No Shares shall be issued upon the exercise of this option unless and until the Company has determined that:

(a) It and the Optionee have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof;

(b) Any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; and

(c) Any other applicable provision of federal, State or foreign law has been satisfied.

SECTION 10. NO REGISTRATION RIGHTS.

The Company may, but shall not be obligated to, register or qualify the sale of Shares under the Securities Act or any other applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Shares under this Agreement to comply with any law.

SECTION 11. RESTRICTIONS ON TRANSFER OF SHARES.

(a) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on stock certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any State or any other law.

(b) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, the Optionee or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date of the final prospectus for the offering as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days plus such additional period as may reasonably be requested by the

 

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Company or such underwriter to accommodate regulatory restrictions on (i) the publication or other distribution of research reports or (ii) analyst recommendations and opinions, including (without limitation) the restrictions set forth in Rule 2711(f)(4) of the National Association of Securities Dealers and Rule 472(f)(4) of the New York Stock Exchange, as amended, or any similar successor rules. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (b). This Subsection (b) shall not apply to Shares registered in the public offering under the Securities Act.

(c) Investment Intent at Grant. The Optionee represents and agrees that the Shares to be acquired upon exercising this option will be acquired for investment, and not with a view to the sale or distribution thereof.

(d) Investment Intent at Exercise. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, the Optionee shall represent and agree at the time of exercise that the Shares being acquired upon exercising this option are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel.

(e) Legends. All certificates evidencing Shares purchased under this Agreement shall bear the following legend:

“THE SHARES REPRESENTED HEREBY MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF A WRITTEN AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED HOLDER OF THE SHARES (OR THE PREDECESSOR IN INTEREST TO THE SHARES). SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES AND CERTAIN REPURCHASE RIGHTS UPON TERMINATION OF SERVICE WITH THE COMPANY. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

All certificates evidencing Shares purchased under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

 

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“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.”

(f) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares sold under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(g) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 11 shall be conclusive and binding on the Optionee and all other persons.

SECTION 12. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 8(a) of the Plan, the terms of this option (including, without limitation, the number and kind of Shares subject to this option and the Exercise Price) shall be adjusted as set forth in Section 8(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, this option shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 8(b) of the Plan.

SECTION 13. MISCELLANEOUS PROVISIONS.

(a) Rights as a Stockholder. Neither the Optionee nor the Optionee’s representative shall have any rights as a stockholder with respect to any Shares subject to this option until the Optionee or the Optionee’s representative becomes entitled to receive such Shares by filing a notice of exercise and paying the Purchase Price pursuant to Sections 4 and 5.

(b) No Retention Rights. Nothing in this option or in the Plan shall confer upon the Optionee any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Optionee) or of the Optionee, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

(c) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid or (iii) deposit with Federal Express Corporation, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to the Optionee at the address that he or she most recently provided to the Company in accordance with this Subsection (c).

 

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(d) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Optionee and by an authorized officer of the Company (other than the Optionee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(e) Entire Agreement. The Notice of Stock Option Grant, this Agreement and the Plan constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(f) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

SECTION 14. ACKNOWLEDGEMENTS OF THE OPTIONEE.

(a) Tax Consequences. The Optionee agrees that the Company does not have a duty to design or administer the Plan or its other compensation programs in a manner that minimizes the Optionee’s tax liabilities. The Optionee shall not make any claim against the Company or its Board of Directors, officers or employees related to tax liabilities arising from this option or the Optionee’s other compensation. In particular, the Optionee acknowledges that this option is exempt from Section 409A of the Code only if the Exercise Price is at least equal to the Fair Market Value per Share on the Date of Grant. Since Shares are not traded on an established securities market, the determination of their Fair Market Value is made by the Board of Directors or by an independent valuation firm retained by the Company. The Optionee acknowledges that there is no guarantee in either case that the Internal Revenue Service will agree with the valuation, and the Optionee shall not make any claim against the Company or its Board of Directors, officers or employees in the event that the Internal Revenue Service asserts that the valuation was too low.

(b) Electronic Delivery of Documents. The Optionee agrees to accept by email all documents relating to the Company, the Plan or this option and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission). The Optionee also agrees that the Company may deliver these documents by posting them on a website maintained by the Company or by a third party under contract with the Company. If the Company posts these documents on a website, it shall notify the Optionee by email of their availability. The Optionee acknowledges that he or she may incur costs in connection with electronic delivery, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents. This consent shall remain in effect until this option expires or until the Optionee gives the Company written notice that it should deliver paper documents.

(c) No Notice of Expiration Date. The Optionee agrees that the Company and its officers, employees, attorneys and agents do not have any obligation to notify him or her prior to the expiration of this option pursuant to Section 6, regardless of whether this option will expire at the end of its full term or on an earlier date related to the termination of the Optionee’s

 

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Service. The Optionee further agrees that he or she has the sole responsibility for monitoring the expiration of this option and for exercising this option, if at all, before it expires. This Subsection (c) shall supersede any contrary representation that may have been made, orally or in writing, by the Company or by an officer, employee, attorney or agent of the Company.

SECTION 15. DEFINITIONS.

(a) “Agreement” shall mean this Stock Option Agreement.

(b) “Board of Directors” shall mean the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

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

(d) “Committee” shall mean a committee of the Board of Directors, as described in Section 2 of the Plan.

(e) “Company” shall mean Mulberry Health Inc., a Delaware corporation.

(f) “Consultant” shall mean a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

(g) “Date of Grant” shall mean the date of grant specified in the Notice of Stock Option Grant, which date shall be the later of (i) the date on which the Board of Directors resolved to grant this option or (ii) the first day of the Optionee’s Service.

(h) “Disability” shall mean that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(i) “Employee” shall mean any individual who is a common-law employee of the Company, a Parent or a Subsidiary.

(j) “Exercise Price” shall mean the amount for which one Share may be purchased upon exercise of this option, as specified in the Notice of Stock Option Grant.

(k) “Fair Market Value” shall mean the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

(l) “Immediate Family” shall mean any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(m) “ISO” shall mean an employee incentive stock option described in Section 422(b) of the Code.

 

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(n) “Notice of Stock Option Grant” shall mean the document so entitled to which this Agreement is attached.

(o) “NSO” shall mean a stock option not described in Section 422(b) or 423(b) of the Code.

(p) “Optionee” shall mean the person named in the Notice of Stock Option Grant.

(q) “Outside Director” shall mean a member of the Board of Directors who is not an Employee.

(r) “Parent” shall mean any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(s) “Plan” shall mean the Mulberry Health Inc. 2012 Stock Plan, as in effect on the Date of Grant.

(t) “Purchase Price” shall mean the Exercise Price multiplied by the number of Shares with respect to which this option is being exercised.

(u) “Repurchase Period” shall mean a period of 90 consecutive days commencing on the date when the Optionee’s Service terminates for any reason, including (without limitation) death or disability.

(v) “Restricted Share” shall mean a Share that is subject to the Right of Repurchase.

(w) “Right of First Refusal” shall mean the Company’s right of first refusal described in Section 8.

(x) “Right of Repurchase” shall mean the Company’s right of repurchase described in Section 7.

(y) “Securities Act” shall mean the Securities Act of 1933, as amended.

(z) “Service” shall mean service as an Employee, Outside Director or Consultant.

(aa) “Share” shall mean one share of Stock, as adjusted in accordance with Section 8 of the Plan (if applicable).

(bb) “Stock” shall mean the Series A Common Stock of the Company.

 

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(cc) “Subsidiary” shall mean any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(dd) “Transferee” shall mean any person to whom the Optionee has directly or indirectly transferred any Share acquired under this Agreement.

(ee) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 8.

 

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Exhibit 10.7

MULBERRY HEALTH INC. 2012 STOCK PLAN

NOTICE OF STOCK OPTION GRANT (INSTALLMENT EXERCISE)

The Optionee has been granted the following option to purchase shares of the Series A Common Stock of Mulberry Health Inc.:

 

Name of Optionee:    «Name»
Total Number of Shares:    «TotalShares»
Type of Option:   

«ISO» Incentive Stock Option (ISO)

 

«NSO» Nonstatutory Stock Option (NSO)

Exercise Price per Share:    $ «PricePerShare»
Date of Grant:    «DateGrant»
Date Exercisable:    This option may be exercised with respect to the first «Percent»% of the Shares subject to this option when the Optionee completes «CliffPeriod» months of continuous Service beginning with the Vesting Commencement Date set forth below. This option may be exercised with respect to an additional «Fraction»% of the Shares subject to this option when the Optionee completes each month of continuous Service thereafter.
Vesting Commencement Date:    «VestComDate»
Expiration Date:    «ExpDate». This option expires earlier if the Optionee’s Service terminates earlier, as provided in Section 6 of the Stock Option Agreement, or if the Company engages in certain corporate transactions, as provided in Section 8(b) of the Plan.

By signing below, the Optionee and the Company agree that this option is granted under, and governed by the terms and conditions of, the 2012 Stock Plan and the Stock Option Agreement. Both of these documents are attached to, and made a part of, this Notice of Stock Option Grant. Section 13 of the Stock Option Agreement includes important acknowledgements of the Optionee.


OPTIONEE:     MULBERRY HEALTH INC.

 

    By:  

 

    Title:  

 


THE OPTION GRANTED PURSUANT TO THIS AGREEMENT AND THE SHARES ISSUABLE UPON THE EXERCISE THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC. 2012 STOCK PLAN:

STOCK OPTION AGREEMENT (INSTALLMENT EXERCISE)

SECTION 1. GRANT OF OPTION.

(a) Option. On the terms and conditions set forth in the Notice of Stock Option Grant and this Agreement, the Company grants to the Optionee on the Date of Grant the option to purchase at the Exercise Price the number of Shares set forth in the Notice of Stock Option Grant. The Exercise Price is agreed to be at least 100% of the Fair Market Value per Share on the Date of Grant (110% of Fair Market Value if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies). This option is intended to be an ISO or an NSO, as provided in the Notice of Stock Option Grant.

(b) $100,000 Limitation. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it shall be deemed to be an NSO to the extent (and only to the extent) required by the $100,000 annual limitation under Section 422(d) of the Code.

(c) Stock Plan and Defined Terms. This option is granted pursuant to the Plan, a copy of which the Optionee acknowledges having received. The provisions of the Plan are incorporated into this Agreement by this reference. Capitalized terms are defined in Section 14 of this Agreement.

SECTION 2. RIGHT TO EXERCISE.

(a) Exercisability. Subject to Subsection (b) below and the other conditions set forth in this Agreement, all or part of this option may be exercised prior to its expiration at the time or times set forth in the Notice of Stock Option Grant.

(b) Stockholder Approval. Any other provision of this Agreement notwithstanding, no portion of this option shall be exercisable at any time prior to the approval of the Plan by the Company’s stockholders.

SECTION 3. NO TRANSFER OR ASSIGNMENT OF OPTION.

Except as otherwise provided in this Agreement, this option and the rights and privileges conferred hereby shall not be sold, pledged or otherwise transferred (whether by operation of law or otherwise) and shall not be subject to sale under execution, attachment, levy or similar process.


SECTION 4. EXERCISE PROCEDURES.

(a) Notice of Exercise. The Optionee or the Optionee’s representative may exercise this option by giving written notice to the Company pursuant to Section 12(c). The notice shall specify the election to exercise this option, the number of Shares for which it is being exercised and the form of payment. The person exercising this option shall sign the notice. In the event that this option is being exercised by the representative of the Optionee, the notice shall be accompanied by proof (satisfactory to the Company) of the representative’s right to exercise this option. The Optionee or the Optionee’s representative shall deliver to the Company, at the time of giving the notice, payment in a form permissible under Section 5 for the full amount of the Purchase Price.

(b) Issuance of Shares. After receiving a proper notice of exercise, the Company shall cause to be issued one or more certificates evidencing the Shares for which this option has been exercised. Such Shares shall be registered (i) in the name of the person exercising this option, (ii) in the names of such person and his or her spouse as community property or as joint tenants with the right of survivorship or (iii) with the Company’s consent, in the name of a revocable trust. The Company shall cause such certificates to be delivered to or upon the order of the person exercising this option.

(c) Withholding Taxes. In the event that the Company determines that it is required to withhold any tax as a result of the exercise of this option, the Optionee, as a condition to the exercise of this option, shall make arrangements satisfactory to the Company to enable it to satisfy all withholding requirements. The Optionee shall also make arrangements satisfactory to the Company to enable it to satisfy any withholding requirements that may arise in connection with the disposition of Shares purchased by exercising this option.

SECTION 5. PAYMENT FOR STOCK.

(a) Cash. All or part of the Purchase Price may be paid in cash or cash equivalents.

(b) Surrender of Stock. At the discretion of the Board of Directors, all or any part of the Purchase Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when this option is exercised.

(c) Exercise/Sale. All or part of the Purchase Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company. However, payment pursuant to this Subsection (c) shall be permitted only if (i) Stock then is publicly traded and (ii) such payment does not violate applicable law.

 

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SECTION 6. TERM AND EXPIRATION.

(a) Basic Term. This option shall in any event expire on the expiration date set forth in the Notice of Stock Option Grant, which date is 10 years after the Date of Grant (five years after the Date of Grant if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies).

(b) Termination of Service (Except by Death). If the Optionee’s Service terminates for any reason other than death, then this option shall expire on the earliest of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) above;

(ii) The date three months after the termination of the Optionee’s Service for any reason other than Disability; or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability.

The Optionee may exercise all or part of this option at any time before its expiration under the preceding sentence, but only to the extent that this option had become exercisable before the Optionee’s Service terminated. When the Optionee’s Service terminates, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable. In the event that the Optionee dies after termination of Service but before the expiration of this option, all or part of this option may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option had become exercisable before the Optionee’s Service terminated.

(c) Death of the Optionee. If the Optionee dies while in Service, then this option shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (a) above; or

(ii) The date 12 months after the Optionee’s death.

All or part of this option may be exercised at any time before its expiration under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option had become exercisable before the Optionee’s death. When the Optionee dies, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable.

 

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(d) Part-Time Employment and Leaves of Absence. If the Optionee commences working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant. If the Optionee goes on a leave of absence, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant in accordance with the Company’s leave of absence policy or the terms of such leave. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while the Optionee is on a bona fide leave of absence, if (i) such leave was approved by the Company in writing and (ii) continued crediting of Service for such purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company). Service shall be deemed to terminate when such leave ends, unless the Optionee immediately returns to active work.

(e) Notice Concerning ISO Treatment. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it ceases to qualify for favorable tax treatment as an ISO to the extent that it is exercised:

(i) More than three months after the date when the Optionee ceases to be an Employee for any reason other than death or permanent and total disability (as defined in Section 22(e)(3) of the Code);

(ii) More than 12 months after the date when the Optionee ceases to be an Employee by reason of permanent and total disability (as defined in Section 22(e)(3) of the Code); or

(iii) More than three months after the date when the Optionee has been on a leave of absence for 90 days, unless the Optionee’s reemployment rights following such leave were guaranteed by statute or by contract.

SECTION 7. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. In the event that the Optionee proposes to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If the Optionee desires to transfer Shares acquired under this Agreement, the Optionee shall give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by the Optionee and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Subsection (b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

 

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(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, the Optionee may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which the Optionee is bound. Any proposed transfer on terms and conditions different from those described in the Transfer Notice, as well as any subsequent proposed transfer by the Optionee, shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Subsection (a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 7 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 7.

(d) Termination of Right of First Refusal. Any other provision of this Section 7 notwithstanding, in the event that the Stock is readily tradable on an established securities market when the Optionee desires to transfer Shares, the Company shall have no Right of First Refusal, and the Optionee shall have no obligation to comply with the procedures prescribed by Subsections (a) and (b) above.

(e) Permitted Transfers. This Section 7 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Shares acquired under this Agreement, either under this Subsection (e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 7, then after such time the person from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

 

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(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall assume all of the Company’s rights and obligations under this Section 7.

SECTION 8. LEGALITY OF INITIAL ISSUANCE.

No Shares shall be issued upon the exercise of this option unless and until the Company has determined that:

(a) It and the Optionee have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof;

(b) Any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; and

(c) Any other applicable provision of federal, State or foreign law has been satisfied.

SECTION 9. NO REGISTRATION RIGHTS.

The Company may, but shall not be obligated to, register or qualify the sale of Shares under the Securities Act or any other applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Shares under this Agreement to comply with any law.

SECTION 10. RESTRICTIONS ON TRANSFER OF SHARES.

(a) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on stock certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any State or any other law.

(b) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, the Optionee or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off”)

 

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shall be in effect for such period of time following the date of the final prospectus for the offering as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days plus such additional period as may reasonably be requested by the Company or such underwriter to accommodate regulatory restrictions on (i) the publication or other distribution of research reports or (ii) analyst recommendations and opinions, including (without limitation) the restrictions set forth in Rule 2711(f)(4) of the National Association of Securities Dealers and Rule 472(f)(4) of the New York Stock Exchange, as amended, or any similar successor rules. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (b). This Subsection (b) shall not apply to Shares registered in the public offering under the Securities Act.

(c) Investment Intent at Grant. The Optionee represents and agrees that the Shares to be acquired upon exercising this option will be acquired for investment, and not with a view to the sale or distribution thereof.

(d) Investment Intent at Exercise. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, the Optionee shall represent and agree at the time of exercise that the Shares being acquired upon exercising this option are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel.

(e) Legends. All certificates evidencing Shares purchased under this Agreement shall bear the following legend:

“THE SHARES REPRESENTED HEREBY MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF A WRITTEN AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED HOLDER OF THE SHARES (OR THE PREDECESSOR IN INTEREST TO THE SHARES). SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

All certificates evidencing Shares purchased under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

 

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“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.”

(f) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares sold under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(g) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 10 shall be conclusive and binding on the Optionee and all other persons.

SECTION 11. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 8(a) of the Plan, the terms of this option (including, without limitation, the number and kind of Shares subject to this option and the Exercise Price) shall be adjusted as set forth in Section 8(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, this option shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 8(b) of the Plan.

SECTION 12. MISCELLANEOUS PROVISIONS.

(a) Rights as a Stockholder. Neither the Optionee nor the Optionee’s representative shall have any rights as a stockholder with respect to any Shares subject to this option until the Optionee or the Optionee’s representative becomes entitled to receive such Shares by filing a notice of exercise and paying the Purchase Price pursuant to Sections 4 and 5.

(b) No Retention Rights. Nothing in this option or in the Plan shall confer upon the Optionee any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Optionee) or of the Optionee, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

(c) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid or (iii) deposit with Federal Express Corporation, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to the Optionee at the address that he or she most recently provided to the Company in accordance with this Subsection (c).

 

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(d) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Optionee and by an authorized officer of the Company (other than the Optionee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(e) Entire Agreement. The Notice of Stock Option Grant, this Agreement and the Plan constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(f) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

SECTION 13. ACKNOWLEDGEMENTS OF THE OPTIONEE.

(a) Tax Consequences. The Optionee agrees that the Company does not have a duty to design or administer the Plan or its other compensation programs in a manner that minimizes the Optionee’s tax liabilities. The Optionee shall not make any claim against the Company or its Board of Directors, officers or employees related to tax liabilities arising from this option or the Optionee’s other compensation. In particular, the Optionee acknowledges that this option is exempt from Section 409A of the Code only if the Exercise Price is at least equal to the Fair Market Value per Share on the Date of Grant. Since Shares are not traded on an established securities market, the determination of their Fair Market Value is made by the Board of Directors or by an independent valuation firm retained by the Company. The Optionee acknowledges that there is no guarantee in either case that the Internal Revenue Service will agree with the valuation, and the Optionee shall not make any claim against the Company or its Board of Directors, officers or employees in the event that the Internal Revenue Service asserts that the valuation was too low.

(b) Electronic Delivery of Documents. The Optionee agrees to accept by email all documents relating to the Company, the Plan or this option and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission). The Optionee also agrees that the Company may deliver these documents by posting them on a website maintained by the Company or by a third party under contract with the Company. If the Company posts these documents on a website, it shall notify the Optionee by email of their availability. The Optionee acknowledges that he or she may incur costs in connection with electronic delivery, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents. This consent shall remain in effect until this option expires or until the Optionee gives the Company written notice that it should deliver paper documents.

(c) No Notice of Expiration Date. The Optionee agrees that the Company and its officers, employees, attorneys and agents do not have any obligation to notify him or her prior to the expiration of this option pursuant to Section 6, regardless of whether this option will expire at the end of its full term or on an earlier date related to the termination of the Optionee’s Service. The Optionee further agrees that he or she has the sole responsibility for monitoring the expiration of this option and for exercising this option, if at all, before it expires. This Subsection (c) shall supersede any contrary representation that may have been made, orally or in writing, by the Company or by an officer, employee, attorney or agent of the Company.

 

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SECTION 14. DEFINITIONS.

(a) “Agreement” shall mean this Stock Option Agreement.

(b) “Board of Directors” shall mean the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

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

(d) “Committee” shall mean a committee of the Board of Directors, as described in Section 2 of the Plan.

(e) “Company” shall mean Mulberry Health Inc., a Delaware corporation.

(f) “Consultant” shall mean a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

(g) “Date of Grant” shall mean the date of grant specified in the Notice of Stock Option Grant, which date shall be the later of (i) the date on which the Board of Directors resolved to grant this option or (ii) the first day of the Optionee’s Service.

(h) “Disability” shall mean that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(i) “Employee” shall mean any individual who is a common-law employee of the Company, a Parent or a Subsidiary.

(j) “Exercise Price” shall mean the amount for which one Share may be purchased upon exercise of this option, as specified in the Notice of Stock Option Grant.

(k) “Fair Market Value” shall mean the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

(l) “Immediate Family” shall mean any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(m) “ISO” shall mean an employee incentive stock option described in Section 422(b) of the Code.

 

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(n) “Notice of Stock Option Grant” shall mean the document so entitled to which this Agreement is attached.

(o) “NSO” shall mean a stock option not described in Section 422(b) or 423(b) of the Code.

(p) “Optionee” shall mean the person named in the Notice of Stock Option Grant.

(q) “Outside Director” shall mean a member of the Board of Directors who is not an Employee.

(r) “Parent” shall mean any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(s) “Plan” shall mean the Mulberry Health Inc. 2012 Stock Plan, as in effect on the Date of Grant.

(t) “Purchase Price” shall mean the Exercise Price multiplied by the number of Shares with respect to which this option is being exercised.

(u) “Right of First Refusal” shall mean the Company’s right of first refusal described in Section 7.

(v) “Securities Act” shall mean the Securities Act of 1933, as amended.

(w) “Service” shall mean service as an Employee, Outside Director or Consultant.

(x) “Share” shall mean one share of Stock, as adjusted in accordance with Section 8 of the Plan (if applicable).

(y) “Stock” shall mean the Series A Common Stock of the Company.

(z) “Subsidiary” shall mean any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(aa) “Transferee” shall mean any person to whom the Optionee has directly or indirectly transferred any Share acquired under this Agreement.

(bb) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 7.

 

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Exhibit 10.8

MULBERRY HEALTH INC. 2012 STOCK PLAN

NOTICE OF STOCK OPTION GRANT (INSTALLMENT EXERCISE)

The Optionee has been granted the following option to purchase shares of the Series A Common Stock of Mulberry Health Inc.:

 

Name of Optionee:    Mario Schlosser
Total Number of Shares:    13,200,000
Type of Option:    Option Awards (NQ)
Exercise Price per Share:    $3.25 USD
Date of Grant:    17-Dec-2019
Date Exercisable:    1/48th of the shares subject to this grant shall vest when the optionee completes each month of continuous service following the Vesting Commencement Date. In addition, if the Company is subject to a Change in Control (as defined in the optionee’s Stock Option Agreement) before the optionee’s service terminates and the optionee is subject to an Involuntary Termination (as defined in the optionee’s Stock Option Agreement) within twelve months after such Change in Control, then 100% of the unvested option shares will vest.
Vesting Commencement Date:    01/01/2019
Expiration Date:    16-Dec-2029. This option expires earlier if the Optionee’s Service terminates earlier, as provided in Section 6 of the Stock Option Agreement, or if the Company engages in certain corporate transactions, as provided in Section 8(b) of the Plan.

By signing below, the Optionee and the Company agree that this option is granted under, and governed by the terms and conditions of, the 2012 Stock Plan and the Stock Option Agreement. Both of these documents are attached to, and made a part of, this Notice of Stock Option Grant. Section 13 of the Stock Option Agreement includes important acknowledgements of the Optionee.

 

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OPTIONEE:     MULBERRY HEALTH INC.

/s/ Mario Schlosser

    By:  

/s/ Harold Greenberg

Mario Schlosser     Name:   Harold Greenberg
Agreed on: 28-Sep-2020     Title:   Corporate Secretary

 

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THE OPTION GRANTED PURSUANT TO THIS AGREEMENT AND THE SHARES ISSUABLE UPON THE EXERCISE THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC. 2012 STOCK PLAN:

STOCK OPTION AGREEMENT (INSTALLMENT EXERCISE)

SECTION 1. GRANT OF OPTION.

(a) Option. On the terms and conditions set forth in the Notice of Stock Option Grant and this Agreement, the Company grants to the Optionee on the Date of Grant the option to purchase at the Exercise Price the number of Shares set forth in the Notice of Stock Option Grant. The Exercise Price is agreed to be at least 100% of the Fair Market Value per Share on the Date of Grant (110% of Fair Market Value if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies). This option is intended to be an ISO or an NSO, as provided in the Notice of Stock Option Grant.

(b) $100,000 Limitation. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it shall be deemed to be an NSO to the extent (and only to the extent) required by the $100,000 annual limitation under Section 422(d) of the Code.

(c) Stock Plan and Defined Terms. This option is granted pursuant to the Plan, a copy of which the Optionee acknowledges having received. The provisions of the Plan are incorporated into this Agreement by this reference. Capitalized terms are defined in Section 14 of this Agreement.

SECTION 2. RIGHT TO EXERCISE.

(a) Exercisability. Subject to Subsection (b) below and the other conditions set forth in this Agreement, all or part of this option may be exercised prior to its expiration at the time or times set forth in the Notice of Stock Option Grant.

(b) Stockholder Approval. Any other provision of this Agreement notwithstanding, no portion of this option shall be exercisable at any time prior to the approval of the Plan by the Company’s stockholders.

SECTION 3. NO TRANSFER OR ASSIGNMENT OF OPTION.

Except as otherwise provided in this Agreement, this option and the rights and privileges conferred hereby shall not be sold, pledged or otherwise transferred (whether by operation of law or otherwise) and shall not be subject to sale under execution, attachment, levy or similar process.

 

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SECTION 4. EXERCISE PROCEDURES.

(a) Notice of Exercise. The Optionee or the Optionee’s representative may exercise this option by (i) giving written notice to the Company pursuant to Section 12(c) and (ii) executing either an Adoption Agreement or a counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. The notice shall specify the election to exercise this option, the number of Shares for which it is being exercised and the form of payment. The person exercising this option shall sign the notice and the Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. In the event that this option is being exercised by the representative of the Optionee, the notice shall be accompanied by proof (satisfactory to the Company) of the representative’s right to exercise this option. The Optionee or the Optionee’s representative shall deliver to the Company, at the time of giving the notice, payment in a form permissible under Section 5 for the full amount of the Purchase Price.

(b) Issuance of Shares. After receiving a proper notice of exercise and executed Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement, the Company shall cause to be issued one or more certificates evidencing the Shares for which this option has been exercised. Such Shares shall be registered (i) in the name of the person exercising this option, (ii) in the names of such person and his or her spouse as community property or as joint tenants with the right of survivorship or (iii) with the Company’s consent, in the name of a revocable trust. The Company shall cause such certificates to be delivered to or upon the order of the person exercising this option.

(c) Withholding Taxes. In the event that the Company determines that it is required to withhold any tax as a result of the exercise of this option, the Optionee, as a condition to the exercise of this option, shall make arrangements satisfactory to the Company to enable it to satisfy all withholding requirements. The Optionee shall also make arrangements satisfactory to the Company to enable it to satisfy any withholding requirements that may arise in connection with the disposition of Shares purchased by exercising this option.

SECTION 5. PAYMENT FOR STOCK.

(a) Cash. All or part of the Purchase Price may be paid in cash or cash equivalents.

(b) Surrender of Stock. At the discretion of the Board of Directors, all or any part of the Purchase Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when this option is exercised.

(c) Exercise/Sale. All or part of the Purchase Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company. However, payment pursuant to this Subsection (c) shall be permitted only if (i) Stock then is publicly traded and (ii) such payment does not violate applicable law.

 

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SECTION 6. TERM AND EXPIRATION.

(a) Basic Term. This option shall in any event expire on the expiration date set forth in the Notice of Stock Option Grant, which date is 10 years after the Date of Grant (five years after the Date of Grant if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies).

(b) Termination of Service (Except by Death). If the Optionee’s Service terminates for any reason other than death, then this option shall expire on the earliest of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) above;

(ii) The date three months after the termination of the Optionee’s Service for any reason other than Disability; or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability.

The Optionee may exercise all or part of this option at any time before its expiration under the preceding sentence, but only to the extent that this option had become exercisable before the Optionee’s Service terminated. When the Optionee’s Service terminates, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable. In the event that the Optionee dies after termination of Service but before the expiration of this option, all or part of this option may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option had become exercisable before the Optionee’s Service terminated.

(c) Death of the Optionee. If the Optionee dies while in Service, then this option shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (a) above; or

(ii) The date 12 months after the Optionee’s death.

All or part of this option may be exercised at any time before its expiration under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option had become exercisable before the Optionee’s death. When the Optionee dies, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable.

 

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(d) Part-Time Employment and Leaves of Absence. If the Optionee commences working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant. If the Optionee goes on a leave of absence, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant in accordance with the Company’s leave of absence policy or the terms of such leave. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while the Optionee is on a bona fide leave of absence, if (i) such leave was approved by the Company in writing and (ii) continued crediting of Service for such purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company). Service shall be deemed to terminate when such leave ends, unless the Optionee immediately returns to active work.

(e) Notice Concerning ISO Treatment. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it ceases to qualify for favorable tax treatment as an ISO to the extent that it is exercised:

(i) More than three months after the date when the Optionee ceases to be an Employee for any reason other than death or permanent and total disability (as defined in Section 22(e)(3) of the Code);

(ii) More than 12 months after the date when the Optionee ceases to be an Employee by reason of permanent and total disability (as defined in Section 22(e)(3) of the Code); or

(iii) More than three months after the date when the Optionee has been on a leave of absence for 90 days, unless the Optionee’s reemployment rights following such leave were guaranteed by statute or by contract.

SECTION 7. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. Subject to Section 10(a) below, in the event that the Optionee proposes to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If the Optionee desires to transfer Shares acquired under this Agreement, the Optionee shall give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by the Optionee and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Subsection (b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

 

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(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, the Optionee may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which the Optionee is bound. Any proposed transfer on terms and conditions different from those described in the Transfer Notice, as well as any subsequent proposed transfer by the Optionee, shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Subsection (a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 7 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 7.

(d) Termination of Right of First Refusal. Any other provision of this Section 7 notwithstanding, in the event that the Stock is readily tradable on an established securities market when the Optionee desires to transfer Shares, the Company shall have no Right of First Refusal, and the Optionee shall have no obligation to comply with the procedures prescribed by Subsections (a) and (b) above.

(e) Permitted Transfers. This Section 7 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Shares acquired under this Agreement, either under this Subsection (e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 7, then after such time the person

 

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from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall assume all of the Company’s rights and obligations under this Section 7.

SECTION 8. LEGALITY OF INITIAL ISSUANCE.

No Shares shall be issued upon the exercise of this option unless and until the Company has determined that:

(a) It and the Optionee have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof;

(b) Any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; and

(c) Any other applicable provision of federal, State or foreign law has been satisfied.

SECTION 9. NO REGISTRATION RIGHTS.

The Company may, but shall not be obligated to, register or qualify the sale of Shares under the Securities Act or any other applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Shares under this Agreement to comply with any law.

SECTION 10. RESTRICTIONS ON TRANSFER OF SHARES.

(a) Bylaws Restrictions. The Shares acquired under this Agreement shall be subject to the transfer restrictions in Article X of the Company’s Second Amended and Restated Bylaws in addition to, and not in limitation of, the provisions of Section 7 of this Agreement.

(b) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on stock certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any State or any other law.

 

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(c) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, the Optionee or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date of the final prospectus for the offering as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days plus such additional period as may reasonably be requested by the Company or such underwriter to accommodate regulatory restrictions on (i) the publication or other distribution of research reports or (ii) analyst recommendations and opinions, including (without limitation) the restrictions set forth in Rule 2711(f)(4) of the National Association of Securities Dealers and Rule 472(f)(4) of the New York Stock Exchange, as amended, or any similar successor rules. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (c). This Subsection (c) shall not apply to Shares registered in the public offering under the Securities Act.

(d) Investment Intent at Grant. The Optionee represents and agrees that the Shares to be acquired upon exercising this option will be acquired for investment, and not with a view to the sale or distribution thereof.

(e) Investment Intent at Exercise. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, the Optionee shall represent and agree at the time of exercise that the Shares being acquired upon exercising this option are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel.

(f) Legends. All certificates evidencing Shares purchased under this Agreement shall bear the following legends:

“THE SHARES REPRESENTED HEREBY MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF A WRITTEN AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED HOLDER OF THE SHARES (OR THE PREDECESSOR IN INTEREST TO THE SHARES). SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN

 

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RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

“THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE BYLAWS OF THE CORPORATION. COPIES OF THE BYLAWS OF THE CORPORATION MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE CORPORATION.”

All certificates evidencing Shares purchased under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.”

(g) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares sold under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(h) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 10 shall be conclusive and binding on the Optionee and all other persons.

SECTION 11. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 8(a) of the Plan, the terms of this option (including, without limitation, the number and kind of Shares subject to this option and the Exercise Price) shall be adjusted as set forth in Section 8(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, this option shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 8(b) of the Plan.

SECTION 12. MISCELLANEOUS PROVISIONS.

(a) Rights as a Stockholder. Neither the Optionee nor the Optionee’s representative shall have any rights as a stockholder with respect to any Shares subject to this option until the Optionee or the Optionee’s representative becomes entitled to receive such Shares by filing a notice of exercise and paying the Purchase Price pursuant to Sections 4 and 5.

 

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(b) No Retention Rights. Nothing in this option or in the Plan shall confer upon the Optionee any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Optionee) or of the Optionee, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

(c) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid or (iii) deposit with Federal Express Corporation, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to the Optionee at the address that he or she most recently provided to the Company in accordance with this Subsection (c).

(d) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Optionee and by an authorized officer of the Company (other than the Optionee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(e) Entire Agreement. The Notice of Stock Option Grant, this Agreement and the Plan constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(f) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

SECTION 13. ACKNOWLEDGEMENTS OF THE OPTIONEE.

(a) Tax Consequences. The Optionee agrees that the Company does not have a duty to design or administer the Plan or its other compensation programs in a manner that minimizes the Optionee’s tax liabilities. The Optionee shall not make any claim against the Company or its Board of Directors, officers or employees related to tax liabilities arising from this option or the Optionee’s other compensation. In particular, the Optionee acknowledges that this option is exempt from Section 409A of the Code only if the Exercise Price is at least equal to the Fair Market Value per Share on the Date of Grant. Since Shares are not traded on an established securities market, the determination of their Fair Market Value is made by the Board of Directors or by an independent valuation firm retained by the Company. The Optionee acknowledges that there is no guarantee in either case that the Internal Revenue Service will agree with the valuation, and the Optionee shall not make any claim against the Company or its Board of Directors, officers or employees in the event that the Internal Revenue Service asserts that the valuation was too low.

 

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(b) Electronic Delivery of Documents. The Optionee agrees to accept by email all documents relating to the Company, the Plan or this option and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission). The Optionee also agrees that the Company may deliver these documents by posting them on a website maintained by the Company or by a third party under contract with the Company. If the Company posts these documents on a website, it shall notify the Optionee by email of their availability. The Optionee acknowledges that he or she may incur costs in connection with electronic delivery, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents. This consent shall remain in effect until this option expires or until the Optionee gives the Company written notice that it should deliver paper documents.

(c) No Notice of Expiration Date. The Optionee agrees that the Company and its officers, employees, attorneys and agents do not have any obligation to notify him or her prior to the expiration of this option pursuant to Section 6, regardless of whether this option will expire at the end of its full term or on an earlier date related to the termination of the Optionee’s Service. The Optionee further agrees that he or she has the sole responsibility for monitoring the expiration of this option and for exercising this option, if at all, before it expires. This Subsection (c) shall supersede any contrary representation that may have been made, orally or in writing, by the Company or by an officer, employee, attorney or agent of the Company.

SECTION 14. DEFINITIONS.

(a) “Adoption Agreement” shall mean an Adoption Agreement to the Voting Agreement, substantially in the form attached as Exhibit A thereto.

(b) “Agreement” shall mean this Stock Option Agreement.

(c) “Board of Directors” shall mean the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

(d) “Co-Sale Agreement” shall mean that certain Seventh Amended and Restated First Refusal and Co-Sale Agreement, dated as of January 20, 2016, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

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

(f) “Committee” shall mean a committee of the Board of Directors, as described in Section 2 of the Plan.

(g) “Company” shall mean Mulberry Health Inc., a Delaware corporation.

(h) “Consultant” shall mean a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

 

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(i) “Date of Grant” shall mean the date of grant specified in the Notice of Stock Option Grant, which date shall be the later of (i) the date on which the Board of Directors resolved to grant this option or (ii) the first day of the Optionee’s Service.

(j) “Disability” shall mean that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(k) “Employee” shall mean any individual who is a common-law employee of the Company, a Parent or a Subsidiary.

(l) “Exercise Price” shall mean the amount for which one Share may be purchased upon exercise of this option, as specified in the Notice of Stock Option Grant.

(m) “Fair Market Value” shall mean the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

(n) “Immediate Family” shall mean any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(o) “ISO” shall mean an employee incentive stock option described in Section 422(b) of the Code.

(p) “Notice of Stock Option Grant” shall mean the document so entitled to which this Agreement is attached.

(q) “NSO” shall mean a stock option not described in Section 422(b) or 423(b) of the Code.

(r) “Optionee” shall mean the person named in the Notice of Stock Option Grant.

(s) “Outside Director” shall mean a member of the Board of Directors who is not an Employee.

(t) “Parent” shall mean any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(u) “Plan” shall mean the Mulberry Health Inc. 2012 Stock Plan, as in effect on the Date of Grant.

(v) “Purchase Price” shall mean the Exercise Price multiplied by the number of Shares with respect to which this option is being exercised.

 

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(w) “Right of First Refusal” shall mean the Company’s right of first refusal described in Section 7.

(x) “Securities Act” shall mean the Securities Act of 1933, as amended.

(y) “Service” shall mean service as an Employee, Outside Director or Consultant.

(z) “Share” shall mean one share of Stock, as adjusted in accordance with Section 8 of the Plan (if applicable).

(aa) “Stock” shall mean the Series A Common Stock of the Company.

(bb) “Subsidiary” shall mean any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(cc) “Transferee” shall mean any person to whom the Optionee has directly or indirectly transferred any Share acquired under this Agreement.

(dd) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 7.

(ee) “Voting Agreement” shall mean that certain Seventh Amended and Restated Voting Agreement, dated as of January 20, 2016, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

 

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Exhibit 10.9

MULBERRY HEALTH INC. 2012 STOCK PLAN

NOTICE OF STOCK OPTION GRANT (EARLY EXERCISE)

The Optionee has been granted the following option to purchase shares of the Series A Common Stock of Mulberry Health Inc.:

 

Name of Optionee:    Meghan Verena Joyce
Total Number of Shares:    4,500,000
Type of Option:    Non-statutory Stock Option (NSO)
Exercise Price per Share:    $3.17
Date of Grant:    August 30, 2019
Date Exercisable:    This option may be exercised at any time after the Date of Grant for all or any part of the Shares subject to this option.
  
Vesting Commencement Date:    September 9, 2019
Vesting Schedule:    The Right of Repurchase shall lapse with respect to the first 25% of the Shares subject to this option when the Optionee completes 12 months of continuous Service beginning with the Vesting Commencement Date set forth above. The Right of Repurchase shall lapse with respect to an additional 1/48th of the Shares subject to this option when the Optionee completes each month of continuous Service thereafter. The Right of Repurchase may lapse on an accelerated basis under Section 7(b) of the Stock Option Agreement.
Expiration Date:    August 29, 2029. This option expires earlier if the Optionee’s Service terminates earlier, as provided in Section 6 of the Stock Option Agreement, or if the Company engages in certain corporate transactions, as provided in Section 8(b) of the Plan.
  

By signing below, the Optionee and the Company agree that this option is granted under, and governed by the terms and conditions of, the 2012 Stock Plan and the Stock Option Agreement. Both of these documents are attached to, and made a part of, this Notice of Stock Option Grant. Section 14 of the Stock Option Agreement includes important acknowledgements of the Optionee.

 

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OPTIONEE:     MULBERRY HEALTH INC.

/s/ Meghan Verena Joyce

    By:   /s/ Mario Schlosser
Meghan Verena Joyce     Name: Mario Schlosser
    Title: CEO

 

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THE OPTION GRANTED PURSUANT TO THIS AGREEMENT AND THE SHARES ISSUABLE UPON THE EXERCISE THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC. 2012 STOCK PLAN:

STOCK OPTION AGREEMENT (EARLY EXERCISE)

SECTION 1. GRANT OF OPTION.

(a) Option. On the terms and conditions set forth in the Notice of Stock Option Grant and this Agreement, the Company grants to the Optionee on the Date of Grant the option to purchase at the Exercise Price the number of Shares set forth in the Notice of Stock Option Grant. The Exercise Price is agreed to be at least 100% of the Fair Market Value per Share on the Date of Grant (110% of Fair Market Value if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies). This option is intended to be an ISO or an NSO, as provided in the Notice of Stock Option Grant.

(b) $100,000 Limitation. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it shall be deemed to be an NSO to the extent (and only to the extent) required by the $100,000 annual limitation under Section 422(d) of the Code.

(c) Stock Plan and Defined Terms. This option is granted pursuant to the Plan, a copy of which the Optionee acknowledges having received. The provisions of the Plan are incorporated into this Agreement by this reference. Capitalized terms are defined in Section 15 of this Agreement.

SECTION 2. RIGHT TO EXERCISE.

(a) Exercisability. Subject to Subsection (b) below and the other conditions set forth in this Agreement, all or part of this option may be exercised prior to its expiration at the time or times set forth in the Notice of Stock Option Grant. Shares purchased by exercising this option may be subject to the Right of Repurchase under Section 7.

(b) Stockholder Approval. Any other provision of this Agreement notwithstanding, no portion of this option shall be exercisable at any time prior to the approval of the Plan by the Company’s stockholders.

 

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SECTION 3. NO TRANSFER OR ASSIGNMENT OF OPTION.

Except as otherwise provided in this Agreement, this option and the rights and privileges conferred hereby shall not be sold, pledged or otherwise transferred (whether by operation of law or otherwise) and shall not be subject to sale under execution, attachment, levy or similar process.

SECTION 4. EXERCISE PROCEDURES.

(a) Notice of Exercise. The Optionee or the Optionee’s representative may exercise this option by (i) giving written notice to the Company pursuant to Section 13(c) and (ii) executing either an Adoption Agreement or a counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. The notice shall specify the election to exercise this option, the number of Shares for which it is being exercised and the form of payment. The person exercising this option shall sign the notice and the Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. In the event that this option is being exercised by the representative of the Optionee, the notice shall be accompanied by proof (satisfactory to the Company) of the representative’s right to exercise this option. The Optionee or the Optionee’s representative shall deliver to the Company, at the time of giving the notice, payment in a form permissible under Section 5 for the full amount of the Purchase Price. In the event of a partial exercise of this option, Shares shall be deemed to have been purchased in the order in which they vest in accordance with the Notice of Stock Option Grant.

(b) Issuance of Shares. After receiving a proper notice of exercise and executed Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement, the Company shall cause to be issued one or more certificates evidencing the Shares for which this option has been exercised. Such Shares shall be registered (i) in the name of the person exercising this option, (ii) in the names of such person and his or her spouse as community property or as joint tenants with the right of survivorship or (iii) with the Company’s consent, in the name of a revocable trust. In the case of Restricted Shares, the Company shall cause such certificates to be deposited in escrow under Section 7(c). In the case of other Shares, the Company shall cause such certificates to be delivered to or upon the order of the person exercising this option.

(c) Withholding Taxes. In the event that the Company determines that it is required to withhold any tax as a result of the exercise of this option, the Optionee, as a condition to the exercise of this option, shall make arrangements satisfactory to the Company to enable it to satisfy all withholding requirements. The Optionee shall also make arrangements satisfactory to the Company to enable it to satisfy any withholding requirements that may arise in connection with the vesting or disposition of Shares purchased by exercising this option.

SECTION 5. PAYMENT FOR STOCK.

(a) Cash. All or part of the Purchase Price may be paid in cash or cash equivalents.

 

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(b) Surrender of Stock. At the discretion of the Board of Directors, all or any part of the Purchase Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when this option is exercised.

(c) Exercise/Sale. All or part of the Purchase Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company. However, payment pursuant to this Subsection (c) shall be permitted only if (i) Stock then is publicly traded and (ii) such payment does not violate applicable law.

SECTION 6. TERM AND EXPIRATION.

(a) Basic Term. This option shall in any event expire on the expiration date set forth in the Notice of Stock Option Grant, which date is 10 years after the Date of Grant (five years after the Date of Grant if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies).

(b) Termination of Service (Except by Death). If the Optionee’s Service terminates for any reason other than death, then this option shall expire on the earliest of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) above;

(ii) The date three years after the termination of the Optionee’s Service for any reason other than Disability; or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability.

The Optionee may exercise all or part of this option at any time before its expiration under the preceding sentence, but only to the extent that this option is exercisable for vested Shares on or before the date when the Optionee’s Service terminates. When the Optionee’s Service terminates, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable and with respect to any Restricted Shares. In the event that the Optionee dies after termination of Service but before the expiration of this option, all or part of this option may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option was exercisable for vested Shares on or before the date when the Optionee’s Service terminated.

(c) Death of the Optionee. If the Optionee dies while in Service, then this option shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (a) above; or

 

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(ii) The date 12 months after the Optionee’s death.

All or part of this option may be exercised at any time before its expiration under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option is exercisable for vested Shares on or before the date of the Optionee’s death. When the Optionee dies, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable and with respect to any Restricted Shares.

(d) Part-Time Employment and Leaves of Absence. If the Optionee commences working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant. If the Optionee goes on a leave of absence, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant in accordance with the Company’s leave of absence policy or the terms of such leave. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while the Optionee is on a bona fide leave of absence, if (i) such leave was approved by the Company in writing and (ii) continued crediting of Service for such purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company). Service shall be deemed to terminate when such leave ends, unless the Optionee immediately returns to active work.

(e) Notice Concerning ISO Treatment. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it ceases to qualify for favorable tax treatment as an ISO to the extent that it is exercised:

(i) More than three months after the date when the Optionee ceases to be an Employee for any reason other than death or permanent and total disability (as defined in Section 22(e)(3) of the Code);

(ii) More than 12 months after the date when the Optionee ceases to be an Employee by reason of permanent and total disability (as defined in Section 22(e)(3) of the Code); or

(iii) More than three months after the date when the Optionee has been on a leave of absence for 90 days, unless the Optionee’s reemployment rights following such leave were guaranteed by statute or by contract.

SECTION 7. RIGHT OF REPURCHASE.

(a) Scope of Repurchase Right. Until they vest in accordance with the Notice of Stock Option Grant and Subsection (b) below, the Shares acquired under this Agreement shall be Restricted Shares and shall be subject to the Company’s Right of Repurchase. The Company, however, may decline to exercise its Right of Repurchase or may exercise its Right of Repurchase only with respect to a portion of the Restricted Shares. The Company may exercise its Right of Repurchase only during the Repurchase Period following the termination of the Optionee’s Service, but the Right of Repurchase may be exercised automatically under Subsection (d) below. If the Right of Repurchase is exercised, the Company shall pay the Optionee an amount equal to the lower of (i) the Exercise Price of each Restricted Share being repurchased or (ii) the Fair Market Value of such Restricted Share at the time the Right of Repurchase is exercised.

 

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(b) Lapse of Repurchase Right. The Right of Repurchase shall lapse with respect to the Restricted Shares in accordance with the vesting schedule set forth in the Notice of Stock Option Grant. In addition, if the Company is subject to a Change in Control before the Optionee’s Service terminates and the Optionee is subject to an Involuntary Termination within 12 months after such Change in Control, then all of the then Restricted Shares shall become vested and the Right of Repurchase shall lapse with respect to such then Restricted Shares.

(c) Escrow. Upon issuance, the certificate(s) for Restricted Shares shall be deposited in escrow with the Company to be held in accordance with the provisions of this Agreement. Any additional or exchanged securities or other property described in Subsection (f) below shall immediately be delivered to the Company to be held in escrow. All ordinary cash dividends on Restricted Shares (or on other securities held in escrow) shall be paid directly to the Optionee and shall not be held in escrow. Restricted Shares, together with any other assets held in escrow under this Agreement, shall be (i) surrendered to the Company for repurchase upon exercise of the Right of Repurchase or the Right of First Refusal or (ii) released to the Optionee upon his or her request to the extent that the Shares have ceased to be Restricted Shares (but not more frequently than once every six months). In any event, all Shares that have ceased to be Restricted Shares, together with any other vested assets held in escrow under this Agreement, shall be released within 90 days after the earlier of (i) the termination of the Optionee’s Service or (ii) the lapse of the Right of First Refusal.

(d) Exercise of Repurchase Right. The Company shall be deemed to have exercised its Right of Repurchase automatically for all Restricted Shares as of the commencement of the Repurchase Period, unless the Company during the Repurchase Period notifies the holder of the Restricted Shares pursuant to Section 13(c) that it will not exercise its Right of Repurchase for some or all of the Restricted Shares. The Company shall pay to the holder of the Restricted Shares the purchase price determined under Subsection (a) above for the Restricted Shares being repurchased. Payment shall be made in cash or cash equivalents and/or by canceling indebtedness to the Company incurred by the Optionee in the purchase of the Restricted Shares. The certificate(s) representing the Restricted Shares being repurchased shall be delivered to the Company.

(e) Termination of Rights as Stockholder. If the Right of Repurchase is exercised in accordance with this Section 7 and the Company makes available the consideration for the Restricted Shares being repurchased, then the person from whom the Restricted Shares are repurchased shall no longer have any rights as a holder of the Restricted Shares (other than the right to receive payment of such consideration). Such Restricted Shares shall be deemed to have been repurchased pursuant to this Section 7, whether or not the certificate(s) for such Restricted Shares have been delivered to the Company or the consideration for such Restricted Shares has been accepted.

 

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(f) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Restricted Shares shall immediately be subject to the Right of Repurchase. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Restricted Shares. Appropriate adjustments shall also be made to the price per share to be paid upon the exercise of the Right of Repurchase, provided that the aggregate purchase price payable for the Restricted Shares shall remain the same. In the event of a merger or consolidation of the Company with or into another entity or any other corporate reorganization, the Right of Repurchase may be exercised by the Company’s successor.

(g) Transfer of Restricted Shares. The Optionee shall not transfer, assign, encumber or otherwise dispose of any Restricted Shares without the Company’s written consent, except as provided in the following sentence. The Optionee may transfer Restricted Shares to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Restricted Shares, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(h) Assignment of Repurchase Right. The Board of Directors may freely assign the Company’s Right of Repurchase, in whole or in part. Any person who accepts an assignment of the Right of Repurchase from the Company shall assume all of the Company’s rights and obligations under this Section 7.

SECTION 8. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. Subject to Section 11(a) below, in the event that the Optionee proposes to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If the Optionee desires to transfer Shares acquired under this Agreement, the Optionee shall give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by the Optionee and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Subsection (b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

 

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(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, the Optionee may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which the Optionee is bound. Any proposed transfer on terms and conditions different from those described in the Transfer Notice, as well as any subsequent proposed transfer by the Optionee, shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Subsection (a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 8 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 8.

(d) Termination of Right of First Refusal. Any other provision of this Section 8 notwithstanding, in the event that the Stock is readily tradable on an established securities market when the Optionee desires to transfer Shares, the Company shall have no Right of First Refusal, and the Optionee shall have no obligation to comply with the procedures prescribed by Subsections (a) and (b) above.

(e) Permitted Transfers. This Section 8 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Shares acquired under this Agreement, either under this Subsection (e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 8, then after such time the person from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

 

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(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall assume all of the Company’s rights and obligations under this Section 8.

SECTION 9. LEGALITY OF INITIAL ISSUANCE.

No Shares shall be issued upon the exercise of this option unless and until the Company has determined that:

(a) It and the Optionee have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof;

(b) Any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; and

(c) Any other applicable provision of federal, State or foreign law has been satisfied.

SECTION 10. NO REGISTRATION RIGHTS.

The Company may, but shall not be obligated to, register or qualify the sale of Shares under the Securities Act or any other applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Shares under this Agreement to comply with any law.

SECTION 11. RESTRICTIONS ON TRANSFER OF SHARES.

(a) Bylaws Restrictions. The Shares acquired under this Agreement shall be subject to the transfer restrictions in Article X of the Company’s Second Amended and Restated Bylaws in addition to, and not in limitation of, the provisions of Section 8 of this Agreement.

(b) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on stock certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any State or any other law.

(c) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, the Optionee or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant

 

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or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date of the final prospectus for the offering as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days plus such additional period as may reasonably be requested by the Company or such underwriter to accommodate regulatory restrictions on (i) the publication or other distribution of research reports or (ii) analyst recommendations and opinions, including (without limitation) the restrictions set forth in Rule 2711(f)(4) of the National Association of Securities Dealers and Rule 472(f)(4) of the New York Stock Exchange, as amended, or any similar successor rules. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (c). This Subsection (c) shall not apply to Shares registered in the public offering under the Securities Act.

(d) Investment Intent at Grant. The Optionee represents and agrees that the Shares to be acquired upon exercising this option will be acquired for investment, and not with a view to the sale or distribution thereof.

(e) Investment Intent at Exercise. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, the Optionee shall represent and agree at the time of exercise that the Shares being acquired upon exercising this option are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel.

(f) Legends. All certificates evidencing Shares purchased under this Agreement shall bear the following legends:

“THE SHARES REPRESENTED HEREBY MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF A WRITTEN AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED HOLDER OF THE SHARES (OR THE PREDECESSOR IN INTEREST TO THE SHARES). SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES AND CERTAIN REPURCHASE RIGHTS UPON TERMINATION OF SERVICE WITH THE COMPANY. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

 

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“THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE BYLAWS OF THE CORPORATION. COPIES OF THE BYLAWS OF THE CORPORATION MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE CORPORATION.”

All certificates evidencing Shares purchased under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.”

(g) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares sold under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(h) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 11 shall be conclusive and binding on the Optionee and all other persons.

SECTION 12. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 8(a) of the Plan, the terms of this option (including, without limitation, the number and kind of Shares subject to this option and the Exercise Price) shall be adjusted as set forth in Section 8(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, this option shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 8(b) of the Plan.

SECTION 13. MISCELLANEOUS PROVISIONS.

(a) Rights as a Stockholder. Neither the Optionee nor the Optionee’s representative shall have any rights as a stockholder with respect to any Shares subject to this option until the Optionee or the Optionee’s representative becomes entitled to receive such Shares by filing a notice of exercise and paying the Purchase Price pursuant to Sections 4 and 5.

(b) No Retention Rights. Nothing in this option or in the Plan shall confer upon the Optionee any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Optionee) or of the Optionee, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

 

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(c) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid or (iii) deposit with Federal Express Corporation, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to the Optionee at the address that he or she most recently provided to the Company in accordance with this Subsection (c).

(d) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Optionee and by an authorized officer of the Company (other than the Optionee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(e) Entire Agreement. The Notice of Stock Option Grant, this Agreement and the Plan constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(f) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

SECTION 14. ACKNOWLEDGEMENTS OF THE OPTIONEE.

(a) Tax Consequences. The Optionee agrees that the Company does not have a duty to design or administer the Plan or its other compensation programs in a manner that minimizes the Optionee’s tax liabilities. The Optionee shall not make any claim against the Company or its Board of Directors, officers or employees related to tax liabilities arising from this option or the Optionee’s other compensation. In particular, the Optionee acknowledges that this option is exempt from Section 409A of the Code only if the Exercise Price is at least equal to the Fair Market Value per Share on the Date of Grant. Since Shares are not traded on an established securities market, the determination of their Fair Market Value is made by the Board of Directors or by an independent valuation firm retained by the Company. The Optionee acknowledges that there is no guarantee in either case that the Internal Revenue Service will agree with the valuation, and the Optionee shall not make any claim against the Company or its Board of Directors, officers or employees in the event that the Internal Revenue Service asserts that the valuation was too low.

(b) Electronic Delivery of Documents. The Optionee agrees to accept by email all documents relating to the Company, the Plan or this option and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission). The Optionee also agrees that

 

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the Company may deliver these documents by posting them on a website maintained by the Company or by a third party under contract with the Company. If the Company posts these documents on a website, it shall notify the Optionee by email of their availability. The Optionee acknowledges that he or she may incur costs in connection with electronic delivery, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents. This consent shall remain in effect until this option expires or until the Optionee gives the Company written notice that it should deliver paper documents.

(c) No Notice of Expiration Date. The Optionee agrees that the Company and its officers, employees, attorneys and agents do not have any obligation to notify him or her prior to the expiration of this option pursuant to Section 6, regardless of whether this option will expire at the end of its full term or on an earlier date related to the termination of the Optionee’s Service. The Optionee further agrees that he or she has the sole responsibility for monitoring the expiration of this option and for exercising this option, if at all, before it expires. This Subsection (c) shall supersede any contrary representation that may have been made, orally or in writing, by the Company or by an officer, employee, attorney or agent of the Company.

SECTION 15. DEFINITIONS.

(a) “Adoption Agreement” shall mean an Adoption Agreement to the Voting Agreement, substantially in the form attached as Exhibit A thereto.

(b) “Agreement” shall mean this Stock Option Agreement.

(c) “Board of Directors” shall mean the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

(d) “Cause” shall mean:

(i) An unauthorized use or disclosure by the Optionee of the Company’s confidential information or trade secrets, which use or disclosure causes material harm to the Company;

(ii) A material breach by the Optionee of any agreement between the Optionee and the Company;

(iii) A material failure by the Optionee to comply with the Company’s written policies or rules;

(iv) The Optionee’s conviction of, or plea of “guilty” or “no contest” to, a felony under the laws of the United States or any State thereof;

(v) The Optionee’s gross negligence or willful misconduct;

(vi) A continuing failure by the Optionee to perform assigned duties after receiving written notification of such failure from the Board of Directors; or

 

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(vii) A failure by the Optionee to cooperate in good faith with a governmental or internal investigation of the Company or its directors, officers or employees, if the Company has requested the Optionee’s cooperation.

(e) “Change in Control” shall mean (i) the consummation of a merger or consolidation of the Company with or into another entity; or (ii) the dissolution, liquidation or winding up of the Company. The foregoing notwithstanding, a merger or consolidation of the Company does not constitute a “Change in Control” if immediately after the merger or consolidation a majority of the voting power of the capital stock of the continuing or surviving entity, or any direct or indirect parent corporation of the continuing or surviving entity, will be owned by the persons who were the Company’s stockholders immediately prior to such merger or consolidation in substantially the same proportions as their ownership of the voting power of the Company’s capital stock immediately prior to the merger or consolidation.

(f) “Co-Sale Agreement” shall mean that certain Seventh Amended and Restated First Refusal and Co-Sale Agreement, dated as of January 20, 2016, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

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

(h) “Committee” shall mean a committee of the Board of Directors, as described in Section 2 of the Plan.

(i) “Company” shall mean Mulberry Health Inc., a Delaware corporation.

(j) “Consultant” shall mean a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

(k) “Date of Grant” shall mean the date of grant specified in the Notice of Stock Option Grant, which date shall be the later of (i) the date on which the Board of Directors resolved to grant this option or (ii) the first day of the Optionee’s Service.

(l) “Disability” shall mean that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(m) “Employee” shall mean any individual who is a common-law employee of the Company, a Parent or a Subsidiary.

(n) “Exercise Price” shall mean the amount for which one Share may be purchased upon exercise of this option, as specified in the Notice of Stock Option Grant.

(o) “Fair Market Value” shall mean the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

 

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(p) “Immediate Family” shall mean any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(q) “Involuntary Termination” means either (a) the Optionee’s Termination Without Cause or (b) the Optionee’s Resignation for Good Reason.

(r) “ISO” shall mean an employee incentive stock option described in Section 422(b) of the Code.

(s) “Notice of Stock Option Grant” shall mean the document so entitled to which this Agreement is attached.

(t) “NSO” shall mean a stock option not described in Sections 422(b) or 423(b) of the Code.

(u) “Optionee” shall mean the person named in the Notice of Stock Option Grant.

(v) “Outside Director” shall mean a member of the Board of Directors who is not an Employee.

(w) “Parent” shall mean any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(x) “Plan” shall mean the Mulberry Health Inc. 2012 Stock Plan, as in effect on the Date of Grant.

(y) “Purchase Price” shall mean the Exercise Price multiplied by the number of Shares with respect to which this option is being exercised.

(z) “Repurchase Period” shall mean a period of 90 consecutive days commencing on the date when the Optionee’s Service terminates for any reason, including (without limitation) death or disability.

(aa) “Resignation for Good Reason” means a Separation as a result of your resignation within 12 months after one of the following conditions has come into existence without your written consent: (i) a reduction in your base salary; (ii) a material diminution of your position, authority, duties or responsibilities; (iii) a relocation of your principal workplace (A) by more than 25 miles or (B) away from the Company’s headquarters or (iv) a material breach of this Agreement (including for the avoidance of doubt, failure to make the Option grants in violation of Section 4) or any equity agreement by the Company or any of its affiliates. A Resignation for Good Reason shall not be deemed to have occurred unless you give the Company written notice of the condition within 90 days after the condition comes into existence and the Company fails to remedy the condition within 30 days after receiving such written notice.

 

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(bb) “Restricted Share” shall mean a Share that is subject to the Right of Repurchase.

(cc) “Right of First Refusal” shall mean the Company’s right of first refusal described in Section 8.

(dd) “Right of Repurchase” shall mean the Company’s right of repurchase described in Section 7.

(ee) “Securities Act” shall mean the Securities Act of 1933, as amended.

(ff) “Separation” means a “separation from service,” as defined in the regulations under Section 409A of the Code.

(gg) “Service” shall mean service as an Employee, Outside Director or Consultant.

(hh) “Share” shall mean one share of Stock, as adjusted in accordance with Section 8 of the Plan (if applicable).

(ii) “Stock” shall mean the Series A Common Stock of the Company.

(jj) “Subsidiary” shall mean any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

(kk) “Termination Without Cause” means a Separation as a result of a termination of the Optionee’s employment by the Company without Cause, provided the Optionee is willing and able to continue performing services within the meaning of Treasury Regulation 1.409A-1(n)(1).

(ll) “Transferee” shall mean any person to whom the Optionee has directly or indirectly transferred any Share acquired under this Agreement.

(mm) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 8.

(nn) “Voting Agreement” shall mean that certain Seventh Amended and Restated Voting Agreement, dated as of January 20, 2016, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

 

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Exhibit 10.10

MULBERRY HEALTH INC.

2012 STOCK PLAN

NOTICE OF RESTRICTED STOCK UNIT AWARD

You (“Recipient”) have been granted Restricted Stock Units (“RSUs”) representing shares of the Common Stock of Mulberry Health Inc. (the “Company”) on the following terms:

 

Name of Recipient:

   «Name»

Total Number of RSUs Granted:

   «TotalRSUs»

Date of Grant:

   «DateGrant»

Vesting:

   Subject to your continuous Service through the applicable vesting date, [25%] of the total number of RSUs specified above will vest on [INITIAL VESTING DATE] and an additional [6.25%] of the total number of RSUs specified above will vest on each Company Vesting Date thereafter. The “Company Vesting Dates” are [February 15], [May 15], [August 15] and [November 15]1 each year.

Settlement:

   Settlement of RSUs refers to the issuance of Shares once the award is vested. If an RSU vests as a result of satisfaction of the applicable vesting requirements as described above, the Company will deliver one Share for such RSU at the time of settlement specified in Section 4 of the Restricted Stock Unit Agreement.

By signing below or otherwise accepting this award in a manner acceptable to the Company, you and the Company agree that these RSUs are granted under and governed by the terms and conditions of this Notice of Restricted Stock Unit Award, the 2012 Stock Plan (the “Plan”) and the Restricted Stock Unit Agreement. These latter two documents are attached to, and made a part of, this Notice of Restricted Stock Unit Award. Capitalized terms not otherwise defined herein or in the Restricted Stock Unit Agreement shall have the meaning set forth in the Plan. Section 10 of the Restricted Stock Unit Agreement also includes important acknowledgements.

 

1

NTD: Dates should be designed to occur during open trading windows. Proposed dates are often workable for a company with a calendar year fiscal year.

 

Page 1 of 14


RECIPIENT:    MULBERRY HEALTH INC.

 

 

   By:   

 

Email Address:    Title:   

 

 

     
Address for Mailing Stock Certificate (only applicable if the Company has certificated shares):

 

     

 

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THE RSUS GRANTED PURSUANT TO THE NOTICE OF RESTRICTED STOCK UNIT AWARD AND THIS AGREEMENT AND THE SHARES ISSUABLE THEREUNDER HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC.

2012 STOCK PLAN

RESTRICTED STOCK UNIT AGREEMENT

SECTION 1. GRANT OF RESTRICTED STOCK UNITS.

(a) Grant. On the terms and conditions set forth in the Notice of Restricted Stock Unit Award and this Agreement, the Company grants to you on the Date of Grant the number of RSUs set forth in the Notice of Restricted Stock Unit Award. Each RSU represents the right to receive one Share on the terms and conditions set forth in this Agreement.

(b) Consideration. No payment is required for the RSUs that have been granted to you.

(c) Nature of Units; No Rights As a Stockholder. Your RSUs are mere bookkeeping entries and represent only the Company’s unfunded and unsecured promise to issue Shares on a future date under specified conditions. As a holder of RSUs, you have no rights other than the rights of a general creditor of the Company. Your RSUs carry neither voting rights nor rights to cash dividends. You have no rights as a stockholder of the Company unless and until your RSUs are settled pursuant to Section 4.

(d) Stock Plan and Defined Terms. Your RSUs are granted pursuant to the Plan, a copy of which you acknowledge having received. The provisions of the Plan are incorporated into this Agreement by this reference. Certain capitalized terms are defined in Section 11 of this Agreement. Capitalized terms not otherwise defined herein or in the Notice of Restricted Stock Unit Award shall have the meanings set forth in the Plan.

SECTION 2. VESTING.

(a) Generally. The RSUs vest in accordance with the vesting schedule set forth in the Notice of Restricted Stock Unit Award.

(b) Termination of Service. If your Service terminates for any reason, all RSUs which have not vested as of your termination date shall automatically terminate and be cancelled on the date that is thirty days after your termination date (such thirty-day period, the “post-termination period”). Except as provided in Subsection (c) below, no additional RSUs will vest after your Service has terminated for any reason.

 

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(c) Additional Vesting Credit After Termination of Service. To the extent the RSUs are not fully vested when your Service terminates, the Board of Directors may, during the post-termination period, take action to cause additional RSUs to vest. In no event will any RSUs vest after termination of your Service unless the Board of Directors takes affirmative action pursuant to the preceding sentence or unless expressly provided in a written agreement between you and the Company.

(d) Expiration of RSUs. Upon a termination of one or more RSUs pursuant to this Section 2, you will have no further right with respect to such RSUs or the Shares previously allocated thereto.

(e) Part-Time Employment and Leaves of Absence. If you commence working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Restricted Stock Unit Award. If you go on a leave of absence, then, to the extent permitted by applicable law, the Company may adjust or suspend the vesting schedule set forth in the Notice of Restricted Stock Unit Award. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while you are on a bona fide leave of absence approved by the Company in writing. Service shall be deemed to terminate when such leave ends, unless you immediately return to active work when such leave ends.

SECTION 3. RESTRICTIONS APPLICABLE TO RSUS.

Except as otherwise provided in or pursuant to this Agreement or the Plan, these RSUs and the rights and privileges conferred hereby shall not be sold, assigned, transferred, pledged, hypothecated, or otherwise disposed of by you prior to the settlement of the RSUs. However, you may designate a third party who, in the event of your death, shall thereafter be entitled to receive any distribution of Shares to which you were entitled at the time of your death pursuant to this Agreement by delivering a written beneficiary designation to the Company’s headquarters on the prescribed form before your death. If you deliver no such beneficiary designation or if your designated beneficiaries do not survive you, your estate will receive payments in respect of any vested RSUs.

SECTION 4. SETTLEMENT OF RSUS.

(a) Settlement Date. Upon vesting of an RSU, the Company will settle the RSU by delivering one Share for that RSU. Settlement shall occur on or following the date the RSU vests, but not later than the Short-Term Deferral End Date. In no event will you be permitted, directly or indirectly, to specify the taxable year of settlement of any RSU subject to this award.

(b) Form of Delivery. The form of any delivery of Shares (e.g., a stock certificate or electronic entry evidencing such shares) shall be determined by the Company.

 

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(c) Legality of Issuance. No Shares shall be issued to you upon settlement of these RSUs unless and until the Company has determined that (i) you and the Company have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof; (ii) any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; (iii) you have executed either an Adoption Agreement or a counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement; and (iv) any other applicable provision of federal, State or foreign law has been satisfied. The Company shall have no liability to issue Shares in respect of the RSUs unless it is able to do so in compliance with applicable law.

SECTION 5. TAXES.

(a) Withholding Taxes. No consideration will be paid to you in respect of this award unless you have made arrangements satisfactory to the Company and/or the Parent or Subsidiary employing you (your “Employer”) for the payment of all applicable federal, State, local and foreign income and employment withholding taxes which arise in connection with the vesting and/or settlement of these RSUs (the “Withholding Taxes”). In this regard, you authorize the Company (at its sole discretion) to satisfy your Withholding Taxes by one or a combination of the following: (i) withholding from other compensation or amounts that are owed to you by your Employer, (ii) if the Stock is publicly traded, payment from the proceeds of the sale of shares through a Company-approved broker, (iii) withholding a number of Shares that otherwise would be issued to you when the RSUs are settled, or (iv) any other method approved by the Company. If the Withholding Taxes are satisfied pursuant to clause (iii), you will be deemed to have been issued the full number of Shares subject to the RSUs and the Fair Market Value of the withheld Shares, determined as of the date when taxes otherwise would have been withheld in cash, will be applied to the Withholding Taxes and such amount will be remitted to appropriate tax authorities by the Company or your Employer. You agree to pay to the Company in cash any amount of Withholding Taxes that the Company does not elect to satisfy by the means described above. To the extent you fail to make satisfactory arrangements for the payment of any Withholding Taxes, you will permanently forfeit the applicable RSUs. You acknowledge that the responsibility for all Withholding Taxes is yours and may exceed the amount actually withheld by the Company or your Employer.

(b) Section 409A. The settlement of these RSUs is intended to be exempt from the application of Code Section 409A pursuant to the “short-term deferral exemption” in Treasury Regulation 1.409A-1(b)(4) and shall be administered and interpreted in a manner that complies with such exemption. To the extent that any provision of this Agreement is ambiguous as to its exemption from Code Section 409A, the provision shall be read in such a manner so that all payments hereunder are exempt from Code Section 409A. Notwithstanding the foregoing, if this award of RSUs is interpreted as not being exempt from Code Section 409A, it shall be interpreted to comply with the requirements of Code Section 409A so that this award is not subject to additional tax or interest under Code Section 409A. In this regard, to the extent necessary to comply with or qualify for an exemption from Code Section 409A, any reference to “termination of employment” or similar terms will mean your “separation from service” within

 

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the meaning of Code Section 409A(2)(A)(i) (a “Separation”). In addition, if this award is payable upon your Separation and you are a “specified employee” of the Company or any affiliate thereof within the meaning of Code Section 409A(a)(2)(B)(i) on the day of your Separation, then no such payment shall be made prior to the date that is the earlier of (i) six months and one day after your Separation, or (ii) your death, but only to the extent such delay is necessary so that this award is not subject to additional tax or interest under Code Section 409A. Each installment of your RSUs that vests is intended to constitute a separate payment for purposes of Code Section 409A.

SECTION 6. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. Subject to Section 7(a) below, in the event that you propose to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If you desire to transfer Shares acquired under this Agreement, you must give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by you and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Section 6(b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, you may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions no less favorable to you than those described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which you are bound. Any proposed transfer on terms and conditions less favorable than those described in the Transfer Notice, as well as any subsequent proposed transfer by you, shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Section 6(a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

 

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(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 6 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 6.

(d) Termination of Right of First Refusal. Any other provision of this Section 6 notwithstanding, in the event that the Stock is readily tradable on an established securities market when you desire to transfer Shares, the Company shall have no Right of First Refusal, and you shall have no obligation to comply with the procedures prescribed by Sections 6(a) and 6(b) above.

(e) Permitted Transfers. This Section 6 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of your Immediate Family or to a trust or other entity established by you solely for the benefit of you and/or one or more members of your Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If you transfer any Shares acquired under this Agreement, either under this Section 6(e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to you.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 6, then after such time the person from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall be entitled to and assume all of the Company’s rights and obligations under this Section 6.

SECTION 7. RESTRICTIONS APPLICABLE TO SHARES.

(a) Bylaws Restrictions. The Shares acquired under this Agreement shall be subject to the transfer restrictions in Article X of the Company’s Second Amended and Restated Bylaws in addition to, and not in limitation of, the provisions of Section 6 of this Agreement.

 

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(b) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State or other relevant jurisdiction, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on the stock certificates (or electronic equivalent) or the imposition of stop-transfer instructions) and may refuse (or may be required to refuse) to transfer Shares acquired hereunder (or Shares proposed to be transferred in a subsequent transfer) if, in the judgment of the Company, such restrictions, legends or refusal are necessary or appropriate to achieve compliance with the Securities Act or other relevant securities or other laws, including without limitation under Regulation S of the Securities Act or pursuant to another available exemption from registration. You (or the beneficiary or your personal representative in the event of your death or incapacity, as the case may be) shall deliver to the Company any representations or other documents or assurances as the Company may deem necessary or reasonably desirable to ensure compliance with all applicable legal and regulatory requirements.

(c) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, you or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date of the public filing of the registration statement relating to the initial public offering (or commencing on the date of the final prospectus relating to any subsequent offering) as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Section 7(c). This Section 7(c) shall not apply to Shares registered in the public offering under the Securities Act.

(d) Investment Intent at Grant. You represent and agree that the Shares to be acquired upon settlement of these RSUs will be acquired for investment, and not with a view to the sale or distribution thereof.

 

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(e) Investment Intent at Settlement. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, you shall represent and agree at the time of issuance that the Shares being acquired upon settlement of these RSUs are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel, including, at the time of settlement, such representations as required by Regulation S of the Securities Act (if the Company is relying on such exemption).

(f) Rights of the Company. The Company shall not be required to (i) transfer on its books any Shares that have been sold or transferred in contravention of this Agreement or (ii) treat as the owner of Shares, or otherwise to accord voting, dividend or liquidation rights to, any Transferee to whom the Shares have been transferred in contravention of this Agreement.

(g) Legends. All certificates evidencing the Shares issued under this Agreement shall bear the following legends:

“THE SHARES REPRESENTED HEREBY (AND ANY INTEREST THEREIN) MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF THE RESTRICTED STOCK UNIT AGREEMENT PURSUANT TO WHICH SUCH SHARES WERE ACQUIRED. SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES. IN ADDITION, THE SHARES ARE SUBJECT TO RESTRICTIONS ON TRANSFER AS SET FORTH IN SUCH RESTRICTED STOCK UNIT AGREEMENT, INCLUDING FOR A LIMITED PERIOD FOLLOWING THE EFFECTIVE DATE OF THE UNDERWRITTEN PUBLIC OFFERING OF THE COMPANY’S SECURITIES AND MAY NOT BE SOLD OR OTHERWISE DISPOSED OF BY THE HOLDER WITHOUT THE CONSENT OF THE COMPANY OR THE MANAGING UNDERWRITER. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH RESTRICTED STOCK UNIT AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

“THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE BYLAWS OF THE COMPANY. COPIES OF THE BYLAWS OF THE COMPANY MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE COMPANY.”

All certificates evidencing Shares issued under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

 

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“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”) OR ANY SECURITIES LAWS OF ANY U.S. STATE, AND MAY NOT BE SOLD, REOFFERED, PLEDGED, ASSIGNED, ENCUMBERED OR OTHERWISE TRANSFERRED OR DISPOSED OF WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED. IN THE ABSENCE OF REGISTRATION OR THE AVAILABILITY (CONFIRMED BY OPINION OF COUNSEL) OF AN ALTERNATIVE EXEMPTION FROM REGISTRATION UNDER THE ACT (INCLUDING WITHOUT LIMITATION IN ACCORDANCE WITH REGULATION S UNDER THE ACT), THESE SHARES MAY NOT BE SOLD, REOFFERED, PLEDGED, ASSIGNED, ENCUMBERED OR OTHERWISE TRANSFERRED OR DISPOSED OF. HEDGING TRANSACTIONS INVOLVING THESE SHARES MAY NOT BE CONDUCTED UNLESS IN COMPLIANCE WITH THE ACT.”

(h) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares issued under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(i) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 7 shall be conclusive and binding on you and all other persons.

SECTION 8. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 9(a) of the Plan, the terms of these RSUs (including, without limitation, the number and kind of shares subject to these RSUs) shall be adjusted as set forth in Section 9(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, your RSUs shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 9(b) of the Plan; provided, however, that any action taken must either preserve the exemption of your RSUs from Code Section 409A or comply with Code Section 409A. Any additional RSUs and any new, substituted or additional shares, cash or other property that become subject to this award as a result of any such transaction shall be subject to the same conditions and restrictions as applicable to the RSUs to which they relate.

SECTION 9. MISCELLANEOUS PROVISIONS.

(a) No Retention Rights. Nothing in this Agreement or in the Plan shall confer upon you the right to remain in Service in any capacity for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining you) or you, which rights are hereby expressly reserved by each, to terminate your Service at any time and for any reason, with or without cause.

 

Page 10 of 14


(b) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid, (iii) deposit with Federal Express Corporation, with shipping charges prepaid or (iv) deposit with any internationally recognized express mail courier service, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to you at the address that you most recently provided to the Company in accordance with this Section 9(b). In addition, to the extent required or permitted pursuant to rules established by the Company from time to time, notices may be delivered electronically.

(c) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by you and by an authorized officer of the Company (other than you). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(d) Entire Agreement. The Notice of Restricted Stock Unit Award, this Agreement and the Plan constitute the entire understanding between you and the Company regarding the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(e) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

(f) Severability. Whenever possible, each provision of this Agreement shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Agreement shall be held to be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidating the remainder of such provision or the remaining provisions of this Agreement.

(g) Successors and Assigns. Except as otherwise expressly provided to the contrary, the provisions of this Agreement shall inure to the benefit of, and be binding upon, the Company and its successors and assigns and be binding upon you and your legal representatives, heirs, legatees, distributees, assigns and transferees by operation of law, whether or not any such person has become a party to this Agreement or has agreed in writing to join herein and to be bound by the terms, conditions and restrictions hereof.

SECTION 10. ACKNOWLEDGEMENTS.

In addition to the other terms, conditions and restrictions imposed on your RSUs and the Shares issuable upon settlement of your RSUs pursuant to this Agreement and the Plan, you expressly acknowledge being subject to Sections 6 (Right of First Refusal) and 7 (Restrictions Applicable to Shares, including without limitation the Market Stand-Off), as well as the following provisions:

 

Page 11 of 14


(a) Tax Consequences. You acknowledge that there will be tax consequences upon vesting and/or settlement of the RSUs and/or disposition of the Shares, if any, received hereunder, and you should consult a tax adviser regarding your tax obligations prior to such event. You acknowledge that the Company is not providing any tax, legal, or financial advice, nor is the Company making any recommendations regarding your participation in the Plan or acquisition or sale of Shares subject to this award. You are hereby advised to consult with your own personal tax, legal, and financial advisors regarding your participation in the Plan. You further acknowledge that the Company (i) makes no representations or undertakings regarding the tax treatment of the award of RSUs, including, but not limited to the grant, vesting, or settlement of the RSUs, the subsequent sale of Shares acquired pursuant to such RSUs, and the receipt of any dividends; and (ii) does not commit to and is under no obligation to structure the terms of the grant of the RSUs to reduce or eliminate your tax liability or achieve any particular tax result. You agree that the Company does not have a duty to design or administer the RSUs, the Plan or its other compensation programs in a manner that minimizes your tax liability. You shall not make any claim against the Company or its Board of Directors, officers, or employees related to tax matters arising from this award or your other compensation.

(b) Electronic Delivery of Documents. You acknowledge and agree that the Company may, in its sole discretion, deliver all documents relating the Company, the Plan or these RSUs and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission) by email or other means of electronic transmission (including by posting them on a website maintained by the Company or a third party under contract with the Company). You acknowledge that you may incur costs in connection with any such delivery by means of electronic transmission, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents.

(c) Plan Discretionary. You understand and acknowledge that (i) the Plan is entirely discretionary, (ii) the Company and your employer have reserved the right to amend, suspend or terminate the Plan at any time, (iii) the grant of the RSUs does not in any way create any contractual or other right to receive additional grants of RSUs (or benefits in lieu of RSUs) at any time or in any amount and (iv) all determinations with respect to any additional grants, including (without limitation) the times when RSUs will be granted, the number of Shares offered, and the vesting schedule, will be at the sole discretion of the Company.

(d) Termination of Service. You understand and acknowledge that participation in the Plan ceases upon termination of your Service for any reason, except as may explicitly be provided otherwise in the Plan or this Agreement.

(e) Extraordinary Compensation. The value of your RSUs and the Shares issuable thereunder shall be an extraordinary item of compensation outside the scope of your employment contract, if any, and shall not be considered a part of your normal or expected compensation for purposes of calculating severance, resignation, redundancy or end-of-service payments, bonuses, long-service awards, pension or retirement benefits or similar payments.

 

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(f) Authorization to Disclose. You hereby authorize and direct your employer to disclose to the Company or any Subsidiary any information regarding your employment, the nature and amount of your compensation and the fact and conditions of your participation in the Plan, as your employer deems necessary or appropriate to facilitate the administration of the Plan.

(g) Personal Data Authorization. You consent to the collection, use and transfer of personal data as described in this Subsection (g). You understand and acknowledge that the Company, your employer and the Company’s other Subsidiaries hold certain personal information regarding you for the purpose of managing and administering the Plan, including (without limitation) your name, home address, telephone number, date of birth, social insurance number, salary, nationality, job title, any Shares or directorships held in the Company and details of all RSUs or any other entitlements to Shares awarded, canceled, exercised, vested, unvested or outstanding in your favor (the “Data”). You further understand and acknowledge that the Company and/or its Subsidiaries will transfer Data among themselves as necessary for the purpose of implementation, administration and management of your participation in the Plan and that the Company and/or any Subsidiary may each further transfer Data to any third party assisting the Company in the implementation, administration and management of the Plan. You understand and acknowledge that the recipients of Data may be located in the United States or elsewhere. You authorize such recipients to receive, possess, use, retain and transfer Data, in electronic or other form, for the purpose of administering your participation in the Plan, including a transfer to any broker or other third party with whom you elect to deposit Shares acquired under the Plan of such Data as may be required for the administration of the Plan and/or the subsequent holding of Shares on your behalf. You may, at any time, view the Data, require any necessary modifications of Data or withdraw the consents set forth in this Subsection (g) by contacting the Company in writing.

SECTION 11. DEFINITIONS.

(a) “Adoption Agreement” shall mean an Adoption Agreement to the Voting Agreement, substantially in the form attached as Exhibit A thereto.

(b) “Agreement” means this Restricted Stock Unit Agreement.

(c) “Board of Directors” means the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

(d) “Co-Sale Agreement” shall mean that certain Seventh Amended and Restated First Refusal and Co-Sale Agreement, dated as of January 20, 2016, by and among the Company and certain other stockholders of the Company party thereto, as may be amended from time to time.

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

 

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(f) “Company” means Mulberry Health Inc., a Delaware corporation.

(g) “Date of Grant” means the date specified in the Notice of Restricted Stock Unit Award, which date shall be the later of (i) the date on which the Board of Directors resolved to grant these RSUs or (ii) your first date of Service.

(h) “Immediate Family” means any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(i) “Plan” means the Mulberry Health Inc. 2012 Stock Plan, as amended, as in effect on the Date of Grant.

(j) “Right of First Refusal” means the Company’s right of first refusal described in Section 6.

(k) “RSUs” means the Restricted Stock Units granted to you by the Company as set forth in the Notice of Restricted Stock Unit Award.

(l) “Service” means service as an Employee, Consultant or Outside Director. In the event of any dispute over whether and when Service has terminated, the Board of Directors shall have sole discretion to determine whether such termination has occurred and the effective date of such termination.

(m) “Short-Term Deferral End Date” means the date that is the later of (i) two and one-half months following the end of the calendar year in which the RSU vests or (ii) two and one-half months following the end of the Company’s fiscal year in which the RSU vests.

(n) “Transferee” means any person to whom you have directly or indirectly transferred any Shares acquired under this Agreement.

(o) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 6.

(p) “Voting Agreement” shall mean that certain Seventh Amended and Restated Voting Agreement, dated as of January 20, 2016, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

 

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Exhibit 10.15

MULBERRY HEALTH INC.

295 LAFAYETTE STREET, 7TH FLOOR

NEW YORK, NY 10012

November 29, 2012

Mario Schlosser

####

####

Dear Mario:

Mulberry Health Inc. (the “Company”) is pleased to offer you employment on the following terms:

1. Position. Your initial title will be Co-Chief Executive Officer, and you will initially report to the Company’s Board of Directors. This is a full-time position. While you render services to the Company, you will not engage in any other employment, consulting or other business activity (whether full-time or part-time) that would create a conflict of interest with the Company. By signing this letter agreement, you confirm to the Company that you have no contractual commitments or other legal obligations that would prohibit you from performing your duties for the Company.

2. Cash Compensation. The Company will pay you a starting salary at the rate of $225,000 per year, payable in accordance with the Company’s standard payroll schedule. This salary will be subject to adjustment pursuant to the Company’s employee compensation policies in effect from time to time.

3. Employee Benefits. As a regular employee of the Company, you will be eligible to participate in a number of Company-sponsored benefits. In addition, you will be entitled to paid vacation in accordance with the Company’s vacation policy, as in effect from time to time.

4. Proprietary Information and Inventions Agreement. Like all Company employees, you will be required, as a condition of your employment with the Company, to sign the Company’s standard Proprietary Information and Inventions Agreement, a copy of which is attached hereto as Exhibit A.

5. Employment Relationship. Employment with the Company is for no specific period of time. Your employment with the Company will be “at will,” meaning that either you or the Company may terminate your employment at any time and for any reason, with or without cause. Any contrary representations that may have been made to you are superseded by this letter agreement. This is the full and complete agreement between you and the Company on this term. Although your job duties, title, compensation and benefits, as well as the Company’s personnel policies and procedures, may change from time to time, the “at will” nature of your employment may only be changed in an express written agreement signed by you and a duly authorized officer of the Company (other than you).


Mario Schlosser

November 29, 2012

Page 2

 

6. Tax Matters.

(a) Withholding. All forms of compensation referred to in this letter agreement are subject to reduction to reflect applicable withholding and payroll taxes and other deductions required by law.

(b) Tax Advice. You are encouraged to obtain your own tax advice regarding your compensation from the Company. You agree that the Company does not have a duty to design its compensation policies in a manner that minimizes your tax liabilities, and you will not make any claim against the Company or its Board of Directors related to tax liabilities arising from your compensation.

7. Interpretation, Amendment and Enforcement. This letter agreement and Exhibit A supersede and replace any prior agreements, representations or understandings (whether written, oral, implied or otherwise) between you and the Company and constitute the complete agreement between you and the Company regarding the subject matter set forth herein. This letter agreement may not be amended or modified, except by an express written agreement signed by both you and a duly authorized officer of the Company. The terms of this letter agreement and the resolution of any disputes as to the meaning, effect, performance or validity of this letter agreement or arising out of, related to, or in any way connected with, this letter agreement, your employment with the Company or any other relationship between you and the Company (the “Disputes”) will be governed by New York law, excluding laws relating to conflicts or choice of law. You and the Company submit to the exclusive personal jurisdiction of the federal and state courts located in New York County in connection with any Dispute or any claim related to any Dispute.

* * * * *

We hope that you will accept our offer to join the Company. You may indicate your agreement with these terms and accept this offer by signing and dating both the enclosed duplicate original of this letter agreement and the enclosed Proprietary Information and Inventions Agreement and returning them to me. This offer, if not accepted, will expire at the close of business on December 3, 2012. As required by law, your employment with the Company is contingent upon your providing legal proof of your identity and authorization to work in the United States. Your employment is also contingent upon your starting work with the Company on or before December 3, 2012.


Mario Schlosser

November 29, 2012

Page 3

 

If you have any questions, please call me at _____________.

 

Very truly yours,
MULBERRY HEALTH INC.
By:  

/s/ Joshua Kushner

Name:   Joshua Kushner
Title:   President

 

I have read and accept this employment offer:

/s/ Mario Schlosser

Signature of Employee
Dated:                                                                                          

Attachment

Exhibit A: Proprietary Information and Inventions Agreement


MULBERRY HEALTH INC. EMPLOYEE PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT

The following agreement (the “Agreement”) between Mulberry Health Inc., a Delaware corporation (the “Company”), and the individual identified on the signature page to this Agreement (“Employee” or “I”) is effective as of December 3, 2012, the first day of my employment by the Company. I acknowledge that this Agreement is a material part of the consideration for my employment and continued employment by the Company. In exchange for the foregoing, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows:

 

1. No Conflicts. I have not made, and agree not to make, any agreement, oral or written, that is in conflict with this Agreement or my employment with the Company. I will not violate any agreement with or the rights of any third party. When acting within the scope of my employment (or otherwise on behalf of the Company), I will not use or disclose my own or any third party’s confidential information or intellectual property (collectively, “Restricted Materials”), except as expressly authorized by the Company in writing. Further, I have not retained anything containing or reflecting any confidential information of a prior employer or other third party, whether or not created by me.

2. Inventions.

a. Definitions. Intellectual Property Rights” means any and all patent rights, copyright rights, trademark rights, mask work rights, trade secret rights, sui generis database rights and all other intellectual and industrial property rights of any sort throughout the world (including any application therefor). “Invention” means any idea, concept, discovery, invention, development, research, technology, work of authorship, trade secret, software, firmware, content, audio-visual material, tool, process, technique, know- how, data, plan, device, apparatus, specification, design, prototype, circuit, layout, mask work, algorithm, program, code, documentation or other material or information, tangible or intangible, whether or not it may be patented, copyrighted, trademarked or otherwise protected (including all versions, modifications, enhancements and derivative works thereof).

b. Assignment. To the fullest extent under applicable law, the Company shall own all right, title and interest in and to all Inventions (including all Intellectual Property Rights therein or related thereto) that are made, conceived or reduced to practice, in whole or in part, by me during the term of my employment with the Company and which arise out of any use of Company’s facilities or assets or any research or other activity conducted by, for or under the direction of the Company (whether or not (i) conducted at the Company’s facilities, (ii) during working hours or (iii) using Company assets), or which are useful with or relate directly or indirectly to any “Company Interest” (meaning any product, service, other Invention or Intellectual Property Right that is sold, leased, used, proposed, under consideration or under development by the Company). I will promptly disclose and provide all of the foregoing Inventions (the “Assigned Inventions”) to the Company. I hereby make and agree to make all assignments to the Company necessary to effectuate and accomplish the foregoing ownership. Assigned Inventions shall not include any Invention that is both (x) developed entirely on my own time, without use of any Company facilities, assets, ideas or direction and (y) not useful with or related to any Company Interest.

c. Assurances. I will further assist the Company, at its expense, to evidence, record and perfect such assignments, and to perfect, obtain, maintain, enforce and defend any rights specified to be so owned or assigned. I hereby irrevocably designate and appoint the Company and its officers as my agents and attorneys-in-fact, coupled with an interest, to act for and on my behalf to execute and file any document and to perform all other lawfully permitted acts to further the purposes of the foregoing with the same legal force and effect as if executed by me.

d. Other Inventions. If I wish to clarify that something created by me prior to my employment, which relates or may relate to the Company’s actual or proposed business, is not within the scope of the assignment of Inventions under this Agreement, then I have listed it on Appendix A. If (i) I use or disclose any Restricted Materials (including anything listed in Appendix A) when acting within the scope of my employment (or otherwise on behalf of the Company), or (ii) any Assigned Invention cannot be fully made, used, reproduced, sold, distributed, or otherwise exploited without using, misappropriating or violating any Restricted Materials, I hereby grant and agree to grant to the Company a perpetual, irrevocable, worldwide, royalty-free, non-exclusive, transferable, sublicensable right and license to use, disclose, exploit and exercise all rights in such Restricted Materials, including any Intellectual Property Rights therein. I will not use or disclose any Restricted Materials for which I am not fully authorized to grant the foregoing license.

e. Moral Rights. To the extent allowed by applicable law, the terms of this Section 2 include all rights of paternity, integrity, disclosure, withdrawal and any other rights that may be known or referred to as moral rights, artist’s rights, droit moral or the like (collectively, “Moral Rights”). To the extent I retain any such Moral Rights under applicable law, I hereby ratify and consent to any action that may be taken with respect to such Moral Rights by or authorized by the Company and agree not to assert any Moral Rights with respect thereto. I will confirm any such ratification, consent or agreement from time to time as requested by the Company. Furthermore, I agree that notwithstanding any rights of publicity, privacy or otherwise (whether or not statutory) anywhere in the world and without any further compensation, the Company may and is hereby authorized to use my name, likeness and voice in connection with promotion of its business, products and services and to allow others to do the same.

3. Proprietary Information. I agree that all Assigned Inventions and all other financial, business, legal and technical information, including the identity of and any other information relating to the Company’s employees, Affiliates and Business Partners (as such terms are defined below), which I develop, learn or obtain during my employment or that are received by or for the Company in confidence, constitute “Proprietary Information.” I will hold in strict confidence and not directly or indirectly disclose or use any Proprietary Information, except (x) as required within the scope of my employment, (y) as required by applicable law, subpoena or governmental or regulatory investigation or (z)

 

 

1


to my legal representatives or a court of law, as reasonably necessary in connection with any bona fide dispute between the Company and me; provided that in the event Proprietary Information is required to be disclosed pursuant to subsection (y) above, I will (i) give the Company prompt written notice of such requirement, (ii) reasonably cooperate with the Company, at the Company’s expense, in seeking a protective order or otherwise challenging such requirement and (iii) limit the disclosure to the minimum amount required to comply with such requirement. Nothing in this Agreement prohibits me from reporting possible violations of federal law or regulation to any governmental agency or entity, including but not limited to the Department of Justice, the Securities and Exchange Commission, the Congress, and any agency Inspector General, or making other disclosures that are protected under the whistleblower provisions of federal law or regulation, and I do not need prior authorization from the Company to make any such reports or disclosures and am not required to notify the Company that I have made such reports or disclosures. Proprietary Information shall not include information that, I can document, is or becomes readily available to the public without restriction through no fault of mine (including breach of this Agreement). Upon termination of my employment (for any or no reason, whether voluntary or involuntary), I will promptly return to the Company all items containing or embodying Proprietary Information (including all copies), except that I may keep my personal copies of (a) my compensation records, (b) materials distributed to shareholders generally, (c) contacts and calendar and (d) this Agreement. I also recognize and agree that I have no expectation of privacy with respect to the Company’s networks, telecommunications systems or information processing systems (including, without limitation, stored computer files, email messages and voice messages), and that my activity and any files or messages on or using any of those systems may be monitored at any time without notice, regardless of whether such activity occurs on equipment owned by me or the Company. I further agree that any property situated on the Company’s premises and owned, leased or otherwise possessed by the Company, including computers, computer files, email, voicemail, storage media, filing cabinets or other work areas, is subject to inspection by Company personnel at any time with or without notice.

4. Restricted Activities. For the purposes of this Section 4, the term Company includes the Company and all other persons or entities that control, are controlled by or are under common control with the Company excluding (i) institutional investors and (ii) companies controlled by any such institutional investors in (i) that are not otherwise affiliates of the Company (“Affiliates”).

a. Definitions. Any Capacity” includes, without limitation, to (i) be an owner, founder, shareholder, partner, member, advisor, director, consultant, contractor, agent, employee, affiliate or coventurer, (ii) otherwise invest, engage or participate in, (iii) be compensated by, or (iv) prepare to be or do any of the foregoing or assist any third party to do so in anticipation of being or doing any of the foregoing under (i), (ii) or (iii) upon the expiration of any restrictive periods described herein; provided, Any Capacity will not include being a holder of less than two percent (2%) of the outstanding equity of a public company or any non-public company through investments in mutual funds, private equity funds or hedge funds or similar passive investment vehicles. “Business Partner” means any present or prospective customer,

vendor, supplier, distributor or other business partner of the Company. “Cause” means to recruit, employ, retain or otherwise solicit, induce or influence, or to attempt to do so. “Solicit” means to (1) service, take orders from or solicit the business or patronage of any Business Partner for myself or any other person or entity in connection with a Competing Business, (2) divert, entice or otherwise take away from the Company the business or patronage of any Business Partner, or to attempt to do so, or (3) solicit, induce or encourage any Business Partner to terminate or reduce its relationship with the Company.

b. Acknowledgments.

i. I acknowledge and agree that (1) the Company’s business is highly competitive, secrecy of the Proprietary Information is of the utmost importance to the Company, and I will learn and use Proprietary Information in the course of performing my work for the Company and (2) my position may require me to establish goodwill with Business Partners and employees on behalf of the Company and such goodwill is extremely important to the Company’s success, and the Company has made substantial investments to develop its business interests and goodwill.

ii. I agree that the limitations as to time, geographical area and scope of activity to be restrained in this Section 4 are reasonable and are not greater than necessary to protect the goodwill or other business interests of the Company. I further agree that such investments are worthy of protection and that the Company’s need for protection afforded by this Section 4 is greater than any hardship I may experience by complying with its terms.

iii. I acknowledge that my violation or attempted violation of the agreements in this Section 4 will cause irreparable damage to the Company or its Affiliates, and I therefore agree that the Company shall be entitled as a matter of right to seek an injunction, out of any court of competent jurisdiction, restraining any violation or further violation of such agreements by me or others acting on my behalf. The Company’s right to injunctive relief shall be cumulative and in addition to any other remedies provided by law or equity.

iv. Although the parties believe that the limitations as to time, geographical area and scope of activity contained herein are reasonable and do not impose a greater restraint than necessary to protect the goodwill or other business interests of the Company, if it is judicially determined otherwise, the limitations shall be reformed to the extent necessary to make them reasonable and not to impose a restraint that is greater than necessary to protect the goodwill or other business interests of the Company. In any such case, the Company and I agree that the provisions of this Section 4 shall be valid and binding as though any invalid or unenforceable provision had not been included.

c. As an Employee. During my employment with the Company, I will not directly or indirectly: (i) Cause any person to leave their employment with the Company (other than terminating subordinate employees in the course of my duties for the Company); (ii) Solicit; (iii) act in Any Capacity in or with respect to any commercial activity which competes, or is reasonably likely to compete, with any business that the Company conducts, proposes to conduct or demonstrably anticipates conducting, at any time during my employment (a “Competing Business”); (iv) enter into an employment, consulting or other similar relationship with another person or entity that requires a significant time commitment without the prior written consent of the Company.

 

 

2


d. After Termination. For the period of twelve (12) months immediately following termination of my employment with the Company (for any or no reason, whether voluntary or involuntary), I will not directly or indirectly: (i) Cause any person to leave their employment with the Company (provided that providing a reference for an employee or hiring an employee who responds to a non-targeted advertisement shall not be deemed a breach of this subsection 4(d)(i)); (ii) Solicit; or (iii) act in Any Capacity in or with respect to any Competing Business located within the State of New York, the rest of the United States, or anywhere else in the world. The foregoing time frames shall be increased by the period of time beginning from the commencement of any violation of the foregoing provisions until such time as I have cured such violation.

5. Employment at Will. I agree that this Agreement is not an employment contract for any particular term. I have the right to resign and the Company has the right to terminate my employment at will, at any time, for any or no reason, with or without cause. This Agreement does not purport to set forth all of the terms and conditions of my employment, and as an employee of the Company, I have obligations to the Company which are not described in this Agreement. However, the terms of this Agreement govern over any such terms that are inconsistent with this Agreement, and supersede the terms of any similar form that I may have previously signed. This Agreement can only be changed by a subsequent written agreement signed by the Chief Executive Officer or President of the Company, or an authorized designee.

6. Survival. I agree that any change or changes in my employment title, duties, compensation or equity interest after the signing of this Agreement shall not affect the validity or scope of

this Agreement. I agree that my obligations under Sections 2, 3 and 4 of this Agreement shall continue in effect after termination of my employment, regardless of the reason, and whether such termination is voluntary or involuntary, and that the Company is entitled to communicate my obligations under this Agreement to any of my potential or future employers. I will provide a copy of this Agreement to any potential or future employers of mine, so that they are aware of my obligations hereunder. My obligations under Sections 2, 3 and 4 also shall be binding upon my heirs, executors, assigns and administrators, and shall inure to the benefit of the Company, its Affiliates, successors and assigns. This Agreement may be freely assigned by the Company to any third party in connection with the sale or merger of the Company’s assets or business.

7. Miscellaneous. Any dispute in the meaning, effect or validity of this Agreement shall be resolved in accordance with the laws of the State of New York without regard to the conflict of laws provisions thereof. Any legal action or proceeding relating to this Agreement shall be brought exclusively in the state or federal courts located in New York County, New York, and each party consents to the jurisdiction thereof. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of such rights. Unless expressly provided otherwise, each right and remedy in this Agreement is in addition to any other right or remedy, at law or in equity, and the exercise of one right or remedy will not be deemed a waiver of any other right or remedy. If one or more provisions of this Agreement are held to be illegal or unenforceable under applicable law, such illegal or unenforceable portion shall be limited or excluded from this Agreement to the minimum extent required so that this Agreement shall otherwise remain in full force and effect and enforceable. I acknowledge and agree that any breach or threatened breach of this Agreement will cause irreparable harm to the Company for which damages would not be an adequate remedy, and, therefore, the Company is entitled to injunctive relief with respect thereto (without the necessity of posting any bond) in addition to any other remedies.

 

 

[Signature Page Follows]

 

3


I HAVE READ THIS AGREEMENT CAREFULLY AND I UNDERSTAND AND ACCEPT THE OBLIGATIONS THAT IT IMPOSES UPON ME WITHOUT RESERVATION. NO PROMISES OR REPRESENTATIONS HAVE BEEN MADE TO ME TO INDUCE ME TO SIGN THIS AGREEMENT. I SIGN THIS AGREEMENT VOLUNTARILY AND FREELY, WITH THE UNDERSTANDING THAT I EITHER (1) HAVE RETAINED A COPY OF THIS AGREEMENT OR (2) MAY, AT ANY TIME, REQUEST A COPY OF THIS AGREEMENT FROM THE COMPANY.

 

COMPANY                   EMPLOYEE
By:  

/s/ Joshua Kushner

     By:   

/s/ Mario Schlosser

Name:  

Joshua Kushner

     Name:    Mario Schlosser
Title:  

 

     Address:   

####

SIGNATURE PAGE TO MULBERRY HEALTH INC. EMPLOYEE PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT


Appendix A

Prior Matters

None.

Exhibit 10.16

OSCAR INSURANCE CORPORATION

295 LAFAYETTE STREET, 7TH FLOOR

NEW YORK, NY 10012

January 1, 2016

Joel Klein

Dear Joel:

Oscar Insurance Corporation including its affiliates (the “Company”) is pleased to offer you employment commencing on January 1, 2016 (the “Effective Date”) on the following terms:

1. Position. Your title will be Chief Policy and Strategy Officer, and you will report to the Company’s Chief Executive Officer. This is a full-time position and you shall be employed at the Company’s headquarters in New York City. While you render services to the Company, you will not engage in any other employment, consulting or other business activity (whether full-time or part-time) that would create a conflict of interest with the Company; provided, that, in the absence of such conflict you may (a) serve on (i) for profit boards with the prior consent of the Company’s Board of Directors, which consent shall not be unreasonably withheld and (ii) charitable boards and (b) manage your personal investments. For the avoidance of doubt, you may continue to serve on the boards of directors of Amplify Education, Inc., Boston Properties, Inc. and News Corporation and the advisory board of Point72 Asset Management. By signing this letter agreement, you confirm to the Company that you have no contractual commitments or other legal obligations that would prohibit you from performing your duties for the Company.

2. Cash Compensation. The Company will pay you a starting salary at the rate of $500,000 per year, payable in accordance with the Company’s standard payroll schedule. This salary will be subject to adjustment for increase pursuant to the Company’s employee compensation policies in effect from time to time. In addition, you will be eligible to receive a bonus of up to $150,000 per year. The bonus (if any) will be awarded based on objective or subjective criteria established by the Company’s Chief Executive Officer following consultation with you and approved by the Company’s Board of Directors. Any bonus for the fiscal year in which your employment begins will be prorated, based on the number of days you are employed by the Company during that fiscal year. Any bonus for a fiscal year will be paid within 212 months after the close of that fiscal year, but only if you are still employed by the Company at the time of payment or you have been subject to an Involuntary Termination (or your employment has terminated as a result of your death or disability) following the close of the applicable fiscal year but prior to the date of payment. The determinations of the Company’s Board of Directors with respect to your bonus will be final and binding.

3. Employee Benefits. As a regular employee of the Company, you will be eligible to participate in Company-sponsored benefits provided to executive-level employees. In addition, you will be entitled to paid vacation in accordance with the Company’s vacation policy,


as in effect from time to time. Beginning on the Effective Date and continuing thereafter, including after the termination of your employment hereunder in connection with services as an employee, you will be covered under the Company’s indemnification agreement or policy and have coverage under the Company’s director’s and officer’s liability insurance policy in amounts no less than, and on terms no less favorable than, those provided to the other senior executive officers of the Company from time to time. If you are required to travel by air on Company business, the Company will pay or reimburse you for business class airfare.

4. Equity Compensation.

(a) Stock Option(s).

(i) Subject to the approval of the Board of Directors of Mulberry Health Inc. (“Mulberry”), you will be granted an option (the “Option”) to purchase a number of shares of Mulberry Series A Common Stock equal to 0.75% of the fully-diluted capitalization of Mulberry as of the date of grant, including shares reserved under Mulberry’s 2012 Stock Plan (the “Plan”). The Option will be granted as soon as reasonably practicable after the Effective Date. In the event that the closing of Mulberry’s next equity financing after the date hereof (the “Next Equity Financing”) occurs after the date that the Option is approved, but prior to May 1, 2016, Mulberry will grant you an additional option (with the same vesting terms as the Option) to purchase a number of shares of Mulberry Series A Common Stock so that, together with the Option, your options cover 0.75% of the fully-diluted capitalization of Mulberry as of the closing of the Next Equity Financing, including shares reserved under the Plan (and such additional options shall also be treated as the “Option” under this Agreement). For the avoidance of doubt, there is no guarantee of any additional anti-dilution equity awards for any equity issuances other than the Next Equity Financing, provided it occurs prior to May 1, 2016.

(ii) The exercise price per share of the Option will be the fair market value per share of Mulberry Series A Common Stock as determined by Mulberry’s Board of Directors when the Option is granted. The Option will be subject to the terms and conditions of the Plan, as described in the Plan and the applicable Stock Option Agreement, in the form attached as Exhibit A. You will vest in 25% of the Option after 12 months of continuous service from the Effective Date (e.g., the first anniversary of the Effective Date), and the remainder will vest in equal monthly installments over the following 36 months of your continuous service, as described in the applicable Stock Option Agreement. In addition, if (a) Mulberry is subject to a Change in Control (as defined below) and (b) you are subject to an Involuntary Termination (as defined below) within 12 months after such Change in Control (or during the 1 month period prior to the consummation of such Change in Control), 100% of the Option will vest, as described in the applicable Stock Option Agreement. In addition, if you are subject to an Involuntary Termination then, subject to your executing and not revoking a general release of claims in accordance with this Section 4(a), the expiration date of the Option(s) will be extended until the earlier of (A) four years after the date of termination of your employment and (B) ten years after the date the Option(s) are granted. The extended post-termination Option exercise period described in this Section 4(a) is subject to your executing a general release of all claims that you may have against the Company or persons affiliated with the Company in the form attached as Exhibit B, returning the release to the Company within the time frame prescribed by the Company and you not revoking such release.

 

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(b) Loan(s). The Option will be exercisable for up to $2,000,000 of aggregate exercise price (the “Option Loan”), through delivery of a full recourse Promissory Note and entry into a Stock Pledge Agreement between you and Mulberry, each on a form provided by Mulberry. The Option Loan shall be secured by the Option shares purchased with the loan proceeds and shall be full recourse to you. The Option Loan shall accrue interest at the minimum interest rate required to avoid the imputation of interest under the Code, determined as of the date of the Loan.

5. Proprietary Information and Inventions Agreement. Like all Company employees, you will be required, as a condition of your employment with the Company, to sign the Company’s standard Proprietary Information and Inventions Agreement, a copy of which is attached hereto as Exhibit C (the “PIIA”).

6. Employment Relationship. Employment with the Company is for no specific period of time. Your employment with the Company will be “at will,” meaning that either you or the Company may terminate your employment at any time and for any reason, with or without cause. Any contrary representations that may have been made to you are superseded by this letter agreement. This is the full and complete agreement between you and the Company on this term. Although your job duties, title, compensation and benefits, as well as the Company’s personnel policies and procedures, may change from time to time, the “at will” nature of your employment may only be changed in an express written agreement signed by you and a duly authorized officer of the Company (other than you).

7. Severance Benefits.

(a) General. If you are subject to an Involuntary Termination, then you will be entitled to the benefits described in this Section 7. However, this Section 7 will not apply unless you (i) have returned all Company property in your possession (subject to any exceptions set forth in the PIIA), (ii) have resigned as a member of the boards of directors of the Company and all of its subsidiaries, to the extent applicable, and (iii) have executed a general release of all claims that you may have against the Company or persons affiliated with the Company arising out of your employment with the Company or the termination thereof. The release shall be in the form attached as Exhibit B. You must execute and return the release on or before the date specified by the Company in the prescribed form (the “Release Deadline”), which Release Deadline shall be no earlier than 21 days following your receipt of the release from the Company and no later than 50 days after your Separation. If you fail to return the release on or before the Release Deadline, or if you revoke the release, then you will not be entitled to the benefits described in this Section 7.

(b) Salary Continuation. If you are subject to an Involuntary Termination, then the Company will continue to pay your base salary for a period of six months after your Separation. Your base salary will be paid at the rate in effect at the time of your Separation and in accordance with the Company’s standard payroll procedures. The salary continuation payments will (subject to Section 8(b) below) commence within 60 days after your Separation and, once they commence, will include any unpaid amounts accrued from the date of your Separation. However, if the 60-day period described in the preceding sentence spans two calendar years, then the payments will in any event begin in the second calendar year.

 

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(c) Bonus. If you are subject to an Involuntary Termination, then the Company will pay you an amount equal to the annual bonus that you would be entitled to receive based on actual performance, pro-rated for the number of days worked for the Company in the year of your termination, up to and including the date of your Separation. The pro-rated bonus payment will be paid at the same time as the bonus would otherwise be paid in accordance with Section 2 if you had remained employed through the date of payment.

8. Tax Matters.

(a) Withholding. All forms of compensation referred to in this letter agreement are subject to reduction to reflect applicable withholding and payroll taxes and other deductions required by law.

(b) Section 409A. It is the intent of the parties that the payments and benefits under this letter agreement comply with (or be exempt from) Section 409A of the Internal Revenue Code of 1986, as amended (the “Code”), and the regulations and guidance promulgated thereunder (collectively, “Section 409A”), and, accordingly, to the maximum extent permitted, this letter agreement shall be interpreted in accordance therewith. For purposes of Section 409A, each salary continuation payment under Section 7(b) is hereby designated as a separate payment. If the Company determines that you are a “specified employee” under Section 409A(a)(2)(B)(i) of the Code at the time of your Separation, then (i) the salary continuation payments under Section 7(b), to the extent that they are subject to Section 409A of the Code, will commence on the first business day following (A) expiration of the six-month period measured from your Separation or (B) the date of your death and (ii) the installments that otherwise would have been paid prior to such date will be paid in a lump sum when the salary continuation payments commence. Any amount that you are entitled to be reimbursed under this letter agreement will be reimbursed to you as promptly as practical, and in any event not later than the last day of the calendar year after the calendar year in which the expenses are incurred. Any right to reimbursement or in kind benefits will not be subject to liquidation or exchange for another benefit. The amount of the expenses eligible for reimbursement during any taxable year will not affect the amount of expenses eligible for reimbursement in any other taxable year.

(c) Section 280G. If there is a Change in Control of Mulberry and Mulberry does not have any readily tradable public stock at the time of such Change in Control, and in the event that it shall be determined that any payment or benefit (including payments and benefits pursuant to this letter agreement) that you would receive from Mulberry, the Company or otherwise in connection with such Change in Control (a “Transaction Payment”) would not be deductible, in whole or part when aggregated with any other right, payment or benefit to or for you under all other agreements or benefit plans of Mulberry or the Company, by Mulberry, the Company or the person making such payment or distribution or providing such right or benefit as a result of Section 280G of Code and you waive any Transaction Payment subject to stockholder approval, Mulberry shall use commercially reasonable efforts to prepare and deliver to its stockholders the disclosure required by Section 280G(b)(5)(B) of the Code with respect to any Transaction Payment to obtain the approval of Mulberry’s stockholders in accordance with Section 280G(b)(5)(B) of the Code and the regulation codified at 26 C.F.R. §1.280G-1.

 

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(d) Tax Advice. You are encouraged to obtain your own tax advice regarding your compensation from the Company. You agree that the Company does not have a duty to design its compensation policies in a manner that minimizes your tax liabilities, and you will not make any claim against the Company or its Board of Directors related to tax liabilities arising from your compensation.

9. Interpretation, Amendment and Enforcement. This letter agreement and Exhibit C supersede and replace any prior agreements, representations or understandings (whether written, oral, implied or otherwise) between you and the Company and constitute the complete agreement between you and the Company regarding the subject matter set forth herein. This letter agreement may not be amended or modified, except by an express written agreement signed by both you and a duly authorized officer of the Company. The terms of this letter agreement and the resolution of any disputes as to the meaning, effect, performance or validity of this letter agreement or arising out of, related to, or in any way connected with, this letter agreement, your employment with the Company or any other relationship between you and the Company (the “Disputes”) will be governed by New York law, excluding laws relating to conflicts or choice of law. You and the Company submit to the exclusive personal jurisdiction of the federal and state courts located in New York County in connection with any Dispute or any claim related to any Dispute.

10. Definitions. The following terms have the meaning set forth below wherever they are used in this letter agreement:

(a) “Cause” means a determination evidenced by an affirmative vote of a majority of the Company’s Board of Directors of (i) your unauthorized use or disclosure of the Company’s confidential information or trade secrets, which use or disclosure causes material harm to the Company; (ii) your willful and material breach of any agreement between you and the Company; (iii) your willful and material failure to comply with the Company’s written policies or rules; (iv) your conviction of, or plea of “guilty” or “no contest” to, a felony under the laws of the United States or any State thereof; (v) your gross negligence or willful misconduct; (vi) your continuing failure to perform assigned duties after receiving written notification of such failure from the Company’s Board of Directors; or (vii) your failure to cooperate in good faith with a governmental or internal investigation of the Company or its directors, officers or employees, if the Company has requested your cooperation; provided that, in the case of clauses (ii), (iii), (vi) and (vii), you have received written notification from the Company describing the nature of the failure or breach constituting Cause and you have not cured that failure or breach within 10 days following such notice (to the extent curable). For purposes of this Section 10(a) no action or inaction shall be treated as “willful” if not done or omitted in bad faith and without reasonable belief it was in the best interests of the Company and its affiliates. Notwithstanding anything to the contrary in this letter agreement, a termination may be deemed for Cause so long as the vote required by this Section 10(a) occurs within 14 days following the date of your termination and the circumstances otherwise constituting Cause are not curable.

(b) “Change in Control” means (i) the consummation of a merger or consolidation of Mulberry with or into another entity; or (ii) the dissolution, liquidation or winding up of Mulberry. The foregoing notwithstanding, a merger or consolidation of Mulberry does not constitute a “Change in Control” if immediately after the merger or consolidation a majority of the voting power of the capital stock of the continuing or surviving entity, or any direct or indirect parent corporation of the continuing or surviving entity, will be owned by the persons who were Mulberry’s stockholders immediately prior to such merger or consolidation in substantially the same proportions as their ownership of the voting power of Mulberry’s capital stock immediately prior to the merger or consolidation.

 

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(c) “Involuntary Termination” means either (i) your Termination Without Cause or (b) your Resignation for Good Reason.

(d) “Resignation for Good Reason” means a Separation as a result of your resignation within 12 months after one of the following conditions has come into existence without your written consent: (i) a reduction in your base salary; (ii) a material diminution of your position, authority, duties or responsibilities; (iii) a relocation of your principal workplace (A) by more than 25 miles or (B) away from the Company’s headquarters or (iv) a material breach of this Agreement (including for the avoidance of doubt, failure to make the grants described in Section 4(a)) or any equity agreement by the Company or any of its affiliates. A Resignation for Good Reason shall not be deemed to have occurred unless you give the Company written notice of the condition within 90 days after the condition comes into existence and the Company fails to remedy the condition within 30 days after receiving such written notice.

(e) “Separation” means a “separation from service,” as defined in the regulations under Section 409A of the Code, from the Company.

(f) “Termination Without Cause” means a Separation as a result of a termination of your employment by the Company without Cause, provided you are willing and able to continue performing services within the meaning of Treasury Regulation 1.409A-1(n)(1).

* * * * *

 

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We hope that you will accept our offer to join the Company. You may indicate your agreement with these terms and accept this offer by signing and dating both the enclosed duplicate original of this letter agreement and the enclosed Proprietary Information and Inventions Agreement and returning them to me. As required by law, your employment with the Company is contingent upon your providing legal proof of your identity and authorization to work in the United States. Your employment is also contingent upon your starting work with the Company on or before January 1, 2016.

If you have any questions, please call me at ####

 

Very truly yours,
OSCAR INSURANCE CORPORATION
By:  

/s/ Mario Schlosser

  Name: Mario Schlosser
  Title: Chief Executive Officer

I have read and accept this employment offer:

 

/s/ Joel Klein

Signature of Employee
Dated:   1/20/2016

Attachment

 

Exhibit A:    Form of Stock Option Agreement
Exhibit B:    Form of Release Agreement
Exhibit C:    Proprietary Information and Inventions Agreement

 

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MULBERRY HEALTH INC. 2012 STOCK PLAN

NOTICE OF STOCK OPTION GRANT (EARLY EXERCISE)

The Optionee has been granted the following option to purchase shares of the Series A Common Stock of Mulberry Health Inc.:

 

Name of Optionee:

   Joel Klein

Total Number of Shares:

   3,894,693

Type of Option:

   Incentive Stock Option (ISO)

Exercise Price per Share:

   $2.93

Date of Grant:

   July 27, 2016

Date Exercisable:

   This option shall be exercisable as to 3,758,177 shares as of the Date of Grant. This option shall be exercisable as to an additional 34,129 Shares on each of January 1, 2017, January 1, 2018, January 1, 2019 and January 1, 2020, subject to the Optionee’s continuous Service through such dates.

Vesting Commencement Date:

   January 1, 2016

Vesting Schedule:

   The Right of Repurchase shall lapse with respect to the first 25% of the Shares subject to this option when the Optionee completes 12 months of continuous Service beginning with the Vesting Commencement Date set forth above. The Right of Repurchase shall lapse with respect to an additional 1/48th of the Shares subject to this option when the Optionee completes each month of continuous Service thereafter. The Right of Repurchase may lapse on an accelerated basis under Section 7(b) of the Stock Option Agreement.

Expiration Date:

   July 26, 2026. This option expires earlier if the Optionee’s Service terminates earlier, as provided in Section 6 of the Stock Option Agreement, or if the Company engages in certain corporate transactions, as provided in Section 8(b) of the Plan.

By signing below, the Optionee and the Company agree that this option is granted under, and governed by the terms and conditions of, the 2012 Stock Plan and the Stock Option Agreement. Both of these documents are attached to, and made a part of, this Notice of Stock Option Grant. Section 14 of the Stock Option Agreement includes important acknowledgements of the Optionee.

 

OPTIONEE:      MULBERRY HEALTH INC.

/s/ Joel Klein

     By:   

/s/ Mario Schlosser

Joel Klein     

Name: Mario Schlosser

Title: Chief Executive Officer

 


THE OPTION GRANTED PURSUANT TO THIS AGREEMENT AND THE SHARES ISSUABLE UPON THE EXERCISE THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

MULBERRY HEALTH INC. 2012 STOCK PLAN:

STOCK OPTION AGREEMENT (EARLY EXERCISE)

SECTION 1. GRANT OF OPTION.

(a) Option. On the terms and conditions set forth in the Notice of Stock Option Grant and this Agreement, the Company grants to the Optionee on the Date of Grant the option to purchase at the Exercise Price the number of Shares set forth in the Notice of Stock Option Grant. The Exercise Price is agreed to be at least 100% of the Fair Market Value per Share on the Date of Grant (110% of Fair Market Value if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies). This option is intended to be an ISO or an NSO, as provided in the Notice of Stock Option Grant.

(b) $100,000 Limitation. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it shall be deemed to be an NSO to the extent (and only to the extent) required by the $100,000 annual limitation under Section 422(d) of the Code.

(c) Stock Plan and Defined Terms. This option is granted pursuant to the Plan, a copy of which the Optionee acknowledges having received. The provisions of the Plan are incorporated into this Agreement by this reference. Capitalized terms are defined in Section 15 of this Agreement.

SECTION 2. RIGHT TO EXERCISE.

(a) Exercisability. Subject to Subsection (b) below and the other conditions set forth in this Agreement, all or part of this option may be exercised prior to its expiration at the time or times set forth in the Notice of Stock Option Grant. Shares purchased by exercising this option may be subject to the Right of Repurchase under Section 7.

(b) Stockholder Approval. Any other provision of this Agreement notwithstanding, no portion of this option shall be exercisable at any time prior to the approval of the Plan by the Company’s stockholders.


SECTION 3. NO TRANSFER OR ASSIGNMENT OF OPTION.

Except as otherwise provided in this Agreement, this option and the rights and privileges conferred hereby shall not be sold, pledged or otherwise transferred (whether by operation of law or otherwise) and shall not be subject to sale under execution, attachment, levy or similar process.

SECTION 4. EXERCISE PROCEDURES.

(a) Notice of Exercise. The Optionee or the Optionee’s representative may exercise this option by (i) giving written notice to the Company pursuant to Section 13(c) and (ii) executing either an Adoption Agreement or a counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. The notice shall specify the election to exercise this option, the number of Shares for which it is being exercised and the form of payment. The person exercising this option shall sign the notice and the Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement. In the event that this option is being exercised by the representative of the Optionee, the notice shall be accompanied by proof (satisfactory to the Company) of the representative’s right to exercise this option. The Optionee or the Optionee’s representative shall deliver to the Company, at the time of giving the notice, payment in a form permissible under Section 5 for the full amount of the Purchase Price. In the event of a partial exercise of this option, Shares shall be deemed to have been purchased in the order in which they vest in accordance with the Notice of Stock Option Grant.

(b) Issuance of Shares. After receiving a proper notice of exercise and executed Adoption Agreement or counterpart signature page to the Voting Agreement and a counterpart signature page to the Co-Sale Agreement, the Company shall cause to be issued one or more certificates evidencing the Shares for which this option has been exercised. Such Shares shall be registered (i) in the name of the person exercising this option, (ii) in the names of such person and his or her spouse as community property or as joint tenants with the right of survivorship or (iii) with the Company’s consent, in the name of a revocable trust. In the case of Restricted Shares, the Company shall cause such certificates to be deposited in escrow under Section 7(c). In the case of other Shares, the Company shall cause such certificates to be delivered to or upon the order of the person exercising this option.

(c) Withholding Taxes. In the event that the Company determines that it is required to withhold any tax as a result of the exercise of this option, the Optionee, as a condition to the exercise of this option, shall make arrangements satisfactory to the Company to enable it to satisfy all withholding requirements. The Optionee shall also make arrangements satisfactory to the Company to enable it to satisfy any withholding requirements that may arise in connection with the vesting or disposition of Shares purchased by exercising this option.

SECTION 5. PAYMENT FOR STOCK.

(a) Cash. All or part of the Purchase Price may be paid in cash or cash equivalents.

 

 

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(b) Surrender of Stock. At the discretion of the Board of Directors, all or any part of the Purchase Price may be paid by surrendering, or attesting to the ownership of, Shares that are already owned by the Optionee. Such Shares shall be surrendered to the Company in good form for transfer and shall be valued at their Fair Market Value as of the date when this option is exercised.

(c) Exercise/Sale. All or part of the Purchase Price and any withholding taxes may be paid by the delivery (on a form prescribed by the Company) of an irrevocable direction to a securities broker approved by the Company to sell Shares and to deliver all or part of the sales proceeds to the Company. However, payment pursuant to this Subsection (c) shall be permitted only if (i) Stock then is publicly traded and (ii) such payment does not violate applicable law.

SECTION 6. TERM AND EXPIRATION.

(a) Basic Term. This option shall in any event expire on the expiration date set forth in the Notice of Stock Option Grant, which date is 10 years after the Date of Grant (five years after the Date of Grant if this option is designated as an ISO in the Notice of Stock Option Grant and Section 3(b) of the Plan applies).

(b) Termination of Service by Involuntary Termination. If the Optionee is subject to an Involuntary Termination, then, subject to the Optionee’s executing and not revoking a general release of claims in accordance with the terms of the Optionee’s employment agreement, this option shall expire on the earlier of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) Above; or

(ii) The date four years after the date of such Involuntary Termination.

(c) Termination of Service (Except by Death or by Involuntary Termination). If the Optionee’s Service terminates for any reason other than death or Involuntary Termination, then this option shall expire on the earliest of the following occasions:

(i) The expiration date determined pursuant to Subsection (a) above;

(ii) The date three months after the termination of the Optionee’s Service for any reason other than Disability; or

(iii) The date six months after the termination of the Optionee’s Service by reason of Disability.

The Optionee may exercise all or part of this option at any time before its expiration under the preceding sentence, but only to the extent that this option is exercisable for vested Shares on or before the date when the Optionee’s Service terminates. When the Optionee’s Service terminates, this option shall expire immediately with respect to the number of Shares for which

 

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this option is not yet exercisable and with respect to any Restricted Shares. In the event that the Optionee dies after termination of Service but before the expiration of this option, all or part of this option may be exercised (prior to expiration) by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option was exercisable for vested Shares on or before the date when the Optionee’s Service terminated.

(d) Death of the Optionee. If the Optionee dies while in Service, then this option shall expire on the earlier of the following dates:

(i) The expiration date determined pursuant to Subsection (a) above; or

(ii) The date 12 months after the Optionee’s death.

All or part of this option may be exercised at any time before its expiration under the preceding sentence by the executors or administrators of the Optionee’s estate or by any person who has acquired this option directly from the Optionee by beneficiary designation, bequest or inheritance, but only to the extent that this option is exercisable for vested Shares on or before the date of the Optionee’s death. When the Optionee dies, this option shall expire immediately with respect to the number of Shares for which this option is not yet exercisable and with respect to any Restricted Shares.

(e) Part-Time Employment and Leaves of Absence. If the Optionee commences working on a part-time basis, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant. If the Optionee goes on a leave of absence, then the Company may adjust the vesting schedule set forth in the Notice of Stock Option Grant in accordance with the Company’s leave of absence policy or the terms of such leave. Except as provided in the preceding sentence, Service shall be deemed to continue for any purpose under this Agreement while the Optionee is on a bona fide leave of absence, if (i) such leave was approved by the Company in writing and (ii) continued crediting of Service for such purpose is expressly required by the terms of such leave or by applicable law (as determined by the Company). Service shall be deemed to terminate when such leave ends, unless the Optionee immediately returns to active work.

(f) Notice Concerning ISO Treatment. Even if this option is designated as an ISO in the Notice of Stock Option Grant, it ceases to qualify for favorable tax treatment as an ISO to the extent that it is exercised:

(i) More than three months after the date when the Optionee ceases to be an Employee for any reason other than death or permanent and total disability (as defined in Section 22(e)(3) of the Code);

(ii) More than 12 months after the date when the Optionee ceases to be an Employee by reason of permanent and total disability (as defined in Section 22(e)(3) of the Code); or

 

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(iii) More than three months after the date when the Optionee has been on a leave of absence for 90 days, unless the Optionee’s reemployment rights following such leave were guaranteed by statute or by contract.

SECTION 7. RIGHT OF REPURCHASE.

(a) Scope of Repurchase Right. Until they vest in accordance with the Notice of Stock Option Grant and Subsection (b) below, the Shares acquired under this Agreement shall be Restricted Shares and shall be subject to the Company’s Right of Repurchase. The Company, however, may decline to exercise its Right of Repurchase or may exercise its Right of Repurchase only with respect to a portion of the Restricted Shares. The Company may exercise its Right of Repurchase only during the Repurchase Period following the termination of the Optionee’s Service, but the Right of Repurchase may be exercised automatically under Subsection (d) below. If the Right of Repurchase is exercised, the Company shall pay the Optionee an amount equal to the lower of (i) the Exercise Price of each Restricted Share being repurchased or (ii) the Fair Market Value of such Restricted Share at the time the Right of Repurchase is exercised.

(b) Lapse of Repurchase Right. The Right of Repurchase shall lapse with respect to the Restricted Shares in accordance with the vesting schedule set forth in the Notice of Stock Option Grant. In addition, if the Company is subject to a Change in Control before the Optionee’s Service terminates and the Optionee is subject to an Involuntary Termination within 12 months after such Change in Control (or during the 1 month period prior to the consummation of such Change in Control), then all of the then Restricted Shares shall become vested and the Right of Repurchase shall lapse with respect to such then Restricted Shares.

(c) Escrow. Upon issuance, the certificate(s) for Restricted Shares shall be deposited in escrow with the Company to be held in accordance with the provisions of this Agreement. Any additional or exchanged securities or other property described in Subsection (f) below shall immediately be delivered to the Company to be held in escrow. All ordinary cash dividends on Restricted Shares (or on other securities held in escrow) shall be paid directly to the Optionee and shall not be held in escrow. Restricted Shares, together with any other assets held in escrow under this Agreement, shall be (i) surrendered to the Company for repurchase upon exercise of the Right of Repurchase or the Right of First Refusal or (ii) released to the Optionee upon his or her request to the extent that the Shares have ceased to be Restricted Shares (but not more frequently than once every six months). In any event, all Shares that have ceased to be Restricted Shares, together with any other vested assets held in escrow under this Agreement, shall be released within 90 days after the earlier of (i) the termination of the Optionee’s Service or (ii) the lapse of the Right of First Refusal.

(d) Exercise of Repurchase Right. The Company shall be deemed to have exercised its Right of Repurchase automatically for all Restricted Shares as of the commencement of the Repurchase Period, unless the Company during the Repurchase Period notifies the holder of the Restricted Shares pursuant to Section 13(c) that it will not exercise its Right of Repurchase for some or all of the Restricted Shares. The Company shall pay to the holder of the Restricted Shares the purchase price determined under Subsection (a) above for the Restricted Shares being repurchased. Payment shall be made in cash or cash equivalents and/or by canceling indebtedness to the Company incurred by the Optionee in the purchase of the Restricted Shares. The certificate(s) representing the Restricted Shares being repurchased shall be delivered to the Company.

 

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(e) Termination of Rights as Stockholder. If the Right of Repurchase is exercised in accordance with this Section 7 and the Company makes available the consideration for the Restricted Shares being repurchased, then the person from whom the Restricted Shares are repurchased shall no longer have any rights as a holder of the Restricted Shares (other than the right to receive payment of such consideration). Such Restricted Shares shall be deemed to have been repurchased pursuant to this Section 7, whether or not the certificate(s) for such Restricted Shares have been delivered to the Company or the consideration for such Restricted Shares has been accepted.

(f) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Restricted Shares shall immediately be subject to the Right of Repurchase. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Restricted Shares. Appropriate adjustments shall also be made to the price per share to be paid upon the exercise of the Right of Repurchase, provided that the aggregate purchase price payable for the Restricted Shares shall remain the same. In the event of a merger or consolidation of the Company with or into another entity or any other corporate reorganization, the Right of Repurchase may be exercised by the Company’s successor.

(g) Transfer of Restricted Shares. The Optionee shall not transfer, assign, encumber or otherwise dispose of any Restricted Shares without the Company’s written consent, except as provided in the following sentence. The Optionee may transfer Restricted Shares to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Restricted Shares, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(h) Assignment of Repurchase Right. The Board of Directors may freely assign the Company’s Right of Repurchase, in whole or in part. Any person who accepts an assignment of the Right of Repurchase from the Company shall assume all of the Company’s rights and obligations under this Section 7.

 

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SECTION 8. RIGHT OF FIRST REFUSAL.

(a) Right of First Refusal. Subject to Section 11(a) below, in the event that the Optionee proposes to sell, pledge or otherwise transfer to a third party any Shares acquired under this Agreement, or any interest in such Shares, the Company shall have the Right of First Refusal with respect to all (and not less than all) of such Shares. If the Optionee desires to transfer Shares acquired under this Agreement, the Optionee shall give a written Transfer Notice to the Company describing fully the proposed transfer, including the number of Shares proposed to be transferred, the proposed transfer price, the name and address of the proposed Transferee and proof satisfactory to the Company that the proposed sale or transfer will not violate any applicable federal, State or foreign securities laws. The Transfer Notice shall be signed both by the Optionee and by the proposed Transferee and must constitute a binding commitment of both parties to the transfer of the Shares. The Company shall have the right to purchase all, and not less than all, of the Shares on the terms of the proposal described in the Transfer Notice (subject, however, to any change in such terms permitted under Subsection (b) below) by delivery of a notice of exercise of the Right of First Refusal within 30 days after the date when the Transfer Notice was received by the Company.

(b) Transfer of Shares. If the Company fails to exercise its Right of First Refusal within 30 days after the date when it received the Transfer Notice, the Optionee may, not later than 90 days following receipt of the Transfer Notice by the Company, conclude a transfer of the Shares subject to the Transfer Notice on the terms and conditions described in the Transfer Notice, provided that any such sale is made in compliance with applicable federal, State and foreign securities laws and not in violation of any other contractual restrictions to which the Optionee is bound. Any proposed transfer on terms and conditions different from those described in the Transfer Notice, as well as any subsequent proposed transfer by the Optionee, shall again be subject to the Right of First Refusal and shall require compliance with the procedure described in Subsection (a) above. If the Company exercises its Right of First Refusal, the parties shall consummate the sale of the Shares on the terms set forth in the Transfer Notice within 60 days after the date when the Company received the Transfer Notice (or within such longer period as may have been specified in the Transfer Notice); provided, however, that in the event the Transfer Notice provided that payment for the Shares was to be made in a form other than cash or cash equivalents paid at the time of transfer, the Company shall have the option of paying for the Shares with cash or cash equivalents equal to the present value of the consideration described in the Transfer Notice.

(c) Additional or Exchanged Securities and Property. In the event of a merger or consolidation of the Company, a sale of all or substantially all of the Company’s stock or assets, any other corporate reorganization, a stock split, the declaration of a stock dividend, the declaration of an extraordinary dividend payable in a form other than stock, a spin-off, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities, any securities or other property (including cash or cash equivalents) that are by reason of such transaction exchanged for, or distributed with respect to, any Shares subject to this Section 8 shall immediately be subject to the Right of First Refusal. Appropriate adjustments to reflect the exchange or distribution of such securities or property shall be made to the number and/or class of the Shares subject to this Section 8.

(d) Termination of Right of First Refusal. Any other provision of this Section 8 notwithstanding, in the event that the Stock is readily tradable on an established securities market when the Optionee desires to transfer Shares, the Company shall have no Right of First Refusal, and the Optionee shall have no obligation to comply with the procedures prescribed by Subsections (a) and (b) above.

 

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(e) Permitted Transfers. This Section 8 shall not apply to (i) a transfer by beneficiary designation, will or intestate succession or (ii) a transfer to one or more members of the Optionee’s Immediate Family or to a trust established by the Optionee for the benefit of the Optionee and/or one or more members of the Optionee’s Immediate Family, provided in either case that the Transferee agrees in writing on a form prescribed by the Company to be bound by all provisions of this Agreement. If the Optionee transfers any Shares acquired under this Agreement, either under this Subsection (e) or after the Company has failed to exercise the Right of First Refusal, then this Agreement shall apply to the Transferee to the same extent as to the Optionee.

(f) Termination of Rights as Stockholder. If the Company makes available, at the time and place and in the amount and form provided in this Agreement, the consideration for the Shares to be purchased in accordance with this Section 8, then after such time the person from whom such Shares are to be purchased shall no longer have any rights as a holder of such Shares (other than the right to receive payment of such consideration in accordance with this Agreement). Such Shares shall be deemed to have been purchased in accordance with the applicable provisions hereof, whether or not the certificate(s) therefor have been delivered as required by this Agreement.

(g) Assignment of Right of First Refusal. The Board of Directors may freely assign the Company’s Right of First Refusal, in whole or in part. Any person who accepts an assignment of the Right of First Refusal from the Company shall assume all of the Company’s rights and obligations under this Section 8.

SECTION 9. LEGALITY OF INITIAL ISSUANCE.

No Shares shall be issued upon the exercise of this option unless and until the Company has determined that:

(a) It and the Optionee have taken any actions required to register the Shares under the Securities Act or to perfect an exemption from the registration requirements thereof;

(b) Any applicable listing requirement of any stock exchange or other securities market on which Stock is listed has been satisfied; and

(c) Any other applicable provision of federal, State or foreign law has been satisfied.

SECTION 10. NO REGISTRATION RIGHTS.

The Company may, but shall not be obligated to, register or qualify the sale of Shares under the Securities Act or any other applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Shares under this Agreement to comply with any law.

 

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SECTION 11. RESTRICTIONS ON TRANSFER OF SHARES.

(a) Bylaws Restrictions. The Shares acquired under this Agreement shall be subject to the transfer restrictions in Article X of the Company’s Second Amended and Restated Bylaws in addition to, and not in limitation of, the provisions of Section 8 of this Agreement.

(b) Securities Law Restrictions. Regardless of whether the offering and sale of Shares under the Plan have been registered under the Securities Act or have been registered or qualified under the securities laws of any State, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of such Shares (including the placement of appropriate legends on stock certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any State or any other law.

(c) Market Stand-Off. In connection with any underwritten public offering by the Company of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Company’s initial public offering, the Optionee or a Transferee shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement without the prior written consent of the Company or its managing underwriter. Such restriction (the “Market Stand-Off’) shall be in effect for such period of time following the date of the final prospectus for the offering as may be requested by the Company or such underwriter. In no event, however, shall such period exceed 180 days plus such additional period as may reasonably be requested by the Company or such underwriter to accommodate regulatory restrictions on (i) the publication or other distribution of research reports or (ii) analyst recommendations and opinions, including (without limitation) the restrictions set forth in Rule 2711(f)(4) of the National Association of Securities Dealers and Rule 472(f)(4) of the New York Stock Exchange, as amended, or any similar successor rules. The Market Stand-Off shall in any event terminate two years after the date of the Company’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Company’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Company may impose stop-transfer instructions with respect to the Shares acquired under this Agreement until the end of the applicable stand-off period. The Company’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (c). This Subsection (c) shall not apply to Shares registered in the public offering under the Securities Act.

(d) Investment Intent at Grant. The Optionee represents and agrees that the Shares to be acquired upon exercising this option will be acquired for investment, and not with a view to the sale or distribution thereof.

 

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(e) Investment Intent at Exercise. In the event that the sale of Shares under the Plan is not registered under the Securities Act but an exemption is available that requires an investment representation or other representation, the Optionee shall represent and agree at the time of exercise that the Shares being acquired upon exercising this option are being acquired for investment, and not with a view to the sale or distribution thereof, and shall make such other representations as are deemed necessary or appropriate by the Company and its counsel.

(f) Legends. All certificates evidencing Shares purchased under this Agreement shall bear the following legends:

“THE SHARES REPRESENTED HEREBY MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE TERMS OF A WRITTEN AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED HOLDER OF THE SHARES (OR THE PREDECESSOR IN INTEREST TO THE SHARES). SUCH AGREEMENT GRANTS TO THE COMPANY CERTAIN RIGHTS OF FIRST REFUSAL UPON AN ATTEMPTED TRANSFER OF THE SHARES AND CERTAIN REPURCHASE RIGHTS UPON TERMINATION OF SERVICE WITH THE COMPANY. THE SECRETARY OF THE COMPANY WILL UPON WRITTEN REQUEST FURNISH A COPY OF SUCH AGREEMENT TO THE HOLDER HEREOF WITHOUT CHARGE.”

“THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR IN ANY MANNER DISPOSED OF, EXCEPT IN COMPLIANCE WITH THE BYLAWS OF THE CORPORATION. COPIES OF THE BYLAWS OF THE CORPORATION MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE CORPORATION.”

All certificates evidencing Shares purchased under this Agreement in an unregistered transaction shall bear the following legend (and such other restrictive legends as are required or deemed advisable under the provisions of any applicable law):

“THE SHARES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.”

(g) Removal of Legends. If, in the opinion of the Company and its counsel, any legend placed on a stock certificate representing Shares sold under this Agreement is no longer required, the holder of such certificate shall be entitled to exchange such certificate for a certificate representing the same number of Shares but without such legend.

(h) Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 11 shall be conclusive and binding on the Optionee and all other persons.

 

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SECTION 12. ADJUSTMENT OF SHARES.

In the event of any transaction described in Section 8(a) of the Plan, the terms of this option (including, without limitation, the number and kind of Shares subject to this option and the Exercise Price) shall be adjusted as set forth in Section 8(a) of the Plan. In the event that the Company is a party to a merger or consolidation or in the event of a sale of all or substantially all of the Company’s stock or assets, this option shall be subject to the treatment provided by the Board of Directors in its sole discretion, as provided in Section 8(b) of the Plan.

SECTION 13. MISCELLANEOUS PROVISIONS.

(a) Rights as a Stockholder. Neither the Optionee nor the Optionee’s representative shall have any rights as a stockholder with respect to any Shares subject to this option until the Optionee or the Optionee’s representative becomes entitled to receive such Shares by filing a notice of exercise and paying the Purchase Price pursuant to Sections 4 and 5.

(b) No Retention Rights. Nothing in this option or in the Plan shall confer upon the Optionee any right to continue in Service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company (or any Parent or Subsidiary employing or retaining the Optionee) or of the Optionee, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and for any reason, with or without cause.

(c) Notice. Any notice required by the terms of this Agreement shall be given in writing. It shall be deemed effective upon (i) personal delivery, (ii) deposit with the United States Postal Service, by registered or certified mail, with postage and fees prepaid or (iii) deposit with Federal Express Corporation, with shipping charges prepaid. Notice shall be addressed to the Company at its principal executive office and to the Optionee at the address that he or she most recently provided to the Company in accordance with this Subsection (c).

(d) Modifications and Waivers. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Optionee and by an authorized officer of the Company (other than the Optionee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time.

(e) Entire Agreement. The Notice of Stock Option Grant, this Agreement and the Plan constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or written and whether express or implied) that relate to the subject matter hereof.

(f) Choice of Law. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Delaware, as such laws are applied to contracts entered into and performed in such State.

 

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SECTION 14. ACKNOWLEDGEMENTS OF THE OPTIONEE.

(a) Tax Consequences. The Optionee agrees that the Company does not have a duty to design or administer the Plan or its other compensation programs in a manner that minimizes the Optionee’s tax liabilities. The Optionee shall not make any claim against the Company or its Board of Directors, officers or employees related to tax liabilities arising from this option or the Optionee’s other compensation. In particular, the Optionee acknowledges that this option is exempt from Section 409A of the Code only if the Exercise Price is at least equal to the Fair Market Value per Share on the Date of Grant. Since Shares are not traded on an established securities market, the determination of their Fair Market Value is made by the Board of Directors or by an independent valuation firm retained by the Company. The Optionee acknowledges that there is no guarantee in either case that the Internal Revenue Service will agree with the valuation, and the Optionee shall not make any claim against the Company or its Board of Directors, officers or employees in the event that the Internal Revenue Service asserts that the valuation was too low.

(b) Electronic Delivery of Documents. The Optionee agrees to accept by email all documents relating to the Company, the Plan or this option and all other documents that the Company is required to deliver to its security holders (including, without limitation, disclosures that may be required by the Securities and Exchange Commission). The Optionee also agrees that the Company may deliver these documents by posting them on a website maintained by the Company or by a third party under contract with the Company. If the Company posts these documents on a website, it shall notify the Optionee by email of their availability. The Optionee acknowledges that he or she may incur costs in connection with electronic delivery, including the cost of accessing the internet and printing fees, and that an interruption of internet access may interfere with his or her ability to access the documents. This consent shall remain in effect until this option expires or until the Optionee gives the Company written notice that it should deliver paper documents.

(c) No Notice of Expiration Date. The Optionee agrees that the Company and its officers, employees, attorneys and agents do not have any obligation to notify him or her prior to the expiration of this option pursuant to Section 6, regardless of whether this option will expire at the end of its full term or on an earlier date related to the termination of the Optionee’s Service. The Optionee further agrees that he or she has the sole responsibility for monitoring the expiration of this option and for exercising this option, if at all, before it expires. This Subsection (c) shall supersede any contrary representation that may have been made, orally or in writing, by the Company or by an officer, employee, attorney or agent of the Company.

SECTION 15. DEFINITIONS.

(a) “Adoption Agreement” shall mean an Adoption Agreement to the Voting Agreement, substantially in the form attached as Exhibit A thereto.

(b) “Agreement” shall mean this Stock Option Agreement.

(c) “Board of Directors’ shall mean the Board of Directors of the Company, as constituted from time to time or, if a Committee has been appointed, such Committee.

 

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(d) “Cause” shall mean:

(i) An unauthorized use or disclosure by the Optionee of the Company’s confidential information or trade secrets, which use or disclosure causes material harm to the Company;

(ii) A material breach by the Optionee of any agreement between the Optionee and the Company;

(iii) A material failure by the Optionee to comply with the Company’s written policies or rules;

(iv) The Optionee’s conviction of, or plea of “guilty” or “no contest” to, a felony under the laws of the United States or any State thereof;

(v) The Optionee’s gross negligence or willful misconduct;

(vi) A continuing failure by the Optionee to perform assigned duties after receiving written notification of such failure from the Board of Directors; or

(vii) A failure by the Optionee to cooperate in good faith with a governmental or internal investigation of the Company or its directors, officers or employees, if the Company has requested the Optionee’s cooperation.

(e) “Change in Control” shall mean (i) the consummation of a merger or consolidation of the Company with or into another entity; or (ii) the dissolution, liquidation or winding up of the Company. The foregoing notwithstanding, a merger or consolidation of the Company does not constitute a “Change in Control” if immediately after the merger or consolidation a majority of the voting power of the capital stock of the continuing or surviving entity, or any direct or indirect parent corporation of the continuing or surviving entity, will be owned by the persons who were the Company’s stockholders immediately prior to such merger or consolidation in substantially the same proportions as their ownership of the voting power of the Company’s capital stock immediately prior to the merger or consolidation.

(f) “Co-Sale Agreement” shall mean that certain Fifth Amended and Restated First Refusal and Co-Sale Agreement, dated as of April 13, 2015, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

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

(h) “Committee” shall mean a committee of the Board of Directors, as described in Section 2 of the Plan.

(i) “Company” shall mean Mulberry Health Inc., a Delaware corporation.

 

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(j) “Consultant” shall mean a person, excluding Employees and Outside Directors, who performs bona fide services for the Company, a Parent or a Subsidiary as a consultant or advisor and who qualifies as a consultant or advisor under Rule 701(c)(1) of the Securities Act or under Instruction A.1.(a)(1) of Form S-8 under the Securities Act.

(k) “Date of Grant” shall mean the date of grant specified in the Notice of Stock Option Grant, which date shall be the later of (i) the date on which the Board of Directors resolved to grant this option or (ii) the first day of the Optionee’s Service.

(l) “Disability” shall mean that the Optionee is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.

(m) “Employee” shall mean any individual who is a common-law employee of the Company, a Parent or a Subsidiary.

(n) “Exercise Price” shall mean the amount for which one Share may be purchased upon exercise of this option, as specified in the Notice of Stock Option Grant.

(o) “Fair Market Value” shall mean the fair market value of a Share, as determined by the Board of Directors in good faith. Such determination shall be conclusive and binding on all persons.

(p) “Immediate Family” shall mean any child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law and shall include adoptive relationships.

(q) “Involuntary Termination” means either (a) the Optionee’s Termination Without Cause or (b) the Optionee’s Resignation for Good Reason.

(r) “ISO” shall mean an employee incentive stock option described in Section 422(b) of the Code.

(s) “Notice of Stock Option Grant” shall mean the document so entitled to which this Agreement is attached.

(t) “NSO” shall mean a stock option not described in Sections 422(b) or 423(b) of the Code.

(u) “Optionee” shall mean the person named in the Notice of Stock Option Grant.

(v) “Outside Director” shall mean a member of the Board of Directors who is not an Employee.

(w) “Parent” shall mean any corporation (other than the Company) in an unbroken chain of corporations ending with the Company, if each of the corporations other than the Company owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

 

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(x) “Plan” shall mean the Mulberry Health Inc. 2012 Stock Plan, as in effect on the Date of Grant.

(y) “Purchase Price” shall mean the Exercise Price multiplied by the number of Shares with respect to which this option is being exercised.

(z) “Repurchase Period” shall mean a period of 90 consecutive days commencing on the date when the Optionee’s Service terminates for any reason, including (without limitation) death or disability.

(aa) “Resignation for Good Reason” means a Separation as a result of the Optionee’s resignation within 12 months after one of the following conditions has come into existence without the Optionee’s consent: (a) a reduction in the Optionee’s base salary by more than 10%; (b) a material diminution of the Optionee’s authority, duties or responsibilities; or (c) a relocation of the Optionee’s principal workplace by more than 50 miles. A Resignation for Good Reason shall not be deemed to have occurred unless the Optionee gives the Company written notice of the condition within 90 days after the condition comes into existence and the Company fails to remedy the condition within 30 days after receiving such written notice.

(bb) “Restricted Share” shall mean a Share that is subject to the Right of Repurchase.

(cc) “Right of First Refusal” shall mean the Company’s right of first refusal described in Section 8.

(dd) “Right of Repurchase” shall mean the Company’s right of repurchase described in Section 7.

(ee) “Securities Act” shall mean the Securities Act of 1933, as amended.

(ff) “Separation” means a “separation from service,” as defined in the regulations under Section 409A of the Code.

(gg) “Service” shall mean service as an Employee, Outside Director or Consultant.

(hh) “Share” shall mean one share of Stock, as adjusted in accordance with Section 8 of the Plan (if applicable).

(ii) “Stock” shall mean the Series A Common Stock of the Company.

(jj) “Subsidiary” shall mean any corporation (other than the Company) in an unbroken chain of corporations beginning with the Company, if each of the corporations other than the last corporation in the unbroken chain owns stock possessing 50% or more of the total combined voting power of all classes of stock in one of the other corporations in such chain.

 

15


(kk) “Termination Without Cause” means a Separation as a result of a termination of the Optionee’s employment by the Company without Cause, provided the Optionee is willing and able to continue performing services within the meaning of Treasury Regulation 1.409A-1(n)(1).

(ll) “Transferee” shall mean any person to whom the Optionee has directly or indirectly transferred any Share acquired under this Agreement.

(mm) “Transfer Notice” shall mean the notice of a proposed transfer of Shares described in Section 8.

(nn) “Voting Agreement” shall mean that certain Fifth Amended and Restated Voting Agreement, dated as of April 13, 2015, by and among the Company and certain stockholders of the Company party thereto, as may be amended from time to time.

 

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MULBERRY HEALTH INC. EMPLOYEE PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT

The following agreement (the “Agreement”) between Mulberry Health Inc., a Delaware corporation (the “Company”), and the individual identified on the signature page to this Agreement (“Employee” or “I”) is effective as of January 1, 2016, the first day of my employment by the Company. I acknowledge that this Agreement is a material part of the consideration for my employment and continued employment by the Company. In exchange for the foregoing, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows:

 

1. No Conflicts. I have not made, and agree not to make, any agreement, oral or written, that is in conflict with this Agreement or my employment with the Company. I will not violate any agreement with or the rights of any third party. When acting within the scope of my employment (or otherwise on behalf of the Company), I will not use or disclose my own or any third party’s confidential information or intellectual property (collectively, “Restricted Materials”), except as expressly authorized by the Company in writing. Further, I have not retained anything containing or reflecting any confidential information of a prior employer or other third party, whether or not created by me.

2. Inventions.

a. Definitions. Intellectual Property Rights” means any and all patent rights, copyright rights, trademark rights, mask work rights, trade secret rights, sui generis database rights and all other intellectual and industrial property rights of any sort throughout the world (including any application therefor). “Invention” means any idea, concept, discovery, invention, development, research, technology, work of authorship, trade secret, software, firmware, content, audio-visual material, tool, process, technique, know- how, data, plan, device, apparatus, specification, design, prototype, circuit, layout, mask work, algorithm, program, code, documentation or other material or information, tangible or intangible, whether or not it may be patented, copyrighted, trademarked or otherwise protected (including all versions, modifications, enhancements and derivative works thereof).

b. Assignment. To the fullest extent under applicable law, the Company shall own all right, title and interest in and to all Inventions (including all Intellectual Property Rights therein or related thereto) that are made, conceived or reduced to practice, in whole or in part, by me during the term of my employment with the Company and which arise out of any use of Company’s facilities or assets or any research or other activity conducted by, for or under the direction of the Company (whether or not (i) conducted at the Company’s facilities, (ii) during working hours or (iii) using Company assets), or which are useful with or relate directly or indirectly to any “Company Interest” (meaning any product, service, other Invention or Intellectual Property Right that is sold, leased, used, proposed, under consideration or under development by the Company). I will promptly disclose and provide all of the foregoing Inventions (the “Assigned Inventions”) to the Company. I hereby make and agree to make all assignments to the Company necessary to effectuate and accomplish the foregoing ownership. Assigned Inventions shall not include any Invention that is both (x) developed entirely on my own time, without use of any Company facilities, assets, ideas or direction and (y) not useful with or related to any Company Interest.

c. Assurances. I will further assist the Company, at its expense, to evidence, record and perfect such assignments, and to perfect, obtain, maintain, enforce and defend any rights specified to be so owned or assigned. I hereby irrevocably designate and appoint the Company and its officers as my agents and attorneys-in-fact, coupled with an interest, to act for and on my behalf to execute and file any document and to perform all other lawfully permitted acts to further the purposes of the foregoing with the same legal force and effect as if executed by me.

d. Other Inventions. If I wish to clarify that something created by me prior to my employment, which relates or may relate to the Company’s actual or proposed business, is not within the scope of the assignment of Inventions under this Agreement, then I have listed it on Appendix A. If (i) I use or disclose any Restricted Materials (including anything listed in Appendix A) when acting within the scope of my employment (or otherwise on behalf of the Company), or (ii) any Assigned Invention cannot be fully made, used, reproduced, sold, distributed, or otherwise exploited without using, misappropriating or violating any Restricted Materials, I hereby grant and agree to grant to the Company a perpetual, irrevocable, worldwide, royalty-free, non-exclusive, transferable, sublicensable right and license to use, disclose, exploit and exercise all rights in such Restricted Materials, including any Intellectual Property Rights therein. I will not use or disclose any Restricted Materials for which I am not fully authorized to grant the foregoing license.

e. Moral Rights. To the extent allowed by applicable law, the terms of this Section 2 include all rights of paternity, integrity, disclosure, withdrawal and any other rights that may be known or referred to as moral rights, artist’s rights, droit moral or the like (collectively, “Moral Rights”). To the extent I retain any such Moral Rights under applicable law, I hereby ratify and consent to any action that may be taken with respect to such Moral Rights by or authorized by the Company and agree not to assert any Moral Rights with respect thereto. I will confirm any such ratification, consent or agreement from time to time as requested by the Company. Furthermore, I agree that notwithstanding any rights of publicity, privacy or otherwise (whether or not statutory) anywhere in the world and without any further compensation, the Company may and is hereby authorized to use my name, likeness and voice in connection with promotion of its business, products and services and to allow others to do the same.

3. Proprietary Information. I agree that all Assigned Inventions and all other financial, business, legal and technical information, including the identity of and any other information relating to the Company’s employees, Affiliates and Business Partners (as such terms are defined below), which I develop, learn or obtain during my employment or that are received by or for the Company in confidence, constitute “Proprietary Information.” I will hold in strict confidence and not directly or indirectly disclose or use any Proprietary Information, except (x) as required within the scope of my employment, (y) as required by applicable law, subpoena or governmental or regulatory investigation or (z)

 

 

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to my legal representatives or a court of law, as reasonably necessary in connection with any bona fide dispute between the Company and me; provided that in the event Proprietary Information is required to be disclosed pursuant to subsection (y) above, I will (i) give the Company prompt written notice of such requirement, (ii) reasonably cooperate with the Company, at the Company’s expense, in seeking a protective order or otherwise challenging such requirement and (iii) limit the disclosure to the minimum amount required to comply with such requirement. Nothing in this Agreement prohibits me from reporting possible violations of federal law or regulation to any governmental agency or entity, including but not limited to the Department of Justice, the Securities and Exchange Commission, the Congress, and any agency Inspector General, or making other disclosures that are protected under the whistleblower provisions of federal law or regulation, and I do not need prior authorization from the Company to make any such reports or disclosures and am not required to notify the Company that I have made such reports or disclosures. Proprietary Information shall not include information that, I can document, is or becomes readily available to the public without restriction through no fault of mine (including breach of this Agreement). Upon termination of my employment (for any or no reason, whether voluntary or involuntary), I will promptly return to the Company all items containing or embodying Proprietary Information (including all copies), except that I may keep my personal copies of (a) my compensation records, (b) materials distributed to shareholders generally, (c) contacts and calendar and (d) this Agreement. I also recognize and agree that I have no expectation of privacy with respect to the Company’s networks, telecommunications systems or information processing systems (including, without limitation, stored computer files, email messages and voice messages), and that my activity and any files or messages on or using any of those systems may be monitored at any time without notice, regardless of whether such activity occurs on equipment owned by me or the Company. I further agree that any property situated on the Company’s premises and owned, leased or otherwise possessed by the Company, including computers, computer files, email, voicemail, storage media, filing cabinets or other work areas, is subject to inspection by Company personnel at any time with or without notice.

4. Restricted Activities. For the purposes of this Section 4, the term Company includes the Company and all other persons or entities that control, are controlled by or are under common control with the Company excluding (i) institutional investors and (ii) companies controlled by any such institutional investors in (i) that are not otherwise affiliates of the Company (“Affiliates”).

a. Definitions. Any Capacity” includes, without limitation, to (i) be an owner, founder, shareholder, partner, member, advisor, director, consultant, contractor, agent, employee, affiliate or coventurer, (ii) otherwise invest, engage or participate in, (iii) be compensated by, or (iv) prepare to be or do any of the foregoing or assist any third party to do so in anticipation of being or doing any of the foregoing under (i), (ii) or (iii) upon the expiration of any restrictive periods described herein; provided, Any Capacity will not include being a holder of less than two percent (2%) of the outstanding equity of a public company or any non-public company through investments in mutual funds, private equity funds or hedge funds or similar passive investment vehicles. “Business Partner” means any present or prospective customer,

vendor, supplier, distributor or other business partner of the Company. “Cause” means to recruit, employ, retain or otherwise solicit, induce or influence, or to attempt to do so. “Solicit” means to (1) service, take orders from or solicit the business or patronage of any Business Partner for myself or any other person or entity in connection with a Competing Business, (2) divert, entice or otherwise take away from the Company the business or patronage of any Business Partner, or to attempt to do so, or (3) solicit, induce or encourage any Business Partner to terminate or reduce its relationship with the Company.

b. Acknowledgments.

i. I acknowledge and agree that (1) the Company’s business is highly competitive, secrecy of the Proprietary Information is of the utmost importance to the Company, and I will learn and use Proprietary Information in the course of performing my work for the Company and (2) my position may require me to establish goodwill with Business Partners and employees on behalf of the Company and such goodwill is extremely important to the Company’s success, and the Company has made substantial investments to develop its business interests and goodwill.

ii. I agree that the limitations as to time, geographical area and scope of activity to be restrained in this Section 4 are reasonable and are not greater than necessary to protect the goodwill or other business interests of the Company. I further agree that such investments are worthy of protection and that the Company’s need for protection afforded by this Section 4 is greater than any hardship I may experience by complying with its terms.

iii. I acknowledge that my violation or attempted violation of the agreements in this Section 4 will cause irreparable damage to the Company or its Affiliates, and I therefore agree that the Company shall be entitled as a matter of right to seek an injunction, out of any court of competent jurisdiction, restraining any violation or further violation of such agreements by me or others acting on my behalf. The Company’s right to injunctive relief shall be cumulative and in addition to any other remedies provided by law or equity.

iv. Although the parties believe that the limitations as to time, geographical area and scope of activity contained herein are reasonable and do not impose a greater restraint than necessary to protect the goodwill or other business interests of the Company, if it is judicially determined otherwise, the limitations shall be reformed to the extent necessary to make them reasonable and not to impose a restraint that is greater than necessary to protect the goodwill or other business interests of the Company. In any such case, the Company and I agree that the provisions of this Section 4 shall be valid and binding as though any invalid or unenforceable provision had not been included.

c. As an Employee. During my employment with the Company, I will not directly or indirectly: (i) Cause any person to leave their employment with the Company (other than terminating subordinate employees in the course of my duties for the Company); (ii) Solicit; (iii) act in Any Capacity in or with respect to any commercial activity which competes, or is reasonably likely to compete, with any business that the Company conducts, proposes to conduct or demonstrably anticipates conducting, at any time during my employment (a “Competing Business”); (iv) enter into an employment, consulting or other similar relationship with another person or entity that requires a significant time commitment without the prior written consent of the Company.

 

 

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d. After Termination. For the period of twelve (12) months immediately following termination of my employment with the Company (for any or no reason, whether voluntary or involuntary), I will not directly or indirectly: (i) Cause any person to leave their employment with the Company (provided that providing a reference for an employee or hiring an employee who responds to a non-targeted advertisement shall not be deemed a breach of this subsection 4(d)(i)); (ii) Solicit; or (iii) act in Any Capacity in or with respect to any Competing Business located within the State of New York, the rest of the United States, or anywhere else in the world. The foregoing time frames shall be increased by the period of time beginning from the commencement of any violation of the foregoing provisions until such time as I have cured such violation.

5. Employment at Will. I agree that this Agreement is not an employment contract for any particular term. I have the right to resign and the Company has the right to terminate my employment at will, at any time, for any or no reason, with or without cause. This Agreement does not purport to set forth all of the terms and conditions of my employment, and as an employee of the Company, I have obligations to the Company which are not described in this Agreement. However, the terms of this Agreement govern over any such terms that are inconsistent with this Agreement, and supersede the terms of any similar form that I may have previously signed. This Agreement can only be changed by a subsequent written agreement signed by the Chief Executive Officer or President of the Company, or an authorized designee.

6. Survival. I agree that any change or changes in my employment title, duties, compensation or equity interest after the signing of this Agreement shall not affect the validity or scope of

this Agreement. I agree that my obligations under Sections 2, 3 and 4 of this Agreement shall continue in effect after termination of my employment, regardless of the reason, and whether such termination is voluntary or involuntary, and that the Company is entitled to communicate my obligations under this Agreement to any of my potential or future employers. I will provide a copy of this Agreement to any potential or future employers of mine, so that they are aware of my obligations hereunder. My obligations under Sections 2, 3 and 4 also shall be binding upon my heirs, executors, assigns and administrators, and shall inure to the benefit of the Company, its Affiliates, successors and assigns. This Agreement may be freely assigned by the Company to any third party in connection with the sale or merger of the Company’s assets or business.

7. Miscellaneous. Any dispute in the meaning, effect or validity of this Agreement shall be resolved in accordance with the laws of the State of New York without regard to the conflict of laws provisions thereof. Any legal action or proceeding relating to this Agreement shall be brought exclusively in the state or federal courts located in New York County, New York, and each party consents to the jurisdiction thereof. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of such rights. Unless expressly provided otherwise, each right and remedy in this Agreement is in addition to any other right or remedy, at law or in equity, and the exercise of one right or remedy will not be deemed a waiver of any other right or remedy. If one or more provisions of this Agreement are held to be illegal or unenforceable under applicable law, such illegal or unenforceable portion shall be limited or excluded from this Agreement to the minimum extent required so that this Agreement shall otherwise remain in full force and effect and enforceable. I acknowledge and agree that any breach or threatened breach of this Agreement will cause irreparable harm to the Company for which damages would not be an adequate remedy, and, therefore, the Company is entitled to injunctive relief with respect thereto (without the necessity of posting any bond) in addition to any other remedies.

 

 

[Signature Page Follows]

 

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I HAVE READ THIS AGREEMENT CAREFULLY AND I UNDERSTAND AND ACCEPT THE OBLIGATIONS THAT IT IMPOSES UPON ME WITHOUT RESERVATION. NO PROMISES OR REPRESENTATIONS HAVE BEEN MADE TO ME TO INDUCE ME TO SIGN THIS AGREEMENT. I SIGN THIS AGREEMENT VOLUNTARILY AND FREELY, WITH THE UNDERSTANDING THAT I EITHER (1) HAVE RETAINED A COPY OF THIS AGREEMENT OR (2) MAY, AT ANY TIME, REQUEST A COPY OF THIS AGREEMENT FROM THE COMPANY.

 

COMPANY                   EMPLOYEE
By:  

/s/ Mario Schlosser

     By:   

/s/ Joel Klein

Name:  

 

     Name:    JOEL KLEIN
Title:  

 

     Address:   

####

SIGNATURE PAGE TO MULBERRY HEALTH INC. EMPLOYEE PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT


Appendix A

Prior Matters

None.

Exhibit 10.17

oscar

Mulberry Management Corporation

75 Varick St, 5th floor

New York, NY 10013

June 26, 2019

Meghan Joyce

####

Dear Meghan:

Mulberry Management Corporation (“Oscar” or the “Company”) is pleased to offer you employment on the following terms:

 

1.

Position. Your title will be EVP, Chief Operating Officer, and you will report to the Company’s CEO. This is a full-time position beginning on September 9, 2019 (the actual date you commence full-time employment, the “Start Date”), based in New York. In addition, prior to the commencement of your tenure as EVP, Chief Operating Officer, you agree to be reasonably available, consistent with your other obligations, for limited consulting services with the Company, from the date you execute this Agreement until your Start Date (“the Consulting Period”).

 

2.

Conflicts. From your Start Date forward, while you render services to the Company, you will not engage in any other employment, consulting or other business activity (whether full-time or part-time) that would create a conflict of interest with the Company. By signing this letter agreement, you confirm to the Company that you have no contractual commitments or other legal obligations that would prohibit you from performing your duties for the Company, and that you are willing to and able to assist the Company in complying with applicable regulatory requirements arising from your hiring and employment, including the completion of biographical affidavits. We are aware that you have certain consulting obligations to Uber and we have agreed that this poses no conflict that would prohibit you from serving as an Oscar officer, provided, however, that such obligations do not render you unable to fully perform your job duties.

 

3.

Cash Compensation. Beginning with your Start Date, the Company will pay you a starting salary at the rate of $600,000 per year, payable in accordance with the Company’s standard payroll schedule. This salary will be subject to adjustment pursuant to the Company’s employee compensation policies in effect from time to time.

 

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4.

Corporate Housing. As part of your need to have housing in New York the Company will pay you a one-time bonus of $120,000 (the “Relocation Bonus”) payable on September 9, 2019, to be used for relocation costs. If, within six months of your start date, you voluntarily terminate your employment (unless your departure constitutes a Resignation for Good Reason, as defined herein) or are terminated for Cause, you will be required to pay back the Company for the Relocation Bonus. In addition, the Company will provide a one-time reimbursement of up to $10,000 for out-of-pocket expenses you incur for executive coaching services.

 

5.

Employee Benefits. Upon your Start Date, as a regular employee of the Company, you will be eligible to participate in a number of Company-sponsored benefits. In addition, you will be entitled to paid vacation in accordance with the Company’s vacation policy, as in effect from time to time.

 

6.

Stock Options. Subject to the approval of the Board of Directors of Oscar’s parent, Mulberry Health Inc. (“Mulberry”) or its Compensation Committee, with such approval not to be unreasonably withheld, you will be granted an option to purchase 4,500,000 shares of Mulberry’s Common Stock (the “Option”). In consideration of your availability to the Company during the Consulting Period as set forth above, the Option will be granted within 30 days after the start of that Consulting Period. The exercise price per share of the Option will be the fair market value of the Option as determined by the Board of Directors or its Compensation Committee when the Option is granted. The Option will be subject to the terms and conditions applicable to options granted under Mulberry’s 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable Stock Option Agreement. Subject to Section 7(d), you will vest in 25% of the Option shares after 12 months of continuous service beginning on the Start Date, and the balance will vest in equal monthly installments over the next 36 months of continuous service, as described in the applicable Stock Option Agreement. For the avoidance of doubt, Upon a Change of Control and upon (i) an Involuntary Termination or (ii) a Resignation for Good Reason (all as such terms are defined below), if such events occur within one year after a Change of Control (as defined herein), One-Hundred Percent (100%) of the Option will vest, as described in the applicable Stock Option Agreement. You and the Company hereby agree to make such conforming changes to the form of Stock Option Agreement as required to make the Stock Option Agreement consistent with the vesting provisions of this Agreement.

 

7.

Performance Bonus: In addition, if your employment at Oscar begins between January 1 and September 30, you will be eligible to receive a discretionary performance bonus of up to 30% of your annual salary based upon you and the Company satisfactorily reaching various goals that are established for the calendar year in which your employment begins (payable, at the sole discretion of the Company, in the first quarter of year following the calendar year for which performance is measured). If you are eligible to receive a performance bonus, your performance bonus will be prorated for the length of time you are employed with Oscar in the applicable calendar year. The bonus will be payable only if you are employed at the time the Company makes the payment. You will not be eligible for a performance bonus for the year in which you join the Company if your employment at Oscar begins after September 30. The timing of bonus payments is subject to the Company’s sole discretion.

 

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8.

Proprietary Information and Inventions Agreement. Like all Company employees, you will be required, as a condition of your employment with the Company, to sign the Company’s standard Proprietary Information and Inventions Agreement, a copy of which is attached hereto as Exhibit A.

9. Severance Benefits.

 

  (a)

General. If you are subject to an Involuntary Termination, then you will be entitled to the benefits described in this Section 7. However, this Section 7 will not apply unless you (i) have returned all Company property in your possession (subject to any exceptions set forth herein), and (ii) have resigned as a member of the boards of directors of the Company and all of its affiliates, to the extent applicable, and (iii) have executed a general release of all claims, excepting claims for which you have a private right of action under any applicable federal or state statute, including without limitation, civil rights or employment claims under state or federal law (e.g., Title VII of the 1964 Civil Rights Act and similar state law provision), statutory whistleblower claims, or claims for intentionally tortious conduct, that you may have against the Company and/or persons affiliated with the Company in their capacities as agents of the Company arising out of your employment with the Company and/or the termination thereof, and your not revoking such release. For avoidance of all doubt, in addition to the claims preserved above as against the Company, this provision preserves your rights as against individual persons affiliated with the Company and shall not release any claims against such individuals. The release shall be in the form reasonably acceptable to the Company and reasonably limited as set forth herein.

 

  (b)

Salary Continuation. In the event that you are subject to an Involuntary Termination, the Company will continue to pay your base salary for a period of six months after your Separation. You will also be paid a reasonable pro-rata bonus for the year in which you are terminated. Your base salary will be paid at the rate in effect at the time of your Separation and in accordance with the Company’s standard payroll procedures.

 

  (c)

Option Exercisability Extension. In addition, provided you are not terminated for Cause, as defined herein, upon the termination of your service, the Company will cause the Stock Option Agreement for the Option to be amended such that the Option will expire with respect to vested Option shares ten (10) years after the date on which the Option was granted by the Board of Directors or its Compensation Committee.

 

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  (d)

Option Vesting. In the event that you are subject to an Involuntary Termination before you have completed 12 months of continuous service, the vested percentage of the Option will be determined by dividing (i) half the number of months of continuous service between the Start Date and the date you cease providing service by (ii) 48 months.

 

10.

Employment Relationship. Employment with the Company is for no specific period of time. Your employment with the Company will be “at will,” meaning that either you or the Company may terminate your employment at any time and for any reason, with or without cause. Any contrary representations that may have been made to you are superseded by this letter agreement. This is the full and complete agreement between you and the Company on this term. Although your job duties, title, compensation and benefits, as well as the Company’s personnel policies and procedures, may change from time to time, the “at will” nature of your employment may only be changed in an express written agreement signed by you and a duly authorized officer of the Company (other than you).

11. Tax Matters.

Withholding. All forms of compensation referred to in this letter agreement are subject to reduction to reflect applicable withholding and payroll taxes and other deductions required by law.

Tax Advice. You are encouraged to obtain your own tax advice regarding your compensation from the Company. You agree that the Company does not have a duty to design its compensation policies in a manner that minimizes your tax liabilities, and you will not make any claim against the Company or its Board of Directors related to tax liabilities arising from your compensation.

 

12.

Interpretation, Amendment and Enforcement. This letter agreement and Exhibit A supersede and replace any prior agreements, representations or understandings (whether written, oral, implied or otherwise) between you and the Company and constitute the complete agreement between you and the Company regarding the subject matter set forth herein. This letter agreement may not be amended or modified, except by an express written agreement signed by both you and a duly authorized officer of the Company. The terms of this letter agreement and the resolution of any disputes as to the meaning, effect, performance or validity of this letter agreement or arising out of, related to, or in any way connected with, this letter agreement, your employment with the Company or any other relationship between you and the Company (the “Disputes”) will be governed by New York law, excluding laws relating to conflicts or choice of law.

 

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13.

Arbitration Agreement. The Company and you mutually agree that, except as otherwise provided in this Arbitration Agreement, any and all claims, disputes, or controversies, past, present, or future, between you and the Company arising out of or relating to your selection and application for employment, employment, and/or termination of employment, excepting any and all claims against the Company for which you have a private right of action under any applicable federal or state statute (including without limitation, civil rights or employment claims under state or federal law (e.g., Title VII of the 1964 Civil Rights Act and similar state law provision), statutory whistleblower claims), or claims for intentionally tortious conduct, will be decided by a single arbitrator in final and binding arbitration, and not by way of court or jury trial. Except as otherwise provided in this section, this Arbitration Agreement applies, without limitation, to claims based upon or related to breach of any alleged contract or covenant, fraud, negligence, breach of fiduciary duty, trade secrets, unfair competition, wages, compensation or any monies claimed to be owed, tort claims, common law claims, equitable claims, state statutes or regulations addressing the same or similar subject matters, and all other federal, state, or local legal claims. The Federal Arbitration Act applies to this Arbitration Agreement. The arbitration will be administered by the American Arbitration Association (“AAA”), under the then current Employment Arbitration Rules of the AAA (“AAA Rules”); provided however, that if there is a conflict between the AAA Rules and this Arbitration Agreement, this Arbitration Agreement shall govern. The Company and you agree to bring any claim or dispute in arbitration on an individual basis only, and not as a class or collective action, and there will be no right or authority for any claim or dispute to be brought, heard or arbitrated as a class or collective action (“Class Action Waiver”). Regardless of anything else in this Arbitration Agreement and/or the AAA Rules, or any amendments and/or modifications to those rules, any claim that all or part of the Class Action Waiver is invalid, unenforceable, unconscionable, void or voidable, may be determined only by a court of competent jurisdiction and not by an arbitrator.

The award issued by the arbitrator (which must be in writing and state the legal and factual bases for the award) may be entered in any court of competent jurisdiction. The arbitrator may award any remedy to which a party is entitled in their individual capacity under applicable law. The parties will pay the fees and costs of arbitration in accordance with applicable law and the AAA Rules. The Company will pay the costs of arbitration but each party will pay for its or her own attorneys’ fees, if any, but if any party prevails on a claim which affords the prevailing party attorneys’ fees, the arbitrator may award reasonable fees to the prevailing party as provided by law.

Notwithstanding the foregoing, the following claims are expressly excluded from arbitration: (i) Workers’ Compensation benefits, state disability insurance benefits or unemployment insurance benefits; (ii) disputes that an applicable federal statute expressly states cannot be arbitrated or subject to a pre-dispute arbitration agreement; and (iii) representative actions for civil penalties filed under the California Private Attorney General Act (“PAGA”) (but to the extent permitted by

 

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applicable law, any claim by you on your own behalf under PAGA to recover your unpaid wages must be arbitrated and is covered by this Arbitration Agreement); (iv) claims for which you have a private right of action under any applicable federal or state statute, or claims for intentionally tortious conduct, as described above; and (v) claims against individuals affiliated with the Company brought against them in their individual not corporate capacities. Additionally, nothing in this agreement to arbitrate prevents you from reporting to or filing a claim or charge with a governmental agency, including without limitation, the Equal Employment Opportunity Commission, U.S. Department of Labor, or law enforcement agencies, and nothing in this Arbitration Agreement prevents the investigation by a government agency of any report, claim or charge otherwise covered by this Arbitration Agreement. Both the Company and you may apply to a court of competent jurisdiction for temporary or preliminary injunctive relief in connection with an arbitrable controversy, but all determinations of final relief will be decided in arbitration, and the pursuit of temporary or preliminary injunctive relief shall not be deemed incompatible with or constitute a waiver of rights under this Arbitration Agreement.

This Arbitration Agreement survives the termination of your employment with the Company, and may only be modified or terminated by a writing signed by both you and the Company. If any provision of this Arbitration Agreement is adjudged to be invalid, unenforceable, unconscionable, void or voidable, in whole or in part, such adjudication will not affect the validity of the remainder of the Arbitration Agreement. All remaining provisions will remain in full force and effect.

 

14.

Definitions. The following terms have the meaning set forth below wherever they are used in this Offer Letter:

 

  (a)

“Cause” shall mean the occurrence of any of the following circumstances: (i) gross negligence or willful misconduct by you (including any gross and willful breach of material Company policies or of material obligations to the Company), (ii) your indictment for, conviction of, or pleading guilty or nolo contendere to, a felony under the laws of the United States or any State thereof, (iii) your unauthorized use or disclosure of the Company’s confidential information or trade secrets, which use or disclosure causes material harm to the Company or (iv) your failure to cooperate reasonably and in good faith with a governmental or internal investigation of the Company or its directors, officers or employees, if the Company has requested your reasonable and truthful cooperation; provided that, in the case of clauses (i), (iii) or (iv), you have received written notification from the Company describing the nature of the failure or breach constituting Cause in reasonable detail and you have not cured that failure or breach within 10 days following such notice (to the extent curable). For purposes of this Section 12(a), no action or inaction shall be treated as “willful” unless it is action or inaction committed or omitted in bad faith and with no reasonable belief it was in the interests of the Company.

 

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  (b)

“Change in Control” means (i) the consummation of a merger or consolidation of Mulberry with or into another entity; or (ii) the dissolution, liquidation or winding up of Mulberry. The foregoing notwithstanding, a merger or consolidation of Mulberry does not constitute a “Change in Control” if immediately after the merger or consolidation a majority of the voting power of the capital stock of the continuing or surviving entity, or any direct or indirect parent corporation of the continuing or surviving entity, will be owned by the persons who were Mulberry’s stockholders immediately prior to such merger or consolidation in substantially the same proportions as their ownership of the voting power of Mulberry’s capital stock immediately prior to the merger or consolidation.

 

  (c)

“Involuntary Termination” means either your (i) Termination Without Cause; or (b) Resignation for Good Reason.

 

  (d)

“Resignation for Good Reason” means a Separation as a result of your resignation within 12 months after one of the following conditions has come into existence without your written consent: (i) a reduction in your base salary; (ii) a material diminution of your position, authority, duties or responsibilities; (iii) a relocation of your principal workplace (A) by more than 25 miles or (B) away from the Company’s headquarters or (iv) a material breach of this Agreement (including for the avoidance of doubt, failure to make the Option grants in violation of Section 4) or any equity agreement by the Company or any of its affiliates. A Resignation for Good Reason shall not be deemed to have occurred unless you give the Company written notice of the condition within 90 days after the condition comes into existence and the Company fails to remedy the condition within 30 days after receiving such written notice.

 

  (e)

“Separation” means a “separation from service,” as defined in the regulations under Section 409A of the Internal Revenue Code, from the Company.

 

  (f)

“Termination Without Cause” means a Separation as a result of a termination of your employment by the Company without Cause, provided you are willing and able to continue performing services within the meaning of Treasury Regulation 1.409A-1(n)(1).

* * * * *

We hope that you will accept our offer to join the Company. You may indicate your agreement with these terms and accept this offer by signing and dating both the enclosed duplicate original of this letter agreement and the enclosed Proprietary Information and Inventions Agreement and returning them to me. This offer, if not accepted, will expire at the close of business on June 28, 2019. As required by law, your employment with the Company is contingent upon your providing legal proof of your identity and authorization to work in the United States. Your employment is also contingent upon completion of an employment application, your starting work with the Company on the agreed upon date, and pending passing a background check, which may include a check of your credit history.

 

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If you have any questions, please contact Kerry Van Voris at ####

 

Very truly yours,

Mulberry Management Corporation

By:

 

/s/ Mario Schlosser

Mario Schlosser

Title:

 

Chief Executive Officer

 

I have read and accept this employment offer:

/s/ Meghan Joyce

Signature of Meghan Joyce
Dated: 6/27/2019

Attachment

Exhibit A: Proprietary Information and Inventions Agreement

 

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EMPLOYEE INVENTIONS AND PROPRIETARY INFORMATION AGREEMENT

The following agreement (the “Agreement”) between Mulberry Management Corporation, a Delaware corporation (the “Company”), and the individual identified on the signature page to this Agreement (“Employee” or “I”) is effective as of the first day of Employee’s employment by the Company and confirms and memorializes the agreement that (regardless of the execution date hereof) the Company and I have had since the commencement of my employment (which term, for purposes of this Agreement, shall be deemed to include any relationship of service to the Company that I may have had prior to actually becoming an employee). I acknowledge that this Agreement is a material part of the consideration for my employment or continued employment by the Company. In exchange for the foregoing and for other good and valuable consideration, including my access to and use of the Company’s Inventions (defined below) and Proprietary Information (defined below) for performance of my employment, training and/or receipt of certain other valuable consideration, the parties agree as follows:

 

1. No Conflicts. I have not made, and agree not to make, any agreement, oral or written, that is in conflict with this Agreement or my employment with the Company. I will not violate any agreement with, or the rights of, any third party. When acting within the scope of my employment (or otherwise on behalf of the Company), I will not use or disclose my own or any third party’s confidential information or intellectual property (collectively, “Restricted Materials”), except as expressly authorized by the Company in writing. Further, I have not retained anything containing or reflecting any confidential information or intellectual property of a prior employer or other third party, whether or not created by me.

2. Inventions.

a. Definitions. Company Interest” means any of the Company’s current and reasonably anticipated business, research and development of which I am aware or should reasonably be aware upon the termination of my employment, as well as any product, service, other Invention or Intellectual Property Rights (defined below) that is sold, leased, used, licensed, provided, proposed, under consideration or under development by the Company. “Intellectual Property Rights” means any and all patent rights, copyright rights, trademark rights, mask work rights, trade secret rights, sui generis database rights and all other intellectual and industrial property rights of any sort throughout the world (including any application therefor and any rights to apply therefor, as well as all rights to pursue remedies for infringement or violation thereof). “Invention” means any idea, concept, discovery, learning, invention, development, research, technology, work of authorship, trade secret, software, firmware, content, audio-visual material, tool, process, technique, know-how, data, plan, device, apparatus, specification, design, prototype, circuit, layout, mask work, algorithm, program, code, documentation or other material or information, tangible or intangible, and all versions, modifications, enhancements and

derivative works thereof, whether or not it may be patented, copyrighted, trademarked or otherwise protected.

b. Assignment. The Company shall own, and I hereby assign and agree to assign, all right, title and interest in and to all Inventions (including all Intellectual Property Rights therein, related thereto or embodied therein) that are collected, made, conceived, developed, reduced to practice or set out in any tangible medium of expression or otherwise created, in whole or in part (collectively “Created”), by me during the term of my employment with the Company that either (i) arise out of any use of the Company’s facilities, equipment, Proprietary Information or other assets (collectively “Company Assets”) or any research or other activity conducted by, for or under the direction of the Company (whether or not conducted (A) at the Company’s facilities; (B) during working hours or (C) using Company Assets), or (ii) are useful with or in or relate directly or indirectly to any Company Interest. I will promptly disclose and provide all of the foregoing Inventions (the “Assigned Inventions”) to the Company. However, the foregoing does not purport to assign to the Company (and Assigned Inventions shall not include) any Invention that: (1) by law (including, without limitation, the applicable statutory provision for my state of employment set forth in Appendix A, if any) I cannot be required to so assign; or (2) otherwise meets all of the following requirements: (I) the Invention is Created entirely on my own time; (II) the Invention is Created entirely without use of any Company Assets and (III) the Invention is not useful with or related to any Company Interest. In the event that I believe any Invention Created by me during the term of my employment is not within the definition of Assigned Inventions, unless so doing would be unreasonable given the circumstances, I will nevertheless disclose it to the Company so that the Company may make its assessment.

 


c. Assurances. I hereby make and agree to make all assignments to the Company necessary to effectuate and accomplish the Company’s ownership in and to all Assigned Inventions. I will further assist the Company, at its expense, to evidence, record and perfect such assignments, and to perfect, obtain, maintain, enforce and defend any rights specified to be so owned or assigned. I hereby irrevocably designate and appoint the Company and its officers as my agents and attorneys-in-fact, coupled with an interest, to act for and on my behalf to execute and file any document and to perform all other lawfully permitted acts to further the purposes of the foregoing with the same legal force and effect as if executed by me.

d. Other Inventions. If (i) I use or disclose any Restricted Materials when acting within the scope of my employment (or otherwise to or on behalf of the Company) or (ii) any Assigned Invention cannot be fully made, used, reproduced, sold, distributed, modified, commercialized or otherwise exploited (collectively, “Exploited”) without using, misappropriating, infringing or violating any Restricted Materials, I hereby grant and agree to grant to the Company a perpetual, irrevocable, worldwide, fully paid-up, royalty-free, non-exclusive, assignable, transferable, sublicensable right and license to use, disclose, fully Exploit and exercise all rights in such Restricted Materials and all Intellectual Property Rights embodied therein or related thereto. I will not use or disclose any Restricted Materials for which I am not fully authorized to grant the foregoing license.

e. Moral Rights. To the extent allowed by applicable law, the terms of this Section 2 include all rights of paternity, integrity, disclosure, withdrawal and any other rights that may be known or referred to as moral rights, artist’s rights, droit moral or the like (collectively, “Moral Rights”). To the extent I retain any such Moral Rights under applicable law, I hereby ratify and consent to any action that may be taken with respect to such Moral Rights by or authorized by the Company, and agree not to assert any Moral Rights with respect thereto. I will confirm any such ratification, consent or agreement from time to time as requested by the Company. Furthermore, I agree that notwithstanding any rights of publicity, privacy or otherwise (whether or not statutory) anywhere in the world and without any further compensation, the Company may and is hereby authorized to use my name, likeness and voice in connection with promotion of its business, products and services, and to allow others to do the same.

3. Proprietary Information.

a. Definition; Restrictions on Use. I agree that all Assigned Inventions (and all other financial, business, legal and technical information concerning any Company Interest that that I develop, learn or obtain during my employment or that are received by or for the Company in confidence constitute “Proprietary Information.” I will hold in strict confidence and not directly or indirectly disclose or use any Proprietary Information, except as required within the scope of my employment. My obligation of nondisclosure and nonuse of Proprietary Information under this Section shall cease if the information becomes available to the public by a reasonably diligent search through no fault of mine (including breach of this Agreement) or, if a court requires a shorter duration, then the maximum time allowable by law will control. Furthermore, I understand that this Agreement does not affect my immunity under 18 USC Sections 1833(b) (1) or (2), which read as follows:

 

  (1)

An individual shall not be held criminally or civilly liable under any federal or state trade secret law for the disclosure of a trade secret that (A) is made (i) in confidence to a federal, state, or local government official, either directly or indirectly, or to an attorney; and (ii) solely for the purpose of reporting or investigating a suspected violation of law; or (B) is made in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal.

 

  (2)

An individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual (A) files any document containing the trade secret under seal; and (B) does not disclose the trade secret, except pursuant to court order.

 

  b.

Upon Termination. Upon termination of my employment (for any or no reason, whether voluntary or involuntary), I will promptly identify and, as directed by the Company, destroy, delete or return to the Company all items containing or embodying Proprietary Information (including all original or copies of content, whether in electronic or hard-copy form), except that I may keep my personal copies of (i) my compensation records; (ii) materials distributed to shareholders generally; (iii) this Agreement or (iv) as permitted by law in the context of pending, threatened, contemplated or potential regulatory or legal disputes.

 

 

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c. Company Systems. I also recognize and agree that I have no expectation of privacy with respect to the Company’s networks, telecommunications systems or information processing systems (including, without limitation, stored computer files, email messages and voicemail messages or other devices (including personal devices)) in which Company Proprietary Information resides, is stored or is passed through (“Company Systems”), and in order to ensure compliance with work rules and safety concerns, the Company or its agents may monitor, at any time and without further notice to me, any Company Systems and any of my activity, files or messages on or using any Company Systems, regardless of whether such activity occurs on equipment owned by me or the Company. I further agree that any property situated on the Company’s premises and owned, leased or otherwise possessed by the Company, including computers, computer files, email, voicemail, storage media, filing cabinets or other work areas, is subject to inspection by Company personnel at any time with or without notice. I understand and acknowledge that (A) any such searches or monitoring efforts are not formal accusations of wrongdoing but rather part of the procedure of an investigation and (B) refusal to consent to such a search may be grounds for discipline.

4. Restricted Activities. For the purposes of this Section 4, the term “the Company” includes the Company and all other persons or entities that control, are controlled by or are under common control with the Company (“Affiliates”) and for whom Employee performed responsibilities, or about whom Employee has Proprietary Information.

a. Definitions. “Any Capacity” includes, without limitation, to (i) be an owner, founder, shareholder, partner, member, advisor, director, consultant, contractor, agent, employee, affiliate, or co-venturer, (ii) otherwise invest, engage or participate in, (iii) be compensated by, or (iv) prepare to be or do any of the foregoing or assist any third party to do so in anticipation of being or doing any of the foregoing under (i), (ii), or (iii) upon the expiration of any restrictive periods described herein; provided, Any Capacity, will not include being a holder of less than two percent (2%) of the outstanding equity of a public company or nonpublic company through investments in mutual funds, private equity funds or hedge funds or similar passive investment vehicles. “Business Partner” means any past (i.e., within the twelve (12) months preceding Employee’s termination from the Company), present or prospective (i.e., actively pursued by the Company within the twelve (12) months preceding Employee’s termination from the Company) customer, vendor, supplier, distributor or other business partner of the Company with whom Employee comes into contact during Employee’s employment with the Company or

about whom Employee had knowledge by reason of Employee’s relationship with the Company or because of Employee’s access to Proprietary Information. “Cause” means to recruit, employ, retain or otherwise solicit, induce or influence, or to attempt to do so (provided that if I am a resident of California, “Cause” means to recruit, or otherwise solicit, induce or influence, or to attempt to do so). “Solicit”, with respect to Business Partners, means to (A) service, take orders from or solicit the business or patronage of any Business Partner for Employee or any other person or entity, (B) divert, entice or otherwise take away from the Company the business or patronage of any Business Partner, or to attempt to do so, or (C) solicit, induce or encourage any Business Partner to terminate or reduce its relationship with the Company.

b. Acknowledgments.

i. I acknowledge and agree that (A) the Company’s business is highly competitive; (B) secrecy of the Proprietary Information is of the utmost importance to the Company, and I will learn and use Proprietary Information in the course of performing my work for the Company and (C) my position may require me to establish goodwill with Business Partners and employees on behalf of the Company and such goodwill is extremely important to the Company’s success, and the Company has made substantial investments to develop its business interests and goodwill.

ii. I agree that the limitations as to time, geographical area and scope of activity to be restrained in this Section 4 are coextensive with the Company’s footprint and my performance of responsibilities for the Company and are therefore reasonable and not greater than necessary to protect the goodwill or other business interests of the Company. I further agree that such investments are worthy of protection and that the Company’s need for protection afforded by this Section 4 is greater than any hardship I may experience by complying with its terms.

iii. I acknowledge that a material violation of or attempted violation of the agreements in this Section 4 will cause irreparable damage to the Company or its Affiliates, and may, upon the finding of such circumstances, I therefore agree that the Company shall be entitled as a matter of right to an injunction entered by a court of competent jurisdiction, restraining any violation or further violation of such agreements by me or others acting on my behalf. The Company’s right to seek injunctive relief shall be cumulative and in addition to any other remedies provided by law or equity.

 

 

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iv. Although the parties believe that the limitations as to time, geographical area and scope of activity contained herein are reasonable and do not impose a greater restraint than necessary to protect the goodwill or other business interests of the Company, if it is judicially determined otherwise, the limitations shall be reformed to the extent necessary to make them reasonable and not to impose a restraint that is greater than necessary to protect the goodwill or other business interests of the Company.

v. In any such case, the Company and I agree that the remaining provisions of this Section 4 shall be valid and binding as though any invalid or unenforceable provision had not been included.

c. As an Employee. During my employment with the Company, I will not willfully: (i) Cause any person to cease or reduce their services (as an employee or otherwise) to the Company (other than terminating subordinate employees in the course of my duties for the Company); (ii) Solicit any Business Partner; (iii) act in any capacity in or with respect to any commercial activity which competes, or is reasonably likely to compete, with any business that the Company conducts, proposes to conduct or demonstrably anticipates conducting, at any time during my employment with the Company where I am aware or reasonably should be aware of such activities or plans; or (iv) enter into in an employment, consulting or other similar relationship with another person or entity that requires a significant time commitment without the prior written consent of the Company.

d. After Termination. For the period of twelve (12) months immediately following my termination of employment with the Company (for any or no reason, whether voluntary or involuntary), I will not intentionally (either directly or indirectly) engage in conduct that is reasonably likely to or intended to: (i) Cause any person to cease or reduce their services (as an employee or otherwise) to the Company; or (ii) unless I am a resident of California (A) Solicit any Business Partner or (B) act in Any Capacity in or with respect to any Competing Business located within the State of New York, the rest of the United States, or anywhere else in the world. The foregoing timeframes shall be increased by the period of time beginning from the commencement of any violation of the foregoing provisions until such time as I have cured such violation. For purposes of this Section (d), the term “Competing Business” shall be restricted to the following entities and their known affiliates or subsidiaries: Devoted Health, Inc.; Bright Health Management, Inc.; Clover Health, Centene Corporation, Molina Healthcare, Inc.; Humana Inc.;

United HealthCare Services, Inc.; Cigna Corporation, CVS Health Corporation, Aetna Inc.; Anthem, Inc.; (including Empire Blue Cross/Blue Shield and Horizon); Health Care Service Corporation, Highmark Inc.; EmblemHealth and AmeriHealth.

5. Employment Not For A Defined Term. The Company and I agree that the terms of my Employment are set out in my offer letter dated June 20, 2019 and executed by the Parties. While certain terms of my employment are thus established by the offer letter, I agree that this Agreement is not an employment contract for any particular term. I have the right to resign and the Company has the right to terminate my employment at will, at any time, for any or no reason, with or without cause. This Agreement does not purport to set forth all of the terms and conditions of my employment, and as an employee of the Company, and the Company and I agree that I have rights and obligations to the Company which are not described in this Agreement. However, the terms of this Agreement govern over any such terms that are inconsistent with this Agreement, and supersede the terms of any similar form that I may have previously signed. This Agreement can only be changed by a subsequent written agreement signed by the Chief Executive Officer or President of the Company, or an officer designee authorized in writing by the foregoing or the Company’s Board of Directors.

6. Survival. I agree that any change or changes in my employment title, duties, compensation, or equity interest after the signing of this Agreement shall not affect the validity or scope of this Agreement. I agree that the terms of this Agreement, and any obligations I have hereunder, shall continue in effect after termination of my employment, regardless of the reason, and whether such termination is voluntary or involuntary, and that the Company is entitled to communicate my obligations under this Agreement to any of my potential or future employers. I agree that, consistent with what is reasonable, given the passage of time and the nature of any potential future employment, I will provide a copy of this Agreement to any potential or future employers of mine, so that they are aware of my obligations hereunder. This Agreement, and any obligations I have hereunder, also shall be binding upon my heirs, executors, assigns and administrators, and shall inure to the benefit of the Company, its Affiliates, successors and assigns. This Agreement and any rights and obligations of the Company hereunder may be freely assigned and transferred by the Company, in whole or part, to any third party.

 

 

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7. Miscellaneous. Any dispute in the meaning, effect or validity of this Agreement shall be resolved in accordance with the laws of the State of New York without regard to the conflict of laws provisions thereof. Any legal action or proceeding relating to this Agreement shall be brought exclusively in the state or federal courts located in or with jurisdiction over New York, and each party consents to the jurisdiction thereof; however, the Company may seek injunctive relief and specific performance in any court of competent jurisdiction. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of such rights. Unless expressly provided otherwise, each right and remedy in this Agreement is in addition to any other right or remedy, at law or in equity, and the

exercise of one right or remedy will not be deemed a waiver of any other right or remedy. If one or more provisions of this Agreement is held to be illegal or unenforceable under applicable law, such illegal or unenforceable portion shall be limited or excluded from this Agreement to the minimum extent required so that this Agreement shall otherwise remain in full force and effect and enforceable. I acknowledge and agree that any breach or threatened breach of this Agreement will cause irreparable harm to the Company for which damages would not be an adequate remedy, and, therefore, the Company is entitled to injunctive relief with respect thereto (without the necessity of posting any bond) in addition to any other remedies.

 

 

[Signature Page Follows]

 

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I HAVE READ THIS AGREEMENT CAREFULLY AND I UNDERSTAND AND ACCEPT THE OBLIGATIONS THAT IT IMPOSES UPON ME WITHOUT RESERVATION. NO PROMISES OR REPRESENTATIONS HAVE BEEN MADE TO ME TO INDUCE ME TO SIGN THIS AGREEMENT. I SIGN THIS AGREEMENT VOLUNTARILY AND FREELY, WITH THE UNDERSTANDING THAT I EITHER (1) HAVE RETAINED A COPY OF THIS AGREEMENT OR (2) MAY REQUEST A COPY OF THIS AGREEMENT FROM THE COMPANY AT ANY TIME.

 

MULBERRY MANAGEMENT CORPORATION     EMPLOYEE
By:  

/s/ Mario Schlosser

    By:  

/s/ Meghan Joyce

  Signature of Mario Schlosser       Signature of Meghan Joyce
Name:   Mario Schlosser     Name:   Meghan Joyce
Title:   CEO     Address:   ####
Dated:   6/27/2019       ####
       
      Dated:   6/27/2019

 

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Appendix A

If I am employed by the Company in the State of California, the following provision applies:

California Labor Code Section 2870. Application of provision providing that employee shall assign or offer to assign rights in invention to employer.

(a) Any provision in an employment agreement which provides that an employee shall assign, or offer to assign, any of his or her rights in an invention to his or her employer shall not apply to an invention that the employee developed entirely on his or her own time without using the employer’s equipment, supplies, facilities, or trade secret information except for those inventions that either:

(1) Relate at the time of conception or reduction to practice of the invention to the employer’s business, or actual or demonstrably anticipated research or development of the employer; or

(2) Result from any work performed by the employee for his employer.

(b) To the extent a provision in an employment agreement purports to require an employee to assign an invention otherwise excluded from being required to be assigned under subdivision (a), the provision is against the public policy of this state and is unenforceable.

If I am employed by the Company in the State of Delaware, the following provision applies:

Delaware Code, Title 19, § 805

Employee’s right to certain inventions.

Any provision in an employment agreement which provides that the employee shall assign or offer to assign any of the employee’s rights in an invention to the employee’s employer shall not apply to an invention that the employee developed entirely on the employee’s own time without using the employer’s equipment, supplies, facility or trade secret information, except for those inventions that: (i) relate to the employer’s business or actual or demonstrably anticipated research or development, or (ii) result from any work performed by the employee for the employer. To the extent a provision in an employment agreement purports to apply to the type of invention described, it is against the public policy of this State and is unenforceable. An employer may not require a provision of an employment agreement made unenforceable under this section as a condition of employment or continued employment.

If I am employed by the Company in the State of Illinois, the following provision applies:

Illinois Compiled Statutes Chapter 765, Section 1060/2.

Sec. 2. Employee rights to inventions—conditions. (1) A provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer does not apply to an invention for which no equipment, supplies, facilities, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this State and is to that extent void and unenforceable. The employee shall bear the burden of proof in establishing that his invention qualifies under this subsection.

(2) An employer shall not require a provision made void and unenforceable by subsection (1) of this Section as a condition of employment or continuing employment. This Act shall not preempt existing common law applicable to any shop rights of employers with respect to employees who have not signed an employment agreement.

(3) If an employment agreement entered into after January 1, 1984, contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer must also, at the time the agreement is made, provide a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer.

 

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If I am employed by the Company in the State of Kansas, the following provision applies:

Chapter 44.—LABOR AND INDUSTRIES

Article 1.—PROTECTION OF EMPLOYEES

44-130. Employment agreements assigning employee rights in inventions to employer; restrictions; certain provisions void; notice and disclosure. (a) Any provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer shall not apply to an invention for which no equipment, supplies, facilities or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless:

(1) The invention relates to the business of the employer or to the employer’s actual or demonstrably anticipated research or development; or

(2) the invention results from any work performed by the employee for the employer.

(b) Any provision in an employment agreement which purports to apply to an invention which it is prohibited from applying to under subsection (a), is to that extent against the public policy of this state and is to that extent void and unenforceable. No employer shall require a provision made void and unenforceable by this section as a condition of employment or continuing employment.

(c) If an employment agreement contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer shall provide, at the time the agreement is made, a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless:

(1) The invention relates directly to the business of the employer or to the employer’s actual or demonstrably anticipated research or development; or

(2) the invention results from any work performed by the employee for the employer.

(d) Even though the employee meets the burden of proving the conditions specified in this section, the employee shall disclose, at the time of employment or thereafter, all inventions being developed by the employee, for the purpose of determining employer and employee rights in an invention.

If I am employed by the Company in the State of Minnesota, the following provision applies:

Minnesota Statute Section 181.78. Subdivision 1.

Inventions not related to employment. Any provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer shall not apply to an invention for which no equipment, supplies, facility or trade secret information of the employer was used and which was developed entirely on the employee’s own time, and (1) which does not relate (a) directly to the business of the employer or (b) to the employer’s actual or demonstrably anticipated research or development, or (2) which does not result from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this state and is to that extent void and unenforceable.

If I am employed by the Company in the State of North Carolina, the following provision applies:

North Carolina General Statutes Section 66-57.1.

EMPLOYEE’S RIGHT TO CERTAIN INVENTIONS

Any provision in an employment agreement which provides that the employees shall assign or offer to assign any of his rights in an invention to his employer shall not apply to an invention that the employee developed entirely on his own time without using the employer’s equipment, supplies, facility or trade secret information except for those inventions that (i) relate to the employer’s business or actual or demonstrably anticipated research or development, or (ii) result from any work performed by the employee for the employer. To the extent a provision in an employment agreement purports to apply to the type of invention described, it is against the public policy of this State and in unenforceable. The employee shall bear the burden of proof in establishing that his invention qualifies under this section.

 

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If I am employed by the Company in the State of Utah, the following provision applies:

Utah Code, §§ 34-39-2 and 34-39-3

34-39-2. Definitions.

As used in this chapter:

(1) “Employment invention” means any invention or part thereof conceived, developed, reduced to practice, or created by an employee which is:

(a) conceived, developed, reduced to practice, or created by the employee:

(1) within the scope of his employment;

(ii) on his employer’s time; or

(iii) with the aid, assistance, or use of any of his employer’s property, equipment, facilities, supplies, resources, or intellectual property;

(b) the result of any work, services, or duties performed by an employee for his employer;

(c) related to the industry or trade of the employer; or

(d) related to the current or demonstrably anticipated business, research, or development of the employer.

(2) “Intellectual property” means any and all patents, trade secrets, know-how, technology, confidential information, ideas, copyrights, trademarks, and service marks and any and all rights, applications, and registrations relating to them.

34-39-3. Scope of act — When agreements between an employee and employer are enforceable or unenforceable with respect to employment inventions — Exceptions.

(1) An employment agreement between an employee and his employer is not enforceable against the employee to the extent that the agreement requires the employee to assign or license, or to offer to assign or license, to the employer any right or intellectual property in or to an invention that is:

(a) created by the employee entirely on his own time; and

(b) not an employment invention.

(2) An agreement between an employee and his employer may require the employee to assign or license, or to offer to assign or license, to his employer any or all of his rights and intellectual property in or to an employment invention.

(3) Subsection (1) does not apply to:

(a) any right, intellectual property or invention that is required by law or by contract between the employer and the United States government or a state or local government to be assigned or licensed to the United States; or

(b) an agreement between an employee and his employer which is not an employment agreement.

(4) Notwithstanding Subsection (1), an agreement is enforceable under Subsection (1) if the employee’s employment or continuation of employment is not conditioned on the employee’s acceptance of such agreement and the employee receives a consideration under such agreement which is not compensation for employment.

(5) Employment of the employee or the continuation of his employment is sufficient consideration to support the enforceability of an agreement under Subsection (2) whether or not the agreement recites such consideration.

(6) An employer may require his employees to agree to an agreement within the scope of Subsection (2) as a condition of employment or the continuation of employment.

(7) An employer may not require his employees to agree to anything unenforceable under Subsection (1) as a condition of employment or the continuation of employment.

(8) Nothing in this chapter invalidates or renders unenforceable any employment agreement or provisions of an employment agreement unrelated to employment inventions.

If I am employed by the Company in the State of Washington, the following provision applies:

TITLE 49. LABOR REGULATIONS

CHAPTER 49.44. VIOLATIONS — PROHIBITED PRACTICES

 

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(i) A provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer does not apply to an invention for which no equipment, supplies, facilities, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) directly to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this state and is to that extent void and unenforceable.

(ii) An employer shall not require a provision made void and unenforceable by subsection (1) of this section as a condition of employment or continuing employment.

(iii) If an employment agreement entered into after September 1, 1979, contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer must also, at the time the agreement is made, provide a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) directly to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employee for the employer.

 

 

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1. Employer Information

Name:

Mulberry Management Corporation

Doing Business As (DBA)

Name(s): N/A

FEIN (optional):

Physical Address:

295 Lafayette Street

6th Floor

New York, NY 10012

Mailing Address:

295 Lafayette Street

6th Floor

New York, NY 10012

Phone: 855-672-2755

 

    

The employee must receive a signed copy of this form. The employer must keep the original for 6 years.

2. Employee’s pay rate(s): State if pay is

based on an hourly, salary, day rate, piece rate, or other basis. $$11,538.46 per week

(Employees usually must be paid on a salary basis to be exempt.)

The employee acknowledges that his/her salary is compensation for all hours worked in the work week.

3. Regular payday: The 15th and last day of every month; in the event that the 15th or last day fall on a weekend, payment will be made on the closest weekday prior.

4. Pay is:

☒ Weekly

Bi-weekly

☐ Other—semi-monthly

5. Overtime Pay Rate:

The employee acknowledges that he/she is exempt from overtime.

6. Employee Acknowledgement:

On this day, I received

notice of my pay rate and designated payday. I told my employer what my primary language is.

I acknowledge that my compensation is subject to change. I further acknowledge that nothing in this notice shall constitute a contract for a specific term of employment.

Check one:

 

 

I have been given this pay notice in English because it is my primary language.

Contact your Recruiter if English is not your primary language and you would like to receive this notice in your primary language.

 

Meghan Joyce
Employee Name (printed)

/s/ Meghan Joyce

Meghan Joyce Signature

6/27/2019

Date
 

Exhibit 10.20

EMPLOYMENT AGREEMENT

THIS EMPLOYMENT AGREEMENT (this “Agreement”), dated as of December 5, 2020 (the “Effective Date”), is entered into by and between Mulberry Health Inc., a Delaware corporation (“Holdings”) and Mulberry Management Corporation (“OpCo” and, together with Holdings, the “Company”) and R. Scott Blackley (the “Executive”).

WHEREAS, the Company desires to employ the Executive and the Company and the Executive desires to enter into an agreement embodying the terms of such employment, subject to the terms and conditions of this Agreement.

NOW, THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:

1. Employment Period. Effective upon the Effective Date, the Executive’s employment hereunder shall be for a term (the “Employment Period”) commencing on the Effective Date and continuing indefinitely until terminated in accordance with the terms of this Agreement. Notwithstanding anything to the contrary in the foregoing, the Executive’s employment hereunder is terminable at will by the Company or by the Executive at any time (for any reason or for no reason), subject to the provisions of Section 4 hereof.

2. Terms of Employment.

(a) Position and Duties.

(i) Role and Responsibilities. During the portion of the Employment Period beginning on the Effective Date and ending at the close of business on March 15, 2021 (the “Senior Advisor Period”), the Executive shall serve as a Senior Advisor to the Chief Executive Officer (“CEO”) of the Company. During the Employment Period thereafter, the Executive shall serve as the Company’s Chief Financial Officer (“CFO”), and shall perform such employment duties as are usual and customary for such position. The Executive shall report directly to the CEO. At the Company’s request, the Executive shall serve the Company and/or its subsidiaries and affiliates in other capacities in addition to the foregoing, consistent with the Executive’s position hereunder. In the event that the Executive, during the Employment Period, serves in any one or more of such additional capacities, the Executive’s compensation shall not be increased beyond that specified in Section 2(b) hereof. In addition, in the event the Executive’s service in one or more of such additional capacities is terminated, the Executive’s compensation, as specified in Section 2(b) hereof, shall not be diminished or reduced in any manner as a result of such termination provided that the Executive otherwise remains employed under the terms of this Agreement.

(ii) Exclusivity. During the Senior Advisor Period, the Executive shall devote approximately five hours per week to the business and affairs of the Company. During the Employment Period thereafter, and excluding any periods of leave to which the Executive may be entitled, the Executive agrees to devote his full business time and attention to the business and affairs of the Company. Notwithstanding the foregoing, during the Employment Period, it shall not be a violation of this Agreement for the Executive to: (A) serve on boards, committees or similar bodies of charitable or nonprofit organizations, including Trout Unlimited, or on the board or committees of Hexamer Therapeutics, (B) fulfill limited teaching, speaking and writing engagements, and (C) manage his personal investments, in each case, so long as such activities do not individually or in the aggregate materially interfere or conflict with the performance of the Executive’s duties and responsibilities under this Agreement; provided, that with respect to the activities in subclauses (A) and/or (B), the Executive receives prior written approval from the Board which shall be deemed to have been obtained with respect to Trout Unlimited and Hexamer Therapeutics.


(iii) Principal Location. During the Employment Period, the Executive shall perform the services required by this Agreement at the Company’s offices located in New York, New York (the “Principal Location”), provided, however, that (i) the Executive shall be permitted to work remotely from his home in Virginia for such portion of his time as is necessary to preserve his tax residence in Virginia, (ii) with respect to the first year during the Employment Period, the Company shall reimburse the Executive for reasonable costs traveling between New York and Virginia (excluding housing and incidental expenses), subject to the Company’s policies and (iii) the parties acknowledge and agree that the Executive may be required to travel to other locations as may be necessary to fulfill the Executive’s duties and responsibilities hereunder.

(b) Compensation, Benefits, Etc.

(i) Base Salary. Effective as of the Effective Date and during the Employment Period, the Executive shall receive a base salary (the “Base Salary”) of (i) with respect to the Senior Advisor Period, $75,000 per annum and (ii) with respect to the Employment Period thereafter, $600,000 per annum. The Base Salary shall be paid in accordance with the Company’s normal payroll practices for executive salaries generally, but no less often than monthly and shall be pro-rated for partial years of employment. The Base Salary may be increased in the discretion of the Board or a subcommittee thereof, but not reduced, and the term “Base Salary” as utilized in this Agreement shall refer to the Base Salary as so increased.

(ii) Annual Cash Bonus. For each calendar year ending during the Employment Period beginning with calendar year 2021, the Executive shall be eligible to earn a cash performance bonus (an “Annual Bonus”) under the Company’s bonus plan or program applicable to senior executives targeted at 30% of the Executive’s Base Salary paid with respect to such year (the “Target Bonus”). The actual amount of any Annual Bonus shall be determined by the Board (or a subcommittee thereof) in its discretion, based on the achievement of individual and/or Company performance goals as determined by the Board (or a subcommittee thereof), and shall be pro-rated for any partial year of employment. The payment of any Annual Bonus, to the extent any Annual Bonus becomes payable, will be made on the date on which annual bonuses are paid generally to the Company’s senior executives, but in no event later than March 15th of the calendar year following the calendar year in which such Annual Bonus was earned. Except as provided in Section 4, payment of the Annual Bonus shall be subject to the Executive’s continued employment through the payment date.

(iii) Sign-On Bonus. The Company shall pay the Executive a cash signing bonus in an aggregate amount equal to $500,000 (the “Sign-On Bonus”). The payment of the Sign-On Bonus shall be made on or within 15 days following March 31, 2021, and payment shall be subject to and conditioned upon the Executive’s continued employment with the Company through March 31, 2021. Notwithstanding the foregoing, in the event that the Executive receives one or more annual cash bonus payments from the Executive’s prior employer with respect to its 2020 fiscal year (each, a “Prior Employer Bonus”), then the Sign-On Bonus shall be reduced by the aggregate amount of such Prior Employer Bonus(es) (but not below zero). The Executive shall notify the Company immediately if the Executive receives a Prior Employer Bonus; and, if a Prior Employer Bonus is paid following the payment of the Sign-On Bonus, such that the Sign-On Bonus would have been reduced as described in the foregoing sentence, then the Executive will be obligated to repay to the Company an amount equal to the amount that otherwise would not have been paid as part of the Sign-On Bonus.

 

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(iv) RSU Award.

(A) Within five days following the Effective Date, Holdings shall grant to the Executive a restricted stock units award covering 3,000,000 shares of Holdings’ Series A common stock (the “RSU Award”).

(B) Subject to the Executive’s continued service with the Company through the applicable vesting date, the RSU Award shall vest (x) with respect to 25% of the restricted stock units underlying the RSU Award on the first anniversary of the Effective Date, and (y) as to the remaining 75% of the restricted stock units underlying the RSU Award, in substantially equal installments on each of the 12 quarterly anniversaries (of the Effective Date) thereafter.

(C) The terms and conditions of the RSU Award will be set forth in a separate award agreement in a form prescribed by the Company, to be entered into by Holdings and the Executive (the “RSU Award Agreement”). The RSU Award Agreement shall provide for the following: (x) the grant of tandem dividend equivalent rights, which will be settled in cash and subject to the same vesting restrictions as the restricted stock units subject to the RSU Award, such that they will only paid out to the Executive to the extent that the vesting conditions are satisfied (with any dividend payable in respect of RSUs that are not vested on the date of payment to be paid as and when the RSU becomes vested); (y) to the extent the Company is a private company on a vesting date, at the Executive’s election any applicable tax withholding associated with the vesting and/or settlement of such portion of the RSU Award shall be conducted by means of a Company “net settlement”; and (z) to the extent the Company is a public company on a vesting date, any applicable tax withholding associated with the vesting and/or settlement of such portion of the RSU Award shall, at the Executive’s election, be conducted by means of a broker-assisted sale of shares. Except as otherwise specifically provided in this Agreement, the RSU Award shall be governed in all respects by the terms and conditions of the Plan and the RSU Award Agreement.

(v) Stock Option.

(A) Within five days following the Effective Date, Holdings shall grant to the Executive a stock option to purchase 3,000,000 shares of Holdings’ Series A common stock (the “Stock Option”).

(B) The Stock Option shall be a nonqualified stock option, shall have an exercise price per share equal to the Fair Market Value of Holding’s Series A common stock on the applicable grant date, and shall have a maximum term of ten years from the applicable grant date.

(C) Subject to the Executive’s continued service with the Company through the applicable vesting date, the Stock Option shall vest and become exercisable (x) with respect to 25% of the shares underlying the Stock Option, on the first anniversary of the Effective Date, and (y) as to the remaining 75% of the shares underlying the Stock Option, in substantially equal installments on each of the 36 monthly anniversaries (of the Effective Date) thereafter.

(D) The terms and conditions of the Stock Option shall be set forth in a separate award agreement in a form prescribed by the Company, to be entered into by Holdings and the Executive (the “Option Agreement” and, together with the RSU Award Agreement, the “Award Agreements”). The Option Agreement shall provide for the following: (x) upon a Qualifying Termination or a termination of employment due to the Executive’s death or Disability, and subject to the time execution and non-revocation of a Release, the ability to exercise the Stock

 

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Option for (I) to the extent the Company is a private company at the time of such Qualifying Termination, the maximum term of the Stock Option or (II) to the extent the Company is a public company at the time of any such termination of employment, one year following the termination date (but not beyond the maximum term of the Stock Option); and (y) to the extent the Company is a public company on an exercise date, any applicable exercise price and/or tax withholding associated with the exercise of such portion of the Stock Option shall, at the Executive’s election, be conducted by means of a broker-assisted sale of shares. Except as otherwise specifically provided in this Agreement, the Stock Option shall be governed in all respects by the terms of and conditions of the Plan and the Option Agreement.

(vi) Benefits. During the Employment Period, the Executive (and the Executive’s spouse and/or eligible dependents to the extent provided in the applicable plans and programs) shall be eligible to participate in and be covered under the health and welfare benefit plans and programs maintained by the Company for the benefit of its employees from time to time, pursuant to the terms of such plans and programs including any medical, life, hospitalization, dental, disability, accidental death and dismemberment and travel accident insurance plans and programs on the same terms and conditions as those applicable to similarly situated senior executives. In addition, during the Employment Period, the Executive shall be eligible to participate in any retirement, savings and other employee benefit plans and programs maintained from time to time by the Company for the benefit of its senior executive officers. Nothing contained in this Section 2(b)(vi) shall create or be deemed to create any obligation on the part of the Company to adopt or maintain any health, welfare, retirement or other benefit plan or program at any time or to create any limitation on the Company’s ability to modify or terminate any such plan or program.

(vii) Expenses. During the Employment Period, the Executive shall be entitled to receive prompt reimbursement for all reasonable business expenses incurred by the Executive in connection with the performance of his duties under this Agreement in accordance with the policies, practices and procedures of the Company provided to employees of the Company. In addition, the Company shall pay or reimburse the Executive for the reasonable attorney’s fees and related expenses actually incurred in connection with the review and negotiation of this Agreement and the PIIA, which shall not exceed $30,000.

(viii) Fringe Benefits. During the Employment Period, the Executive shall be eligible to receive such fringe benefits and perquisites as are provided by the Company to its employees from time to time, in accordance with the policies, practices and procedures of the Company, and shall receive such additional fringe benefits and perquisites as the Company may, in its discretion, from time-to-time provide to its senior executive officers.

(ix) Vacation. During the Employment Period, the Executive shall be entitled to paid vacation in accordance with the plans, policies, programs and practices of the Company applicable to its employees, as in effect from time to time.

3. Termination of Employment.

(a) Death or Disability. The Executive’s employment shall terminate automatically upon the Executive’s death during the Employment Period. Either the Company or the Executive may terminate the Executive’s employment in the event of the Executive’s Disability during the Employment Period.

(b) Termination by the Company. The Company may terminate the Executive’s employment during the Employment Period for Cause or without Cause.

 

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(c) Termination by the Executive. The Executive’s employment may be terminated by the Executive for any or no reason, including with Good Reason or by the Executive without Good Reason.

(d) Notice of Termination. Any termination of employment (other than due to the Executive’s death), shall be communicated by a Notice of Termination to the other parties hereto given in accordance with Section 12(b) hereof. The failure by the Executive or the Company to set forth in the Notice of Termination any fact or circumstance which contributes to a showing of Good Reason or Cause shall not waive any right of the Executive or the Company, respectively, hereunder or preclude the Executive or the Company, respectively, from asserting such fact or circumstance in enforcing the Executive’s or the Company’s rights hereunder.

(e) Termination of Offices and Directorships; Return of Property. Upon termination of the Executive’s employment for any reason, unless otherwise specified in a written agreement between the Executive and the Company, the Executive shall be deemed to have resigned from all offices, directorships, and other employment positions if any, then held with the Company, and shall take all actions reasonably requested by the Company to effectuate the foregoing. In addition, upon the termination of the Executive’s employment for any reason, the Executive agrees to return to the Company all documents of the Company and its affiliates (and all copies thereof) and all other Company or Company affiliate property that the Executive has in his possession, custody or control. Such property includes, without limitation: (i) any materials of any kind that the Executive knows contain or embody any proprietary or confidential information of the Company or an affiliate of the Company (and all reproductions thereof), (ii) computers (including, but not limited to, laptop computers, desktop computers and similar devices) and other portable electronic devices (including, but not limited to, tablet computers), cellular phones/smartphones, credit cards, phone cards, entry cards, identification badges and keys, and (iii) any correspondence, drawings, manuals, letters, notes, notebooks, reports, programs, plans, proposals, financial documents, or any other documents concerning the customers, business plans, marketing strategies, products and/or processes of the Company or any of its affiliates and any information received from the Company or any of its affiliates regarding third parties.

4. Obligations of the Company upon Termination.

(a) Accrued Obligations. In the event that the Executive’s employment under this Agreement terminates during the Employment Period for any reason, the Company will pay or provide to the Executive: (i) any earned but unpaid Base Salary and accrued vacation time, (ii) reimbursement of any business expenses incurred by the Executive prior to the Date of Termination that are reimbursable in accordance with Section 2(b)(vii) hereof, (iii) payment of any earned but unpaid Annual Bonus for any calendar year completed prior to the Date of Termination and (iv) any vested amounts due to the Executive under any plan, program or policy of the Company (together, the “Accrued Obligations”); provided, however, that if the Executive’s employment hereunder is terminated (X) by the Company for Cause or (Y) by the Executive voluntarily without Good Reason and not for death or Disability, then any Annual Bonus earned pursuant to Section 2(b)(ii) in respect of a prior calendar year, but not yet paid, shall be forfeited. The Accrued Obligations described in clauses (i) – (ii) of the preceding sentence shall be paid within 30 days after the Date of Termination (or such earlier date as may be required by applicable law), the Accrued Obligations described in clause (iii) of the preceding sentence shall be paid in the ordinary course pursuant to Section 2(b)(ii) (i.e., on the date on which annual bonuses are paid to the Company’s senior executives generally for such calendar year) and the Accrued Obligations described in clause (iv) of the preceding sentence shall be paid in accordance with the terms of the governing plan or program.

(b) Qualifying Termination. Subject to Sections 4(c), 4(e) and 11(d), and the Executive’s continued compliance with the provisions of Section 7 hereof, if the Executive’s employment with the Company is terminated during the Employment Period due to a Qualifying Termination, then in addition to the Accrued Obligations:

 

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(i) Cash Severance. The Company shall pay the Executive an amount equal to 1.0 times the sum of the Executive’s Base Salary (at the highest rate in effect at any time in the six months prior to the Date of Termination) and the Target Bonus for the calendar year in which the Date of Termination occurs (the “Severance”). The Severance shall be paid in substantially equal installments in accordance with the Company’s normal payroll practices over the twelve-month period following the Date of Termination, but shall commence on the first normal payroll date following the effective date of the Release (as defined below), and amounts otherwise payable prior to such first payroll date shall be paid on such date without interest thereon.

(ii) Pro-Rated Bonus. The Company shall pay the Executive, in a single lump sum cash payment on the 60th day following the Date of Termination, an amount equal to a pro rata portion of the Executive’s Target Bonus for the partial calendar year in which the Date of Termination occurs (prorated based on the number of days in the calendar year in which the Date of Termination occurs, through the Date of Termination).

(iii) COBRA. Subject to the Executive’s valid election to continue healthcare coverage under Section 4980B of the Code, the Company shall continue to provide, during the COBRA Period, the Executive and the Executive’s eligible dependents with coverage under its group health plans at the same levels and the same cost to the Executive as would have applied if the Executive’s employment had not been terminated based on the Executive’s elections in effect on the Date of Termination, provided, however, that (A) if any plan pursuant to which such benefits are provided is not, or ceases prior to the expiration of the period of continuation coverage to be, exempt from the application of Section 409A under Treasury Regulation Section 1.409A-1(a)(5), or (B) the Company is otherwise unable to continue to cover the Executive under its group health plans without incurring penalties (including without limitation, pursuant to Section 2716 of the Public Health Service Act or the Patient Protection and Affordable Care Act), then, in either case, an amount equal to each remaining Company subsidy shall thereafter be paid to the Executive in substantially equal monthly installments over the continuation coverage period (or the remaining portion thereof). For purposes of this Agreement, “COBRA Period” shall mean the period beginning on the Date of Termination and ending on the first anniversary thereof.

(iv) Equity Acceleration. All outstanding Holdings equity awards that vest solely on the passage of time that are held by the Executive on the Date of Termination (the “Time-Vesting Awards”) shall vest and, to the extent applicable, become exercisable, on an accelerated basis as of the Date of Termination with respect to the number of shares underlying such award that would have vested (and become exercisable, if applicable) had the Executive remained in continuous service beyond the Date of Termination for twelve additional months (and, with respect to the RSU Award, assuming such award vests in equal monthly installments (rather than quarterly installments) over the vesting period); provided, however, that if the Date of Termination occurs prior to the one-year anniversary of the Effective Date, then each of the RSU Award and Stock Option shall vest (and, to the extent applicable, become exercisable) with respect to 25% of the shares underlying each such award. Notwithstanding the foregoing, in the event that the Qualifying Termination occurs on or within 12 months following a Change in Control, then all Time-Vesting Awards shall become fully vested and, to the extent applicable, exercisable.

(c) Release. Notwithstanding the foregoing, it shall be a condition to the Executive’s right to receive the amounts provided for in Section 4(b) hereof that the Executive execute and deliver to the Company an effective release of claims in substantially the form attached hereto as Exhibit A (the

 

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Release”) and the Release becomes irrevocable within 30 days (or, to the extent required by law, 52 days) following the Date of Termination (the date such Release becomes irrevocable herein referred to as the “Release Effective Date”). For the avoidance of doubt, all equity awards eligible for accelerated vesting pursuant to Section 4(b) hereof shall remain outstanding and eligible to vest following the Date of Termination and shall actually vest and become exercisable (if applicable) and non-forfeitable upon the Release Effective Date.

(d) Other Terminations. If the Executive’s employment is terminated for any reason not described in Section 4(b) hereof, the Company will pay the Executive only the Accrued Obligations.

(e) Six-Month Delay. Notwithstanding anything to the contrary in this Agreement, no compensation or benefits, including without limitation any severance payments or benefits payable under this Section 4, shall be paid to the Executive during the six-month period following the Executive’s Separation from Service if the Company determines that paying such amounts at the time or times indicated in this Agreement would be a prohibited distribution under Section 409A(a)(2)(B)(i) of the Code. If the payment of any such amounts is delayed as a result of the previous sentence, then on the first day of the seventh month following the date of Separation from Service (or such earlier date upon which such amount can be paid under Section 409A without resulting in a prohibited distribution, including as a result of the Executive’s death), the Company shall pay the Executive a lump-sum amount equal to the cumulative amount that would have otherwise been payable to the Executive during such period.

(f) Exclusive Benefits. Except as expressly provided in this Section 4 and subject to Section 5 hereof, the Executive shall not be entitled to any additional payments or benefits upon or in connection with the Executive’s termination of employment.

5. Non-Exclusivity of Rights. Amounts which are vested benefits or which the Executive is otherwise entitled to receive under any plan, policy, practice or program of or any contract or agreement with the Company at or subsequent to the Date of Termination shall be payable in accordance with such plan, policy, practice or program or contract or agreement except as explicitly modified by this Agreement.

6. Excess Parachute Payments; Limitation on Payments.

(a) Best Pay Cap. Notwithstanding any other provision of this Agreement, in the event that any payment or benefit received or to be received by the Executive (including any payment or benefit received in connection with a termination of the Executive’s employment, whether pursuant to the terms of this Agreement or any other plan, arrangement or agreement) (all such payments and benefits, including the payments and benefits under Section 4 hereof, being hereinafter referred to as the “Total Payments”) would be subject (in whole or part), to the excise tax imposed under Section 4999 of the Code (the “Excise Tax”), then, the Total Payments shall be reduced, to the extent necessary so that no portion of the Total Payments is subject to the Excise Tax but only if (i) the net amount of such Total Payments, as so reduced (and after subtracting the net amount of federal, state and local income taxes on such reduced Total Payments and after taking into account the phase out of itemized deductions and personal exemptions attributable to such reduced Total Payments) is greater than or equal to (ii) the net amount of such Total Payments without such reduction (but after subtracting the net amount of federal, state and local income taxes on such Total Payments and the amount of Excise Tax to which the Executive would be subject in respect of such unreduced Total Payments and after taking into account the phase out of itemized deductions and personal exemptions attributable to such unreduced Total Payments). If the Total Payments are so reduced, the Company shall reduce or eliminate the Total Payments (A) by first reducing or eliminating the portion of the Total Payments which are not payable in cash (other than that portion of the Total Payments subject to clause (C) hereof), (B) then by reducing or eliminating cash payments (other than that portion of

 

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the Total Payments subject to clause (C) hereof) and (C) then by reducing or eliminating the portion of the Total Payments (whether payable in cash or not payable in cash) to which Treasury Regulation § 1.280G-1 Q/A 24(c) (or successor thereto) applies, in each case in reverse order beginning with payments or benefits which are to be paid the farthest in time.

(b) Certain Exclusions. For purposes of determining whether and the extent to which the Total Payments will be subject to the Excise Tax, (i) no portion of the Total Payments the receipt or enjoyment of which the Executive shall have waived at such time and in such manner as not to constitute a “payment” within the meaning of Section 280G(b) of the Code shall be taken into account; (ii) no portion of the Total Payments shall be taken into account which, in the written opinion of an independent, nationally recognized accounting firm (the “Independent Advisors”) selected by the Company, does not constitute a “parachute payment” within the meaning of Section 280G(b)(2) of the Code (including by reason of Section 280G(b)(4)(A) of the Code) and, in calculating the Excise Tax, no portion of such Total Payments shall be taken into account which, in the opinion of Independent Advisors, constitutes reasonable compensation for services actually rendered, within the meaning of Section 280G(b)(4)(B) of the Code, in excess of the “base amount” (as defined in Section 280G(b)(3) of the Code) allocable to such reasonable compensation; and (iii) the value of any non-cash benefit or any deferred payment or benefit included in the Total Payments shall be determined by the Independent Advisors in accordance with the principles of Sections 280G(d)(3) and (4) of the Code.

7. Restrictive Covenants.

(a) The Executive hereby acknowledges that the Executive is concurrently entering into an agreement with the Company, substantially in the form attached hereto as Exhibit B, containing confidentiality, intellectual property assignment, non-competition, non-solicitation and other protective covenants (the “PIIA”), that the Executive shall be bound by the terms and conditions of the PIIA, and that such agreement shall be additional to, and not in limitation of, the covenants contained in any other written agreement between the Company and the Executive.

(b) Notwithstanding anything in this Agreement or the PIIA to the contrary, nothing contained in this Agreement shall prohibit either party (or either party’s attorney(s)) from (i) filing a charge with, reporting possible violations of federal law or regulation to, participating in any investigation by, or cooperating with the U.S. Securities and Exchange Commission, the Financial Industry Regulatory Authority, the Equal Employment Opportunity Commission, the National Labor Relations Board, the Occupational Safety and Health Administration, the U.S. Commodity Futures Trading Commission, the U.S. Department of Justice or any other securities regulatory agency, self-regulatory authority or federal, state or local regulatory authority (collectively, “Government Agencies”), or making other disclosures that are protected under the whistleblower provisions of applicable law or regulation, (ii) communicating directly with, cooperating with, or providing information (including trade secrets) in confidence to any Government Agencies for the purpose of reporting or investigating a suspected violation of law, or from providing such information to such party’s attorney(s) or in a sealed complaint or other document filed in a lawsuit or other governmental proceeding, and/or (iii) receiving an award for information provided to any Government Agency. Pursuant to 18 USC Section 1833(b), (1) the Executive will not be held criminally or civilly liable under any federal or state trade secret law for the disclosure of a trade secret that is made: (x) in confidence to a federal, state, or local government official, either directly or indirectly, or to an attorney, and solely for the purpose of reporting or investigating a suspected violation of law; or (y) in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal and (2) the Executive acknowledges that an individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual files any document containing the

 

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trade secret under seal and does not disclose the trade secret, except pursuant to court order. Further, nothing in this Agreement is intended to or shall preclude either party from providing truthful testimony in response to a valid subpoena, court order, regulatory request or other judicial, administrative or legal process or otherwise as required by law. If the Executive is required to provide testimony, then unless otherwise directed or requested by a Government Agency or law enforcement, the Executive shall notify the Company as soon as reasonably practicable after receiving any such request of the anticipated testimony.

8. Representations. The Executive hereby represents and warrants to the Company that (a) the Executive is entering into this Agreement voluntarily and that the performance of the Executive’s obligations hereunder will not violate any agreement between the Executive and any other person, firm, organization or other entity, or any policy, program or code of such other person, firm, organization or other entity person, and (b) the Executive is not bound by the terms of any agreement with any previous employer or other party to refrain from competing, directly or indirectly, with the business of such previous employer or other party that would be violated by the Executive’s entering into this Agreement and/or providing services to the Company pursuant to the terms of this Agreement.

9. Successors.

(a) This Agreement is personal to the Executive and, without the prior written consent of the Company, shall not be assignable by the Executive other than by will or the laws of descent and distribution. This Agreement shall inure to the benefit of and be enforceable by the Executive’s legal representatives.

(b) This Agreement shall inure to the benefit of and be binding upon the Company and its respective successors and assigns.

10. Certain Definitions.

(a) “Board” means the Board of Directors of Holdings.

(b) “Cause” means the occurrence of any one or more of the following events:

(i) the Executive’s willful failure to substantially perform his duties with the Company (other than any such failure resulting from the Executive’s incapacity due to physical or mental illness or any such actual or anticipated failure after his issuance of a Notice of Termination for Good Reason), including the Executive’s failure to follow any lawful directive from the CEO within the reasonable scope of the Executive’s duties and the Executive’s failure to correct the same (if capable of correction, as determined by the CEO), within 30 days after a written notice is delivered to the Executive, which demand specifically identifies the manner in which the CEO believes that the Executive has not performed his duties. For the avoidance of doubt, the Executive’s failure to satisfy any specific performance goal or metric or the Company’s failure to attain any specific level of financial performance shall not constitute a failure to perform for purposes of this clause (i);

(ii) the Executive’s commission of, indictment for or entry of a plea of guilty or nolo contendere to a felony crime (excluding vehicular crimes) or a crime of moral turpitude;

(iii) the Executive’s material breach of any material obligation under any written agreement with the Company or its affiliates or under any applicable policy of the Company or its affiliates that have been provided to or made available to the Executive (including any code of conduct or harassment policies), and the Executive’s failure to correct the same (if capable of correction, as determined by the CEO), within 30 days after a written notice is delivered to the Executive, which demand specifically identifies the manner in which the CEO believes that the Executive has materially breached such agreement;

 

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(iv) any act of fraud, embezzlement, theft or misappropriation from the Company or its affiliates by the Executive; or

(v) the Executive’s willful misconduct or gross negligence with respect to any material aspect of the Company’s business or a material breach by the Executive of his fiduciary duty to the Company or its affiliates, which willful misconduct, gross negligence or material breach has a material and demonstrable adverse effect on the Company or its subsidiaries.

(c) “Change in Control” means (i) the consummation of a transaction or series of transactions (structured as a merger, consolidation, business combination, sale or redemption of securities, recapitalization or otherwise) (any such transaction, a “Transaction”); or (ii) the dissolution, liquidation or winding up of Holdings. The foregoing notwithstanding, a Transaction does not constitute a “Change in Control” if immediately after the merger or consolidation a majority of the voting power of the capital stock of the continuing or surviving entity, or any direct or indirect parent corporation of the continuing or surviving entity, will be owned by the persons who were Holdings’ stockholders immediately prior to such merger or consolidation in substantially the same proportions as their ownership of the voting power of Holdings’ capital stock immediately prior to the merger or consolidation.

(d) “Code” means the Internal Revenue Code of 1986, as amended and the regulations thereunder.

(e) “Date of Termination” means the date on which the Executive’s employment with the Company terminates.

(f) “Disability” means that the Executive has become entitled to receive benefits under an applicable Company long-term disability plan or, if no such plan covers the Executive, the Executive’s inability, due to physical or mental illness, to perform the essential functions of the Executive’s job, with or without a reasonable accommodation for 180 consecutive days.

(g) “Good Reason” means the occurrence of any one or more of the following events without the Executive’s prior written consent, unless the Company fully corrects the circumstances constituting Good Reason (provided such circumstances are capable of correction) as provided below:

(i) a material diminution in the Executive’s Base Salary or Target Bonus, other than as part of an across-the-board reduction applicable to the Company’s senior executives, and further excluding any voluntary reductions in Base Salary and/or Target Bonus;

(ii) a change in the geographic location of the Principal Location by more than 35 miles from its existing location;

(iii) a material diminution in the Executive’s title, authority or duties, as contemplated by this Agreement, excluding for this purpose any isolated, insubstantial or inadvertent actions not taken in bad faith and which are remedied by the Company promptly after receipt of notice thereof given by the Executive; or

(iv) the Company’s material breach of this Agreement.

 

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Notwithstanding the foregoing, the Executive will not be deemed to have resigned for Good Reason unless (1) the Executive provides the Company with written notice setting forth in reasonable detail the facts and circumstances claimed by the Executive to constitute Good Reason within 45 days after the date of the occurrence of any event that the Executive knows or should reasonably have known to constitute Good Reason, (2) the Company fails to cure such acts or omissions within 30 days following its receipt of such notice, and (3) the effective date of the Executive’s termination for Good Reason occurs no later than 60 days after the expiration of the Company’s cure period.

(h) “Notice of Termination” means a written notice which (i) indicates the specific termination provision in this Agreement relied upon, (ii) sets forth in reasonable detail the facts and circumstances claimed to provide a basis for termination of the Executive’s employment under the provision so indicated and (iii) if the Date of Termination is other than the date of receipt of such notice, specifies the termination date (which date shall be not more than 30 days after the giving of such notice unless as otherwise provided upon a termination for Good Reason).

(i) “Plan” means Company’s 2012 Stock Plan, as amended from time to time.

(j) “Qualifying Termination” means a termination of the Executive’s employment (i) by the Company without Cause (other than by reason of the Executive’s death or Disability) or (ii) by the Executive for Good Reason.

(k) “Section 409A” means Section 409A of the Code and Department of Treasury regulations and other interpretive guidance issued thereunder.

(l) “Separation from Service” means a “separation from service” (within the meaning of Section 409A).

11. Indemnification. The Company shall indemnify the Executive to the fullest extent permitted by applicable law in the event that the Executive was or is a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, by reason of the fact that the Executive is or was a director, officer, employee or agent of the Company or any of its affiliates, whether or not the claim is asserted during the Employment Period. The Executive shall be covered under any directors’ and officers’ insurance that the Company maintains for its directors and other officers in the same manner and on the same basis as the Company’s directors and other officers.

12. Miscellaneous.

(a) Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of New York, without reference to principles of conflict of laws. The captions of this Agreement are not part of the provisions hereof and shall have no force or effect.

(b) Notices. All notices and other communications hereunder shall be in writing and shall be given by hand delivery to the other party or by registered or certified mail, return receipt requested, postage prepaid, addressed as follows:

If to the Executive: at the Executive’s most recent address on the records of the Company.

 

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If to the Company:

Mulberry Health Inc.

75 Varick Street, 5th Floor

New York, NY 10013

Attention: General Counsel

Email: corporate@hioscar.com

or to such other address as either party shall have furnished to the other in writing in accordance herewith. Notice and communications shall be effective when actually received by the addressee.

(c) Sarbanes-Oxley Act of 2002. Notwithstanding anything herein to the contrary, if the Company determines, in its good faith judgment, that any transfer or deemed transfer of funds hereunder is likely to be construed as a personal loan prohibited by Section 13(k) of the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder (the “Exchange Act”), then such transfer or deemed transfer shall not be made to the extent necessary or appropriate so as not to violate the Exchange Act and the rules and regulations promulgated thereunder.

(d) Section 409A of the Code.

(i) To the extent applicable, this Agreement shall be interpreted in accordance with Section 409A. Notwithstanding any provision of this Agreement to the contrary, if the Company determines that any compensation or benefits payable under this Agreement may be subject to Section 409A, the Company shall work in good faith with the Executive to adopt such amendments to this Agreement or adopt other policies and procedures (including amendments, policies and procedures with retroactive effect), or take any other actions, that the Company determines are necessary or appropriate to avoid the imposition of taxes under Section 409A, including without limitation, actions intended to (i) exempt the compensation and benefits payable under this Agreement from Section 409A, and/or (ii) comply with the requirements of Section 409A; provided, however, that this Section 12(d) shall not create an obligation on the part of the Company to adopt any such amendment, policy or procedure or take any such other action, nor shall the Company have any liability for failing to do so.

(ii) Any right to a series of installment payments pursuant to this Agreement is to be treated as a right to a series of separate payments. To the extent permitted under Section 409A, any separate payment or benefit under this Agreement or otherwise shall not be deemed “nonqualified deferred compensation” subject to Section 409A to the extent provided in the exceptions in Treasury Regulation Section 1.409A-1(b)(4), Section 1.409A-1(b)(9) or any other applicable exception or provision of Section 409A. Any payments subject to Section 409A that are subject to execution of a waiver and release which may be executed and/or revoked in a calendar year following the calendar year in which the payment event (such as termination of employment) occurs shall commence payment only in the calendar year in which the consideration period or, if applicable, release revocation period ends, as necessary to comply with Section 409A. All payments of nonqualified deferred compensation subject to Section 409A to be made upon a termination of employment under this Agreement may only be made upon the Executive’s Separation from Service.

(iii) To the extent that any payments or reimbursements provided to the Executive under this Agreement are deemed to constitute compensation to the Executive to which Treasury Regulation Section 1.409A-3(i)(1)(iv) would apply, such amounts shall be paid or reimbursed reasonably promptly, but not later than December 31 of the year following the year in which the expense was incurred. The amount of any such payments eligible for reimbursement in one year shall not affect the payments or expenses that are eligible for payment or reimbursement in any other taxable year, and the Executive’s right to such payments or reimbursement of any such expenses shall not be subject to liquidation or exchange for any other benefit.

 

12


(e) Severability. The invalidity or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision of this Agreement.

(f) Withholding. The Company may withhold from any amounts payable under this Agreement such federal, state, local or foreign taxes as shall be required to be withheld pursuant to any applicable law or regulation.

(g) No Waiver. The Executive’s or the Company’s failure to insist upon strict compliance with any provision of this Agreement or the failure to assert any right the Executive or the Company may have hereunder, including, without limitation, the right of the Executive to terminate employment for Good Reason pursuant to Section 3(c) hereof, shall not be deemed to be a waiver of such provision or right or any other provision or right of this Agreement.

(h) Entire Agreement. As of the Effective Date, this Agreement (including the Award Agreements and the PIIA), constitutes the final, complete and exclusive agreement between the Executive and the Company with respect to the subject matter hereof and replaces and supersedes any and all other agreements, offers or promises, whether oral or written, by any member of the Company and its subsidiaries or affiliates, or representative thereof. Notwithstanding anything herein to the contrary, this Agreement and the obligations and commitments hereunder shall neither commence nor be of any force or effect prior to the Effective Date.

(i) Arbitration.

(i) Any controversy or dispute that establishes a legal or equitable cause of action (“Arbitration Claim”) between any two or more Persons Subject to Arbitration (as defined below), including any controversy or dispute, whether based on contract, common law, or federal, state or local statute or regulation, arising out of, or relating to the Executive’s service or the termination thereof, shall be submitted to final and binding arbitration as the sole and exclusive remedy for such controversy or dispute in accordance with the rules of JAMS pursuant to its Employment Arbitration Rules and Procedures, which are available at http://www.jamsadr.com/rules-employment-arbitration/, and the Company will provide a copy upon the Executive’s request. Notwithstanding the foregoing, this Agreement shall not require any Person Subject to Arbitration to arbitrate pursuant to this Agreement any claims: (A) under a Company benefit plan subject to the Employee Retirement Income Security Act, as amended; or (B) as to which applicable law not preempted by the Federal Arbitration Act prohibits resolution by binding arbitration. Either party may seek provisional non-monetary remedies in a court of competent jurisdiction to the extent that such remedies are not available or not available in a timely fashion through arbitration. It is the parties’ intent that issues of arbitrability of any dispute shall be decided by the arbitrator.

(ii) “Persons Subject to Arbitration” means, individually and collectively, (A) the Executive, (B) any person in privity with or claiming through, on behalf of or in the right of the Executive, (C) the Company, (D) any past, present or future affiliate, employee, officer, director or agent of the Company, and/or (E) any person or entity alleged to be acting in concert with or to be jointly liable with any of the foregoing.

(iii) The arbitration shall take place before a single neutral arbitrator at the JAMS office in New York, New York. Such arbitrator shall be provided through JAMS by mutual

 

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agreement of the parties to the arbitration; provided that, absent such agreement, the arbitrator shall be selected in accordance with the rules of JAMS then in effect. The arbitrator shall permit reasonable discovery. The award or decision of the arbitrator shall be rendered in writing; shall be final and binding on the parties; and may be enforced by judgment or order of a court of competent jurisdiction.

(iv) THE EXECUTIVE AND THE COMPANY UNDERSTAND THAT BY AGREEING TO ARBITRATE ANY ARBITRATION CLAIM, THEY WILL NOT HAVE THE RIGHT TO HAVE ANY ARBITRATION CLAIM DECIDED BY A JURY OR A COURT, BUT SHALL INSTEAD HAVE ANY ARBITRATION CLAIM DECIDED THROUGH ARBITRATION.

(v) THE EXECUTIVE AND THE COMPANY WAIVE ANY CONSTITUTIONAL OR OTHER RIGHT TO BRING CLAIMS COVERED BY THIS AGREEMENT OTHER THAN IN THEIR INDIVIDUAL CAPACITIES. EXCEPT AS MAY BE PROHIBITED BY LAW, THIS WAIVER INCLUDES THE ABILITY TO ASSERT CLAIMS AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING.

(vi) This Section 12(i) shall be interpreted to conform to any applicable law concerning the terms and enforcement of agreements to arbitrate service disputes. To the extent any terms or conditions of this Section 12(i) would preclude its enforcement, such terms shall be severed or interpreted in a manner to allow for the enforcement of this Section 12(i). To the extent applicable law imposes additional requirements to allow enforcement of this Section 12(i), this Agreement shall be interpreted to include such terms or conditions.

(j) Amendment; Survival. No amendment or other modification of this Agreement shall be effective unless made in writing and signed by the parties hereto. The respective rights and obligations of the parties under this Agreement shall survive the Executive’s termination of employment and the termination of this Agreement to the extent necessary for the intended preservation of such rights and obligations.

(k) Counterparts. This Agreement and any agreement referenced herein may be executed in two or more counterparts, each of which shall be deemed an original but which together shall constitute one and the same instrument.

[SIGNATURES APPEAR ON FOLLOWING PAGE]

 

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IN WITNESS WHEREOF, the Executive has hereunto set the Executive’s hand and, pursuant to the authorization from the Board, each of Holdings and OpCo has caused these presents to be executed in its name on its behalf, all as of the day and year first above written.

 

MULBERRY HEALTH INC.
By:  

/s/ Mario Schlosser

  Name: Mario Schlosser
  Title: CEO
MULBERRY MANAGEMENT CORPORATION
By:  

/s/ Mario Schlosser

  Name: Mario Schlosser
  Title: CEO
“EXECUTIVE”
 

/s/ R. Scott Blackley

  R. Scott Blackley

Attachments:

Exhibit A: Release

Exhibit B: PIIA


EXHIBIT A

GENERAL RELEASE

1. Release For valuable consideration, the receipt and adequacy of which are hereby acknowledged, the undersigned does hereby release and forever discharge the “Releasees” hereunder, consisting of Mulberry Health Inc., a Delaware corporation (“Holdings”) and Mulberry Management Corporation (together with Holdings, the “Company”), and the Company’s partners, subsidiaries, associates, affiliates, successors, heirs, assigns, agents, directors, officers, employees, representatives, lawyers, insurers, and all persons acting by, through, under or in concert with them, or any of them, of and from any and all manner of action or actions, cause or causes of action, in law or in equity, suits, debts, liens, contracts, agreements, promises, liability, claims, demands, damages, losses, costs, attorneys’ fees or expenses, of any nature whatsoever, known or unknown, fixed or contingent (hereinafter called “Claims”), which the undersigned now has or may hereafter have against the Releasees, or any of them, by reason of any matter, cause, or thing whatsoever from the beginning of time to the date hereof. The Claims released herein include, without limiting the generality of the foregoing, any Claims in any way arising out of, based upon, or related to the employment or termination of employment of the undersigned by the Releasees, or any of them; any alleged breach of any express or implied contract of employment; any alleged torts or other alleged legal restrictions on Releasees’ right to terminate the employment of the undersigned; and any alleged violation of any federal, state or local statute or ordinance including, without limitation, Title VII of the Civil Rights Act of 1964, the Age Discrimination In Employment Act (“ADEA”), the Americans With Disabilities Act.

2. Claims Not Released. Notwithstanding the foregoing, this general release (the “Release”) shall not operate to release any rights or claims of the undersigned (i) to payments or benefits under Section 4(b) of that certain Employment Agreement, dated as of December 5, 2020, between the Company and the undersigned (the “Employment Agreement”), with respect to the payments and benefits provided in exchange for this Release, (ii) to payments or benefits under any equity award agreement between the undersigned and Holdings or as a holder of any securities of Holdings, (iii) with respect to Sections 2(b)(vii) or 4(a) of the Employment Agreement, (iv) to accrued or vested benefits the undersigned may have, if any, as of the date hereof under any applicable plan, policy, practice, program, contract or agreement with the Company, (v) to any Claims, including claims for indemnification and/or advancement of expenses arising under any indemnification agreement between the undersigned and the Company or under the bylaws, certificate of incorporation or other similar governing document of the Company, (vi) to any Claims which cannot be waived by an employee under applicable law or (vii) with respect to the undersigned’s right to communicate directly with, cooperate with, or provide information to, any federal, state or local government regulator.

3. Exceptions. Notwithstanding anything in this Release to the contrary, nothing contained in this Release shall prohibit the undersigned from (i) filing a charge with, reporting possible violations of federal law or regulation to, participating in any investigation by, or cooperating with any governmental agency or entity or making other disclosures that are protected under the whistleblower provisions of applicable law or regulation and/or (ii) communicating directly with, cooperating with, or providing information (including trade secrets) in confidence to, any federal, state or local government regulator (including, but not limited to, the U.S. Securities and Exchange Commission, the U.S. Commodity Futures Trading Commission, or the U.S. Department of Justice) for the purpose of reporting or investigating a suspected violation of law, or from providing such information to the undersigned’s attorney or in a sealed complaint or other document filed in a lawsuit or other governmental proceeding. Pursuant to 18 USC Section 1833(b), (1) the undersigned will not be held criminally or civilly liable under any federal or state trade secret law for the disclosure of a trade secret that is made: (x) in confidence to a federal, state, or local government official, either directly or indirectly, or to an attorney, and solely for the purpose of reporting

 

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or investigating a suspected violation of law; or (y) in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal and (2) the undersigned acknowledges that an individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual files any document containing the trade secret under seal and does not disclose the trade secret, except pursuant to court order.

4. Representations. The undersigned represents and warrants that there has been no assignment or other transfer of any interest in any Claim which the undersigned may have against Releasees, or any of them, and the undersigned agrees to indemnify and hold Releasees, and each of them, harmless from any liability, Claims, demands, damages, costs, expenses and attorneys’ fees incurred by Releasees, or any of them, as the result of any such assignment or transfer or any rights or Claims under any such assignment or transfer. It is the intention of the parties that this indemnity does not require payment as a condition precedent to recovery by the Releasees against the undersigned under this indemnity.

5. No Action. The undersigned agrees that if the undersigned hereafter commences any suit arising out of, based upon, or relating to any of the Claims released hereunder or in any manner asserts against Releasees, or any of them, any of the Claims released hereunder, then the undersigned agrees to pay to Releasees, and each of them, in addition to any other damages caused to Releasees thereby, all attorneys’ fees incurred by Releasees in defending or otherwise responding to said suit or Claim. Notwithstanding the foregoing, this provision shall not apply to any suit or Claim to the extent is challenges the effectiveness of this release with respect to a claim under the ADEA.

6. No Admission. The undersigned further understands and agrees that neither the payment of any sum of money nor the execution of this Release shall constitute or be construed as an admission of any liability whatsoever by the Releasees, or any of them, who have consistently taken the position that they have no liability whatsoever to the undersigned.

7. OWBPA. The undersigned agrees and acknowledges that this Release constitutes a knowing and voluntary waiver and release of all Claims the undersigned has or may have against the Company and/or any of the Releasees as set forth herein, including, but not limited to, all Claims arising under the Older Worker’s Benefit Protection Act and the ADEA. In accordance with the Older Worker’s Benefit Protection Act, the undersigned is hereby advised as follows:

 

  (i)

the undersigned has read the terms of this Release, and understands its terms and effects, including the fact that the undersigned agreed to release and forever discharge the Company and each of the Releasees, from any Claims released in this Release;

 

  (ii)

the undersigned understands that, by entering into this Release, the undersigned does not waive any Claims that may arise after the date of the undersigned’s execution of this Release, including without limitation any rights or claims that the undersigned may have to secure enforcement of the terms and conditions of this Release;

 

  (iii)

the undersigned has signed this Release voluntarily and knowingly in exchange for the consideration described in this Release, which the undersigned acknowledges is adequate and satisfactory to the undersigned and which the undersigned acknowledges is in addition to any other benefits to which the undersigned is otherwise entitled;

 

  (iv)

the Company advises the undersigned to consult with an attorney prior to executing this Release;

 

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  (v)

the undersigned has been given at least [21]1 days in which to review and consider this Release. To the extent that the undersigned chooses to sign this Release prior to the expiration of such period, the undersigned acknowledges that the undersigned has done so voluntarily, had sufficient time to consider the Release, to consult with counsel and that the undersigned does not desire additional time and hereby waives the remainder of the [21]-day period; and

 

  (vi)

the undersigned may revoke this Release within seven days from the date the undersigned signs this Release and this Release will become effective upon the expiration of that revocation period if the undersigned has not revoked this Release during such seven-day period. If the undersigned revokes this Release during such seven-day period, this Release will be null and void and of no force or effect on either the Company or the undersigned and the undersigned will not be entitled to any of the payments or benefits which are expressly conditioned upon the execution and non-revocation of this Release. Any revocation must be in writing and sent to [name], via electronic mail at [email address], on or before [5:00 p.m. Eastern time] on the seventh day after this Release is executed by the undersigned.

8. Acknowledgement. The undersigned acknowledges that different or additional facts may be discovered in addition to what is now known or believed to be true by the undersigned with respect to the matters released in this Release, and the undersigned agrees that this Release shall be and remain in effect in all respects as a complete and final release of the matters released, notwithstanding any different or additional facts

9. Governing Law. This Release is deemed made and entered into in the State of New York, and in all respects shall be interpreted, enforced and governed under the internal laws of the State of New York, to the extent not preempted by federal law.

IN WITNESS WHEREOF, the undersigned has executed this Release this            day of             ,             .

 

                                                                                  
R. Scott Blackley

 

1 

NTD: Use 45 days in a group termination, and include information regarding terminated positions.

 

A-3


EXHIBIT B

PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT

[Attached]


EMPLOYEE INVENTIONS AND PROPRIETARY INFORMATION AGREEMENT

The following agreement (the “Agreement”) between Mulberry Management Corporation, a Delaware corporation (the “Company”), and the individual identified on the signature page to this Agreement (“Employee” or “I”) is effective as of the first day of Employee’s employment by the Company and confirms and memorializes the agreement that (regardless of the execution date hereof) the Company and I have had since the commencement of my employment (which term, for purposes of this Agreement, shall be deemed to include any relationship of service to the Company that I may have had prior to actually becoming an employee). I acknowledge that this Agreement is a material part of the consideration for my employment or continued employment by the Company. In exchange for the foregoing and for other good and valuable consideration, including my access to and use of the Company’s Inventions (defined below) and Proprietary Information (defined below) for performance of my employment, training and/or receipt of certain other valuable consideration, the parties agree as follows:

 

1. No Conflicts. I have not made, and agree not to make, any agreement, oral or written, that is in conflict with this Agreement or my employment with the Company. I will not violate any agreement with, or the rights of, any third party. When acting within the scope of my employment (or otherwise on behalf of the Company), I will not use or disclose my own or any third party’s confidential information or intellectual property (collectively, “Restricted Materials”), except as expressly authorized by the Company in writing. Further, I have not retained anything containing or reflecting any confidential information or intellectual property of a prior employer or other third party, whether or not created by me.

2. Inventions.

a. Definitions. Company Interest” means any of the Company’s current and anticipated business, research and development, as well as any product, service, other Invention or Intellectual Property Rights (defined below) that is sold, leased, used, licensed, provided, proposed, under consideration or under development by the Company. “Intellectual Property Rights” means any and all patent rights, copyright rights, trademark rights, mask work rights, trade secret rights, sui generis database rights and all other intellectual and industrial property rights of any sort throughout the world (including any application therefor and any rights to apply therefor, as well as all rights to pursue remedies for infringement or violation thereof). “Invention” means any idea, concept, discovery, learning, invention, development, research, technology, work of authorship, trade secret, software, firmware, content, audio-visual material, tool, process, technique, know-how, data, plan, device, apparatus, specification, design, prototype, circuit, layout, mask work, algorithm, program, code, documentation or other material or information, tangible or intangible, and all versions, modifications, enhancements and derivative works thereof, whether or not it may be patented, copyrighted, trademarked or otherwise protected.

b. Assignment. The Company shall own, and I hereby assign and agree to assign, all right, title and interest in and to all Inventions (including all Intellectual Property Rights therein, related thereto or embodied therein) that are collected, made, conceived, developed, reduced to practice or

set out in any tangible medium of expression or otherwise created, in whole or in part (collectively “Created”), by me during the term of my employment with the Company that either (i) arise out of any use of the Company’s facilities, equipment, Proprietary Information or other assets (collectively “Company Assets”) or any research or other activity conducted by, for or under the direction of the Company (whether or not conducted (A) at the Company’s facilities; (B) during working hours or (C) using Company Assets), or (ii) are useful with or in or relate directly or indirectly to any Company Interest. I will promptly disclose and provide all of the foregoing Inventions (the “Assigned Inventions”) to the Company. However, the foregoing does not purport to assign to the Company (and Assigned Inventions shall not include) any Invention that: (1) by law (including, without limitation, the applicable statutory provision for my state of employment set forth in Appendix A, if any) I cannot be required to so assign; or (2) otherwise meets all of the following requirements: (I) the Invention is Created entirely on my own time; (II) the Invention is Created entirely without use of any Company Assets and (III) the Invention is not useful with or related to any Company Interest. Nevertheless, if I believe any Invention Created by me during the term of my employment is not within the definition of Assigned Inventions, I will nevertheless disclose it to the Company so that the Company may make its assessment.

c. Assurances. I hereby make and agree to make all assignments to the Company necessary to effectuate and accomplish the Company’s ownership in and to all Assigned Inventions. I will further assist the Company, at its expense, to evidence, record and perfect such assignments, and to perfect, obtain, maintain, enforce and defend any rights specified to be so owned or assigned. I hereby irrevocably designate and appoint the Company and its officers as my agents and attorneys-in-fact, coupled with an interest, to act for and on my behalf to execute and file any document and to perform all other lawfully permitted acts to further the purposes of the foregoing with the same legal force and effect as if executed by me.

d. Other Inventions. If (i) I use or disclose any Restricted Materials when acting within the scope of my employment (or otherwise to or on behalf of the Company)

 

 

1


or (ii) any Assigned Invention cannot be fully made, used, reproduced, sold, distributed, modified, commercialized or otherwise exploited (collectively, “Exploited”) without using, misappropriating, infringing or violating any Restricted Materials, I hereby grant and agree to grant to the Company a perpetual, irrevocable, worldwide, fully paid-up, royalty-free, non-exclusive, assignable, transferable, sublicensable right and license to use, disclose, fully Exploit and exercise all rights in such Restricted Materials and all Intellectual Property Rights embodied therein or related thereto. I will not use or disclose any Restricted Materials for which I am not fully authorized to grant the foregoing license.

e. Moral Rights. To the extent allowed by applicable law, the terms of this Section 2 include all rights of paternity, integrity, disclosure, withdrawal and any other rights that may be known or referred to as moral rights, artist’s rights, droit moral or the like (collectively, “Moral Rights”). To the extent I retain any such Moral Rights under applicable law, I hereby ratify and consent to any action that may be taken with respect to such Moral Rights by or authorized by the Company, and agree not to assert any Moral Rights with respect thereto. I will confirm any such ratification, consent or agreement from time to time as requested by the Company. Furthermore, I agree that notwithstanding any rights of publicity, privacy or otherwise (whether or not statutory) anywhere in the world and without any further compensation, the Company may and is hereby authorized to use my name, likeness and voice in connection with promotion of its business, products and services, and to allow others to do the same.

3. Proprietary Information.

a. Definition; Restrictions on Use. I agree that all Assigned Inventions (and all other financial, business, legal and technical information regarding or relevant to any Company Interest that is not generally publicly known), including the identity of and any other information relating to the Company’s employees, Affiliates and Business Partners (as such terms are defined below), that I develop, learn or obtain during my employment or that are received by or for the Company in confidence, constitute “Proprietary Information.” I will hold in strict confidence and not directly or indirectly disclose or use any Proprietary Information, except as required within the scope of my employment. My obligation of nondisclosure and nonuse of Proprietary Information under this Section shall continue until I can document that it is or becomes readily generally available to the public without restriction through no fault of mine (including breach of this Agreement) or, if a court requires a shorter duration, then the maximum time allowable by law will control. Furthermore, I understand that this Agreement does not affect my immunity under 18 USC Sections 1833(b)

(1) or (2), which read as follows:

 

  (1)

An individual shall not be held criminally or civilly liable under any federal or state trade secret law for the disclosure of a trade secret that (A) is made (i) in

  confidence to a federal, state, or local government official, either directly or indirectly, or to an attorney; and (ii) solely for the purpose of reporting or investigating a suspected violation of law; or (B) is made in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal.

 

  (2)

An individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual (A) files any document containing the trade secret under seal; and (B) does not disclose the trade secret, except pursuant to court order.

b. Upon Termination. Upon termination of my employment (for any or no reason, whether voluntary or involuntary), I will promptly identify and, as directed by the Company, destroy, delete or return to the Company all items containing or embodying Proprietary Information (including all original or copies of content, whether in electronic or hard-copy form), except that I may keep my personal copies of (i) my compensation records; (ii) materials distributed to shareholders generally and (iii) this Agreement.

c. Company Systems. I also recognize and agree that I have no expectation of privacy with respect to the Company’s networks, telecommunications systems or information processing systems (including, without limitation, stored computer files, email messages and voicemail messages or other devices (including personal devices)) in which Company Proprietary Information resides, is stored or is passed through (“Company Systems”), and in order to ensure compliance with work rules and safety concerns, the Company or its agents may monitor, at any time and without further notice to me, any Company Systems and any of my activity, files or messages on or using any Company Systems, regardless of whether such activity occurs on equipment owned by me or the Company. I further agree that any property situated on the Company’s premises and owned, leased or otherwise possessed by the Company, including computers, computer files, email, voicemail, storage media, filing cabinets or other work areas, is subject to inspection by Company personnel at any time with or without notice. I understand and acknowledge that (A) any such searches or monitoring efforts are not formal accusations of wrongdoing but rather part of the procedure of an investigation and (B) refusal to consent to such a search may be grounds for discipline.

4. Restricted Activities. For the purposes of this Section 4, the term “the Company” includes the Company and all other persons or entities that control, are controlled by or are under common control with the Company (“Affiliates”) and for whom Employee performed responsibilities or about whom Employee has Proprietary Information.

 

 

2


a. Definitions. Competitive Activities” means any direct or indirect non-Company activity (i) that is the same or substantially similar to Employee’s responsibilities for the Company that relates to, is substantially similar to, or competes with the Company (or its demonstrably planned interests) at the time of Employee’s termination from the Company; or (ii) involving the use or disclosure, or the likelihood of the use or disclosure, of Proprietary Information. Competitive Activities do not include being a holder of less than one percent (1%) of the outstanding equity of a public company. “Business Partner” means any past (i.e., within the twelve (12) months preceding Employee’s termination from the Company), present or prospective (i.e., actively pursued by the Company within the twelve (12) months preceding Employee’s termination from the Company) customer, vendor, supplier, distributor or other business partner of the Company with whom Employee comes into contact during Employee’s employment with the Company or about whom Employee had knowledge by reason of Employee’s relationship with the Company or because of Employee’s access to Proprietary Information. “Cause” means to recruit, employ, retain or otherwise solicit, induce or influence, or to attempt to do so (provided that if I am a resident of California, “Cause” means to recruit, or otherwise solicit, induce or influence, or to attempt to do so). “Solicit”, with respect to Business Partners, means to (A) service, take orders from or solicit the business or patronage of any Business Partner for Employee or any other person or entity, (B) divert, entice or otherwise take away from the Company the business or patronage of any Business Partner, or to attempt to do so, or (C) solicit, induce or encourage any Business Partner to terminate or reduce its relationship with the Company.

b. Acknowledgments.

i. I acknowledge and agree that (A) the Company’s business is highly competitive; (B) secrecy of the Proprietary Information is of the utmost importance to the Company, and I will learn and use Proprietary Information in the course of performing my work for the Company and (C) my position may require me to establish goodwill with Business Partners and employees on behalf of the Company and such goodwill is extremely important to the Company’s success, and the Company has made substantial investments to develop its business interests and goodwill.

ii. I agree that the limitations as to time, geographical area and scope of activity to be restrained in this Section 4 are coextensive with the Company’s footprint and my performance of responsibilities for the Company and are therefore reasonable and not greater than necessary to protect the goodwill or other business interests of the Company. I further agree that such investments are worthy of protection and that the Company’s need for protection afforded by this Section 4 is greater than any hardship I may experience by complying with its terms.

iii. I acknowledge that my violation or attempted violation of the agreements in this Section 4 will cause irreparable damage to the Company or its Affiliates, and I therefore agree that the Company shall be entitled as a matter of right to an injunction out of any court of competent jurisdiction, restraining any violation or further violation of such agreements by me or others acting on my behalf. The Company’s right to injunctive relief shall be cumulative and in addition to any other remedies provided by law or equity.

iv. Although the parties believe that the limitations as to time, geographical area and scope of activity contained herein are reasonable and do not impose a greater restraint than necessary to protect the goodwill or other business interests of the Company, if it is judicially determined otherwise, the limitations shall be reformed to the extent necessary to make them reasonable and not to impose a restraint that is greater than necessary to protect the goodwill or other business interests of the Company.

v. In any such case, the Company and I agree that the remaining provisions of this Section 4 shall be valid and binding as though any invalid or unenforceable provision had not been included.

c. As an Employee. During my employment with the Company, I will not directly or indirectly: (i) Cause any person to cease or reduce their services (as an employee or otherwise) to the Company (other than terminating subordinate employees in the course of my duties for the Company); (ii) Solicit any Business Partner; (iii) act in any capacity in or with respect to any commercial activity which competes, or is reasonably likely to compete, with any business that the Company conducts, proposes to conduct or demonstrably anticipates conducting, at any time during my employment with the Company or (iv) enter into in an employment, consulting or other similar relationship with another person or entity that requires a significant time commitment without the prior written consent of the Company.

d. After Termination. For the period of twelve (12) months immediately following my termination of employment with the Company (for any or no reason, whether voluntary or involuntary), I will not directly or indirectly: (i) Cause any person to cease or reduce their services (as an employee or otherwise) to the Company; or (ii) unless I am a resident of California (A) Solicit any Business Partner or (B) engage in any Competitive Activities (I) anywhere the Company offers its services or has customers during my employment with the Company or where my use or disclosure of Proprietary Information could materially disadvantage the Company regardless of my physical location; or (II) anywhere the Company offers its services or has customers and where I have responsibility for the Company or (III) anywhere within a fifty (50) mile radius of any physical location I work for the Company. The foregoing timeframes shall be increased by the period of time beginning from the commencement of any violation of the foregoing provisions until such time as I have cured such violation.

 

 

3


5. Employment at Will. I agree that this Agreement is not an employment contract for any particular term. I have the right to resign and the Company has the right to terminate my employment at will, at any time, for any or no reason, with or without cause. This Agreement does not purport to set forth all of the terms and conditions of my employment, and as an employee of the Company, I have obligations to the Company which are not described in this Agreement. However, the terms of this Agreement govern over any such terms that are inconsistent with this Agreement, and supersede the terms of any similar form that I may have previously signed. This Agreement can only be changed by a subsequent written agreement signed by the Chief Executive Officer or President of the Company, or an officer designee authorized in writing by the foregoing or the Company’s Board of Directors.

6. Survival. I agree that any change or changes in my employment title, duties, compensation, or equity interest after the signing of this Agreement shall not affect the validity or scope of this Agreement. I agree that the terms of this Agreement, and any obligations I have hereunder, shall continue in effect after termination of my employment, regardless of the reason, and whether such termination is voluntary or involuntary, and that the Company is entitled to communicate my obligations under this Agreement to any of my potential or future employers. I will provide a copy of this Agreement to any potential or future employers of mine, so that they are aware of my obligations hereunder. This Agreement, and any obligations I have hereunder, also shall be binding upon my heirs, executors, assigns and

administrators, and shall inure to the benefit of the Company, its Affiliates, successors and assigns. This Agreement and any rights and obligations of the Company hereunder may be freely assigned and transferred by the Company, in whole or part, to any third party.

7. Miscellaneous. Any dispute in the meaning, effect or validity of this Agreement shall be resolved in accordance with the laws of the State of New York without regard to the conflict of laws provisions thereof. Any legal action or proceeding relating to this Agreement shall be brought exclusively in the state or federal courts located in or with jurisdiction over New York, and each party consents to the jurisdiction thereof; however, the Company may seek injunctive relief and specific performance in any court of competent jurisdiction. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of such rights. Unless expressly provided otherwise, each right and remedy in this Agreement is in addition to any other right or remedy, at law or in equity, and the exercise of one right or remedy will not be deemed a waiver of any other right or remedy. If one or more provisions of this Agreement is held to be illegal or unenforceable under applicable law, such illegal or unenforceable portion shall be limited or excluded from this Agreement to the minimum extent required so that this Agreement shall otherwise remain in full force and effect and enforceable. I acknowledge and agree that any breach or threatened breach of this Agreement will cause irreparable harm to the Company for which damages would not be an adequate remedy, and, therefore, the Company is entitled to injunctive relief with respect thereto (without the necessity of posting any bond) in addition to any other remedies.

 

 

[Signature Page Follows]

 

4


I HAVE READ THIS AGREEMENT CAREFULLY AND I UNDERSTAND AND ACCEPT THE OBLIGATIONS THAT IT IMPOSES UPON ME WITHOUT RESERVATION. NO PROMISES OR REPRESENTATIONS HAVE BEEN MADE TO ME TO INDUCE ME TO SIGN THIS AGREEMENT. I SIGN THIS AGREEMENT VOLUNTARILY AND FREELY, WITH THE UNDERSTANDING THAT I EITHER (1) HAVE RETAINED A COPY OF THIS AGREEMENT OR (2) MAY REQUEST A COPY OF THIS AGREEMENT FROM THE COMPANY AT ANY TIME.

 

MULBERRY MANAGEMENT CORPORATION       EMPLOYEE
By:  

/s/ Mario Schlosser

                   By:   

/s/ R. Scott Blackley

  Signature of Mario Schlosser          Signature of R. Scott Blackley
Name:  

 

      Name:   

 

  CEO         
Title:  

 

      Address:   

####

Dated:   12/5/2020         

 

          

 

        Dated:    12/6/2020

 

5


Appendix A

If I am employed by the Company in the State of California, the following provision applies:

California Labor Code Section 2870. Application of provision providing that employee shall assign or offer to assign rights in invention to employer.

(a) Any provision in an employment agreement which provides that an employee shall assign, or offer to assign, any of his or her rights in an invention to his or her employer shall not apply to an invention that the employee developed entirely on his or her own time without using the employer’s equipment, supplies, facilities, or trade secret information except for those inventions that either:

(1) Relate at the time of conception or reduction to practice of the invention to the employer’s business, or actual or demonstrably anticipated research or development of the employer; or

(2) Result from any work performed by the employee for his employer.

(b) To the extent a provision in an employment agreement purports to require an employee to assign an invention otherwise excluded from being required to be assigned under subdivision (a), the provision is against the public policy of this state and is unenforceable.

If I am employed by the Company in the State of Delaware, the following provision applies:

Delaware Code, Title 19, § 805

Employee’s right to certain inventions.

Any provision in an employment agreement which provides that the employee shall assign or offer to assign any of the employee’s rights in an invention to the employee’s employer shall not apply to an invention that the employee developed entirely on the employee’s own time without using the employer’s equipment, supplies, facility or trade secret information, except for those inventions that: (i) relate to the employer’s business or actual or demonstrably anticipated research or development, or (ii) result from any work performed by the employee for the employer. To the extent a provision in an employment agreement purports to apply to the type of invention described, it is against the public policy of this State and is unenforceable. An employer may not require a provision of an employment agreement made unenforceable under this section as a condition of employment or continued employment.

If I am employed by the Company in the State of Illinois, the following provision applies:

Illinois Compiled Statutes Chapter 765, Section 1060/2.

Sec. 2. Employee rights to inventions - conditions. (1) A provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer does not apply to an invention for which no equipment, supplies, facilities, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this State and is to that extent void and unenforceable. The employee shall bear the burden of proof in establishing that his invention qualifies under this subsection.

(2) An employer shall not require a provision made void and unenforceable by subsection (1) of this Section as a condition of employment or continuing employment. This Act shall not preempt existing common law applicable to any shop rights of employers with respect to employees who have not signed an employment agreement.

(3) If an employment agreement entered into after January 1, 1984, contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer must also, at the time the agreement is made, provide a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer.

If I am employed by the Company in the State of Kansas, the following provision applies:

Chapter 44.—LABOR AND INDUSTRIES

 

1


Article 1.—PROTECTION OF EMPLOYEES

44-130. Employment agreements assigning employee rights in inventions to employer; restrictions; certain provisions void; notice and disclosure. (a) Any provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer shall not apply to an invention for which no equipment, supplies, facilities or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless:

(1) The invention relates to the business of the employer or to the employer’s actual or demonstrably anticipated research or development; or

(2) the invention results from any work performed by the employee for the employer.

(b) Any provision in an employment agreement which purports to apply to an invention which it is prohibited from applying to under subsection (a), is to that extent against the public policy of this state and is to that extent void and unenforceable. No employer shall require a provision made void and unenforceable by this section as a condition of employment or continuing employment.

(c) If an employment agreement contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer shall provide, at the time the agreement is made, a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless:

(1) The invention relates directly to the business of the employer or to the employer’s actual or demonstrably anticipated research or development; or

(2) the invention results from any work performed by the employee for the employer.

(d) Even though the employee meets the burden of proving the conditions specified in this section, the employee shall disclose, at the time of employment or thereafter, all inventions being developed by the employee, for the purpose of determining employer and employee rights in an invention.

If I am employed by the Company in the State of Minnesota, the following provision applies:

Minnesota Statute Section 181.78. Subdivision 1.

Inventions not related to employment. Any provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer shall not apply to an invention for which no equipment, supplies, facility or trade secret information of the employer was used and which was developed entirely on the employee’s own time, and (1) which does not relate (a) directly to the business of the employer or (b) to the employer’s actual or demonstrably anticipated research or development, or (2) which does not result from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this state and is to that extent void and unenforceable.

If I am employed by the Company in the State of North Carolina, the following provision applies:

North Carolina General Statutes Section 66-57.1.

EMPLOYEE’S RIGHT TO CERTAIN INVENTIONS

Any provision in an employment agreement which provides that the employees shall assign or offer to assign any of his rights in an invention to his employer shall not apply to an invention that the employee developed entirely on his own time without using the employer’s equipment, supplies, facility or trade secret information except for those inventions that (i) relate to the employer’s business or actual or demonstrably anticipated research or development, or (ii) result from any work performed by the employee for the employer. To the extent a provision in an employment agreement purports to apply to the type of invention described, it is against the public policy of this State and in unenforceable. The employee shall bear the burden of proof in establishing that his invention qualifies under this section.

If I am employed by the Company in the State of Utah, the following provision applies:

Utah Code, §§ 34-39-2 and 34-39-3

34-39-2. Definitions.

As used in this chapter:

(1) “Employment invention” means any invention or part thereof conceived, developed, reduced to practice, or created by an employee which is:

(a) conceived, developed, reduced to practice, or created by the employee:

(i) within the scope of his employment;

(ii) on his employer’s time; or

 

2


(iii) with the aid, assistance, or use of any of his employer’s property, equipment, facilities, supplies, resources, or intellectual property;

(b) the result of any work, services, or duties performed by an employee for his employer;

(c) related to the industry or trade of the employer; or

(d) related to the current or demonstrably anticipated business, research, or development of the employer.

(2) “Intellectual property” means any and all patents, trade secrets, know-how, technology, confidential information, ideas, copyrights, trademarks, and service marks and any and all rights, applications, and registrations relating to them.

34-39-3. Scope of act — When agreements between an employee and employer are enforceable or unenforceable with respect to employment inventions — Exceptions.

(1) An employment agreement between an employee and his employer is not enforceable against the employee to the extent that the agreement requires the employee to assign or license, or to offer to assign or license, to the employer any right or intellectual property in or to an invention that is:

(a) created by the employee entirely on his own time; and

(b) not an employment invention.

(2) An agreement between an employee and his employer may require the employee to assign or license, or to offer to assign or license, to his employer any or all of his rights and intellectual property in or to an employment invention.

(3) Subsection (1) does not apply to:

(a) any right, intellectual property or invention that is required by law or by contract between the employer and the United States government or a state or local government to be assigned or licensed to the United States; or

(b) an agreement between an employee and his employer which is not an employment agreement.

(4) Notwithstanding Subsection (1), an agreement is enforceable under Subsection (1) if the employee’s employment or continuation of employment is not conditioned on the employee’s acceptance of such agreement and the employee receives a consideration under such agreement which is not compensation for employment.

(5) Employment of the employee or the continuation of his employment is sufficient consideration to support the enforceability of an agreement under Subsection (2) whether or not the agreement recites such consideration.

(6) An employer may require his employees to agree to an agreement within the scope of Subsection (2) as a condition of employment or the continuation of employment.

(7) An employer may not require his employees to agree to anything unenforceable under Subsection (1) as a condition of employment or the continuation of employment.

(8) Nothing in this chapter invalidates or renders unenforceable any employment agreement or provisions of an employment agreement unrelated to employment inventions.

If I am employed by the Company in the State of Washington, the following provision applies:

TITLE 49. LABOR REGULATIONS

CHAPTER 49.44. VIOLATIONS — PROHIBITED PRACTICES

(i) A provision in an employment agreement which provides that an employee shall assign or offer to assign any of the employee’s rights in an invention to the employer does not apply to an invention for which no equipment, supplies, facilities, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) directly to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employer. Any provision which purports to apply to such an invention is to that extent against the public policy of this state and is to that extent void and unenforceable.

(ii) An employer shall not require a provision made void and unenforceable by subsection (1) of this section as a condition of employment or continuing employment.

(iii) If an employment agreement entered into after September 1, 1979, contains a provision requiring the employee to assign any of the employee’s rights in any invention to the employer, the employer must also, at the time the agreement is made, provide a written notification to the employee that the agreement does not apply to an invention for which no equipment, supplies, facility, or trade secret information of the employer was used and which was developed entirely on the employee’s own time, unless (a) the invention relates (i) directly to the business of the employer, or (ii) to the employer’s actual or demonstrably anticipated research or development, or (b) the invention results from any work performed by the employee for the employee for the employer

 

3

Exhibit 10.21

MULBERRY HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

December 29, 2020

Jeffery Boyd

####

Dear Mr. Boyd:

As we discussed, the requisite stockholders of Mulberry Health Inc. (the “Company”) plan to elect you as Chairman of the Board of Directors of the Company (the “Board”), effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you an option to purchase 350,000 shares of the Company’s Series A Common Stock (the “Option”) and restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), each with a vesting commencement date of December 15, 2020. The exercise price per share of the Option will be determined by the Board or the Compensation Committee when the Option is granted. Both the Option and the RSUs will be subject to the terms and conditions applicable to stock options and RSUs, respectively, granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable Stock Option Agreement and RSU Agreement. You will vest in the Option shares in equal monthly installments, and RSUs in equal quarterly installments, over your first three years of continuous service with the Company, as described in the applicable Stock Option Agreement and RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.


“You have provided us with a description of your investments and activities in healthcare and we have agreed they do not pose a conflict of interest at this time. You will advise the Company of any additional investments or activities in health insurance or healthcare delivery and, in addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.

As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
MULBERRY HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ Jeffery Boyd

Jeffery Boyd
Dated: 1/4/2021

Exhibit 10.22

OSCAR HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

January 7, 2021

Teri List-Stoll

####

Dear Ms. List-Stoll:

As we discussed, the requisite stockholders of Oscar Health Inc. (the “Company”) plan to elect you as a member of the Board of Directors of the Company (the “Board”), and Chair of the Audit Committee effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), with vesting commencing on the date of your appointment. The RSUs will be subject to the terms and conditions applicable to RSUs granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable RSU Agreement. You will vest in the RSUs in equal quarterly installments over your first 12 quarters of continuous service with the Company, as described in the applicable RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.


As a precautionary matter and to avoid any conflicts of interest, we ask you to refrain, while you are a member of the Board, from providing advice or otherwise providing services to any entity active in the health insurance and healthcare delivery fields. In addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.

As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
OSCAR HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ Teri List-Stoll

Teri List-Stoll
Dated: 1/15/2021

Exhibit 10.23

OSCAR HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

January 4, 2021

Charles Phillips

####

Dear Mr. Phillips:

As we discussed, the requisite stockholders of Oscar Health Inc. (the “Company”) plan to elect you as a member of the Board of Directors of the Company (the “Board”), effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), with vesting commencing on the date of your appointment. The RSUs will be subject to the terms and conditions applicable to RSUs granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable RSU Agreement. You will vest in the RSUs in equal quarterly installments over your first 12 quarters of continuous service with the Company, as described in the applicable RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.

As a precautionary matter and to avoid any conflicts of interest, we ask you to refrain, while you are a member of the Board, from providing advice or otherwise providing services to any entity active in the health insurance and healthcare delivery fields. In addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.


As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
OSCAR HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ Charles Phillips

Charles Phillips
Dated:  

1/19/2021

Exhibit 10.24

OSCAR HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

January 14, 2021

David Plouffe

####

Dear Mr. Plouffe:

As we discussed, the requisite stockholders of Oscar Health Inc. (the “Company”) plan to elect you as a member of the Board of Directors of the Company (the “Board”), effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), with vesting commencing on the date of your appointment. The RSUs will be subject to the terms and conditions applicable to RSUs granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable RSU Agreement. You will vest in the RSUs in equal quarterly installments over your first 12 quarters of continuous service with the Company, as described in the applicable RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.


As a precautionary matter and to avoid any conflicts of interest, we ask you to refrain, while you are a member of the Board, from providing advice or otherwise providing services to any entity active in the health insurance and healthcare delivery fields. In addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.

As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company. In the event the Company is not publicly traded by the end of calendar year 2021, we anticipate that the Company’s stockholders will remove you from the Board.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
OSCAR HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ David Plouffe

David Plouffe
Dated: 1/14/2021

Exhibit 10.25

OSCAR HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

January 14, 2021

Elbert (“Robbie”) O’Neal Robinson Jr.

####

Dear Mr. Robinson:

As we discussed, the requisite stockholders of Oscar Health Inc. (the “Company”) plan to elect you as a member of the Board of Directors of the Company (the “Board”), effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), with vesting commencing on the date of your appointment. The RSUs will be subject to the terms and conditions applicable to RSUs granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable RSU Agreement. You will vest in the RSUs in equal quarterly installments over your first 12 quarters of continuous service with the Company, as described in the applicable RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.


As a precautionary matter and to avoid any conflicts of interest, we ask you to refrain, while you are a member of the Board, from providing advice or otherwise providing services to any entity active in the health insurance and healthcare delivery fields. In addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.

As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company. In the event the Company is not publicly traded by the end of calendar year 2021, we anticipate that the Company’s stockholders will remove you from the Board.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
OSCAR HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ Elbert O’Neal Robinson Jr.

Elbert (“Robbie”) O’Neal Robinson Jr.
Dated: 1/20/2021

Exhibit 10.26

OSCAR HEALTH INC.

75 VARICK STREET, 5TH FLOOR

NEW YORK, NY 10013

January 6, 2021

Vanessa Wittman

####

Dear Ms. Wittman:

As we discussed, the requisite stockholders of Oscar Health Inc. (the “Company”) plan to elect you as a member of the Board of Directors of the Company (the “Board”), effective prior to February 1, 2021. We appreciate your willingness to accept this position, and we look forward to your valuable contributions.

In consideration of your service, the Board will grant you restricted stock units covering 150,000 shares of the Company’s Series A Common Stock (the “RSUs”), with vesting commencing on the date of your appointment. The RSUs will be subject to the terms and conditions applicable to RSUs granted under the Company’s Amended and Restated 2012 Stock Plan (the “Plan”), as described in the Plan and the applicable RSU Agreement. You will vest in the RSUs in equal quarterly installments over your first 12 quarters of continuous service with the Company, as described in the applicable RSU Agreement. The RSUs will be settled in shares of the Company’s Series A Common Stock, and will, to the extent vested, be settled by March 15 in the year after vesting. Unless and until the RSUs are settled in shares of the Company’s Series A Common Stock, you will not have voting or dividend rights.

We currently do not pay a cash retainer or cash fees for attendance at meetings. However, we will reimburse you for reasonable out-of-pocket travel expenses in connection with attending meetings of the Board. You will also be entitled to reimbursement from the Company for reasonable out-of-pocket travel expenses related to the Company for non-Board related issues, not to exceed $10,000 annually without the Company’s prior written approval. We will review our compensation policy for Board members in the event of an initial public offering, after which we expect to implement a post-initial public offering director compensation program.

We plan to have at least one scheduled Board meeting each calendar quarter. As a Board member, you are responsible for attending these scheduled meetings in person or by telephone.

In connection with your services to the Company, we expect that technical, business or financial information of the Company (“Confidential Information”) will be disclosed to you. To the extent that Confidential Information is not publicly known or not otherwise previously known by you without an obligation of confidentiality, you agree not to use (except in connection with your services to the Company) or disclose Confidential Information to any third party and to take reasonable steps to maintain the confidential nature of all Confidential Information.

As a precautionary matter and to avoid any conflicts of interest, we ask you to refrain, while you are a member of the Board, from providing advice or otherwise providing services to any entity active in the health insurance and healthcare delivery fields. In addition, we ask that you inform the Board of any potential or actual, direct or indirect, conflict of interest that you think exists or may arise because of your relationship with the Company, so that we may come to a quick and mutually agreeable resolution. By signing this letter agreement, you also represent and warrant that you have no contractual commitments or other legal obligations to a third party that would prohibit you from performing your duties for the Company.


As part of our overall responsibilities, the Company and the Company’s stockholders reserve the right to remove any individual from the Board at any time in accordance with the provisions of applicable law. You, of course, may also terminate your relationship with Company at any time. When you cease to be a member of the Board (whether at our request or your election), you must return all Confidential Information to the Company.

During your tenure on the Board, you will at all times and for all purposes be acting as an independent contractor and not as an employee of the Company. Accordingly, you will not be eligible to participate in any employee benefit plans provided by the Company to its employees and the Company will not, on your account, (i) pay any unemployment tax or other taxes required under the law to be paid with respect to employees or (ii) withhold any monies from any compensation paid to you for income or employment tax purposes.

I am excited about your joining our Board and look forward to working with you to help make the Company truly great and prosperous. You may indicate your agreement with these terms and accept this offer by signing and dating the enclosed duplicate original of this letter agreement and returning it to me.

 

Very truly yours,
OSCAR HEALTH INC.
By:  

/s/ Mario Schlosser

Name: Mario Schlosser
Title: Chief Executive Officer

I have read and accept this offer:

 

/s/ Vanessa Wittman

Vanessa Wittman
Dated: January 7, 2021

 

Exhibit 10.28

OSCAR HEALTH, INC.

INDEMNIFICATION AGREEMENT

THIS INDEMNIFICATION AGREEMENT (this “Agreement”) is made and entered into as of ____________________, 2021 between Oscar Health, Inc., a Delaware corporation (the “Company”), and __________________ (“Indemnitee”).

WITNESSETH THAT:

WHEREAS, highly competent persons have become more reluctant to serve corporations as directors, officers or in other capacities unless they are provided with adequate protection through insurance or adequate indemnification against inordinate risks of claims and actions against them arising out of their service to and activities on behalf of the corporation;

WHEREAS, the Board of Directors of the Company (the “Board”) has determined that, in order to attract and retain qualified individuals, the Company will attempt to maintain on an ongoing basis, at its sole expense, liability insurance to protect persons serving the Company and its subsidiaries from certain liabilities. Although the furnishing of such insurance has been a customary and widespread practice among United States-based corporations and other business enterprises, the Company believes that, given current market conditions and trends, such insurance may be available to it in the future only at higher premiums and with more exclusions. At the same time, directors, officers, and other persons in service to corporations or business enterprises are being increasingly subjected to expensive and time-consuming litigation relating to, among other things, matters that traditionally would have been brought only against the Company or business enterprise itself. The Bylaws of the Company and the Certificate of Incorporation of the Company (as amended and/or restated from time to time, the “Certificate of Incorporation”) require indemnification of the officers and directors of the Company. Indemnitee may also be entitled to indemnification pursuant to the General Corporation Law of the State of Delaware (“DGCL”). The Bylaws and Certificate of Incorporation and the DGCL expressly provide that the indemnification provisions set forth therein are not exclusive, and thereby contemplate that contracts may be entered into between the Company and members of the Board, officers and other persons with respect to indemnification;

WHEREAS, the uncertainties relating to such insurance and to indemnification have increased the difficulty of attracting and retaining such persons;

WHEREAS, the Board has determined that the increased difficulty in attracting and retaining such persons is detrimental to the best interests of the Company’s stockholders and that the Company should act to assure such persons that there will be increased certainty of such protection in the future;

WHEREAS, it is reasonable, prudent and necessary for the Company contractually to obligate itself to indemnify, and to advance expenses on behalf of, such persons to the fullest extent permitted by applicable law so that they will serve or continue to serve the Company free from undue concern that they will not be so indemnified;

 

1


WHEREAS, this Agreement is a supplement to and in furtherance of the Certificate of Incorporation and Bylaws of the Company and any resolutions adopted pursuant thereto, and shall not be deemed a substitute therefor, nor to diminish or abrogate any rights of Indemnitee thereunder; [and]

WHEREAS, Indemnitee does not regard the protection available under the Company’s Certificate of Incorporation, Bylaws and insurance as adequate in the present circumstances, and may not be willing to serve as an officer or director without adequate protection, and the Company desires Indemnitee to serve in such capacity. Indemnitee is willing to serve, continue to serve and to take on additional service for or on behalf of the Company on the condition that he or she be so indemnified[; and]

[WHEREAS, Indemnitee is a representative of or affiliated with ____________________ (together with any affiliated venture capital funds and the general partners, managing members or other control persons and/or any affiliated management companies, the “VC Funds,” and each, individually, a “VC Fund”), and has certain rights to indemnification and/or insurance provided by the VC Funds, which Indemnitee and the VC Fund intend to be secondary to the primary obligation of the Company to indemnify Indemnitee as provided herein, with the Company’s acknowledgement and agreement to the foregoing being a material condition to Indemnitee’s willingness to serve on the Board;]1.

NOW, THEREFORE, in consideration of Indemnitee’s agreement to serve as an officer or director from and after the date hereof, the parties hereto agree as follows:

1. Indemnity of Indemnitee. The Company hereby agrees to hold harmless and indemnify Indemnitee to the fullest extent permitted by law, as such may be amended from time to time. In furtherance of the foregoing indemnification, and without limiting the generality thereof:

(a) Proceedings Other Than Proceedings by or in the Right of the Enterprise. Indemnitee shall be entitled to the rights of indemnification provided in this Section l(a) if, by reason of such person’s Corporate Status (as hereinafter defined), Indemnitee is, or is threatened to be made, a party to or participant in any Proceeding (as hereinafter defined) other than a Proceeding by or in the right of the Enterprise. Pursuant to this Section 1(a), Indemnitee shall be indemnified against all Expenses (as hereinafter defined), judgments, penalties, fines and amounts paid in settlement actually and reasonably incurred by such person, or on such person’s behalf, in connection with such Proceeding or any claim, issue or matter therein, if Indemnitee acted in good faith and in a manner Indemnitee reasonably believed to be in or not opposed to the best interests of the Enterprise, and with respect to any criminal Proceeding, had no reasonable cause to believe Indemnitee’s conduct was unlawful.

(b) Proceedings by or in the Right of the Enterprise. Indemnitee shall be entitled to the rights of indemnification provided in this Section 1(b) if, by reason of such person’s Corporate Status, Indemnitee is, or is threatened to be made, a party to or participant in any Proceeding brought by or in the right of the Enterprise. Pursuant to this Section 1(b), Indemnitee shall be indemnified against all Expenses actually and reasonably incurred by

 

1 

NTD: For VC-affiliated director only.

 

2


Indemnitee, or on Indemnitee’s behalf, in connection with such Proceeding if Indemnitee acted in good faith and in a manner Indemnitee reasonably believed to be in or not opposed to the best interests of the Enterprise; provided, however, if applicable law so provides, no indemnification against such Expenses shall be made in respect of any claim, issue or matter in such Proceeding as to which Indemnitee shall have been adjudged to be liable to the Enterprise unless and to the extent that the Court of Chancery of the State of Delaware shall determine that such indemnification may be made.

(c) Indemnification for Expenses of a Party Who is Wholly or Partly Successful. Notwithstanding any other provision of this Agreement, to the extent that Indemnitee is, by reason of Indemnitee’s Corporate Status, a party to and is successful, on the merits or otherwise, in any Proceeding, Indemnitee shall be indemnified to the maximum extent permitted by law, as such may be amended from time to time, against all Expenses actually and reasonably incurred by Indemnitee or on Indemnitee’s behalf in connection therewith. If Indemnitee is not wholly successful in such Proceeding but is successful, on the merits or otherwise, as to one or more but less than all claims, issues or matters in such Proceeding, the Company shall indemnify Indemnitee against all Expenses actually and reasonably incurred by Indemnitee or on Indemnitee’s behalf in connection with each successfully resolved claim, issue or matter. For purposes of this Section and without limitation, the termination of any claim, issue or matter in such a Proceeding by dismissal, with or without prejudice, shall be deemed to be a successful result as to such claim, issue or matter.

(d) [Indemnification of VC Fund. If any VC Fund is, or is threatened to be made, a party to or a participant in any Proceeding, and such VC Fund’s involvement in the Proceeding arises out of facts or circumstances that are the same or substantially similar to the facts and circumstances that form the basis of claims that have been, could have been or could be brought against the Indemnitee in a Proceeding, regardless of whether the legal basis of the claims against the Indemnitee and such VC Fund are the same or similar, then such VC Fund shall be entitled to all of the indemnification rights and remedies under this Agreement pursuant to this Agreement as if such VC Fund were the Indemnitee. The Company and Indemnitee agree that the VC Fund is an express third party beneficiary of the terms of this Section 1(d).]2

2. Additional Indemnity. In addition to, and without regard to any limitations on, the indemnification provided for in Section 1 of this Agreement, the Company shall and hereby does indemnify and hold harmless Indemnitee against all Expenses, judgments, penalties, fines and amounts paid in settlement actually and reasonably incurred by Indemnitee or on Indemnitee’s behalf if, by reason of Indemnitee’s Corporate Status, he is, or is threatened to be made, a party to or participant in any Proceeding (including a Proceeding by or in the right of the Enterprise), including, without limitation, all liability arising out of the negligence or active or passive wrongdoing of Indemnitee. The only limitation that shall exist upon the Company’s obligations pursuant to this Agreement shall be that the Company shall not be obligated to make any payment to Indemnitee that is finally determined (under the procedures, and subject to the presumptions, set forth in Sections 6 and 7 hereof) to be unlawful.

 

2 

NTD: For VC-affiliated director only.

 

3


3. Contribution.

(a) Whether or not the indemnification provided in Sections 1 and 2 hereof is available, in respect of any threatened, pending or completed action, suit or proceeding in which the Enterprise is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), the Company shall cause the Enterprise to pay, in the first instance, the entire amount of any judgment or settlement of such action, suit or proceeding without requiring Indemnitee to contribute to such payment and the Company, on behalf of the Enterprise, hereby waives and relinquishes any right of contribution it may have against Indemnitee. The Company shall not, and shall cause the Enterprise to not, enter into any settlement of any action, suit or proceeding in which the Enterprise is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding) unless such settlement provides for a full and final release of all claims asserted against Indemnitee.

(b) Without diminishing or impairing the obligations of the Company set forth in the preceding subparagraph, if, for any reason, Indemnitee shall elect or be required to pay all or any portion of any judgment or settlement in any threatened, pending or completed action, suit or proceeding in which the Enterprise is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), the Company shall cause the Enterprise to contribute to the amount of Expenses, judgments, fines and amounts paid in settlement actually and reasonably incurred and paid or payable by Indemnitee in proportion to the relative benefits received by the Enterprise and all officers, directors or employees of the Enterprise, other than Indemnitee, who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, from the transaction or events from which such action, suit or proceeding arose; provided, however, that the proportion determined on the basis of relative benefit may, to the extent necessary to conform to law, be further adjusted by reference to the relative fault of the Enterprise and all officers, directors or employees of the Enterprise other than Indemnitee who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, in connection with the transaction or events that resulted in such expenses, judgments, fines or settlement amounts, as well as any other equitable considerations which the Law may require to be considered. The relative fault of the Enterprise and all officers, directors or employees of the Enterprise, other than Indemnitee, who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, shall be determined by reference to, among other things, the degree to which their actions were motivated by intent to gain personal profit or advantage, the degree to which their liability is primary or secondary and the degree to which their conduct is active or passive.

(c) The Company hereby agrees to fully indemnify and hold Indemnitee harmless from any claims of contribution which may be brought by officers, directors or employees of the Enterprise, other than Indemnitee, who may be jointly liable with Indemnitee.

(d) To the fullest extent permissible under applicable law and without diminishing or impairing the obligations of the Company set forth in the preceding subparagraphs of this Section, if the indemnification provided for in this Agreement is unavailable to Indemnitee for any reason whatsoever, the Company, in lieu of indemnifying Indemnitee, shall cause the Enterprise to contribute to the amount incurred by Indemnitee, whether for judgments, fines, penalties, excise taxes, amounts paid or to be paid in settlement and/or for Expenses, in connection with any claim relating to an indemnifiable event under this Agreement, in such proportion as is deemed fair and reasonable in light of all of the circumstances of such Proceeding in order to

 

4


reflect (i) the relative benefits received by the Enterprise and Indemnitee as a result of the event(s) and/or transaction(s) giving cause to such Proceeding; and/or (ii) the relative fault of the Enterprise (and its directors, officers, employees and agents) and Indemnitee in connection with such event(s) and/or transaction(s).

4. Indemnification for Expenses of a Witness. Notwithstanding any other provision of this Agreement, to the extent that Indemnitee is, by reason of Indemnitee’s Corporate Status, a witness, or is made (or asked) to respond to discovery requests, in any Proceeding to which Indemnitee is not a party, Indemnitee shall be indemnified against all Expenses actually and reasonably incurred by Indemnitee or on Indemnitee’s behalf in connection therewith.

5. Advancement of Expenses. Notwithstanding any other provision of this Agreement, the Company shall advance all Expenses incurred by or on behalf of Indemnitee in connection with any Proceeding by reason of Indemnitee’s Corporate Status within thirty (30) days after the receipt by the Company of a statement or statements from Indemnitee requesting such advance or advances from time to time, whether prior to or after final disposition of such Proceeding. Such statement or statements shall reasonably evidence the Expenses incurred by Indemnitee. The Indemnitee shall qualify for advances upon the execution and delivery to the Company of this Agreement, which shall constitute an undertaking by or on behalf of Indemnitee to repay any Expenses advanced if it shall ultimately be determined that Indemnitee is not entitled to be indemnified against such Expenses. Any advances and undertakings to repay pursuant to this Section 5 shall be unsecured and interest free and not conditioned on Indemnitee’s ability to repay such advances.

6. Procedures and Presumptions for Determination of Entitlement to Indemnification. It is the intent of this Agreement to secure for Indemnitee rights of indemnity that are as favorable as may be permitted under the DGCL and public policy of the State of Delaware. Accordingly, the parties agree that the following procedures and presumptions shall apply in the event of any question as to whether Indemnitee is entitled to indemnification under this Agreement:

(a) To obtain indemnification under this Agreement, Indemnitee shall submit to the Company a written request, including therein or therewith such documentation and information as is reasonably available to Indemnitee and is reasonably necessary to determine whether and to what extent Indemnitee is entitled to indemnification. The Secretary of the Company shall, promptly upon receipt of such a request for indemnification, advise the Board in writing that Indemnitee has requested indemnification. Notwithstanding the foregoing, any failure of Indemnitee to provide such a request to the Company, or to provide such a request in a timely fashion, shall not relieve the Company of any liability that it may have to Indemnitee unless, and to the extent that, such failure actually and materially prejudices the interests of the Company.

(b) Upon written request by Indemnitee for indemnification pursuant to the first sentence of Section 6(a) hereof, a determination with respect to Indemnitee’s entitlement thereto shall be made in the specific case by one of the following four methods, which shall be at the election of the Board: (1) by a majority vote of the Disinterested Directors (as hereinafter defined), even though less than a quorum, (2) by a committee of Disinterested Directors designated by a majority vote of the Disinterested Directors, even though less than a quorum, (3) if there are no Disinterested Directors or if the Disinterested Directors so direct, by Independent Counsel (as hereinafter defined) in a written opinion to the Board, a copy of which shall be delivered to Indemnitee, or (4) if so directed by the Board, by the stockholders of the Company.

 

5


(c) If the determination of entitlement to indemnification is to be made by Independent Counsel pursuant to Section 6(b) hereof, the Independent Counsel shall be selected as provided in this Section 6(c). The Independent Counsel shall be selected by the Board. Indemnitee may, within ten (10) days after such written notice of selection shall have been given, deliver to the Company a written objection to such selection; provided, however, that such objection may be asserted only on the ground that the Independent Counsel so selected does not meet the requirements of “Independent Counsel” as defined in Section 13 of this Agreement, and the objection shall set forth with particularity the factual basis of such assertion. Absent a proper and timely objection, the person so selected shall act as Independent Counsel. If a written objection is made and substantiated, the Independent Counsel selected may not serve as Independent Counsel unless and until such objection is withdrawn or a court has determined that such objection is without merit. If, within twenty (20) days after submission by Indemnitee of a written request for indemnification pursuant to Section 6(a) hereof, no Independent Counsel shall have been selected and not objected to, either the Company or Indemnitee may petition the Court of Chancery of the State of Delaware or other court of competent jurisdiction for resolution of any objection which shall have been made by Indemnitee to the Company’s selection of Independent Counsel and/or for the appointment as Independent Counsel of a person selected by the court or by such other person as the court shall designate, and the person with respect to whom all objections are so resolved or the person so appointed shall act as Independent Counsel under Section 6(b) hereof. The Company shall pay any and all reasonable fees and expenses of Independent Counsel incurred by such Independent Counsel in connection with acting pursuant to Section 6(b) hereof, and the Company shall pay all reasonable fees and expenses incident to the procedures of this Section 6(c), regardless of the manner in which such Independent Counsel was selected or appointed.

(d) In making a determination with respect to entitlement to indemnification hereunder, the person or persons or entity making such determination shall presume that Indemnitee is entitled to indemnification under this Agreement. Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence. Neither the failure of the Company (including by its directors or Independent Counsel) to have made a determination prior to the commencement of any action pursuant to this Agreement that indemnification is proper in the circumstances because Indemnitee has met the applicable standard of conduct, nor an actual determination by the Company (including by its directors or Independent Counsel) that Indemnitee has not met such applicable standard of conduct, shall be a defense to the action or create a presumption that Indemnitee has not met the applicable standard of conduct.

(e) Indemnitee shall be deemed to have acted in good faith if Indemnitee’s action is based on the records or books of account of the Enterprise (as hereinafter defined), including financial statements, or on information supplied to Indemnitee by the officers of the Enterprise in the course of their duties, or on the advice of legal counsel for the Enterprise or on information or records given or reports made to the Enterprise by an independent certified public accountant or by an appraiser or other expert selected with reasonable care by the Enterprise. In addition, the knowledge and/or actions, or failure to act, of any director, officer, agent or employee of the Enterprise shall not be imputed to Indemnitee for purposes of determining the right to indemnification under this Agreement. Whether or not the foregoing provisions of this

 

6


Section 6(e) are satisfied, it shall in any event be presumed that Indemnitee has at all times acted in good faith and in a manner he reasonably believed to be in or not opposed to the best interests of the Enterprise. Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence.

(f) If the person, persons or entity empowered or selected under Section 6 to determine whether Indemnitee is entitled to indemnification shall not have made a determination within sixty (60) days after receipt by the Company of the request therefor, the requisite determination of entitlement to indemnification shall be deemed to have been made and Indemnitee shall be entitled to such indemnification absent (i) a misstatement by Indemnitee of a material fact, or an omission of a material fact necessary to make Indemnitee’s statement not materially misleading, in connection with the request for indemnification, or (ii) a prohibition of such indemnification under applicable law; provided, however, that such sixty (60)-day period may be extended for a reasonable time, not to exceed an additional thirty (30) days, if the person, persons or entity making such determination with respect to entitlement to indemnification in good faith requires such additional time to obtain or evaluate documentation and/or information relating thereto; and provided, further, that the foregoing provisions of this Section 6(f) shall not apply if the determination of entitlement to indemnification is to be made by the stockholders pursuant to Section 6(b) of this Agreement and if (A) within fifteen (15) days after receipt by the Company of the request for such determination, the Board or the Disinterested Directors, if appropriate, resolve to submit such determination to the stockholders for their consideration at an annual meeting thereof to be held within seventy-five (75) days after such receipt and such determination is made thereat, or (B) a special meeting of stockholders is called within fifteen (15) days after such receipt for the purpose of making such determination, such meeting is held for such purpose within sixty (60) days after having been so called and such determination is made thereat.

(g) Indemnitee shall cooperate with the person, persons or entity making such determination with respect to Indemnitee’s entitlement to indemnification, including providing to such person, persons or entity upon reasonable advance request any documentation or information which is not privileged or otherwise protected from disclosure and which is reasonably available to Indemnitee and reasonably necessary to such determination. Any Independent Counsel, member of the Board or stockholder of the Company shall act reasonably and in good faith in making a determination regarding Indemnitee’s entitlement to indemnification under this Agreement. Any costs or expenses (including attorneys’ fees and disbursements) incurred by Indemnitee in so cooperating with the person, persons or entity making such determination shall be borne by the Company (irrespective of the determination as to Indemnitee’s entitlement to indemnification) and the Company hereby indemnifies and agrees to hold Indemnitee harmless therefrom.

(h) The Company acknowledges that a settlement or other disposition short of final judgment may be successful if it permits a party to avoid expense, delay, distraction, disruption and uncertainty. In the event that any action, claim or proceeding to which Indemnitee is a party is resolved in any manner other than by adverse judgment against Indemnitee (including, without limitation, settlement of such action, claim or proceeding with or without payment of money or other consideration) it shall be presumed that Indemnitee has been successful on the merits or otherwise in such action, suit or proceeding. Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence.

 

7


(i) The termination of any Proceeding or of any claim, issue or matter therein, by judgment, order, settlement or conviction, or upon a plea of nolo contendere or its equivalent, shall not (except as otherwise expressly provided in this Agreement) of itself adversely affect the right of Indemnitee to indemnification or create a presumption that Indemnitee did not act in good faith and in a manner which he reasonably believed to be in or not opposed to the best interests of the Enterprise or, with respect to any criminal Proceeding, that Indemnitee had reasonable cause to believe that Indemnitee’s conduct was unlawful.

7. Remedies of Indemnitee.

(a) In the event that (i) a determination is made pursuant to Section 6 of this Agreement that Indemnitee is not entitled to indemnification under this Agreement, (ii) advancement of Expenses is not timely made pursuant to Section 5 of this Agreement, (iii) no determination of entitlement to indemnification is made pursuant to Section 6(b) of this Agreement within ninety (90) days after receipt by the Company of the request for indemnification, (iv) payment of indemnification required by Section 4 is not made pursuant to this Agreement within ten (10) days after receipt by the Company of a written request therefor or (v) payment of indemnification is not made within ten (10) days after a determination has been made that Indemnitee is entitled to indemnification or such determination is deemed to have been made pursuant to Section 6 of this Agreement, Indemnitee shall be entitled to an adjudication in an appropriate court of the State of Delaware, or in any other court of competent jurisdiction, of Indemnitee’s entitlement to such indemnification. Indemnitee shall commence such proceeding seeking an adjudication within one hundred eighty (180) days following the date on which Indemnitee first has the right to commence such proceeding pursuant to this Section 7(a). The Company shall not oppose Indemnitee’s right to seek any such adjudication.

(b) In the event that a determination shall have been made pursuant to Section 6(b) of this Agreement that Indemnitee is not entitled to indemnification, any judicial proceeding commenced pursuant to this Section 7 shall be conducted in all respects as a de novo trial on the merits, and Indemnitee shall not be prejudiced by reason of the adverse determination under Section 6(b).

(c) If a determination shall have been made pursuant to Section 6(b) of this Agreement that Indemnitee is entitled to indemnification, the Company shall be bound by such determination in any judicial proceeding commenced pursuant to this Section 7, absent (i) a misstatement by Indemnitee of a material fact, or an omission of a material fact necessary to make Indemnitee’s misstatement not materially misleading in connection with the application for indemnification, or (ii) a prohibition of such indemnification under applicable law.

(d) In the event that Indemnitee, pursuant to this Section 7, seeks a judicial adjudication of such Indemnitee’s rights under, or to recover damages for breach of, this Agreement, or to recover under any directors’ and officers’ liability insurance policies maintained by the Enterprise, the Company shall pay on Indemnitee’s behalf, in advance, any and all expenses (of the types described in the definition of Expenses in Section 13 of this Agreement) actually and reasonably incurred by Indemnitee in such judicial adjudication, regardless of whether Indemnitee ultimately is determined to be entitled to such indemnification, advancement of expenses or insurance recovery. The Company irrevocably authorizes Indemnitee from time to time to retain counsel of Indemnitee’s choice, at the expense of the Company to the extent provided hereunder

 

8


or under applicable law, to advise and represent Indemnitee in connection with any such judicial adjudication or recovery, including without limitation the initiation or defense of any litigation or other legal action, whether by or against the Enterprise or any director, officer, stockholder or other person affiliated with the Enterprise. Notwithstanding any existing or prior attorney-client relationship between the Enterprise and such counsel, the Company irrevocably consents to Indemnitee’s entering into an attorney-client relationship with such counsel, and in that connection the Company and Indemnitee agree that a confidential relationship shall exist between Indemnitee and such counsel.

(e) The Company shall be precluded from asserting in any judicial proceeding commenced pursuant to this Section 7 that the procedures and presumptions of this Agreement are not valid, binding and enforceable and shall stipulate in any such court that the Company is bound by all the provisions of this Agreement. The Company shall indemnify Indemnitee against any and all Expenses and, if requested by Indemnitee, shall (within ten (10) days after receipt by the Company of a written request therefore) advance, to the extent not prohibited by law, such expenses to Indemnitee, which are incurred by Indemnitee in connection with any action brought by Indemnitee for indemnification or advance of Expenses from the Company under this Agreement or under any directors’ and officers’ liability insurance policies maintained by the Enterprise, regardless of whether Indemnitee ultimately is determined to be entitled to such indemnification, advancement of Expenses or insurance recovery, as the case may be.

(f) Notwithstanding anything in this Agreement to the contrary, no determination as to entitlement to indemnification under this Agreement shall be required to be made prior to the final disposition of the Proceeding.

8. Non-Exclusivity; Survival of Rights; Insurance; Primacy of Indemnification; Subrogation.

(a) The rights of indemnification as provided by this Agreement shall not be deemed exclusive of any other rights to which Indemnitee may at any time be entitled under applicable law, the Certificate of Incorporation, the Bylaws, any agreement, a vote of stockholders, a resolution of directors or otherwise of the Company. No amendment, alteration or repeal of this Agreement or of any provision hereof shall limit or restrict any right of Indemnitee under this Agreement in respect of any action taken or omitted by such Indemnitee in such Indemnitee’s Corporate Status prior to such amendment, alteration or repeal. To the extent that a change in the DGCL, whether by statute or judicial decision, permits greater indemnification than would be afforded currently under the Certificate of Incorporation, Bylaws and this Agreement, it is the intent of the parties hereto that Indemnitee shall enjoy by this Agreement the greater benefits so afforded by such change. No right or remedy herein conferred is intended to be exclusive of any other right or remedy, and every other right and remedy shall be cumulative and in addition to every other right and remedy given hereunder or now or hereafter existing at law or in equity or otherwise. The assertion or employment of any right or remedy hereunder, or otherwise, shall not prevent the concurrent assertion or employment of any other right or remedy.

 

9


(b) To the extent that the Enterprise maintains an insurance policy or policies providing liability insurance for directors, officers, employees, or agents or fiduciaries of the Enterprise or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person serves at the request of the Enterprise, Indemnitee shall be covered by such policy or policies in accordance with its or their terms to the maximum extent of the coverage available for any director, officer, employee, agent or fiduciary under such policy or policies. If, at the time of the receipt of a notice of a claim pursuant to the terms hereof, the Enterprise has directors’ and officers’ liability insurance in effect, the Company shall give prompt notice of the commencement of such proceeding to the insurers in accordance with the procedures set forth in the respective policies. The Company shall cause the Enterprise to thereafter take all necessary or desirable action to cause such insurers to pay, on behalf of Indemnitee, all amounts payable as a result of such proceeding in accordance with the terms of such policies.

(c) [The Company hereby acknowledges that Indemnitee has certain rights to indemnification, advancement of expenses and/or insurance provided by one or more VC Funds and certain of its or their affiliates (collectively, the “Fund Indemnitors”). The Company hereby agrees (i) that it is the indemnitor of first resort (i.e., its obligations to Indemnitee are primary and any obligation of the Fund Indemnitors to advance expenses or to provide indemnification for the same expenses or liabilities incurred by Indemnitee are secondary), (ii) that it shall be required to advance the full amount of expenses incurred by Indemnitee and shall be liable for the full amount of all Expenses, judgments, penalties, fines and amounts paid in settlement to the extent legally permitted and as required by the terms of this Agreement, the Certificate of Incorporation and Bylaws of the Company (or any other agreement between the Company and Indemnitee), without regard to any rights Indemnitee may have against the Fund Indemnitors, and, (iii) that it irrevocably waives, relinquishes and releases the Fund Indemnitors from any and all claims against the Fund Indemnitors for contribution, subrogation or any other recovery of any kind in respect thereof. The Company further agrees that no advancement or payment by the Fund Indemnitors on behalf of Indemnitee with respect to any claim for which Indemnitee has sought indemnification from the Company shall affect the foregoing and the Fund Indemnitors shall have a right of contribution and/or be subrogated to the extent of such advancement or payment to all of the rights of recovery of Indemnitee against the Company. The Company and Indemnitee agree that the Fund Indemnitors are express third party beneficiaries of the terms of this Section 8(c).]3

(d) [Except as provided in paragraph (c) above,]4 in the event of any payment under this Agreement, the Company shall be subrogated to the extent of such payment to all of the rights of recovery of Indemnitee (other than against the Fund Indemnitors), who shall execute all papers required and take all action necessary to secure such rights, including execution of such documents as are necessary to enable the Company to bring suit to enforce such rights.

(e) [Except as provided in paragraph (c) above,]5 the Company shall not be liable under this Agreement to make any payment of amounts otherwise indemnifiable hereunder if and to the extent that Indemnitee has otherwise actually received such payment under any insurance policy, contract, agreement or otherwise.

 

 

 

 

3 NTD: For VC-affiliated director only.

4 NTD: For VC-affiliated director only.

5 NTD: For VC-affiliated director only.

 

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(f) [Except as provided in paragraph (c) above,]6 the Company’s obligation to indemnify or advance Expenses hereunder to Indemnitee who is or was serving as a director, officer, employee or agent of the Enterprise, or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person serves at the request of the Enterprise, shall be reduced by any amount Indemnitee has actually received as indemnification or advancement of expenses from the Enterprise or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person serves at the request of the Enterprise.

9. Exception to Right of Indemnification. Notwithstanding any provision in this Agreement, the Company shall not be obligated under this Agreement to make any indemnity in connection with any claim made against Indemnitee:

(a) for which payment has actually been made to or on behalf of Indemnitee under any insurance policy or other indemnity provision, except with respect to any excess beyond the amount paid under any insurance policy or other indemnity provision[, provided, that the foregoing shall not affect the rights of Indemnitee or the Fund Indemnitors set forth in Section 8(c) above]7; or

(b) for an accounting of profits made from the purchase and sale (or sale and purchase) by Indemnitee of securities of the Company within the meaning of Section 16(b) of the Securities Exchange Act of 1934, as amended, or similar provisions of state statutory law or common law; or

(c) in connection with any Proceeding (or any part of any Proceeding) initiated by Indemnitee, including any Proceeding (or any part of any Proceeding) initiated by Indemnitee against the Enterprise or its directors, officers, employees or other indemnitees, unless (i) the Board authorized the Proceeding (or any part of any Proceeding) prior to its initiation, (ii) the Proceeding is initiated by Indemnitee pursuant to Indemnitee’s rights under Section 7 of this Agreement, or (iii) the Company provides the indemnification, in its sole discretion, pursuant to the powers vested in the Company under applicable law.

10. Duration of Agreement. All agreements and obligations of the Company contained herein shall continue during the period Indemnitee is an officer or director of the Enterprise (or is or was serving at the request of the Enterprise as a director, officer, employee or agent of another corporation, partnership, joint venture, trust, employee benefit plan or other enterprise), and shall continue thereafter so long as Indemnitee shall be subject to any Proceeding (or any proceeding commenced under Section 7 hereof) by reason of Indemnitee’s Corporate Status, whether or not he is acting or serving in any such capacity at the time any liability or expense is incurred for which indemnification can be provided under this Agreement. This Agreement shall be binding upon and inure to the benefit of and be enforceable by the parties hereto and their respective successors (including any direct or indirect successor by purchase, merger, consolidation or otherwise to all or substantially all of the business or assets of the Company), assigns, spouses, heirs, executors and personal and legal representatives.

 

6 

NTD: For VC-affiliated director only.

7 

NTD: For VC-affiliated director only.

 

11


11. Security. To the extent requested by Indemnitee and approved by the Board, the Company may at any time and from time to time provide security to Indemnitee for the Company’s obligations hereunder through an irrevocable bank line of credit, funded trust or other collateral. Any such security, once provided to Indemnitee, may not be revoked or released without the prior written consent of Indemnitee.

12. Enforcement.

(a) The Company expressly confirms and agrees that it has entered into this Agreement and assumes the obligations imposed on it hereby in order to induce Indemnitee to serve as an officer or director of the Company, and the Company acknowledges that Indemnitee is relying upon this Agreement in serving as an officer or director of the Company.

(b) This Agreement constitutes the entire agreement between the parties hereto with respect to the subject matter hereof and supersedes all prior agreements and understandings, oral, written and implied, between the parties hereto with respect to the subject matter hereof.

(c) The Company shall not seek from a court, or agree to, a “bar order” which would have the effect of prohibiting or limiting Indemnitee’s rights to receive advancement of expenses under this Agreement.

13. Definitions. For purposes of this Agreement:

(a) “Corporate Status” describes the status of a person who is or was a director, officer, employee, agent or fiduciary of the Company, any subsidiary of the Company or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person is or was serving at the express written request of the Company.

(b) “Disinterested Director” means a director of the Company who is not and was not a party to the Proceeding in respect of which indemnification is sought by Indemnitee.

(c) “Enterprise” shall mean the Company, any subsidiary of the Company and any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that Indemnitee is or was serving at the express written request of the Company as a director, officer, employee, agent or fiduciary.

(d) “Expenses” shall include all reasonable attorneys’ fees, retainers, court costs, transcript costs, fees of experts, witness fees, travel expenses, duplicating costs, printing and binding costs, telephone charges, postage, delivery service fees and all other disbursements or expenses of the types customarily incurred in connection with prosecuting, defending, preparing to prosecute or defend, investigating, participating, or being or preparing to be a witness in a Proceeding, or responding to, or objecting to, a request to provide discovery in any Proceeding. Expenses also shall include Expenses incurred in connection with any appeal resulting from any Proceeding and any federal, state, local or foreign taxes imposed on Indemnitee

 

12


as a result of the actual or deemed receipt of any payments under this Agreement, including without limitation the premium, security for, and other costs relating to any cost bond, supersede as bond, or other appeal bond or its equivalent. Expenses, however, shall not include amounts paid in settlement by Indemnitee or the amount of judgments or fines against Indemnitee.

(e) “Independent Counsel” means a law firm, or a member of a law firm, that is experienced in matters of corporation law and neither presently is, nor in the past five years has been, retained to represent: (i) the Company or Indemnitee in any matter material to either such party (other than with respect to matters concerning Indemnitee under this Agreement, or of other indemnitees under similar indemnification agreements), or (ii) any other party to the Proceeding giving rise to a claim for indemnification hereunder. Notwithstanding the foregoing, the term “Independent Counsel” shall not include any person who, under the applicable standards of professional conduct then prevailing, would have a conflict of interest in representing either the Company or Indemnitee in an action to determine Indemnitee’s rights under this Agreement. The Company agrees to pay the reasonable fees of the Independent Counsel referred to above and to fully indemnify such counsel against any and all Expenses, claims, liabilities and damages arising out of or relating to this Agreement or its engagement pursuant hereto.

(f) “Proceeding” includes any threatened, pending or completed action, suit, arbitration, alternate dispute resolution mechanism, investigation, inquiry, administrative hearing or any other actual, threatened or completed proceeding, whether brought by or in the right of the Enterprise or otherwise and whether civil, criminal, administrative or investigative, in which Indemnitee was, is or will be involved as a party or otherwise, by virtue of the Corporate Status of Indemnitee or by reason of any action taken by such Indemnitee or of any inaction on such Indemnitee’s part while acting as an officer or director of the Enterprise or in Indemnitee’s Corporate Status; in each case whether or not he is acting or serving in any such capacity at the time any liability or expense is incurred for which indemnification can be provided under this Agreement; including one pending on or before the date of this Agreement, but excluding one initiated by an Indemnitee pursuant to Section 7 of this Agreement to enforce Indemnitee’s rights under this Agreement.

14. Severability. The invalidity or unenforceability of any provision hereof shall in no way affect the validity or enforceability of any other provision. Without limiting the generality of the foregoing, this Agreement is intended to confer upon Indemnitee indemnification rights to the fullest extent permitted by applicable laws. In the event any provision hereof conflicts with any applicable law, such provision shall be deemed modified, consistent with the aforementioned intent, to the extent necessary to resolve such conflict.

15. Modification and Waiver. No supplement, modification, termination or amendment of this Agreement shall be binding unless executed in writing by both of the parties hereto. No waiver of any of the provisions of this Agreement shall be deemed or shall constitute a waiver of any other provisions hereof (whether or not similar) nor shall such waiver constitute a continuing waiver.

16. Notice By Indemnitee. Indemnitee agrees promptly to notify the Company in writing upon being served with or otherwise receiving any summons, citation, subpoena, complaint, indictment, information or other document relating to any Proceeding or matter which may be subject to indemnification covered hereunder. The failure to so notify the Company shall not relieve the Company of any obligation which it may have to Indemnitee under this Agreement or otherwise unless and only to the extent that such failure or delay materially prejudices the Company.

 

13


17. Notices. All notices and other communications given or made pursuant to this Agreement shall be in writing and shall be deemed effectively given: (a) upon personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient, and if not so confirmed, then on the next business day, (c) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (d) one (1) day after deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt. All communications shall be sent:

(a) To Indemnitee at the address set forth below Indemnitee signature hereto.

(b) To the Company at:

Oscar Health, Inc.

75 Varick Street, 5th Floor

New York, New York 10013

Attention: Legal

Email: corporate@hioscar.com

or to such other address as may have been furnished to Indemnitee by the Company or to the Company by Indemnitee, as the case may be.

18. Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Counterparts may be delivered via facsimile, electronic mail (including pdf or any electronic signature complying with the U.S. federal ESIGN Act of 2000, e.g., www.docusign.com) or any other transmission method and any counterpart so delivered shall be deemed to have been duly and validly delivered and be valid and effective for all purposes.

19. Headings. The headings of the paragraphs of this Agreement are inserted for convenience only and shall not be deemed to constitute part of this Agreement or to affect the construction thereof.

20. Governing Law and Consent to Jurisdiction. This Agreement and the legal relations among the parties shall be governed by, and construed and enforced in accordance with, the laws of the State of Delaware, without regard to its conflict of laws rules. The Company and Indemnitee hereby irrevocably and unconditionally (i) agree that any action or proceeding arising out of or in connection with this Agreement shall be brought only in the Chancery Court of the State of Delaware (the “Delaware Court”), and not in any other state or federal court in the United States of America or any court in any other country, (ii) consent to submit to the exclusive jurisdiction of the Delaware Court for purposes of any action or proceeding arising out of or in connection with this Agreement, (iii) waive any objection to the laying of venue of any such action or proceeding in the Delaware Court, and (iv) waive, and agree not to plead or to make, any claim that any such action or proceeding brought in the Delaware Court has been brought in an improper or inconvenient forum.

SIGNATURE PAGE TO FOLLOW

 

14


IN WITNESS WHEREOF, the parties hereto have executed this Agreement on and as of the day and year first above written.

 

OSCAR HEALTH, INC.
By:  

 

  Name:____________________________
  Title:_____________________________
INDEMNITEE

 

Name:                                                                          
Address:                                                                      

 

 

 

 

 

[Signature page to the Indemnification Agreement]

Exhibit 10.29

Execution Version

 

 

 

CREDIT AGREEMENT

dated as of

October 30, 2020

among

MULBERRY HEALTH INC.,

as Borrower,

THE LENDERS PARTY HERETO

and

HPS INVESTMENT PARTNERS, LLC,

as Administrative Agent

 

 

 


TABLE OF CONTENTS

 

         Page  

Article I           Definitions

     1  

Section 1.01.

 

Defined Terms

     1  

Section 1.02.

 

Terms Generally

     30  

Section 1.03.

 

Pro Forma Calculations

     31  

Section 1.04.

 

Classification of Loans and Borrowings

     31  

Article II         The Credits

     31  

Section 2.01.

 

Commitments

     31  

Section 2.02.

 

Loans

     32  

Section 2.03.

 

Borrowing Procedure

     33  

Section 2.04.

 

Evidence of Debt; Repayment of Loans

     33  

Section 2.05.

 

Fees

     34  

Section 2.06.

 

Interest on Loans

     35  

Section 2.07.

 

Default Interest

     35  

Section 2.08.

 

Alternate Rate of Interest

     36  

Section 2.09.

 

Termination and Reduction of Commitments

     37  

Section 2.10.

 

Conversion and Continuation of Borrowings

     37  

Section 2.11.

 

Repayment of Term Loan Borrowings

     39  

Section 2.12.

 

Voluntary Prepayment

     39  

Section 2.13.

 

Mandatory Prepayments

     39  

Section 2.14.

 

Reserve Requirements; Change in Circumstances

     40  

Section 2.15.

 

Change in Legality

     41  

Section 2.16.

 

Breakage

     41  

Section 2.17.

 

Pro Rata Treatment

     42  

Section 2.18.

 

Sharing of Setoffs

     42  

Section 2.19.

 

Payments

     43  

Section 2.20.

 

Taxes

     43  

Section 2.21.

 

Assignment of Commitments Under Certain Circumstances; Duty to Mitigate

     47  

Section 2.22.

 

Defaulting Lenders

     48  

 

-i-


TABLE OF CONTENTS

(continued)

 

         Page  

Article III         Representations and Warranties

     49  

Section 3.01.

 

Organization; Powers

     50  

Section 3.02.

 

Authorization

     50  

Section 3.03.

 

Enforceability

     50  

Section 3.04.

 

Governmental Approvals

     50  

Section 3.05.

 

Financial Statements

     50  

Section 3.06.

 

No Material Adverse Change

     51  

Section 3.07.

 

Title to Properties; Possession Under Leases

     51  

Section 3.08.

 

Subsidiaries

     51  

Section 3.09.

 

Litigation; Compliance With Laws

     51  

Section 3.10.

 

Agreements

     52  

Section 3.11.

 

Federal Reserve Regulations

     52  

Section 3.12.

 

Investment Company Act

     52  

Section 3.13.

 

Use of Proceeds

     52  

Section 3.14.

 

Tax Returns

     52  

Section 3.15.

 

No Material Misstatements

     52  

Section 3.16.

 

Employee Benefit Plans

     53  

Section 3.17.

 

Environmental Matters

     53  

Section 3.18.

 

Insurance

     53  

Section 3.19.

 

Security Documents

     53  

Section 3.20.

 

Location of Real Property and Leased Premises

     54  

Section 3.21.

 

Labor Matters

     54  

Section 3.22.

 

Solvency

     54  

Section 3.23.

 

Insurance Licenses

     54  

Section 3.24.

 

Sanctioned Persons

     55  

Section 3.25.

 

Foreign Corrupt Practices Act

     55  

Article IV         Conditions of Lending

     55  

Section 4.01.

 

All Borrowings

     55  

Section 4.02.

 

First Borrowing

     56  

 

-ii-


TABLE OF CONTENTS

(continued)

 

         Page  

Article V           Affirmative Covenants

     58  

Section 5.01.

 

Existence; Compliance with Laws; Businesses and Properties

     58  

Section 5.02.

 

Insurance

     58  

Section 5.03.

 

Obligations and Taxes

     59  

Section 5.04.

 

Financial Statements, Reports, Etc.

     60  

Section 5.05.

 

Litigation and Other Notices

     62  

Section 5.06.

 

Information Regarding Collateral

     62  

Section 5.07.

 

Maintaining Records; Access to Properties and Inspections

     63  

Section 5.08.

 

Use of Proceeds

     63  

Section 5.09.

 

Employee Benefits

     63  

Section 5.10.

 

Compliance with Environmental Laws

     63  

Section 5.11.

 

Preparation of Environmental Reports

     63  

Section 5.12.

 

Further Assurances

     64  

Section 5.13.

 

Post-Closing Requirements

     64  

Article VI         Negative Covenants

     65  

Section 6.01.

 

Indebtedness

     65  

Section 6.02.

 

Liens

     66  

Section 6.03.

 

Sale and Lease-Back Transactions

     68  

Section 6.04.

 

Investments

     68  

Section 6.05.

 

Mergers, Consolidations, Sales of Assets and Acquisitions

     70  

Section 6.06.

 

Restricted Payments; Restrictive Agreements

     71  

Section 6.07.

 

Transactions With Affiliates

     72  

Section 6.08.

 

Business of the Borrower and Subsidiaries

     72  

Section 6.09.

 

Other Indebtedness and Agreements

     72  

Section 6.10.

 

Financial Covenants

     73  

Section 6.11.

 

Fiscal Year

     74  

Section 6.12.

 

Joint Ventures

     74  

 

-iii-


TABLE OF CONTENTS

(continued)

 

         Page  

Article VII          Events of Default

     74  

Article VIII         The Administrative Agent; Etc.

     77  

Section 8.01.

 

Appointment and Authorization

     77  

Section 8.02.

 

Delegation of Duties

     77  

Section 8.03.

 

Default; Collateral

     78  

Section 8.04.

 

Liability of Administrative Agent

     80  

Section 8.05.

 

Reliance by Administrative Agent

     81  

Section 8.06.

 

Notice of Default

     83  

Section 8.07.

 

Credit Decision; Disclosure of Information by Administrative Agent

     83  

Section 8.08.

 

Administrative Agent in Its Individual Capacity

     84  

Section 8.09.

 

Successor Agent

     84  

Section 8.10.

 

Proof of Claim

     85  

Section 8.11.

 

Modifications to Article VIII

     86  

Section 8.12.

 

Discretionary Acts and Solicitation of Lender Consent

     86  

Article IX          Miscellaneous

     86  

Section 9.01.

 

Notices; Electronic Communications

     86  

Section 9.02.

 

Survival of Agreement

     88  

Section 9.03.

 

Binding Effect

     88  

Section 9.04.

 

Successors and Assigns

     88  

Section 9.05.

 

Expenses; Indemnity

     92  

Section 9.06.

 

Right of Setoff

     94  

Section 9.07.

 

Applicable Law

     94  

Section 9.08.

 

Waivers; Amendment

     94  

Section 9.09.

 

Interest Rate Limitation

     95  

Section 9.10.

 

Entire Agreement

     95  

Section 9.11.

 

WAIVER OF JURY TRIAL

     96  

Section 9.12.

 

Severability

     96  

Section 9.13.

 

Counterparts; Electronic Execution

     96  

Section 9.14.

 

Headings

     96  

 

-iv-


TABLE OF CONTENTS

(continued)

 

         Page  

Section 9.15.

 

Jurisdiction; Consent to Service of Process

     96  

Section 9.16.

 

Confidentiality

     97  

Section 9.17.

 

Lender Action

     98  

Section 9.18.

 

USA PATRIOT Act Notice

     98  

Section 9.19.

 

Certain ERISA Matters

     98  

Section 9.20.

 

Acknowledgement and Consent to Bail-In of EEA Financial Institutions

     99  

 

SCHEDULES

Schedule 1.01(b)

    -    

Guarantors

Schedule 1.01(c)

   

Specified ACA Provisions

Schedule 1.01(d)

   

Permitted Investors

Schedule 2.01

    -    

Lenders and Commitments

Schedule 3.08

    -    

Subsidiaries

Schedule 3.09

    -    

Litigation

Schedule 3.17

    -    

Environmental Matters

Schedule 3.18

    -    

Insurance

Schedule 3.19(a)

    -    

UCC Filing Offices

Schedule 3.20(a)

    -    

Owned Real Property

Schedule 3.20(b)

    -    

Leased Real Property

Schedule 3.23

   

Insurance Licenses

Schedule 5.13

    -    

Post-Closing Requirements

Schedule 6.01(a)

    -    

Existing Indebtedness

Schedule 6.02(a)

    -    

Existing Liens

 

EXHIBITS

Exhibit A

    -     Form of Administrative Questionnaire

Exhibit B

    -     Form of Assignment and Acceptance

Exhibit C

    -     Form of Borrowing Request

Exhibit D

    -     Form of Guarantee and Collateral Agreement

Exhibit E

    -     Form of Compliance Certificate

Exhibit F

    -     Form of Affiliate Subordination Agreement

Exhibit G

    -     Form of Tax Compliance Certificates

Exhibit H

    -     Form of Notice of Conversion/Continuation

 

-v-


CREDIT AGREEMENT dated as of October 30, 2020 among MULBERRY HEALTH INC., a Delaware corporation (the “Borrower”), the Lenders (such term and each other capitalized term used but not defined in this introductory statement having the meaning given it in Article I), and HPS INVESTMENT PARTNERS, LLC, as administrative agent (in such capacity, including any successor thereto, the “Administrative Agent”) for the Lenders.

The Borrower has requested the Lenders to extend credit in the form of Term Loans on the Closing Date, in an aggregate principal amount not in excess of $150,000,000. The proceeds of the Term Loans are to be used solely for general corporate purposes of the Borrower and the Subsidiaries.

The Lenders are willing to extend such credit to the Borrower on the terms and subject to the conditions set forth herein. Accordingly, the parties hereto agree as follows:

ARTICLE I

Definitions

SECTION 1.01. Defined Terms. As used in this Agreement, the following terms shall have the meanings specified below:

ABR”, when used in reference to any Loan or Borrowing, refers to whether such Loan, or the Loans comprising such Borrowing, are bearing interest at a rate determined by reference to the Alternate Base Rate.

Acquired Entity” shall have the meaning assigned to such term in Section 6.04(g).

“Adjusted LIBO Rate” shall mean, with respect to any Eurodollar Borrowing for any Interest Period, an interest rate per annum equal to the greater of (a) 1.00% per annum and (b) the product of (i) the LIBO Rate in effect for such Interest Period and (ii) Statutory Reserves.

Administrative Agent” shall have the meaning assigned to such term in the introductory statement to this Agreement.

Administrative Agent Fee” shall have the meaning assigned to such term in Section 2.05(a).

Administrative Questionnaire” shall mean an Administrative Questionnaire in the form of Exhibit A, or such other form as may be supplied from time to time by the Administrative Agent.

Affected Financial Institution” shall mean (a) any EEA Financial Institution or (b) any UK Financial Institution.

Affiliate” shall mean, when used with respect to a specified Person, another Person that directly, or indirectly through one or more intermediaries, Controls or is Controlled by or is under common Control with the Person specified; provided that the term “Affiliate” shall also include any Person that directly or indirectly owns 5.00% or more of any class of Equity Interests of the Person specified or that is an officer or director of the Person specified.


Affiliate Subordination Agreement” shall mean an Affiliate Subordination Agreement in the form of Exhibit F pursuant to which intercompany obligations and advances owed by any Loan Party are subordinated to the Obligations.

Agreement” shall have the meaning assigned to such term in the introductory statement hereto.

Agreement Value” shall mean, for each Hedging Agreement, on any date of determination, the maximum aggregate amount (giving effect to any netting agreements) that the Borrower or any of its Subsidiaries would be required to pay if such Hedging Agreement were terminated on such date.

Alternate Base Rate” shall mean, for any day, a rate per annum equal to the greatest of (a) the Prime Rate in effect on such day, (b) the Federal Funds Effective Rate in effect on such day plus 12 of 1.00% and (c) the Adjusted LIBO Rate applicable for an Interest Period of three months commencing on such day (or if such day is not a Business Day, the immediately preceding Business Day) plus 1.00%; provided that, solely for purposes of determining the Adjusted LIBO Rate for purposes of the foregoing, the LIBO Rate for any day shall be based on the rate set forth on such day at approximately 11:00 a.m. (London time) by reference to the interest settlement rates for deposits in Dollars with a term of one month (as set forth by (i) the ICE Benchmark Administration, (ii) any successor service or entity that has been authorized by the U.K. Financial Conduct Authority to administer the London Interbank Offered Rate or (iii) any service selected by the Administrative Agent that has been nominated by such an entity as an authorized information vendor for the purpose of displaying such rates). If the Administrative Agent shall have determined (which determination shall be conclusive absent manifest error) that it is unable to ascertain the Federal Funds Effective Rate or the Adjusted LIBO Rate, as the case may be, for any reason, including the inability or failure of the Administrative Agent to obtain sufficient quotations or offers in accordance with the terms of the respective definitions thereof, the Alternate Base Rate shall be determined without regard to clause (b) or (c), as applicable, of the preceding sentence until the circumstances giving rise to such inability no longer exist. Any change in the Alternate Base Rate due to a change in the Prime Rate, the Federal Funds Effective Rate or the Adjusted LIBO Rate shall be effective as of the opening of business on the effective day of such change in the Prime Rate, the Federal Funds Effective Rate or the Adjusted LIBO Rate, as the case may be.

Applicable Insurance Code” shall mean, as to any Regulated Insurance Company, the insurance code or other statute of any state where such Insurance Company or other Person is domiciled or doing insurance business and any successor statute of similar import, together with the regulations thereunder, as amended or otherwise modified and in effect from time to time.

Applicable Insurance Regulatory Authority” shall mean, when used with respect to any Regulated Insurance Company, the insurance department or similar administrative authority or agency located in (a) each state or other jurisdiction in which such Regulated Insurance Company is domiciled or (b) to the extent asserting regulatory jurisdiction over such Regulated Insurance Company, the insurance department, authority or agency in each state or other jurisdiction in which such Regulated Insurance Company is licensed, and shall include any Federal or national insurance regulatory department, authority or agency that may be created that asserts regulatory jurisdiction over such Regulated Insurance Company.

 

2


Applicable Margin” shall mean, for any day (a) with respect to any Eurodollar Loan, 11.75% per annum, and (b) with respect to any ABR Loan, 10.75% per annum.

Asset Sale” shall mean the sale, division, transfer or other disposition (by way of merger, casualty, condemnation or otherwise) by the Borrower or any of its Subsidiaries to any Person other than the Borrower or any Guarantor of (a) any Equity Interests of any of the Subsidiaries (other than directors’ qualifying shares) or (b) any other assets of the Borrower or any of the Subsidiaries (other than (i) inventory, damaged, obsolete or worn out assets, assets no longer used or useful in the business of the Borrower and its Subsidiaries, scrap, cash and Permitted Investments, in each case disposed of in the ordinary course of business, (ii) dispositions between or among Excluded Subsidiaries, (iii) trade-ins and exchanges of assets with third parties conducted in the ordinary course of business to the extent substantially comparable (or better) assets useful in the operation of the business of the Borrower and its Subsidiaries are obtained in exchange therefor, (iv) the discount, write-off or disposition, in each case, on a non-recourse basis and in the ordinary course of business consistent with past practice, of accounts receivable in connection with the collection or compromise thereof (and not as part of an accounts receivable financing transaction), (v) the termination of leases, surrender or sublease of real or personal property in the ordinary course of business that do not interfere in any material respect with the business of the Borrower or its Subsidiaries, (vi) dispositions in connection with Casualty Events, (vii) the incurrence of Liens expressly permitted pursuant to Section 6.02, (viii) Investments expressly permitted pursuant to Section 6.04, (ix) the unwinding of any Hedging Agreement expressly permitted hereunder pursuant to its terms, (x) leases, subleases, licenses or sublicenses of real or personal property in the ordinary course of business not interfering in any material respect with the business of the Borrower or any of its Subsidiaries, (xi) the issuance, sale, transfer or other disposition of Equity Interests (or any contractual rights equivalent thereto) in, or any assets of, any Subsidiary in connection with a Joint Venture; provided that the aggregate amount of Equity Interests or assets so issued, sold, transferred or otherwise disposed (valued at the greater of book or fair market value at the time of disposition) shall not exceed 15% of Consolidated Total Assets (calculated prior to giving effect to the proposed disposition) and (y) without the prior written consent of the Required Lenders (such consent not to be unreasonably withheld or delayed), no additional Equity Interests under this clause (xi) shall be issued, sold or transferred after the Springing Maturity Exercise Date other than pursuant to a binding agreement executed prior to the Springing Maturity Exercise Date and (xii) any sale, transfer or other disposition or series of related sales, transfers or other dispositions having a value not in excess of $250,000).

Assignment and Acceptance” shall mean an assignment and acceptance entered into by a Lender and an Eligible Assignee, and accepted by the Administrative Agent, in the form of Exhibit B or such other form as shall be approved by the Administrative Agent.

Bail-In Action” shall mean the exercise of any Write-Down and Conversion Powers by the applicable Resolution Authority in respect of any liability of an Affected Financial Institution.

Bail-In Legislation” shall mean, (a) with respect to any EEA Member Country implementing Article 55 of Directive 2014/59/EU of the European Parliament and of the Council

 

3


of the European Union, the implementing law, regulation, rule or requirement for such EEA Member Country from time to time which is described in the EU Bail-In Legislation Schedule and (b) with respect to the United Kingdom, Part I of the United Kingdom Banking Act 2009 (as amended from time to time) and any other law, regulation or rule applicable to the United Kingdom relating to the resolution of unsound or failing banks, investment firms or other financial institutions or their affiliates (other than through liquidation, administration or other insolvency proceedings).

Benchmark Replacement” shall mean the sum of: (a) the alternate benchmark rate (which may include Term SOFR) that has been selected by the Administrative Agent giving due consideration to (i) any selection or recommendation of a replacement rate or the mechanism for determining such a rate by the Relevant Governmental Body or (ii) any evolving or then-prevailing market convention for determining a rate of interest as a replacement to LIBO Rate for U.S. dollar-denominated syndicated or bilateral credit facilities and (b) the Benchmark Replacement Adjustment; provided that, if the Benchmark Replacement as so determined would be less than 1.00%, the Benchmark Replacement will be deemed to be 1.00% for the purposes of this Agreement.

Benchmark Replacement Adjustment” shall mean, with respect to any replacement of the LIBO Rate with an Unadjusted Benchmark Replacement for each applicable Interest Period, the spread adjustment, or method for calculating or determining such spread adjustment (which may be a positive or a negative value or zero), that has been selected by the Administrative Agent giving due consideration to (i) any selection or recommendation of a spread adjustment, or method for calculating or determining such spread adjustment, for the replacement of the LIBO Rate with the applicable Unadjusted Benchmark Replacement by the Relevant Governmental Body or (ii) any evolving or then-prevailing market convention for determining a spread adjustment, or method for calculating or determining such spread adjustment, for the replacement of the LIBO Rate with the applicable Unadjusted Benchmark Replacement for U.S. dollar-denominated syndicated or bilateral credit facilities at such time.

Benchmark Replacement Conforming Changes” shall mean, with respect to any Benchmark Replacement, any technical, administrative or operational changes (including changes to the definition of “ABR”, the definition of “Interest Period”, timing and frequency of determining rates and making payments of interest and other administrative matters) that the Administrative Agent decides may be appropriate to reflect the adoption and implementation of such Benchmark Replacement and to permit the administration thereof by the Administrative Agent in a manner substantially consistent with market practice (or, if the Administrative Agent decides that adoption of any portion of such market practice is not administratively feasible or if the Administrative Agent determines that no market practice for the administration of the Benchmark Replacement exists, in such other manner of administration as the Administrative Agent decides is reasonably necessary in connection with the administration of this Agreement).

Benchmark Replacement Date” shall mean the earlier to occur of the following events with respect to the LIBO Rate: (a) in the case of clause (a) or (b) of the definition of “Benchmark Transition Event,” the later of (i) the date of the public statement or publication of information referenced therein and (ii) the date on which the administrator of the LIBO Rate permanently or indefinitely ceases to provide the LIBO Rate; or (b) in the case of clause (c) of the definition of “Benchmark Transition Event”, the date of the public statement or publication of information referenced therein.

 

4


Benchmark Transition Event” shall mean the occurrence of one or more of the following events with respect to the LIBO Rate:

(a) a public statement or publication of information by or on behalf of the administrator of the LIBO Rate announcing that such administrator has ceased or will cease to provide the LIBO Rate, permanently or indefinitely, provided that, at the time of such statement or publication, there is no successor administrator that will continue to provide the LIBO Rate;

(b) a public statement or publication of information by the regulatory supervisor for the administrator of the LIBO Rate, the U.S. Federal Reserve System, an insolvency official with jurisdiction over the administrator of the LIBO Rate, a resolution authority with jurisdiction over the administrator of the LIBO Rate or a court or an entity with similar insolvency or resolution authority over the administrator of the LIBO Rate, which states that the administrator of the LIBO Rate has ceased or will cease to provide the LIBO Rate permanently or indefinitely, provided that, at the time of such statement or publication, there is no successor administrator that will continue to provide the LIBO Rate; or

(c) a public statement or publication of information by the regulatory supervisor for the administrator of the LIBO Rate announcing that the LIBO Rate is no longer representative.

Benchmark Transition Start Date” shall mean (a) in the case of a Benchmark Transition Event, the earlier of (i) the applicable Benchmark Replacement Date and (ii) if such Benchmark Transition Event is a public statement or publication of information of a prospective event, the 90th day prior to the expected date of such event as of such public statement or publication of information (or if the expected date of such prospective event is fewer than ninety (90) days after such statement or publication, the date of such statement or publication) and (b) in the case of an Early Opt-in Election, the date specified by the Administrative Agent or the Required Lenders, as applicable, by notice to the Borrower, the Administrative Agent (in the case of such notice by the Required Lenders) and the Lenders.

Benchmark Unavailability Period” shall mean, if a Benchmark Transition Event and its related Benchmark Replacement Date have occurred with respect to the LIBO Rate and solely to the extent that the LIBO Rate has not been replaced with a Benchmark Replacement, the period (x) beginning at the time that such Benchmark Replacement Date has occurred if, at such time, no Benchmark Replacement has replaced the LIBO Rate for all purposes hereunder in accordance with Section 2.08 and (y) ending at the time that a Benchmark Replacement has replaced the LIBO Rate for all purposes hereunder pursuant to Section 2.08.

Benefit Plan” shall mean any of (a) an “employee benefit plan” (as defined in ERISA) that is subject to Title I of ERISA, (b) a “plan” as defined in and subject to Section 4975 of the Code or (c) any Person whose assets include (for purposes of ERISA Section 3(42) or otherwise for purposes of Title I of ERISA or Section 4975 of the Code) the assets of any such “employee benefit plan” or “plan”.

 

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Board” shall mean the Board of Governors of the Federal Reserve System of the United States of America and any successor thereto.

Borrower” shall have the meaning assigned to such term in the introductory statement to this Agreement.

Borrower Materials” shall have the meaning assigned to such term in Section 9.01.

Borrowing” shall mean Loans of the same Type made, converted or continued on the same date and, in the case of Eurodollar Loans, as to which a single Interest Period is in effect.

Borrowing Request” shall mean a written request by the Borrower in accordance with the terms of Section 2.03 and substantially in the form of Exhibit C, or such other form as shall be approved by the Administrative Agent.

Breakage Event” shall have the meaning assigned to such term in Section 2.16.

Business Day” shall mean any day other than a Saturday, Sunday or day on which banks in New York City are authorized or required by law to close; provided that when used in connection with a Eurodollar Loan or an ABR Loan based on the Adjusted LIBO Rate, the term “Business Day” shall also exclude any day on which banks are not open for dealings in Dollar deposits in the London interbank market; provided, further that banks shall not be deemed to be authorized or required to be closed for this purpose due to a “shelter in place,” “non-essential employee” or similar closure of physical branch locations.

Capital Lease Obligations” of any Person shall mean the obligations of such Person to pay rent or other amounts under any lease of (or other arrangement conveying the right to use) real or personal property, or a combination thereof, which obligations are required to be classified and accounted for as capital leases on a balance sheet of such Person under GAAP in effect as of December 15, 2018, and the amount of such obligations shall be the capitalized amount thereof determined in accordance with GAAP as of such date. To the extent that any change in GAAP after December 15, 2018 results in leases which are, or would have been, classified as operating leases under GAAP as in effect on December 15, 2018 (whether or not such operating lease was in effect on such date) being classified as capital leases under GAAP, as so revised, such change in classification of leases from operating leases to capital leases shall be ignored for purposes of this Agreement.

Casualty Event” shall mean any casualty or other insured damage to, or any taking under power of eminent domain or by condemnation or similar proceeding of, any property or asset of the Borrower or any other Loan Party.

A “Change in Control” shall be deemed to have occurred if (a) prior to a Qualified IPO, the Permitted Investors shall fail to own, directly or indirectly, beneficially and of record, shares representing at least 51% of each of the aggregate ordinary voting power represented by the issued and outstanding Equity Interests of the Borrower (other than a failure resulting solely from the primary issuance of Equity Interests of the Borrower at a Valuation of greater than $2,000,000,000), (b) after a Qualified IPO, any “person” or “group” (within the meaning of Rule 13d-5 of the Securities Exchange Act of 1934 as in effect on the date hereof), other than the

 

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Permitted Investors, shall own, directly or indirectly, beneficially or of record, shares representing more than 35% of the aggregate ordinary voting power represented by the issued and outstanding capital stock of the Borrower, (c) any change in control (or similar event, however denominated) with respect to the Borrower or any Subsidiary shall occur under and as defined in any indenture or agreement in respect of Material Indebtedness to which the Borrower or any Subsidiary is a party.

Change in Law” shall mean the occurrence, after the date of this Agreement, of any of the following: (a) the adoption or taking effect of any law, rule, regulation or treaty, (b) any change in any law, rule, regulation or treaty or in the administration, interpretation, implementation or application thereof by any Governmental Authority or (c) the making or issuance of any request, rule, guideline or directive (whether or not having the force of law) by any Governmental Authority; provided that notwithstanding anything herein to the contrary, (x) the Dodd-Frank Wall Street Reform and Consumer Protection Act and all requests, rules, guidelines or directives thereunder or issued in connection therewith and (y) all requests, rules, guidelines or directives promulgated by the Bank for International Settlements, the Basel Committee on Banking Supervision (or any successor or similar authority) or the United States or foreign regulatory authorities, in each case pursuant to Basel III, shall in each case be deemed to be a “Change in Law”, regardless of the date enacted, adopted or issued.

Charges” shall have the meaning assigned to such term in Section 9.09.

Closing Date” shall mean October 30, 2020.

Code” shall mean the Internal Revenue Code of 1986, as amended from time to time.

Collateral” shall mean all the “Collateral” as defined in any Security Document and shall also include the Mortgaged Properties.

Combined Ratio” shall mean, as of the last day of the most recent Test Period, the sum of the following for the Borrower and the Subsidiaries for such Test Period (with each ratio measured as a percentage): (a) the ratio of (i) medical claims to (ii) net premiums plus (b) the ratio of (i) variable costs to (ii) net premiums plus (c) the ratio of (i) fixed costs to (ii) net premiums.

Commitmentshall mean a Term Loan Commitment.

Communications” shall have the meaning assigned to such term in Section 9.01.

Company Model” shall mean the financial model delivered by the Borrower to the Administrative Agent and the Lenders prior to the Closing Date.

Competitor” shall mean any Person that is a bona fide direct competitor (which may include a customer or supplier which is also a competitor or potential competitor) of the Borrower or any of its Subsidiaries in the same industry or a substantially similar industry.

Connection Income Taxes” shall mean Other Connection Taxes that are imposed on or measured by net income (however denominated) or that are franchise Taxes or branch profits Taxes.

 

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Consolidated Total Assets” shall mean, as of any date, the total assets (without duplication) of the Borrower, the Subsidiaries and the Joint Ventures based upon the most recent financial statements delivered pursuant to Section 5.04(a), (b) or (c), and calculated on a pro forma basis.

Contractual Obligation” shall mean, as to any Person, any provision of any security issued by such Person or of any agreement, instrument or other undertaking to which such Person is a party or by which it or any of its assets or properties is bound.

Control” shall mean the possession, directly or indirectly, of the power to direct or cause the direction of the management or policies of a Person, whether through the ownership of voting securities, by contract or otherwise, and the terms “Controlling” and “Controlled” shall have meanings correlative thereto.

Debtor Relief Laws” shall mean the Bankruptcy Code of the United States of America, and all other liquidation, conservatorship, bankruptcy, assignment for the benefit of creditors, moratorium, rearrangement, receivership, insolvency, reorganization or similar debtor relief laws of the United States or other applicable jurisdictions from time to time in effect.

Default” shall mean any event or condition which upon notice, lapse of time or both would constitute an Event of Default.

Defaulting Lender” shall mean, subject to Section 2.22(b), any Lender that (a) has failed to (i) fund all or any portion of its Loans within two Business Days of the date such Loans were required to be funded hereunder unless such Lender notifies the Administrative Agent and the Borrower in writing that such failure is the result of such Lender’s determination that one or more conditions precedent to funding (each of which conditions precedent, together with any applicable default, shall be specifically identified in such writing) has not been satisfied, or (ii) pay to the Administrative Agent or any other Lender any other amount required to be paid by it hereunder within two Business Days of the date when due, (b) has notified the Borrower or the Administrative Agent in writing that it does not intend to comply with its funding obligations hereunder, or has made a public statement to that effect (unless such writing or public statement relates to such Lender’s obligation to fund a Loan hereunder and states that such position is based on such Lender’s determination that a condition precedent to funding (which condition precedent, together with any applicable default, shall be specifically identified in such writing or public statement) cannot be satisfied), (c) has failed, within three Business Days after written request by the Administrative Agent or the Borrower, to confirm in writing to the Administrative Agent and the Borrower that it will comply with its prospective funding obligations hereunder (provided that such Lender shall cease to be a Defaulting Lender pursuant to this clause (c) upon receipt of such written confirmation by the Administrative Agent and the Borrower), or (d) has, or has a direct or indirect parent company that has, (i) become the subject of a proceeding under any Debtor Relief Law, (ii) had appointed for it a receiver, custodian, conservator, trustee, administrator, assignee for the benefit of creditors or similar Person charged with reorganization or liquidation of its business or assets, including the Federal Deposit Insurance Corporation or any other state or Federal regulatory authority acting in such a capacity or (iii) become the subject of a Bail-in Action; provided that a Lender shall not be a Defaulting Lender solely by virtue of the ownership or acquisition of any equity interest in that Lender or any direct or indirect parent company thereof

 

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by a Governmental Authority so long as such ownership interest does not result in or provide such Lender with immunity from the jurisdiction of courts within the United States or from the enforcement of judgments or writs of attachment on its assets or permit such Lender (or such Governmental Authority) to reject, repudiate, disavow or disaffirm any contracts or agreements made with such Lender. Any determination by the Administrative Agent that a Lender is a Defaulting Lender under clauses (a) through (d) above shall be conclusive and binding absent manifest error, and such Lender shall be deemed to be a Defaulting Lender (subject to Section 2.22(b)) upon delivery of written notice of such determination to the Borrower and each Lender.

Disqualified Institution” shall mean, on any date, (a) any Person designated by the Borrower as a “Disqualified Institution” by written notice delivered to the Administrative Agent (i) prior to the Closing Date, or (ii) with the consent of the Administrative Agent (and to the extent the contents of such notice are reasonably acceptable to the Administrative Agent), after the Closing Date, (b) any Person designated by the Borrower as a Competitor by written notice delivered to the Administrative Agent prior to the Closing Date, (c) any Person designated by the Borrower as a Person that has become a Competitor after the Closing Date by written notice delivered to the Administrative Agent and (d) Affiliates of the foregoing that are clearly identifiable as such on the basis of their name or are identified as such by written notice delivered to the Administrative Agent; provided that “Disqualified Institution” shall exclude any Person that the Borrower has designated as no longer being a “Disqualified Institution” by written notice delivered to the Administrative Agent from time to time; provided, further that (x) the designation of a Person as a Disqualified Institution after the Closing Date shall not apply to retroactively disqualify any Lender or participant so long as such Lender or participant was not a Disqualified Institution at the time such person became a Lender or acquired a participation and (y) any bona fide debt fund or investment vehicle that is engaged in making, purchasing, holding or otherwise investing in commercial loans and similar extensions of credit in the ordinary course of business which is managed, sponsored or advised by any Person Controlling, Controlled by or under common Control with such Competitor or its Controlling owner and for which no personnel involved with the competitive activities of such Competitor or Controlling owner (1) makes any investment decisions for such debt fund or (2) has access to any confidential information (other than publicly available information) relating to the Borrower and the Subsidiaries shall be deemed not to be a Competitor of the Borrower or any of the Subsidiaries. Notwithstanding anything to the contrary contained in this Agreement, (a) the Administrative Agent shall not be responsible or have any liability for, or have any duty to ascertain, inquire into, monitor or enforce, compliance with the provisions hereof relating to Disqualified Institutions and (b) the Borrower (on behalf of itself and the other Loan Parties) and the Lenders acknowledge and agree that the Administrative Agent shall have no responsibility or obligation to determine whether any Lender or potential Lender is a Disqualified Institution and that the Administrative Agent shall have no liability with respect to any assignment or participation made to a Disqualified Institution.

Disqualified Stock” shall mean any Equity Interest that, by its terms (or by the terms of any security into which it is convertible or for which it is exchangeable), or upon the happening of any event, (a) matures (excluding any maturity as the result of an optional redemption by the issuer thereof) or is mandatorily redeemable, pursuant to a sinking fund obligation or otherwise, or is redeemable at the option of the holder thereof, in whole or in part, or requires the payment of any cash dividend or any other scheduled payment constituting a return of capital, in each case at any

 

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time on or prior to the one-year anniversary of the Term Loan Maturity Date, or (b) is convertible into or exchangeable (unless at the sole option of the issuer thereof) for (i) debt securities or (ii) any Equity Interest referred to in clause (a) above, in each case at any time prior to the one-year anniversary of the Term Loan Maturity Date.

Dollars” or “$” shall mean lawful money of the United States of America.

Domestic Subsidiaries” shall mean all Subsidiaries incorporated or organized under the laws of the United States of America, any State thereof or the District of Columbia.

Early Opt-in Election” shall mean the occurrence of: (1)(i) a determination by the Administrative Agent or (ii) a notification by the Required Lenders to the Administrative Agent (with a copy to the Borrower) that the Required Lenders have determined that U.S. dollar-denominated syndicated credit facilities being executed at such time, or that include language similar to that contained in Section 2.08 are being executed or amended, as applicable, to incorporate or adopt a new benchmark interest rate to replace the LIBO Rate, and (2)(i) the election by the Administrative Agent or (ii) the election by the Required Lenders to declare that an Early Opt-in Election has occurred and the provision, as applicable, by the Administrative Agent of written notice of such election to the Borrower and the Lenders or by the Required Lenders of written notice of such election to the Administrative Agent.

Early Payment Date” shall mean the three-year anniversary of the Closing Date.

Early Payment Fee” shall mean, on the date of any Premium Event:

(a) If a Qualified IPO has occurred on or after the six-month anniversary of the Closing Date and such Premium Event occurs (i) thereafter and on or prior to the Early Payment Date, an amount equal to the applicable IPO Prepayment Percentage multiplied by the aggregate amount of principal of the Term Loans subject to such Premium Event or (ii) after the Early Payment Date, there shall be no Early Payment Fee; or

(b) In the case of any other Premium Event, if such Premium Event occurs at any other time on or prior to the Early Payment Date, (i) on or prior to the two-year anniversary of the Closing Date, an amount equal to (A) 1.00% multiplied by the aggregate amount of principal of the Term Loans subject to such Premium Event plus (B) the present value as of such date (computed using a discount rate equal to the Treasury Rate plus 50 basis points) of the aggregate amount of interest (which shall be deemed to accrue for the duration of such period at the rate equal to the Adjusted LIBO Rate plus the Applicable Margin, in each case, as determined by the Administrative Agent on the date two Business Days prior to the date of such Premium Event) which would have otherwise been payable on the aggregate amount of the principal subject to the Premium Event (assuming all interest had been paid in cash), in each case, from the date of the Premium Event through the two-year anniversary of the Closing Date and (ii) after the two-year anniversary of the Closing Date through and including the Early Payment Date, an amount equal to 1.00% multiplied by the aggregate amount of principal of the Term Loans subject to such Premium Event.

EEA Financial Institution” shall mean (a) any credit institution or investment firm established in any EEA Member Country which is subject to the supervision of an EEA Resolution

 

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Authority, (b) any entity established in an EEA Member Country which is a parent of an institution described in clause (a) of this definition, or (c) any financial institution established in an EEA Member Country which is a subsidiary of an institution described in clause (a) or (b) of this definition and is subject to consolidated supervision with its parent;

EEA Member Country” shall mean any of the member states of the European Union, Iceland, Liechtenstein and Norway.

EEA Resolution Authority” shall mean any public administrative authority or any person entrusted with public administrative authority of any EEA Member Country (including any delegee) having responsibility for the resolution of any EEA Financial Institution.

Eligible Assignee” shall mean (a) a Lender, (b) an Affiliate of a Lender, (c) a Related Fund of a Lender, and (d) any other Person (other than a natural person) approved by the Administrative Agent and, except with respect to assignments when an Event of Default has occurred and is continuing, the Borrower; provided that the Borrower shall be deemed to have consented to any proposed Eligible Assignee unless it shall object thereto by written notice to the Administrative Agent within five Business Days after having received notice thereof; provided, further, that notwithstanding the foregoing, “Eligible Assignee” shall not include the Borrower, any of the Borrower’s Affiliates or any Disqualified Institution.

Environmental Laws” shall mean all former, current and future Federal, state, local and foreign laws (including common law), treaties, regulations, rules, ordinances, codes, decrees, judgments, directives, orders (including consent orders), and agreements in each case, relating to protection of the environment, natural resources, human health and safety or the presence, Release of, or exposure to, Hazardous Materials, or the generation, manufacture, processing, distribution, use, treatment, storage, transport, recycling or handling of, or the arrangement for such activities with respect to, Hazardous Materials.

Environmental Liability” shall mean all liabilities, obligations, damages, losses, claims, actions, suits, judgments, orders, fines, penalties, fees, expenses and costs (including administrative oversight costs, natural resource damages and remediation costs), whether contingent or otherwise, arising out of or relating to (a) compliance or non-compliance with any Environmental Law, (b) the generation, use, handling, transportation, storage, treatment or disposal of any Hazardous Materials, (c) exposure to any Hazardous Materials, (d) the Release of any Hazardous Materials or (e) any contract, agreement or other consensual arrangement pursuant to which liability is assumed or imposed with respect to any of the foregoing.

Equity Interests” shall mean shares of capital stock, partnership interests, membership interests in a limited liability company, beneficial interests in a trust or other equity interests in any Person, and any option, warrant or other right entitling the holder thereof to purchase or otherwise acquire any such equity interest.

Equity Issuance” shall mean any issuance or sale by the Borrower or any of its subsidiaries of any Equity Interests of the Borrower or any such subsidiary, as applicable, except in each case for (a) any issuance or sale to the Borrower or any Subsidiary, (b) any issuance of directors’ qualifying shares and (c) sales or issuances of common stock of the Borrower to

 

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management or employees of the Borrower or any Subsidiary under any bona fide employee stock option, stock purchase or other equity compensation plan or employee benefit plan in existence from time to time.

ERISA” shall mean the Employee Retirement Income Security Act of 1974, as the same may be amended from time to time, and the rules and regulations promulgated thereunder.

ERISA Affiliate” shall mean any trade or business (whether or not incorporated) that, together with the Borrower, is treated as a single employer under Section 414(b) or (c) of the Code, or solely for purposes of Section 302 of ERISA and Section 412 of the Code, is treated as a single employer under Section 414 of the Code.

ERISA Event” shall mean (a) any “reportable event”, as defined in Section 4043 of ERISA or the regulations issued thereunder, with respect to a Plan (other than an event for which the 30-day notice period is waived), (b) the existence with respect to any Plan of an “accumulated funding deficiency” (as defined in Section 412 of the Code or Section 302 of ERISA), whether or not waived or a determination that any Plan or Multiemployer Plan is, or reasonably could be expected to be, an at-risk plan or a plan in endangered or critical status within the meaning of Section 430, 431 or 432 of the Code or Section 303, 304 or 305 of ERISA, (c) the filing pursuant to Section 412(c) of the Code or Section 302(c) of ERISA of an application for a waiver of the minimum funding standard with respect to any Plan, (d) the incurrence by the Borrower or a Subsidiary (including by virtue of a liability imposed on any of their ERISA Affiliates) of any liability under Title IV of ERISA with respect to the termination of any Plan or the withdrawal or partial withdrawal of the Borrower, a Subsidiary or any of their respective ERISA Affiliates from any Plan or Multiemployer Plan, (e) the receipt by the Borrower or the Subsidiaries from the PBGC or a plan administrator of any notice relating to the intention to terminate any Plan or Plans or to appoint a trustee to administer any Plan, (f) the failure by the Borrower or a Subsidiary to make a required contribution to any Plan that results in, or would be reasonably expected to result in, the imposition of a lien or other encumbrance or the provision of security under Section 430 of the Code or Section 303 or 4068 of ERISA, (g) the receipt by the Borrower or a Subsidiary of any notice, concerning the imposition of Withdrawal Liability or a determination that a Multiemployer Plan is, or is expected to be, insolvent, within the meaning of Title IV of ERISA, (h) the occurrence of a material “prohibited transaction” with respect to which the Borrower or any of its Subsidiaries is a “disqualified person” (within the meaning of Section 4975 of the Code) or (i) any other event or condition with respect to a Multiemployer Plan that results in liability of the Borrower or any of its Subsidiaries.

EU Bail-In Legislation Schedule” shall mean the EU Bail-In Legislation Schedule published by the Loan Market Association (or any successor person), as in effect from time to time.

Eurodollar”, when used in reference to any Loan or Borrowing, refers to whether such Loan, or the Loans comprising such Borrowing, are bearing interest at a rate determined by reference to the Adjusted LIBO Rate (other than as a component of the Alternate Base Rate).

Events of Default” shall have the meaning assigned to such term in Article VII.

 

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Excluded Assets” shall the meaning assigned to such term in the Security Documents.

Excluded Subsidiary” shall mean any (a) Regulated Insurance Company to the extent the provision of a Guarantee would require any material consent of a Governmental Authority, (b) non-wholly owned Subsidiary that is a Joint Venture, (c) Subsidiary the provision of a guarantee from which would reasonably be expected to result in material and adverse Tax consequences, as reasonably determined by the Borrower in consultation with the Administrative Agent and (d) any Subsidiary as to which the Administrative Agent and the Borrower shall reasonably determine in good faith that the costs of obtaining the guaranty of the Obligations as otherwise required hereunder are excessive in relation to the value of such guaranty. As of the Closing Date, each Subsidiary other than Mulberry Management Corp. is an Excluded Subsidiary.

Excluded Taxes” shall mean any of the following Taxes imposed on or with respect to a Recipient or required to be withheld or deducted from a payment to a Recipient, (a) Taxes imposed on or measured by net income (however denominated), franchise Taxes and branch profits Taxes, in each case, (i) imposed as a result of such Recipient being organized under the laws of, or having its principal office or, in the case of any Lender, its applicable lending office located in, the jurisdiction imposing such Tax (or any political subdivision thereof) or (ii) that are Other Connection Taxes, (b) in the case of a Lender, U.S. Federal withholding Taxes imposed on amounts payable to or for the account of such Lender with respect to an applicable interest in a Loan or Commitment pursuant to a law in effect on the date on which (i) such Lender acquires such interest in the Loan or Commitment or (ii) such Lender changes its lending office, except in each case to the extent that, pursuant to Section 2.20, amounts with respect to such Taxes were payable either to such Lender’s assignor immediately before such Lender became a party hereto or to such Lender immediately before it changed its lending office, (c) Taxes attributable to such Recipient’s failure to comply with Section 2.20(f) and (d) any Taxes imposed under FATCA.

Extraordinary Receipt” shall mean any cash received by or paid to or for the account of any Loan Party not in the ordinary course of business after the Closing Date, including purchase price adjustments, pension plan reversions, judgments and litigation settlements (other than as set forth in clause (d) below and other than judgments and settlements to the extent that the Borrower in good faith believes such proceeds will be directly or indirectly required by any Governmental Authority to be otherwise applied (including in respect of reduced premiums payable by a Governmental Authority) within the following twelve (12) months), proceeds of insurance (excluding proceeds of business interruption insurance to the extent such proceeds constitute compensation for lost earnings), condemnation awards (and payments in lieu thereof) and indemnity payments and excluding (a) proceeds described in Sections 2.13(a), (b) or (c) or the proceeds of any Qualifying IPO or other Equity Issuance, (b) tax refunds, (c) working capital adjustments in connection with any Permitted Acquisition, (d) judgments and litigation settlements related to “risk corridors” and “cost sharing” claims disclosed in writing to the Administrative Agent prior to the Closing Date and (e) any single or related series of amounts in an aggregate amount less than $250,000.

FATCA” shall mean Sections 1471 through 1474 of the Code, as of the date of this Agreement (or any amended or successor version that is substantively comparable and not materially more onerous to comply with) any current or future regulations or official interpretations thereof, any agreements entered into pursuant to Section 1471(b)(1) of the Code

 

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and any fiscal or regulatory legislation, rules or practices adopted pursuant to any intergovernmental agreement, treaty or convention among Governmental Authorities and implementing such Sections of the Code.

FCPA” shall have the meaning assigned to such term in Section 3.26.

Federal Funds Effective Rate” shall mean, for any day, the weighted average of the rates on overnight Federal funds transactions with members of the Federal Reserve System, as published on the next succeeding Business Day by the Federal Reserve Bank of New York, or, if such rate is not so published for any day that is a Business Day, the average of the quotations for the day for such transactions received by the Administrative Agent from three Federal funds brokers of recognized standing selected by it.

Federal Reserve Bank of New York’s Website” shall mean the website of the Federal Reserve Bank of New York at http://www.newyorkfed.org, or any successor source.

Fees” shall mean the Administrative Agent Fee, the Upfront Fee and each Early Payment Fee.

Financial Officer” of any Person shall mean the chief financial officer, principal accounting officer, treasurer or controller of such Person or other officer with similar duties.

Foreign Lender” shall mean any Lender that is not a U.S. Person.

Foreign Pension Plan” shall mean any benefit plan that under applicable law is required to be funded through a trust or other funding vehicle other than a trust or funding vehicle maintained exclusively by a Governmental Authority to which the Borrower or the Subsidiaries make or are obligated to make contributions.

Foreign Subsidiary” shall mean any Subsidiary that is not a Domestic Subsidiary.

GAAP” shall mean United States generally accepted accounting principles applied on a basis consistent with the financial statements delivered pursuant to Section 3.05.

Government Official” shall mean (a) an executive, official, employee or agent of a governmental department, agency or instrumentality, (b) a director, officer, employee or agent of a wholly or partially government-owned or -controlled company or business, (c) a political party or official thereof, or candidate for political office or (d) an executive, official, employee or agent of a public international organization (e.g., the International Monetary Fund or the World Bank).

Governmental Authority” shall mean any Federal, state, local or foreign court or governmental agency, authority, instrumentality or regulatory body (including the National Association of Insurance Commissioners and any Applicable Insurance Regulatory Authority).

Granting Lender” shall have the meaning assigned to such term in Section 9.04(i).

 

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Gross Premiums” shall mean, for the most recently ended Test Period, the Borrower and the Subsidiaries’ aggregate member policy premiums earned during such Test Period, net of any risk sharing or risk corridor adjustment.

Guarantee” of or by any Person shall mean any obligation, contingent or otherwise, of such Person guaranteeing or having the economic effect of guaranteeing any Indebtedness or other obligation of any other Person (the “primary obligor”) in any manner, whether directly or indirectly, and including any obligation of such Person, direct or indirect, (a) to purchase or pay (or advance or supply funds for the purchase or payment of) such Indebtedness or other obligation or to purchase (or to advance or supply funds for the purchase of) any security for the payment of such Indebtedness or other obligation, (b) to purchase or lease property, securities or services for the purpose of assuring the owner of such Indebtedness or other obligation of the payment of such Indebtedness or other obligation or (c) to maintain working capital, equity capital or any other financial statement condition or liquidity of the primary obligor so as to enable the primary obligor to pay such Indebtedness or other obligation; provided that the term “Guarantee” shall not include endorsements for collection or deposit in the ordinary course of business.

Guarantee and Collateral Agreement” shall mean the Guarantee and Collateral Agreement, substantially in the form of Exhibit D, among the Borrower, the Subsidiaries party thereto and the Administrative Agent for the benefit of the Secured Parties.

Guarantors” shall mean each Subsidiary listed on Schedule 1.01(b), and each other Subsidiary (other than any Excluded Subsidiary) that is or becomes a party to the Guarantee and Collateral Agreement.

Hazardous Materials” shall mean (a) any petroleum products or byproducts and all other hydrocarbons, coal ash, radon gas, asbestos, urea formaldehyde foam insulation, polychlorinated biphenyls, chlorofluorocarbons and all other ozone-depleting substances and radioactive materials, (b) any chemical, material or substance that is defined in an applicable law as a hazardous or toxic substance, material or waste, and (c) any chemical, material, substance or waste that is prohibited, limited or regulated by or pursuant to any Environmental Law.

Healthcare Laws” shall mean all Federal and state laws applicable to the business of the Borrower or any Subsidiary regulating the provision of and payment for healthcare services, including (a) all Federal and state fraud and abuse Laws, including the Federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(6)), the Stark Law (42 U.S.C. § 1395nn), the civil False Claims Act (31 U.S.C. § 3729 et seq.), the Federal health care program exclusion provisions (42 U.S.C. § 1302a-7) and the Civil Monetary Penalties Act (42 U.S.C. § 1302a-7a), (b) HIPAA, (c) PPACA, (d) Medicare and (e) Medicaid, each of which as they may be amended from time to time.

Hedging Agreement” shall mean any interest rate protection agreement, foreign currency exchange agreement, commodity price protection agreement or other interest or currency exchange rate or commodity price hedging arrangement.

HIPAA” shall mean the Health Insurance Portability and Accountability Act of 1996, as amended.

 

15


Indebtedness” of any Person shall mean, without duplication, (a) all obligations of such Person for borrowed money or with respect to deposits or advances of any kind, (b) all obligations of such Person evidenced by bonds, debentures, notes or similar instruments, (c) all obligations of such Person upon which interest charges are customarily paid (excluding trade accounts payable and accrued obligations incurred in the ordinary course of business), (d) all obligations of such Person under conditional sale or other title retention agreements relating to property or assets purchased by such Person, (e) all obligations of such Person issued or assumed as the deferred purchase price of property or services (excluding (x) trade accounts payable and accrued obligations incurred in the ordinary course of business and (y) any earn-out unless not paid when due or it otherwise become a liability on the balance sheet of such Person in accordance with GAAP), (f) all Indebtedness of others secured by (or for which the holder of such Indebtedness has an existing right, contingent or otherwise, to be secured by) any Lien on property owned or acquired by such Person, whether or not the obligations secured thereby have been assumed, (g) all Guarantees by such Person of Indebtedness of others, (h) all Capital Lease Obligations of such Person, (i) all Synthetic Lease Obligations of such Person, (j) net obligations of such Person under any Hedging Agreements, valued at the Agreement Value thereof, (k) all obligations of such Person to purchase, redeem, retire, defease or otherwise make any payment in respect of any Equity Interests of such Person or any other Person or any warrants, rights or options to acquire such equity interests, valued, in the case of redeemable preferred interests, at the greater of its voluntary or involuntary liquidation preference plus accrued and unpaid dividends, (l) all obligations of such Person as an account party in respect of letters of credit, (m) all obligations of such Person in respect of Disqualified Stock and (n) all obligations of such Person in respect of bankers’ acceptances. The Indebtedness of any Person shall include the Indebtedness of any partnership in which such Person is a general partner to the extent such Person is liable therefor as a result of such Person’s ownership interest, except to the extent that the terms of such Indebtedness expressly provide that such Person is not liable therefor. For the avoidance of doubt, operating leases shall not be considered Indebtedness.

Indemnified Taxes” shall mean (a) Taxes, other than Excluded Taxes, imposed on or with respect to any payment made by or on account of any obligation of any Loan Party under any Loan Document and (b) to the extent not otherwise described in clause (a), Other Taxes.

Indemnitee” shall have the meaning assigned to such term in Section 9.05(b).

Information” shall have the meaning assigned to such term in Section 9.16.

Insurance Business” shall mean one or more of the aspects of the business of selling, issuing or underwriting insurance or reinsurance.

Interest Payment Date” shall mean (a) with respect to any ABR Loan, the last Business Day of each March, June, September and December, and (b) with respect to any Eurodollar Loan, the last day of the Interest Period applicable to the Borrowing of which such Loan is a part and, in the case of a Eurodollar Borrowing with an Interest Period of more than three months’ duration, each day that would have been an Interest Payment Date had successive Interest Periods of three months’ duration been applicable to such Borrowing.

 

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Interest Period” shall mean, with respect to any Eurodollar Borrowing, the period commencing on the date of such Borrowing and ending on the numerically corresponding day (or, if there is no numerically corresponding day, on the last day) in the calendar month that is one, three or six months thereafter, as the Borrower may elect; provided that (a) if any Interest Period would end on a day other than a Business Day, such Interest Period shall be extended to the next succeeding Business Day unless such next succeeding Business Day would fall in the next calendar month, in which case such Interest Period shall end on the next preceding Business Day and (b) any Interest Period that begins on the last Business Day of a calendar month (or on a day for which there is no numerically corresponding day in the calendar month at the end of such Interest Period) shall end on the last Business Day of the calendar month at the end of such Interest Period. Interest shall accrue from the first day of an Interest Period to the last day of such Interest Period. For purposes hereof, the date of a Borrowing initially shall be the date on which such Borrowing is made and thereafter shall be the effective date of the most recent conversion or continuation of such Borrowing.

Investment” shall mean, with respect to any Person, that such Person (a) purchases, holds or otherwise acquires any Equity Interests, evidences of Indebtedness or other securities, (b) makes or permits to exist any loans or advances to, or any investment or any other interest in, any other Person or (c) enters into any Joint Venture with any other Person.

Investment Grade Rating” shall mean a rating equal to or higher than Baa3 (or the equivalent) by Moody’s or BBB- (or the equivalent) by S&P.

IPO” shall mean: (i) an initial underwritten public offering of common Equity Interests of the Borrower (or its direct or indirect parent) pursuant to an effective registration statement filed with the Securities and Exchange Commission in accordance with the Securities Act of 1933, as amended or (ii) the direct or indirect acquisition of all or a portion of the Equity Interests of the Borrower (or its direct or indirect parent) by a Person that has a class or series of Equity Interests publicly traded on a nationally recognized securities exchange; provided that immediately prior to such acquisition all or substantially all of the assets of such Person shall constitute cash and cash equivalents.

IPO Prepayment Percentage” shall mean, on any date during any period set forth below, the applicable percentage based upon the Valuation of an IPO:

 

Period

   Valuation
< $4,000,000,000
    Valuation
³ $4,000,000,000
but

<  $7,000,000,000
    Valuation
³ $7,000,000,000
 

Six-month anniversary of the Closing Date through and including the nine-month anniversary of the Closing Date

     6.50     6.50     6.50

 

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Period

   Valuation
< $4,000,000,000
    Valuation
³ $4,000,000,000
but

<  $7,000,000,000
    Valuation
³ $7,000,000,000
 

Date immediately following the nine-month anniversary of the Closing Date through and including the 12-month anniversary of the Closing Date

     5.00     5.50     6.00

Date immediately following the 12-month anniversary of the Closing Date through and including the 15-month anniversary of the Closing Date

     3.50     4.50     5.50

Date immediately following the 15-month anniversary of the Closing Date through and including the 24-month anniversary of the Closing Date

     3.00     4.00     5.00

Date immediately following the 24-month anniversary of the Closing Date through and including the three-year anniversary of the Closing Date

     1.00     1.00     1.00

Joint Venture” shall mean a bona fide joint venture, synthetic joint venture, collaboration agreement, co-branding, co-marketing or similar arrangement entered into by the Borrower or any Subsidiary with a Person that is not an Affiliate of the Borrower or any of the Subsidiaries.

Lenders” shall mean (a) the Persons listed on Schedule 2.01 (other than any such Person that has ceased to be a party hereto pursuant to an Assignment and Acceptance) and (b) any Person that has become a party hereto pursuant to an Assignment and Acceptance.

LIBO Rate” shall mean, with respect to any Eurodollar Borrowing for any Interest Period, the rate per annum determined by the Administrative Agent at approximately 11:00 a.m. (London time) on the date that is two Business Days prior to the commencement of such Interest Period by reference to the interest settlement rates for deposits in Dollars (as set forth by (a) the ICE Benchmark Administration, (b) any successor service or entity that has been authorized by the

 

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U.K. Financial Conduct Authority to administer the London Interbank Offered Rate or (c) any service selected by the Administrative Agent (including Bloomberg) that has been nominated by such an entity as an authorized information vendor for the purpose of displaying such rates) for a period equal to such Interest Period; provided that, to the extent that an interest rate is not ascertainable pursuant to the foregoing provisions of this definition, the “LIBO Rate” shall be the interest rate per annum determined by the Administrative Agent (including by reference to any applicable published market data) to be the average of the rates per annum at which deposits in Dollars are offered for such relevant Interest Period by major banks in the London interbank market in London, England at approximately 11:00 a.m. (London time) on the date that is two Business Days prior to the beginning of such Interest Period.

License” shall mean any license, certificate of authority, permit or other authorization which is required to be obtained from any Applicable Insurance Regulatory Authority or other Governmental Authority in connection with the operation, ownership or transaction of the Insurance Business.

Lien” shall mean, with respect to any asset, (a) any mortgage, deed of trust, lien (statutory or other), pledge, hypothecation, encumbrance, charge or security interest in or on such asset, (b) the interest of a vendor or a lessor under any conditional sale agreement, Capital Lease Obligation or title retention agreement relating to such asset and (c) in the case of securities, any purchase option, call or similar right of a third party with respect to such securities.

Liquidity” shall mean, the average weekly balance of all cash of the Loan Parties that is (a) not Restricted and (b) held in accounts subject to one or more deposit account control agreements in favor of the Administrative Agent for the immediately preceding week.

Loan Documents” shall mean this Agreement, the Security Documents, the promissory notes, if any, executed and delivered pursuant to Section 2.04(e) and any other document executed in connection with the foregoing.

Loan Parties” shall mean the Borrower and the Guarantors.

Loans” shall mean the Term Loans.

Margin Stock” shall have the meaning assigned to such term in Regulation U.

Material Adverse Effect” shall mean a material adverse effect on (a) the business, assets, liabilities, operations, condition (financial or otherwise), operating results or prospects of the Borrower and the Subsidiaries, taken as a whole, (b) the ability of the Borrower or any other Loan Party to perform any of its obligations under any Loan Document to which it is or will be a party or (c) the rights and remedies of or benefits available to the Lenders under any Loan Document.

Material Indebtedness” shall mean Indebtedness (other than the Loans), or obligations in respect of one or more Hedging Agreements, of any one or more of the Borrower or any Subsidiary in an aggregate principal amount exceeding $10,000,000. For purposes of determining Material Indebtedness, the “principal amount” of the obligations of the Borrower or any Subsidiary in respect of any Hedging Agreement at any time shall be the Agreement Value of such Hedging Agreement at such time.

 

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Material Real Property” shall mean any fee-owned real property with a fair market value in excess of $2,500,000.

Maximum Rate” shall have the meaning assigned to such term in Section 9.09.

Medicaid” shall mean that means-tested entitlement program under Title XIX of the Social Security Act, which provides Federal grants to states for medical assistance based on specific eligibility criteria, as set forth at Section 1396, et seq. of Title 42 of the United States Code, as amended, and any statute succeeding thereto.

Medicare” shall mean that government-sponsored entitlement program under Title XVIII of the Social Security Act, which provides for a health insurance system for eligible aged and disabled individuals, as set forth at Section 1395, et seq. of Title 42 of the United States Code, as amended, and any statute succeeding thereto.

Moody’s” shall mean Moody’s Investors Service, Inc., or any successor thereto.

Mortgaged Properties” shall mean each parcel of Material Real Property with respect to which a Mortgage is granted pursuant to Section 5.12.

Mortgages” shall mean the mortgages and other security documents with respect to any Material Real Property delivered pursuant to Section 5.12.

Multiemployer Plan” shall mean a multiemployer plan as defined in Section 4001(a)(3) of ERISA to which the Borrower or any Subsidiary or their ERISA Affiliates makes or is obligated to make contributions, or during the preceding six years has made or has been obligated to make contributions.

Net Cash Proceeds” shall mean (a) with respect to any Asset Sale or Casualty Event, the cash proceeds (including cash proceeds subsequently received (as and when received) in respect of noncash consideration initially received), net of the reasonable direct out-of-pocket costs in connection therewith, including (i) reasonable selling expenses (including reasonable broker’s fees or commissions, legal fees, transfer and similar taxes and the Borrower’s good faith estimate of Taxes paid or payable in connection with such sale), (ii) amounts provided as a reserve, in accordance with GAAP, against any liabilities under any indemnification obligations or purchase price adjustment associated with such Asset Sale (provided that, to the extent and at the time any such amounts are released from such reserve, such amounts shall constitute Net Cash Proceeds) and (iii) the principal amount, premium or penalty, if any, interest and other amounts on any Indebtedness for borrowed money (other than the Obligations) which is secured by the asset sold in such Asset Sale or subject to such Casualty Event and which is required to be repaid with such proceeds (other than any such Indebtedness assumed by the purchaser of such asset); provided that, if (x) the Borrower shall deliver a certificate of a Financial Officer of the Borrower to the Administrative Agent within five (5) Business Days of receipt thereof setting forth the Borrower’s intent to reinvest such proceeds in productive assets of a kind then used or usable in the business of the Borrower and its Subsidiaries within 180 days of receipt of such proceeds and (y) no Default or Event of Default shall have occurred and shall be continuing at the time of such certificate or at the proposed time of the application of such proceeds, such proceeds shall not constitute Net Cash Proceeds except to the extent not so used at the end of such 180-day period, at which time such

 

20


proceeds shall be deemed to be Net Cash Proceeds; (b) with respect to any issuance or incurrence of Indebtedness or any Equity Issuance, the cash proceeds thereof, net of the reasonable direct out-of-pocket costs in connection therewith, including all Taxes and customary fees, commissions, costs and other expenses incurred in connection therewith; and (c) with respect to any Extraordinary Receipt, the cash proceeds received by or paid to or for the account of any Loan Party, net of the reasonable direct out-of-pocket costs incurred in obtaining such Extraordinary Receipt (including legal and accounting expenses) and any amount assigned to or otherwise payable to any third party, including (i) all Taxes and customary fees, commissions, costs and other expenses incurred in connection therewith and (ii) in the case of indemnification payments only, any amount required to compensate or reimburse the Borrower or such Subsidiary, and so applied within 180 days, for (A) replacing, repairing or restoring any assets or otherwise remedying the condition giving rise to the claim for indemnification or (B) paying claims and settlements to third Persons giving rise to the claim for indemnification.

Non-Defaulting Lender” shall mean, at any time, each Lender that is not a Defaulting Lender at such time.

Notice of Conversion/Continuation” shall mean a Notice of Conversion/Continuation substantially in the form of Exhibit H, or such other form as shall be approved by the Administrative Agent.

Obligations” shall mean (a) the due and punctual payment of (i) the principal of and interest (including interest accruing during the pendency of any bankruptcy, insolvency, receivership or other similar proceeding, regardless of whether allowed or allowable in such proceeding) on the Loans, when and as due, whether at maturity, by acceleration, upon one or more dates set for payment or prepayment or otherwise, (ii) each Early Payment Fee due under this Agreement, and (iii) all other monetary obligations of the Borrower to any of the Secured Parties under this Agreement and each of the other Loan Documents, including fees, costs, expenses and indemnities, whether primary, secondary, direct, contingent, fixed or otherwise (including monetary obligations incurred during the pendency of any bankruptcy, insolvency, receivership or other similar proceeding, regardless of whether allowed or allowable in such proceeding), (b) the due and punctual performance of all other obligations of the Borrower under or pursuant to this Agreement and each of the other Loan Documents, and (c) the due and punctual payment and performance of all the obligations of each other Loan Party under or pursuant to this Agreement and each of the other Loan Documents.

OFAC” shall have the meaning assigned to such term in Section 3.25.

Other Connection Taxes” shall mean, with respect to any Recipient, Taxes imposed as a result of a present or former connection between such Recipient and the jurisdiction imposing such Tax (other than connections arising from such Recipient having executed, delivered, become a party to, performed its obligations under, received payments under, received or perfected a security interest under, engaged in any other transaction pursuant to or enforced any Loan Document, or sold or assigned an interest in any Loan or Loan Document).

Other Taxes” shall mean all present or future stamp, court or documentary, intangible, recording, filing or similar Taxes that arise from any payment made under, from the execution,

 

21


delivery, performance, enforcement or registration of, from the receipt or perfection of a security interest under, or otherwise with respect to, any Loan Document, except any such Taxes that are Other Connection Taxes imposed with respect to an assignment.

Participant Register” shall have the meaning assigned to such term in Section 9.04(f).

PBGC” shall mean the Pension Benefit Guaranty Corporation referred to and defined in ERISA.

Perfection Certificate” shall mean the Perfection Certificate substantially in the form of Exhibit B to the Guarantee and Collateral Agreement.

Permitted Acquisition” shall have the meaning assigned to such term in Section 6.04(g).

Permitted Investments” shall mean:

(a) direct obligations of, or obligations the principal of and interest on which are unconditionally guaranteed by, the United States of America (or by any agency thereof to the extent such obligations are backed by the full faith and credit of the United States of America), in each case maturing within one year from the date of issuance thereof;

(b) investments in commercial paper maturing within 270 days from the date of issuance thereof and having, at such date of acquisition, the highest credit rating obtainable from S&P or from Moody’s;

(c) investments in certificates of deposit, banker’s acceptances and time deposits maturing within one year from the date of acquisition thereof issued or guaranteed by or placed with, and money market deposit accounts issued or offered by any domestic office of any commercial bank organized under the laws of the United States of America or any State thereof that has a combined capital and surplus and undivided profits of not less than $500,000,000 and that issues (or the parent of which issues) commercial paper rated at least “Prime-1” (or the then equivalent grade) by Moody’s or “A-1” (or the then equivalent grade) by S&P;

(d) fully collateralized repurchase agreements with a term of not more than 30 days for securities described in clause (a) above and entered into with a financial institution satisfying the criteria of clause (c) above;

(e) investments in “money market funds” within the meaning of Rule 2a-7 of the Investment Company Act of 1940, as amended, substantially all of whose assets are invested in investments of the type described in clauses (a) through (d) above; and

(f) other short-term investments utilized by Foreign Subsidiaries in accordance with normal investment practices for cash management in investments of a type analogous to the foregoing.

Permitted Investors” shall mean those Persons set forth on Schedule 1.01(d) and any Affiliates thereof.

 

22


Permitted Tax Distributions” shall mean, for any taxable period in which the Borrower or any of its Subsidiaries is a member of a consolidated, combined or similar income or similar tax group for which a direct or indirect parent of the Borrower is the common parent or other applicable taxpayer (a “Tax Group”), distributions to pay federal, foreign state and local income or similar Taxes of such Tax Group that are attributable to the Borrower and/or its Subsidiaries; provided that, the aggregate amount of such payments made shall not exceed the aggregate amount that the Borrower and its Subsidiaries would have been required to pay as standalone entities or a standalone tax group.

Person” shall mean any natural person, corporation, business trust, joint venture, association, company, limited liability company, partnership, Governmental Authority or other entity.

Plan” shall mean any employee pension benefit plan (other than a Multiemployer Plan) subject to the provisions of Title IV of ERISA or Section 412 of the Code or Section 302 of ERISA, and in respect of which the Borrower, any Subsidiary or any of their respective ERISA Affiliates is (or, if such plan were terminated, would under Section 4069 of ERISA be deemed to be) an “employer” as defined in Section 3(5) of ERISA.

Platform” shall have the meaning assigned to such term in Section 9.01.

PPACA” shall mean the Patient Protection and Affordable Care Act, Pub. L. 111-148, March 23, 2010.

Premium Event” shall mean the occurrence of any of the following: (a) the principal balance of any Term Loans is prepaid or repaid, for any reason, in whole or in part (other than (x) following the unrescinded occurrence of the Springing Maturity Exercise Date, the prepayment of the Term Loans on or after the date that is 60 days prior to the Term Loan Maturity Date, (y) any mandatory prepayments made in connection with Casualty Events under Section 2.13(a) or (z) any mandatory prepayments made in connection with an Extraordinary Receipt under Section 2.13(d)), (b) the Term Loans are accelerated (whether as a result of an Event of Default, by operation of law or otherwise), including as a result of any Event of Default under clause (g) or (h) of Article VII or (c) there shall occur any satisfaction, release, payment, restructuring, reorganization, replacement, reinstatement, defeasance or compromise of any of the Obligations in any bankruptcy, insolvency proceeding, foreclosure (whether by power of judicial proceeding or otherwise) or deed in lieu of foreclosure or the making of a distribution of any kind in any bankruptcy or insolvency proceeding to the Administrative Agent or any Lender in full or partial satisfaction of the Obligations.

Prime Rate” shall mean the rate of interest which is identified as the “Prime Rate” and normally published in the Money Rates section of The Wall Street Journal (or, if such rate ceases to be so published, the highest per annum interest rate published by the Federal Reserve Board in Federal Reserve Statistical Release H.15 (519) (Selected Interest Rates) as the “bank prime loan” rate or, if such rate is no longer quoted therein, any similar rate quoted therein (as determined by the Administrative Agent) or any similar release by the Federal Reserve Board (as determined by the Administrative Agent)); each change in the Prime Rate shall be effective from the date such change is announced as being effective.

 

23


PTE” shall mean a prohibited transaction class exemption issued by the U.S. Department of Labor, as any such exemption may be amended from time to time.

Qualified IPO” shall mean an IPO with a Valuation of no less than $2,000,000,000 that results in at least $125,000,000 of Net Cash Proceeds to the Borrower (or its direct or indirect parent).

Recipient” shall mean (a) the Administrative Agent or (b) any Lender, as applicable.

Register” shall have the meaning assigned to such term in Section 9.04(d).

Regulated Insurance Company” shall mean any Subsidiary of the Borrower, whether now owned or hereafter acquired, that is authorized or admitted to carry on or transact Insurance Business in any jurisdiction and is regulated by any Applicable Insurance Regulatory Authority.

Regulation T” shall mean Regulation T of the Board as from time to time in effect and all official rulings and interpretations thereunder or thereof.

Regulation U” shall mean Regulation U of the Board as from time to time in effect and all official rulings and interpretations thereunder or thereof.

Regulation X” shall mean Regulation X of the Board as from time to time in effect and all official rulings and interpretations thereunder or thereof.

Related Fund” shall mean, with respect to any Lender that is a fund or commingled investment vehicle that invests in loans, any other fund that invests in loans and is managed or advised by the same investment advisor as such Lender or by an Affiliate of such investment advisor.

Related Parties” shall mean, with respect to any specified Person, such Person’s Affiliates and the respective partners, directors, trustees, officers, employees, members, agents, administrators, managers, representatives and advisors of such Person and such Person’s Affiliates.

Release” shall mean any release, spill, emission, leaking, dumping, injection, pouring, deposit, disposal, discharge, dispersal, leaching or migration into or through the environment or within or upon any building, structure, facility or fixture.

Relevant Governmental Body” shall mean the Federal Reserve Board and/or the Federal Reserve Bank of New York, or a committee officially endorsed or convened by the Federal Reserve Board and/or the Federal Reserve Bank of New York or any successor thereto.

Required Lenders” shall mean, at any time, Lenders having Loans and Term Loan Commitments representing more than 50% of the sum of all Loans outstanding and Term Loan Commitments at such time; provided that (x) Required Lenders shall in any event include all Lenders that are Affiliates or managed funds of HPS Investments Partners, LLC and (y) the Loans and Term Loan Commitments of any Defaulting Lender shall be disregarded in the determination of the Required Lenders at any time.

 

24


Requirements of Law” shall mean, as to any Person, the certificate of incorporation and by-laws or other organizational or governing documents of such Person, and any law, treaty, rule or regulation or determination of an arbitrator or a court or other Governmental Authority, in each case applicable to or binding upon such Person or any of its assets or property or to which such Person or any of its assets or property is subject.

Resolution Authority” shall mean an EEA Resolution Authority or, with respect to any UK Financial Institution, a UK Resolution Authority

Responsible Officer” of any Person shall mean any executive officer or Financial Officer of such Person and any other officer or similar official thereof responsible for the administration of the obligations of such Person in respect of this Agreement.

Restricted” shall mean, when referring to cash of the Loan Parties, that such cash (a) appears (or would be required to appear) as “restricted” on a consolidated balance sheet of the Loan Parties (unless such appearance is solely related to the Loan Documents or Liens created thereunder) as determined in accordance with GAAP, or (b) is subject to any Lien in favor of any Person other than the Administrative Agent for the benefit of the Secured Parties (other than bankers’ liens and rights of setoff and inchoate Liens).

Restricted Indebtedness” shall mean Indebtedness of the Borrower or any Subsidiary, the payment, prepayment, repurchase or defeasance of which is restricted under Section 6.09(b).

Restricted Payment” shall mean any dividend or other distribution (whether in cash, securities or other property) with respect to any Equity Interests in the Borrower or any Subsidiary, or any payment (whether in cash, securities or other property), including any sinking fund or similar deposit, on account of the purchase, redemption, retirement, acquisition, cancellation or termination of any Equity Interests in the Borrower or any Subsidiary.

SAP” shall mean, with respect to any Regulated Insurance Company, the statutory accounting practices prescribed or permitted by the Applicable Insurance Regulatory Authority in the state in which such Regulated Insurance Company is domiciled for the preparation of Statutory Statements and other financial reports by insurance companies of the same type as such Regulated Insurance Company in effect from time to time, applied in a manner consistent with those used in preparing the statutory financial statements referred to in Section 5.5.

S&P” shall mean Standard & Poor’s Financial Services LLC, or any successor thereto.

Secured Parties” shall mean (a) the Lenders, (b) the Administrative Agent, (c) the beneficiaries of each indemnification obligation undertaken by any Loan Party under any Loan Document and (d) the successors and assigns of each of the foregoing.

Security Documents” shall mean the Mortgages, the Guarantee and Collateral Agreement, each deposit account control agreement, each securities account control agreement and each of the security agreements, mortgages and other instruments and documents executed and delivered pursuant to any of the foregoing or pursuant to Section 5.12.

 

25


SOFR” with respect to any day shall mean the secured overnight financing rate published for such day by the Federal Reserve Bank of New York, as the administrator of the benchmark (or a successor administrator), on the Federal Reserve Bank of New York’s Website.

Springing Maturity Exercise Date” shall have the meaning assigned to such term in the definition of “Term Loan Maturity Date”.

SPV” shall have the meaning assigned to such term in Section 9.04(i).

Statutory Reserves” shall mean a fraction (expressed as a decimal), the numerator of which is the number one and the denominator of which is the number one minus the aggregate of the maximum reserve percentages (including any marginal, special, emergency or supplemental reserves) expressed as a decimal established by the Board and any other banking authority, domestic or foreign, to which the Administrative Agent or any Lender (including any branch, Affiliate or other fronting office making or holding a Loan) is subject for Eurocurrency Liabilities (as defined in Regulation D of the Board). Eurodollar Loans shall be deemed to constitute Eurocurrency Liabilities (as defined in Regulation D of the Board) and to be subject to such reserve requirements without benefit of or credit for proration, exemptions or offsets that may be available from time to time to the Administrative Agent or any Lender under such Regulation D. Statutory Reserves shall be adjusted automatically on and as of the effective date of any change in any reserve percentage.

Statutory Statement” shall mean any statutory financial statement of any Regulated Insurance Company required to be filed with the Applicable Insurance Regulatory Authority of the jurisdiction of incorporation or organization of such Regulated Insurance Company, which statement shall be in the form required by the state in which such Regulated Insurance Company is domiciled or, if no specific form is so required, in the form of financial statements permitted by such Applicable Insurance Regulatory Authority to be used for filing statutory financial statements and shall contain the type of information required and/or permitted by such Applicable Insurance Regulatory Authority to be disclosed therein, together with all exhibits or schedules filed therewith.

subsidiary” shall mean, with respect to any Person (herein referred to as the “parent”), any corporation, partnership, limited liability company, association or other business entity (a) of which securities or other ownership interests representing more than 50% of the equity or more than 50% of the ordinary voting power or more than 50% of the general partnership interests are, at the time any determination is being made, owned, Controlled or held, or (b) that is, at the time any determination is made, otherwise Controlled, by the parent or one or more subsidiaries of the parent or by the parent and one or more subsidiaries of the parent.

Subsidiary” shall mean any subsidiary of the Borrower.

Synthetic Lease” shall mean, as to any Person, any lease (including leases that may be terminated by the lessee at any time) of any property (whether real, personal or mixed) (a) that is accounted for as an operating lease under GAAP and (b) in respect of which the lessee retains or obtains ownership of the property so leased for U.S. Federal income tax purposes, other than any such lease under which such Person is the lessor.

 

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Synthetic Lease Obligations” shall mean, as to any Person, an amount equal to the capitalized amount of the remaining lease payments under any Synthetic Lease that would appear on a balance sheet of such Person in accordance with GAAP if such obligations were accounted for as Capital Lease Obligations.

Synthetic Purchase Agreement” shall mean any swap, derivative or other agreement or combination of agreements pursuant to which the Borrower or any Subsidiary is or may become obligated to make (a) any payment in connection with a purchase by any third party from a Person other than the Borrower or any Subsidiary of any Equity Interest or Restricted Indebtedness or (b) any payment (other than on account of a permitted purchase by it of any Equity Interest or Restricted Indebtedness) the amount of which is determined by reference to the price or value at any time of any Equity Interest or Restricted Indebtedness; provided that no phantom stock or similar plan providing for payments only to current or former directors, officers or employees of the Borrower or the Subsidiaries (or to their heirs or estates) shall be deemed to be a Synthetic Purchase Agreement.

Taxes” shall mean any and all present or future taxes, levies, imposts, duties, deductions, charges, withholdings (including backup withholding), assessments, fees or other charges imposed by any Governmental Authority, including any interest, additions to tax or penalties applicable thereto.

Term Loan Commitment” shall mean, with respect to each Lender, the commitment of such Lender to make Term Loans hereunder as set forth opposite such Lender’s name on Schedule 2.01, or in the Assignment and Acceptance pursuant to which such Lender assumed its Term Loan Commitment, and “Term Loan Commitments” shall mean, collectively, the sum of all Lenders’ Term Loan Commitments, which as of the Closing Date amount to $150,000,000 in the aggregate.

Term Loan Maturity Date” shall mean October 30, 2024; provided that the Term Loan Maturity Date shall be deemed to be the date (the “Springing Maturity Date”) twelve months after written notice from the Required Lenders to the Borrower (the date such notice is delivered, the “Springing Maturity Exercise Date”) that any one of the provisions of the Patient Protection and Affordable Care Act (which, for the avoidance of doubt, includes the corresponding statutory text codified in the Public Health Services Act and Internal Revenue Code) set forth on Schedule 1.01(c) (collectively, the “Specified ACA Provisions”) has been invalidated (as defined below) by either (a) any federal court other than the Supreme Court, if such provision remains invalid for a period of longer than 45 days; or (b) the United States Supreme Court, in case of either (a) or (b) pursuant to the case styled California, et. al. v. Texas, et. al., No. 19-840 (including, for the avoidance of doubt, Texas, et. al. v. California, et. al. No. 19-1019, United States House of Representatives v. Texas, et. al. No. 19-841 and any other case consolidated therewith or heard on remand therefrom); provided, further that such invalidation could be reasonably likely to result in a Material Adverse Effect.

Notwithstanding the foregoing, the Term Loan Maturity Date shall be deemed to be October 30, 2024 upon the occurrence of any of the following events (or, with respect to clause (iv), so long as such stay is in effect) after the Closing Date and prior to the Springing Maturity Date:

 

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(i) the following are all the case simultaneously: (A) the sitting President of the United States was the nominee of, or is publicly affiliated with, the Democratic Party, (B) the majority leader of the United States Senate was the nominee of, or is publicly affiliated with, the Democratic Party and (C) the Speaker of the United States House of Representatives was the nominee of, or is publicly affiliated with, the Democratic Party;

(ii) a Qualified IPO shall have been consummated;

(iii) after the occurrence of an event described in the proviso to the first paragraph in this definition above, legislation is enacted that substantially restores each of the Specified ACA Provisions so invalidated; or

(iv) the applicable court decision invalidating such Specified ACA Provision has been stayed or reversed by a court of competent jurisdiction so long as such stay remains in effect; or

(v) the Required Lenders shall have failed within 50 days after the invalidation described in proviso (a) to the first paragraph above, or within 45 days of the invalidation described in proviso (b) to the first paragraph above, to send the notice contemplated therein.

For purposes of this definition, the term “invalidated” shall mean, with respect to any Specified ACA Provision, such court enjoining or declaring invalid, illegal or unenforceable such Specified ACA Provision on the basis that such Specified ACA Provision (x) violates the Constitution of the United States or (y) is inseverable from some other provision that violates the Constitution of the United States. The term “invalid” shall have the meaning correlative thereto. The parties agree that any of the following court actions as described in this definition above shall be deemed to be reasonably likely to result in a Material Adverse Effect:

 

  1.

The invalidation in full of the Patient Protection and Affordable Care Act.

 

  2.

The invalidation in full of Title I of the Patient Protection and Affordable Care Act.

 

  3.

The invalidation in full of Section 1401 of the Patient Protection and Affordable Care Act.

 

  4.

The invalidation in full of Section 1412 of the Patient Protection and Affordable Care Act.

 

  5.

The invalidation in full of Section 1312 of the Patient Protection and Affordable Care Act.

 

  6.

The invalidation in full of Section 1201 of the Patient Protection and Affordable Care Act.

 

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  7.

The invalidation of the portion(s) of Section 1201 of the Patient Protection and Affordable Care Act that amend (v) Section 2701, (w) Section 2702, (x) Section 2704, (y) Section 2705, or (z) Section 2707 of the Public Health Services Act.

Term Loans” shall mean the term loans made by the Lenders to the Borrower pursuant to Section 2.01.

Term SOFR” shall mean the forward-looking term rate based on SOFR that has been selected or recommended by the Relevant Governmental Body.

Test Period” shall mean, as of any date of determination, the period of four consecutive fiscal quarters of the Borrower then last ended for which financial statements have been (or were required to be) delivered pursuant to Section 5.04(a) or (b).

Transactions” shall mean, collectively, (a) the execution, delivery and performance by the Loan Parties of the Loan Documents to which they are a party and the making of the Borrowings hereunder and (b) the payment of related fees and expenses.

Type”, when used in respect of any Loan or Borrowing, shall refer to the Rate by reference to which interest on such Loan or on the Loans comprising such Borrowing is determined. For purposes hereof, the term “Rate” shall mean the Adjusted LIBO Rate and the Alternate Base Rate.

UK Financial Institution” shall mean any BRRD Undertaking (as such term is defined under the PRA Rulebook (as amended from time to time) promulgated by the United Kingdom Prudential Regulation Authority) or any person falling within IFPRU 11.6 of the FCA Handbook (as amended from time to time) promulgated by the United Kingdom Financial Conduct Authority, which includes certain credit institutions and investment firms, and certain affiliates of such credit institutions or investment firms.

UK Resolution Authority” shall mean the Bank of England or any other public administrative authority having responsibility for the resolution of any UK Financial Institution.

Unadjusted Benchmark Replacement” shall mean the Benchmark Replacement excluding the Benchmark Replacement Adjustment.

Upfront Fee” shall have the meaning assigned to such term in Section 2.05(b).

USA PATRIOT Act” shall mean The Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001 (Title III of Pub. L. No. 107-56 (signed into law October 26, 2001)).

U.S. Person” shall mean any Person that is a “United States Person” as defined in Section 7701(a)(30) of the Code.

Valuation” shall mean an amount equal to (a) with respect clause (a) of the definition of IPO, (i) market capitalization of the Borrower (or its direct or indirect parent) based on the IPO price of the equity interests sold in such IPO plus (ii) all Indebtedness of the Borrower and the

 

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Subsidiaries minus (iii) all unrestricted cash of the Borrower and the Subsidiaries, (b) with respect to clause (b) of the definition of IPO, (i) the market capitalization of the Borrower (or its direct or indirect parent) as of the effectiveness of the acquisition contemplated thereby, plus (ii) all Indebtedness of the Borrower and the Subsidiaries minus (iii) all unrestricted cash of the Borrower and the Subsidiaries and (c) with respect to any other Equity Issuance, the aggregate enterprise value of the Borrower (or its direct or indirect parent) based on the price of the equity interests issued in such Equity Issuance.

Wholly Owned Subsidiary” of any Person shall mean a subsidiary of such Person of which securities (except for directors’ qualifying shares) or other ownership interests representing 100.00% of the Equity Interests are, at the time any determination is being made, owned, Controlled or held by such Person or one or more wholly owned Subsidiaries of such Person or by such Person and one or more wholly owned Subsidiaries of such Person.

Withdrawal Liability” shall mean liability to a Multiemployer Plan as a result of a complete or partial withdrawal from such Multiemployer Plan, as such terms are defined in Part I of Subtitle E of Title IV of ERISA.

Withholding Agent” shall mean any Loan Party and the Administrative Agent.

Write-Down and Conversion Powers” shall mean, (a) with respect to any EEA Resolution Authority, the write-down and conversion powers of such EEA Resolution Authority from time to time under the Bail-In Legislation for the applicable EEA Member Country, which write-down and conversion powers are described in the EU Bail-In Legislation Schedule, and (b) with respect to the United Kingdom, any powers of the applicable Resolution Authority under the Bail-In Legislation to cancel, reduce, modify or change the form of a liability of any UK Financial Institution or any contract or instrument under which that liability arises, to convert all or a part of that liability into shares, securities or obligations of that person or any other person, to provide that any such contract or instrument is to have effect as if a right had been exercised under it or to suspend any obligation in respect of that liability or any of the powers under that Bail-In Legislation that are related to or ancillary to any of those powers.

SECTION 1.02. Terms Generally. The definitions in Section 1.01 shall apply equally to both the singular and plural forms of the terms defined. Whenever the context may require, any pronoun shall include the corresponding masculine, feminine and neuter forms. The words “include”, “includes” and “including” shall be deemed to be followed by the phrase “without limitation”. The word “will” shall be construed to have the same meaning and effect as the word “shall”, and the words “asset” and “property” shall be construed as having the same meaning and effect and to refer to any and all tangible and intangible assets and properties, including cash, securities, accounts and contract rights. All references herein to Articles, Sections, Exhibits and Schedules shall be deemed references to Articles and Sections of, and Exhibits and Schedules to, this Agreement unless the context shall otherwise require. Except as otherwise expressly provided herein, (a) any reference in this Agreement to any Loan Document shall mean such document as amended, restated, supplemented or otherwise modified from time to time, in each case, in accordance with the express terms of this Agreement, and (b) all terms of an accounting or financial nature (including the calculation of all financial covenants set forth herein) shall be construed in accordance with GAAP as in effect from time to time and in a manner

 

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consistent with the terms and principles used in preparing the audited financial statements of the Borrower for the fiscal year ended December 31, 2019 and as reflected in the Company Model; provided that if the Borrower notifies the Administrative Agent that the Borrower wishes to amend any covenant in Article VI or any related definition to eliminate the effect of any change in GAAP occurring after the date of this Agreement on the operation of such covenant (or if the Administrative Agent notifies the Borrower that the Required Lenders wish to amend Article VI or any related definition for such purpose), then the Borrower’s compliance with such covenant shall be determined on the basis of GAAP in effect immediately before the relevant change in GAAP became effective, until either such notice is withdrawn or such covenant is amended in a manner satisfactory to the Borrower and the Required Lenders. In the computation of periods of time from a specified date to a later specified date, the word “from” shall be deemed to mean “from and including”, the words “to” and “until” each shall be deemed to mean “to but excluding”, and the word “through” shall be deemed to mean “to and including”. For all purposes under the Loan Documents, in connection with any division or plan of division or establishment of any series under Delaware law (or any comparable event under a different jurisdiction’s laws): (a) if any asset, right, obligation or liability of any Person becomes the asset, right, obligation or liability of a different Person, then it shall be deemed to have been transferred from the original Person to the subsequent Person, (b) if any new Person comes into existence, such new Person shall be deemed to have been organized on the first date of its existence by the holders of its Equity Interests at such time and (c) each division and series of any Person shall be treated as a separate Person hereunder.

SECTION 1.03. Pro Forma Calculations. All pro forma calculations permitted or required to be made by the Borrower or any Subsidiary pursuant to this Agreement shall include only those adjustments that would be permitted or required by Regulation S-X under the Securities Act of 1933, as amended, together with those adjustments that (a) have been certified by a Financial Officer of the Borrower as having been prepared in good faith based upon reasonable assumptions and (b) are based on reasonably detailed written assumptions reasonably acceptable to the Administrative Agent.

SECTION 1.04. Classification of Loans and Borrowings. For purposes of this Agreement, Loans may be classified and referred to by Type (e.g., a “Eurodollar Loan”). Borrowings also may be classified and referred to by Type (e.g., a “Eurodollar Borrowing”).

ARTICLE II

The Credits

SECTION 2.01. Commitments. Subject to the terms and conditions and relying upon the representations and warranties herein set forth, each Lender agrees, severally and not jointly, to make a Term Loan to the Borrower on the Closing Date in a principal amount equaling its Term Loan Commitment. Amounts paid or prepaid in respect of Term Loans may not be re-borrowed.

 

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SECTION 2.02. Loans. (a) Each Loan shall be made as part of a Borrowing consisting of Loans made by the Lenders ratably in accordance with their applicable Commitments; provided that the failure of any Lender to make any Loan shall not in itself relieve any other Lender of its obligation to lend hereunder (it being understood, however, that no Lender shall be responsible for the failure of any other Lender to make any Loan required to be made by such other Lender). The Loans comprising any Borrowing shall be in an aggregate principal amount that is (i) an integral multiple of $1,000,000 and not less than $5,000,000 or (ii) equal to the remaining available balance of the Term Loan Commitments.

(b) Subject to Sections 2.08 and 2.15, each Borrowing shall be comprised entirely of ABR Loans or Eurodollar Loans as the Borrower may request pursuant to Section 2.03. Each Lender may at its option make any Eurodollar Loan by causing any domestic or foreign branch or Affiliate of such Lender to make such Loan; provided that any exercise of such option shall not affect the obligation of the Borrower to repay such Loan in accordance with the terms of this Agreement. Borrowings of more than one Type may be outstanding at the same time; provided that the Borrower shall not be entitled to request any Borrowing that, if made, would result in more than five Eurodollar Borrowings outstanding hereunder at any time. For purposes of the foregoing, Borrowings having different Interest Periods, regardless of whether they commence on the same date, shall be considered separate Borrowings.

(c) Each Lender shall make each Loan to be made by it hereunder on the proposed date thereof by wire transfer of immediately available funds to such account as the Administrative Agent may designate not later than 1:00 p.m., New York City time, and upon receipt of all requested funds, the Administrative Agent shall promptly wire the amounts so received to an account designated by the Borrower in the applicable Borrowing Request or, if a Borrowing shall not occur on such date because any condition precedent herein specified shall not have been met, return the amounts so received to the respective Lenders.

(d) Unless the Administrative Agent shall have received notice from a Lender prior to the date of any Borrowing that such Lender will not make available to the Administrative Agent such Lender’s portion of such Borrowing, the Administrative Agent may assume that such Lender has made such portion available to the Administrative Agent on the date of such Borrowing in accordance with clause (c) above and the Administrative Agent may, in reliance upon such assumption, make available to the Borrower on such date a corresponding amount. If the Administrative Agent shall have so made funds available then, to the extent that such Lender shall not have made such portion available to the Administrative Agent, such Lender and the Borrower severally agree to repay to the Administrative Agent forthwith on demand such corresponding amount together with interest thereon, for each day from the date such amount is made available to the Borrower to the date such amount is repaid to the Administrative Agent at (i) in the case of the Borrower, a rate per annum equal to the interest rate applicable at the time to the Loans comprising such Borrowing and (ii) in the case of such Lender, a rate determined by the Administrative Agent to represent its cost of overnight or short-term funds (which determination shall be conclusive absent manifest error). If such Lender shall repay to the Administrative Agent such corresponding amount, such amount shall constitute such Lender’s Loan as part of such Borrowing for purposes of this Agreement.

 

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SECTION 2.03. Borrowing Procedure. In order to request a Borrowing, the Borrower shall notify the Administrative Agent of such request in writing (a) in the case of a Eurodollar Borrowing, not later than 12:00 (noon), New York City time, three Business Days before a proposed Borrowing, and (b) in the case of an ABR Borrowing, not later than 12:00 noon, New York City time, one Business Day before a proposed Borrowing. Each such written Borrowing Request shall be irrevocable (provided that any such notice may be conditioned on the effectiveness of the Closing Date), and shall be made by hand delivery or e-mail to the Administrative Agent and shall specify the following information: (i) whether the Borrowing then being requested is to be a Eurodollar Borrowing or an ABR Borrowing; (ii) the date of such Borrowing (which shall be a Business Day); (iii) the number and location of the account to which funds are to be disbursed; (iv) the amount of such Borrowing; and (v) if such Borrowing is to be a Eurodollar Borrowing, the Interest Period with respect thereto; provided that, notwithstanding any contrary specification in any Borrowing Request, each requested Borrowing shall comply with the requirements set forth in Section 2.02. If no election as to the Type of Borrowing is specified in any such notice, then the requested Borrowing shall be an ABR Borrowing. If no Interest Period with respect to any Eurodollar Borrowing is specified in any such notice, then the Borrower shall be deemed to have selected an Interest Period of one month’s duration. The Administrative Agent shall promptly advise the applicable Lenders of any notice given pursuant to this Section (and the contents thereof), and of each Lender’s portion of the requested Borrowing.

SECTION 2.04. Evidence of Debt; Repayment of Loans. (a) The Borrower hereby unconditionally promises to pay to the Administrative Agent for the account of each Lender the principal amount of each Term Loan of such Lender as provided in Section 2.11.

(b) Each Lender shall maintain in accordance with its usual practice an account or accounts evidencing the indebtedness of the Borrower to such Lender resulting from each Loan made by such Lender from time to time, including the amounts of principal and interest payable and paid to such Lender from time to time under this Agreement.

(c) The Administrative Agent shall maintain accounts in which it will record (i) the amount of each Loan made hereunder, the Type thereof and, if applicable, the Interest Period applicable thereto, (ii) the amount of any principal or interest due and payable or to become due and payable from the Borrower to each Lender hereunder and (iii) the amount of any sum received by the Administrative Agent hereunder from the Borrower or any Guarantor and each Lender’s share thereof. In the event of any conflict between the accounts recorded pursuant to clauses (b) and (c) of this Section, the records of the Administrative Agent under this clause (c) shall control.

(d) The entries made in the accounts maintained pursuant to clauses (b) and (c) above shall be prima facie evidence of the existence and amounts of the obligations therein recorded; provided that the failure of any Lender or the Administrative Agent to maintain such accounts or any error therein shall not in any manner affect the obligations of the Borrower to repay the Loans in accordance with their terms.

(e) Any Lender may request that Loans made by it hereunder be evidenced by a promissory note. In such event, the Borrower shall execute and deliver to such Lender a promissory note payable to such Lender and its registered assigns and in a form and substance reasonably acceptable to the Lender and the Borrower (with a copy to the Administrative Agent).

 

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SECTION 2.05. Fees. (a) The Borrower agrees to pay to the Administrative Agent, for its own account, an annual administration fee (the “Administrative Agent Fee”) equal to $40,000 per annum, which Administrative Agent Fee shall be earned, due and payable in full in cash on the Closing Date and in advance on each yearly anniversary thereof until the Obligations have been paid in full.

(b) The Borrower agrees to pay to the Administrative Agent, for the account of the Lenders, an upfront fee (the “Upfront Fee”) equal to 2.00% of the amount of all of the Term Loan Commitments of the Lenders as of the Closing Date (prior to the termination of such Term Loan Commitments). The Upfront Fee shall be in all respects fully earned, due and payable on the Closing Date. A portion or the full amount of the Upfront Fee due to any Lender may, at the option of such Lender (and with notice to the Administrative Agent and the Borrower), be off set against the amount of the Loans to be funded by such Lender on the Closing Date; provided that any such off-set shall not reduce the principal amount of the Loans outstanding hereunder.

(c) If, on or prior to the Early Payment Date, any Premium Event occurs, the Borrower shall, in each case, pay to the Administrative Agent, for the benefit of the Lenders, on the date of such Premium Event, the applicable Early Payment Fee. The Early Payment Fee shall constitute an Obligation and shall be due and payable by the Borrower immediately prior to and notwithstanding the automatic acceleration of the outstanding principal of the Term Loans and all other accrued liabilities contemplated hereunder and under the other Loan Documents. If a Lender is involuntarily removed or replaced pursuant to Section 2.21(a), then such Lender’s Term Loans shall be deemed prepaid as of such date, and the Borrower shall pay to such Lender its ratable share of the Early Payment Fee on the date of, and as a condition to, such removal or replacement.

(d) Notwithstanding anything to the contrary in this Agreement or any other Loan Document, it is understood and agreed that if any Term Loans are accelerated (whether as a result of the occurrence and continuance of any Event of Default, by operation of law or otherwise), any Early Payment Fee, determined as of the date of acceleration, will also be due and payable and will be treated and deemed as though the applicable Term Loans were repaid as of such date and shall constitute part of the Obligations for all purposes herein. Any Early Payment Fee shall also be payable in the event the Obligations, the Term Loans and this Agreement are satisfied or released by foreclosure (whether by power of judicial proceeding), deed in lieu of foreclosure or by any other similar means. The Loan Parties expressly waive the provisions of any present or future statute or law that prohibits or may prohibit the collection of the Early Payment Fee in connection with any such acceleration. The parties hereto further acknowledge and agree that any Early Payment Fee is not intended to act as a penalty or to punish the Loan Parties for any repayment or redemption of the Term Loans. The Loan Parties expressly agree that (i) any Early Payment Fee is reasonable and is the product of an arm’s length transaction between sophisticated business people, ably represented by counsel, (ii) any Early Payment Fee shall be payable notwithstanding the then prevailing market rates at the time payment is made, (iii) there has been a course of conduct between the Lenders and the Loan Parties giving specific consideration in this transaction for such agreement to pay any Early Payment Fee, (iv) the Loan Parties shall be estopped hereafter from claiming differently than as agreed to in this Section, (v) the agreement of the Loan Parties to pay any Early Payment Fee is a material inducement to the Lenders to extend the Term Loans, and (vi) any Early Payment Fee represents a good-faith, reasonable estimate and calculation of the lost profits or damages of the Lenders and that it would be impractical and extremely difficult to ascertain the actual amount of damages to any Lender or profits lost by such Lender as a result of any Premium Event.

 

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(e) All Fees shall be paid on the dates due, in immediately available funds, to the Administrative Agent for distribution, if and as appropriate, among the Lenders. Once paid, none of the Fees shall be refundable under any circumstances.

SECTION 2.06. Interest on Loans. (a) Subject to the provisions of Section 2.07, the Loans comprising each ABR Borrowing (including any amount capitalized and added to the principal amount thereof as described in Section 2.06(c) below) shall bear interest (computed on the basis of the actual number of days elapsed over a year of 360 days and calculated from the date of such Borrowing to, and excluding, the date of repayment thereof) at a rate per annum equal to the Alternate Base Rate plus the Applicable Margin.

(b) Subject to the provisions of Section 2.07, the Loans comprising each Eurodollar Borrowing (including any amount capitalized and added to the principal amount thereof as described in Section 2.06(c) below) shall bear interest (computed on the basis of the actual number of days elapsed over a year of 360 days) at a rate per annum equal to the Adjusted LIBO Rate for the Interest Period in effect for such Borrowing plus the Applicable Margin.

(c) Except as otherwise provided in this Agreement, interest on each Loan shall be payable in cash on the Interest Payment Dates applicable to such Loan; provided that so long as no Event of Default has occurred and is continuing, at the written election of the Borrower delivered to the Administrative Agent no less than five Business Days before any Interest Payment Date (or such other date specified in this Agreement for any required payment of interest on such Loan) occurring during the period commencing on the Closing Date and ending on the three-year anniversary of the Closing Date, up to 50% of accrued interest with respect to such Loan shall be paid on such date by capitalizing such interest and adding it to the then outstanding principal amount of the same Type of Loans for which such interest accrued (or, if such Loans are being converted into another Type of Loans, the Loans as so converted) and such capitalized portion of interest shall be deemed to have been paid with the proceeds of such additional Loans to the Borrower in a like amount). The Administrative Agent is authorized and instructed to record the amount of such capitalized portion of interest as an increase the aggregate amount of the applicable Loans ratable among the Lenders. For the avoidance of doubt, with respect to each Interest Payment Date falling after the three-year anniversary of the Closing Date, any accrued interest on the Loans shall be payable on each Interest Payment Date in cash.

(d) The applicable Alternate Base Rate or Adjusted LIBO Rate for each Interest Period or day within an Interest Period, as the case may be, shall be determined by the Administrative Agent, and such determination shall be conclusive absent manifest error.

SECTION 2.07. Default Interest. If (a) the Borrower shall default in the payment of any principal of or interest on any Loan or any other amount due hereunder or under any other Loan Document, by acceleration or otherwise, (b) if any Event of Default under clause (g) or (h) of Article VII has occurred and is continuing or (c) if any other Event of Default under Article VII (other than clause (b), (c), (g) or (h) thereunder) has occurred and is continuing and the Required Lenders so vote, then, in the case of clause (a) above, until such defaulted amount shall have been

 

35


paid in full, in the case of clause (b) above, from the date such Event of Default occurs and for so long as such Event of Default is continuing, or, in the case of clause (c) above, from the date such vote has been exercised by the Required Lenders and for so long as such Event of Default is continuing, to the extent permitted by law, all amounts outstanding under this Agreement and the other Loan Documents shall bear interest (after as well as before judgment), payable on demand, (i) in the case of principal, at the rate otherwise applicable to such Loan pursuant to Section 2.06 plus 2.00% per annum and (ii) in all other cases, at a rate per annum (computed on the basis of the actual number of days elapsed over a year of 365 or 366 days, as the case may be, when determined by reference to the Prime Rate and over a year of 360 days at all other times) equal to the rate that would be applicable to an ABR Loan plus 2.00% per annum.

SECTION 2.08. Alternate Rate of Interest. (a) In the event, and on each occasion, that on the day two Business Days prior to the commencement of any Interest Period for a Eurodollar Borrowing the Administrative Agent shall have determined that Dollar deposits in the principal amounts of the Loans comprising such Borrowing are not generally available in the London interbank market, or that the rates at which such Dollar deposits are being offered will not adequately and fairly reflect the cost to the majority of Lenders of making or maintaining Eurodollar Loans during such Interest Period, or that reasonable means do not exist for ascertaining the Adjusted LIBO Rate, the Administrative Agent shall, as soon as practicable thereafter, give written notice of such determination to the Borrower and the Lenders. In the event of any such determination, until the Administrative Agent shall have advised the Borrower and the Lenders that the circumstances giving rise to such notice no longer exist, any request by the Borrower for a Eurodollar Borrowing pursuant to Section 2.03 or 2.10 shall be deemed to be a request for an ABR Borrowing. Each determination by the Administrative Agent under this Section shall be conclusive absent manifest error.

(b) (i) Notwithstanding anything to the contrary herein or in any other Loan Document, upon the occurrence of a Benchmark Transition Event or an Early Opt-in Election, as applicable, the Administrative Agent and the Borrower may amend this Agreement to replace the LIBO Rate with a Benchmark Replacement. Any such amendment will become effective at 5:00 p.m. on the fifth (5th) Business Day after the Administrative Agent has provided such proposed amendment to the Borrower without any further action or consent of any Lender, so long as the Administrative Agent has not received, by such time, written notice of objection to such amendment from the Required Lenders. Any such amendment with respect to an Early Opt-in Election will become effective on the date that the Lenders have delivered to the Administrative Agent written notice that the Lenders accept such amendment. No replacement of the LIBO Rate with a Benchmark Replacement pursuant to this subsection (b) will occur prior to the applicable Benchmark Transition Start Date.

(ii) In connection with the implementation of a Benchmark Replacement, the Administrative Agent will have the right to make Benchmark Replacement Conforming Changes from time to time and, notwithstanding anything to the contrary herein or in any other Loan Document, any amendments implementing such Benchmark Replacement Conforming Changes will become effective without any further action or consent of any other party to this Agreement.

 

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(iii) The Administrative Agent will promptly notify the Borrower and the Lenders of (A) any known occurrence of a Benchmark Transition Event or an Early Opt-in Election, as applicable, and its related Benchmark Replacement Date and Benchmark Transition Start Date, (B) the implementation of any Benchmark Replacement, (C) the effectiveness of any Benchmark Replacement Conforming Changes and (D) the commencement or conclusion of any Benchmark Unavailability Period. Any determination, decision or election that may be made by the Administrative Agent or Lenders pursuant to this Section 2.08, including any determination with respect to a tenor, rate or adjustment or of the occurrence or non-occurrence of an event, circumstance or date and any decision to take or refrain from taking any action, will be conclusive and binding absent manifest error and may be made in its or their sole discretion and without consent from the Borrower, except, in each case, as expressly required pursuant to this Section 2.08.

(iv) Upon the Borrower’s receipt of notice of the commencement of a Benchmark Unavailability Period, the Borrower may revoke any request for a Borrowing of, conversion to or continuation of Eurodollar Loans to be made, converted or continued during any Benchmark Unavailability Period and, failing that, the Borrower will be deemed to have converted any such request into a request for a Borrowing of or conversion to ABR Loans. During any Benchmark Unavailability Period, the component of the Alternate Base Rate based upon the LIBO Rate will not be used in any determination of the Alternate Base Rate.

(v) Notwithstanding anything herein or in any other Loan Document to the contrary, except as otherwise consented to in writing by the Borrower, any amendments to the Loan Documents made in connection with replacing the LIBO Rate with a Benchmark Replacement shall be undertaken in a manner that satisfies any applicable requirements under Proposed Treasury Regulations Section 1.1001-6 (or any successor or final United States Treasury regulations or other official guidance from the Internal Revenue Service) such that the applicable amendments shall not result in a deemed exchange of any Loan under Section 1001 of the Code.

SECTION 2.09. Termination and Reduction of Commitments. The Term Loan Commitments shall automatically terminate upon the making of the Term Loans on the Closing Date. Notwithstanding the foregoing, all the Commitments shall automatically terminate at 5:00 p.m., New York City time, on October 30, 2020 if the initial Borrowing shall not have occurred by such time.

SECTION 2.10. Conversion and Continuation of Borrowings. The Borrower shall have the right at any time upon prior written irrevocable notice, in the form of a Notice of Conversion/Continuation, to the Administrative Agent (a) not later than 12:00 (noon), New York City time, one Business Day prior to conversion, to convert any Eurodollar Borrowing into an ABR Borrowing, (b) not later than 12:00 (noon), New York City time, three Business Days prior to conversion or continuation, to convert any ABR Borrowing into a Eurodollar Borrowing or to continue any Eurodollar Borrowing as a Eurodollar Borrowing for an additional Interest Period, and (c) not later than 12:00 (noon), New York City time, three Business Days prior to conversion, to convert the Interest Period with respect to any Eurodollar Borrowing to another permissible Interest Period, subject in each case to the following:

 

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(i) each conversion or continuation shall be made pro rata among the Lenders in accordance with the respective principal amounts of the Loans comprising the converted or continued Borrowing;

(ii) if less than all the outstanding principal amount of any Borrowing shall be converted or continued, then each resulting Borrowing shall satisfy the limitations specified in Sections 2.02(a) and 2.02(b) regarding the principal amount and maximum number of Borrowings of the relevant Type;

(iii) each conversion shall be effected by each Lender and the Administrative Agent by recording for the account of such Lender the new Loan of such Lender resulting from such conversion and reducing the Loan (or portion thereof) of such Lender being converted by an equivalent principal amount; accrued interest on any Eurodollar Loan (or portion thereof) being converted shall be paid by the Borrower at the time of conversion;

(iv) if any Eurodollar Borrowing is converted at a time other than the end of the Interest Period applicable thereto, the Borrower shall pay, upon demand, any amounts due to the Lenders pursuant to Section 2.16;

(v) any portion of a Borrowing maturing or required to be repaid in less than one month may not be converted into or continued as a Eurodollar Borrowing;

(vi) any portion of a Eurodollar Borrowing that cannot be converted into or continued as a Eurodollar Borrowing by reason of the immediately preceding clause shall be automatically converted at the end of the Interest Period in effect for such Borrowing into an ABR Borrowing; and

(vii) upon notice to the Borrower from the Administrative Agent given at the request of the Required Lenders, after the occurrence and during the continuance of an Event of Default, no outstanding Loan may be converted into, or continued as, a Eurodollar Loan.

Each Notice of Conversion/Continuation pursuant to this Section shall be irrevocable and shall refer to this Agreement and specify (i) the identity and amount of the Borrowing that the Borrower requests be converted or continued, (ii) whether such Borrowing is to be converted to or continued as a Eurodollar Borrowing or an ABR Borrowing, (iii) if such Notice of Conversion/Continuation requests a conversion, the date of such conversion (which shall be a Business Day) and (iv) if such Borrowing is to be converted to or continued as a Eurodollar Borrowing, the Interest Period with respect thereto. If no Interest Period is specified in any such notice with respect to any conversion to or continuation as a Eurodollar Borrowing, the Borrower shall be deemed to have selected an Interest Period of one month’s duration. The Administrative Agent shall advise the Lenders of any Notice of Conversion/Continuation given pursuant to this Section and of each Lender’s portion of any converted or continued Borrowing. If the Borrower shall not have given a Notice of Conversion/Continuation in accordance with this Section to continue any Borrowing into a subsequent Interest Period (and shall not otherwise have given a Notice of Conversion/Continuation in accordance with this Section to convert such Borrowing), such Borrowing shall, at the end of the Interest Period applicable thereto (unless repaid pursuant to the terms hereof), automatically be continued as an ABR Borrowing.

 

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SECTION 2.11. Repayment of Term Loan Borrowings. To the extent not previously paid, all Term Loans shall be due and payable on the Term Loan Maturity Date, together with accrued and unpaid interest on the principal amount to be paid to the date of payment.

SECTION 2.12. Voluntary Prepayment. (a) Subject to Section 2.05(c), the Borrower shall have the right at any time and from time to time to prepay any Borrowing, in whole or in part, upon at least three Business Days’ prior written notice in the case of Eurodollar Loans, or written notice at least one Business Day prior to the date of prepayment in the case of ABR Loans, to the Administrative Agent before 12:00 (noon), New York City time; provided that each partial prepayment shall be in an amount that is an integral multiple of $1,000,000 and not less than $5,000,000.

(b) Each notice of prepayment shall specify the prepayment date and the principal amount of each Borrowing (or portion thereof) to be prepaid, shall be irrevocable and shall commit the Borrower to prepay such Borrowing by the amount stated therein on the date stated therein; provided that such notice may be conditioned upon the effectiveness of any transaction for which the proceeds are to be applied to such prepayment (and revoked if such condition is unsatisfied) or the Borrower may extend the prepayment date by not more than five Business Days; provided, further that the provisions of Section 2.16 shall apply with respect to any such revocation or extension. All prepayments under this Section shall be subject to Section 2.05(c) and Section 2.16 but otherwise without premium or penalty. All prepayments under this Section shall be accompanied by accrued and unpaid interest on the principal amount to be prepaid to but excluding the date of payment.

SECTION 2.13. Mandatory Prepayments. (a) Not later than the fifth Business Day following the receipt of Net Cash Proceeds in respect of any Asset Sale or Casualty Event, the Borrower shall apply 100% of the Net Cash Proceeds received with respect thereto to prepay outstanding Term Loans.

(b) On each occasion that an Equity Issuance occurs at Valuation of less than $2,000,000,000, the Borrower shall, substantially simultaneously with (and in any event not later than the third Business Day next following) the occurrence of such Equity Issuance, apply 100% of the Net Cash Proceeds therefrom to prepay outstanding Term Loans.

(c) In the event that any Loan Party or any subsidiary of a Loan Party shall receive Net Cash Proceeds from the issuance or incurrence of Indebtedness for money borrowed of any Loan Party or any subsidiary of a Loan Party (other than any cash proceeds from the issuance of Indebtedness for money borrowed permitted pursuant to Section 6.01), the Borrower shall, substantially simultaneously with (and in any event not later than the third Business Day next following) the receipt of such Net Cash Proceeds by such Loan Party or such subsidiary, apply an amount equal to 100% of such Net Cash Proceeds to prepay outstanding Term Loans.

(d) In the event that any Loan Party shall receive Net Cash Proceeds from any Extraordinary Receipt, the Borrower shall, substantially simultaneously with (and in any event not

 

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later than the third Business Day next following) the receipt of such Net Cash Proceeds by such Loan Party, apply an amount equal to 100% of such Net Cash Proceeds to prepay outstanding Term Loans.

(e) The Borrower shall deliver to the Administrative Agent, at the time of each prepayment required under this Section, (i) a certificate signed by a Financial Officer of the Borrower setting forth in reasonable detail the calculation of the amount of such prepayment and (ii) to the extent practicable, at least three days’ prior written notice of such prepayment. Each notice of prepayment shall specify the prepayment date, the Type of each Loan being prepaid and the principal amount of each Loan (or portion thereof) to be prepaid. All prepayments of Borrowings under this Section shall be subject to Section 2.05(c) and Section 2.16, but shall otherwise be without premium or penalty, and shall be accompanied by accrued and unpaid interest on the principal amount to be prepaid to but excluding the date of payment.

SECTION 2.14. Reserve Requirements; Change in Circumstances. (a) Notwithstanding any other provision of this Agreement, if any Change in Law shall (i) impose, modify or deem applicable any reserve, special deposit, compulsory loan, insurance charge or similar requirement against assets of, deposits with or for the account of or credit extended or participated in by any Lender (except any such reserve requirement which is reflected in the Adjusted LIBO Rate); (ii) subject any Recipient to any Taxes (other than (A) Indemnified Taxes, (B) Taxes described in clauses (b) through (d) of the definition of Excluded Taxes and (C) Connection Income Taxes) on its loans, loan principal, commitments or other obligations, or its deposits, reserves, other liabilities or capital attributable thereto; or (iii) impose on any Lender or the London interbank market any other condition, cost or expense (other than Taxes) affecting this Agreement or Eurodollar Loans made by such Lender, and the result of any of the foregoing shall be to increase the cost to such Lender of making or maintaining any Eurodollar Loan or to reduce the amount of any sum received or receivable by such Lender hereunder (whether of principal, interest or otherwise) by an amount deemed by such Lender to be material, then the Borrower will pay to such Lender upon demand such additional amount or amounts as will compensate such Lender for such additional costs incurred or reduction suffered.

(b) If any Lender shall have determined that any Change in Law affecting such Lender or any lending office of such Lender or such Person’s holding company, if any, regarding capital adequacy or liquidity requirements has or would have the effect of reducing the rate of return on such Lender’s capital or on the capital of such Lender’s holding company, if any, as a consequence of this Agreement or the Loans made to a level below that which such Lender or such Lender’s holding company could have achieved but for such Change in Law (taking into consideration such Lender’s policies and the policies of such Lender’s holding company with respect to capital adequacy) by an amount deemed by such Lender to be material, then from time to time the Borrower shall pay to such Lender such additional amount or amounts as will compensate such Lender or such Lender’s holding company for any such reduction suffered.

(c) A certificate of a Lender setting forth the amount or amounts necessary to compensate such Lender or its holding company, as applicable, as specified in clause (a) or (b) above shall be delivered to the Borrower and shall be conclusive absent manifest error. The Borrower shall pay such Lender the amount shown as due on any such certificate delivered by it within ten days after its receipt of the same.

 

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(d) Failure or delay on the part of any Lender to demand compensation pursuant to this Section shall not constitute a waiver of such Lender’s right to demand such compensation; provided that the Borrower shall not be under any obligation to compensate any Lender under clause (a) or (b) above with respect to increased costs or reductions with respect to any period prior to the date that is 120 days prior to such request if such Lender knew or could reasonably have been expected to know of the circumstances giving rise to such increased costs or reductions and of the fact that such circumstances would result in a claim for increased compensation by reason of such increased costs or reductions; provided further that the foregoing limitation shall not apply to any increased costs or reductions arising out of the retroactive application of any Change in Law within such 120-day period.

SECTION 2.15. Change in Legality. (a) Notwithstanding any other provision of this Agreement, if any Change in Law shall make it unlawful for any Lender to make or maintain any Eurodollar Loan or to give effect to its obligations as contemplated hereby with respect to any Eurodollar Loan, then, by written notice to the Borrower and to the Administrative Agent:

(i) such Lender may declare that Eurodollar Loans will not thereafter (for the duration of such unlawfulness) be made by such Lender hereunder (or be continued for additional Interest Periods) and ABR Loans will not thereafter (for such duration) be converted into Eurodollar Loans, whereupon any request for a Eurodollar Borrowing (or to convert an ABR Borrowing to a Eurodollar Borrowing or to continue a Eurodollar Borrowing for an additional Interest Period) shall, as to such Lender only, be deemed a request for an ABR Loan (or a request to continue an ABR Loan as such for an additional Interest Period or to convert a Eurodollar Loan into an ABR Loan, as the case may be), unless such declaration shall be subsequently withdrawn; and

(ii) such Lender may require that all outstanding Eurodollar Loans made by it be converted to ABR Loans, in which event all such Eurodollar Loans shall be automatically converted to ABR Loans as of the effective date of such notice as provided in clause (b) below.

In the event any Lender shall exercise its rights under sub-clause (i) or (ii) above, all payments and prepayments of principal that would otherwise have been applied to repay the Eurodollar Loans that would have been made by such Lender or the converted Eurodollar Loans of such Lender shall instead be applied to repay the ABR Loans made by such Lender in lieu of, or resulting from the conversion of, such Eurodollar Loans.

(b) For purposes of this Section, a notice to the Borrower by any Lender shall be effective as to each Eurodollar Loan made by such Lender, if lawful, on the last day of the Interest Period then applicable to such Eurodollar Loan; in all other cases such notice shall be effective on the date of receipt by the Borrower.

SECTION 2.16. Breakage. The Borrower shall indemnify each Lender against any actual loss or expense (excluding loss of profit) that such Lender may sustain or incur as a consequence of (a) any event, other than a default by such Lender in the performance of its obligations hereunder, which results in (i) such Lender receiving or being deemed to receive any amount on account of the principal of any Eurodollar Loan prior to the end of the Interest Period

 

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in effect therefor, (ii) the conversion of any Eurodollar Loan to an ABR Loan, or the conversion of the Interest Period with respect to any Eurodollar Loan, in each case other than on the last day of the Interest Period in effect therefor, or (iii) any Eurodollar Loan to be made by such Lender (including any Eurodollar Loan to be made pursuant to a conversion or continuation under Section 2.10) not being made after notice of such Loan shall have been given by the Borrower hereunder (any of the events referred to in this clause (a) being called a “Breakage Event”) or (b) any default in the making of any payment or prepayment required to be made hereunder. In the case of any Breakage Event, such loss shall include an amount equal to the excess, as reasonably determined by such Lender, of (i) its actual cost of obtaining funds for the Eurodollar Loan that is the subject of such Breakage Event for the period from the date of such Breakage Event to the last day of the Interest Period in effect (or that would have been in effect) for such Loan over (ii) the amount of interest likely to be realized by such Lender in redeploying the funds released or not utilized by reason of such Breakage Event for such period. A certificate of any Lender setting forth any amount or amounts which such Lender is entitled to receive pursuant to this Section shall be delivered to the Borrower and shall be conclusive absent manifest error.

SECTION 2.17. Pro Rata Treatment. Subject to the express provisions of this Agreement which require, or permit, differing payments to be made to non-Defaulting Lenders as opposed to Defaulting Lenders, and as required under Section 2.15, each Borrowing, each payment or prepayment of principal of any Borrowing, each payment of interest on the Loans, each reduction of the Term Loan Commitments and each conversion of any Borrowing to or continuation of any Borrowing as a Borrowing of any Type shall be allocated pro rata among the Lenders in accordance with their respective applicable Commitments (or, if such Commitments shall have expired or been terminated, in accordance with the respective principal amounts of their outstanding Loans). Each Lender agrees that in computing such Lender’s portion of any Borrowing to be made hereunder, the Administrative Agent may, in its discretion, round each Lender’s percentage of such Borrowing to the next higher or lower whole Dollar amount.

SECTION 2.18. Sharing of Setoffs. Each Lender agrees that if it shall, through the exercise of a right of banker’s lien, setoff or counterclaim against the Borrower or any other Loan Party, or pursuant to a secured claim under Section 506 of Title 11 of the United States Code or other security or interest arising from, or in lieu of, such secured claim, received by such Lender under any applicable bankruptcy, insolvency or other similar law or otherwise, or by any other means, obtain payment (voluntary or involuntary) in respect of any Loan or Loans as a result of which the unpaid principal portion of its Loans shall be proportionately less than the unpaid principal portion of the Loans of any other Lender, it shall be deemed simultaneously to have purchased from such other Lender at face value, and shall promptly pay to such other Lender the purchase price for, a participation in the Loans of such other Lender, so that the aggregate unpaid principal amount of the Loans and participations in Loans held by each Lender shall be in the same proportion to the aggregate unpaid principal amount of all Loans then outstanding as the principal amount of its Loans prior to such exercise of banker’s lien, setoff or counterclaim or other event was to the principal amount of all Loans outstanding prior to such exercise of banker’s lien, setoff or counterclaim or other event; provided that (i) if any such purchase or purchases or adjustments shall be made pursuant to this Section and the payment giving rise thereto shall thereafter be recovered, such purchase or purchases or adjustments shall be rescinded to the extent of such recovery and the purchase price or prices or adjustment restored without interest, and (ii) the provisions of this Section shall not be construed to apply to any payment made by the Borrower

 

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pursuant to and in accordance with the express terms of this Agreement. The Borrower expressly consents to the foregoing arrangements and agrees that any Lender holding a participation in a Loan deemed to have been so purchased may exercise any and all rights of banker’s lien, setoff or counterclaim with respect to any and all moneys owing by the Borrower to such Lender by reason thereof as fully as if such Lender had made a Loan directly to the Borrower in the amount of such participation.

SECTION 2.19. Payments. (a) Other than with respect to any accrued interest which is capitalized and added to the then outstanding principal amount of the applicable Type of Loans in accordance with Section 2.06(c), the Borrower shall make each payment (including principal of or interest on any Borrowing or any Fees or other amounts) hereunder and under any other Loan Document not later than 12:00 (noon), New York City time, on the date when due in immediately available Dollars, without setoff, defense or counterclaim. Each such payment shall be made to such account as the Administrative Agent may designate. The Administrative Agent shall promptly distribute to each Lender any payments received by the Administrative Agent on behalf of such Lender. Any payments made after 12:00 (noon), New York City time, may, in the Administrative Agent’s discretion, be deemed paid the next day.

(b) Except as otherwise expressly provided herein, whenever any payment (including principal of or interest on any Borrowing or any Fees or other amounts) hereunder or under any other Loan Document shall become due, or otherwise would occur, on a day that is not a Business Day, such payment may be made on the next succeeding Business Day, and such extension of time shall in such case be included in the computation of interest or Fees, if applicable.

SECTION 2.20. Taxes. (a) Any and all payments by or on account of any obligation of any Loan Party under any Loan Document shall be made without deduction or withholding for any Taxes, except as required by applicable law. If any applicable law (as determined in the good faith discretion of an applicable Withholding Agent) requires the deduction or withholding of any Tax from any such payment by a Withholding Agent, then the applicable Withholding Agent shall be entitled to make such deduction or withholding and shall timely pay the full amount deducted or withheld to the relevant Governmental Authority in accordance with applicable law and, if such Tax is an Indemnified Tax, then the sum payable by the applicable Loan Party shall be increased as necessary so that after such deduction or withholding of Indemnified Tax has been made (including such deductions and withholdings applicable to additional sums payable under this Section) the applicable Recipient receives an amount equal to the sum it would have received had no such deduction or withholding of Indemnified Tax been made.

(b) The Loan Parties shall timely pay to the relevant Governmental Authority in accordance with applicable law, or at the option of the Administrative Agent timely reimburse it for the payment of, any Other Taxes.

(c) Without duplication of amounts paid pursuant to Sections 2.20(a) and (b), the Loan Parties shall jointly and severally indemnify each Recipient, within ten days after demand therefor, for the full amount of any Indemnified Taxes (including Indemnified Taxes imposed or asserted on or attributable to amounts payable under this Section) payable or paid by such Recipient or required to be withheld or deducted from a payment to such Recipient and any penalties, interest and reasonable expenses arising therefrom or with respect thereto, whether or not such Indemnified

 

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Taxes were correctly or legally imposed or asserted by the relevant Governmental Authority. A certificate as to the amount of such payment or liability delivered to the Borrower by a Lender (with a copy to the Administrative Agent), or by the Administrative Agent on its own behalf or on behalf of another Recipient, shall be conclusive absent manifest error.

(d) Each Lender shall severally indemnify the Administrative Agent, within ten days after demand therefor, for (i) any Indemnified Taxes attributable to such Lender (but only to the extent that any Loan Party has not already indemnified the Administrative Agent for such Indemnified Taxes and without limiting the obligation of the Loan Parties to do so), (ii) any Taxes attributable to such Lender’s failure to comply with the provisions of Section 9.04(f) relating to the maintenance of a Participant Register and (iii) any Excluded Taxes attributable to such Lender, in each case, that are payable or paid by the Administrative Agent in connection with any Loan Document, and any reasonable expenses arising therefrom or with respect thereto, whether or not such Taxes were correctly or legally imposed or asserted by the relevant Governmental Authority. A certificate as to the amount of such payment or liability delivered to any Lender by the Administrative Agent shall be conclusive absent manifest error. Each Lender hereby authorizes the Administrative Agent to set off and apply any and all amounts at any time owing to such Lender under any Loan Document or otherwise payable by the Administrative Agent to the Lender from any other source against any amount due to the Administrative Agent under this clause (d).

(e) As soon as practicable after any payment of Taxes by any Loan Party to a Governmental Authority pursuant to this Section, such Loan Party shall deliver to the Administrative Agent the original or a certified copy of a receipt issued by such Governmental Authority evidencing such payment, a copy of the return reporting such payment or other evidence of such payment reasonably satisfactory to the Administrative Agent.

(f) (i) Any Lender that is entitled to an exemption from or reduction of withholding Tax with respect to payments made under any Loan Document shall deliver to the Borrower and the Administrative Agent, at the time or times reasonably requested by the Borrower or the Administrative Agent, such properly completed and executed documentation reasonably requested by the Borrower or the Administrative Agent as will permit such payments to be made without withholding or at a reduced rate of withholding. In addition, any Lender, if reasonably requested by the Borrower or the Administrative Agent, shall deliver such other documentation prescribed by applicable law or reasonably requested by the Borrower or the Administrative Agent as will enable the Borrower or the Administrative Agent to determine whether or not such Lender is subject to backup withholding or information reporting requirements. Notwithstanding anything to the contrary in the preceding two sentences, the completion, execution and submission of such documentation (other than such documentation set forth in Section 2.20(f)(ii)(A), 2.20(f)(ii)(B) and 2.20(f)(ii)(D) below) shall not be required if in the Lender’s reasonable judgment such completion, execution or submission would subject such Lender to any material unreimbursed cost or expense or would materially prejudice the legal or commercial position of such Lender.

(ii) Without limiting the generality of the foregoing, in the event that the Borrower is a U.S. Person,

(A) any Lender that is a U.S. Person shall deliver to the Borrower and the Administrative Agent on or prior to the date on which such Lender becomes a

 

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Lender under this Agreement (and from time to time thereafter upon the reasonable request of the Borrower or the Administrative Agent), executed originals of IRS Form W-9 certifying that such Lender is exempt from U.S. Federal backup withholding tax;

(B) any Foreign Lender shall, to the extent it is legally entitled to do so, deliver to the Borrower and the Administrative Agent (in such number of copies as shall be requested by the recipient) on or prior to the date on which such Foreign Lender becomes a Lender under this Agreement (and from time to time thereafter upon the reasonable request of the Borrower or the Administrative Agent), whichever of the following is applicable:

(i) in the case of a Foreign Lender claiming the benefits of an income tax treaty to which the United States is a party (x) with respect to payments of interest under any Loan Document, executed originals of IRS Form W-8BEN or IRS Form W-8BEN-E establishing an exemption from, or reduction of, U.S. Federal withholding Tax pursuant to the “interest” article of such tax treaty and (y) with respect to any other applicable payments under any Loan Document, IRS Form W-8BEN or IRS Form W-8BEN-E establishing an exemption from, or reduction of, U.S. Federal withholding Tax pursuant to the “business profits” or “other income” article of such tax treaty;

(ii) executed originals of IRS Form W-8ECI;

(iii) in the case of a Foreign Lender claiming the benefits of the exemption for portfolio interest with respect to interest under Section 881(c) of the Code, (x) a certificate substantially in the form of Exhibit G-1 to the effect that such Foreign Lender is not a “bank” within the meaning of Section 881(c)(3)(A) of the Code, a “10 percent shareholder” of the Borrower within the meaning of Section 881(c)(3)(B) of the Code, or a “controlled foreign corporation” described in Section 881(c)(3)(C) of the Code (a “U.S. Tax Compliance Certificate”) and (y) executed originals of IRS Form W-8BEN; or

(iv) to the extent a Foreign Lender is not the beneficial owner, executed originals of IRS Form W-8IMY, accompanied by IRS Form W-8ECI, IRS Form W-8BEN, IRS Form W-8BEN-E, a U.S. Tax Compliance Certificate substantially in the form of Exhibit G-2 or Exhibit G-3, IRS Form W-9, and/or other certification documents from each beneficial owner, as applicable; provided that if the Foreign Lender is a partnership and one or more direct or indirect partners of such Foreign Lender are claiming the portfolio interest exemption, such Foreign Lender may provide a U.S. Tax Compliance Certificate substantially in the form of Exhibit G-4 on behalf of each such direct and indirect partner;

 

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(C) any Foreign Lender shall, to the extent it is legally entitled to do so, deliver to the Borrower and the Administrative Agent (in such number of copies as shall be requested by the recipient) on or prior to the date on which such Foreign Lender becomes a Lender under this Agreement (and from time to time thereafter upon the reasonable request of the Borrower or the Administrative Agent), executed originals of any other form prescribed by applicable law as a basis for claiming exemption from or a reduction in U.S. Federal withholding Tax, duly completed, together with such supplementary documentation as may be prescribed by applicable law to permit the Borrower or the Administrative Agent to determine the withholding or deduction required to be made; and

(D) if a payment made to a Recipient under any Loan Document would be subject to U.S. Federal withholding Tax imposed by FATCA if such Recipient were to fail to comply with the applicable reporting requirements of FATCA (including those contained in Section 1471(b) or 1472(b) of the Code, as applicable), such Recipient shall deliver to the Borrower and the Administrative Agent at the time or times prescribed by law and at such time or times reasonably requested by the Borrower or the Administrative Agent such documentation prescribed by applicable law (including as prescribed by Section 1471(b)(3)(C)(i) of the Code) and such additional documentation reasonably requested by the Borrower or the Administrative Agent as may be necessary for the Borrower and the Administrative Agent to comply with their obligations under FATCA and to determine that such Recipient has complied with such Recipient’s obligations under FATCA or to determine the amount to deduct and withhold from such payment. Solely for purposes of this clause (D), “FATCA” shall include any amendments made to FATCA after the date of this Agreement.

(iii) the Administrative Agent, and any successor or supplemental Administrative Agent, shall deliver to the Borrower either (A) a duly executed and valid IRS Form W-9 establishing that such person is not subject to U.S. backup withholding and may receive payments from the Borrower without deduction or withholding of any Taxes imposed by the United States or (B) a duly completed IRS Form W-8IMY, with the effect that the Borrower may make payments to the Administrative Agent, to the extent such payments are received by the Administrative Agent as an intermediary, without deduction or withholding of any Taxes imposed by the United States; provided that neither the Administrative Agent, nor any successor or supplemental Administrative Agent shall be required to deliver any such form to the extent that, due to a change in law occurring after the date hereof, such person is not legally permitted to deliver such form. As of the date hereof, the Administrative Agent has delivered to the Borrower a duly executed and valid IRS Form W-9 establishing that it is not subject to U.S. backup withholding.

Each Lender agrees that if any form or certification it previously delivered expires or becomes obsolete or inaccurate in any respect, it shall update such form or certification or promptly notify the Borrower and the Administrative Agent in writing of its legal inability to do so.

(g) If any party determines, in its sole discretion exercised in good faith, that it has received a refund of any Taxes as to which it has been indemnified pursuant to this Section

 

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(including by the payment of additional amounts pursuant to this Section), it shall pay to the indemnifying party an amount equal to such refund (but only to the extent of indemnity payments made under this Section with respect to the Taxes giving rise to such refund), net of all out-of-pocket expenses (including Taxes) of such indemnified party and without interest (other than any interest paid by the relevant Governmental Authority with respect to such refund). Such indemnifying party, upon the request of such indemnified party, shall repay to such indemnified party the amount paid over pursuant to this clause (g) (plus any penalties, interest or other charges imposed by the relevant Governmental Authority) in the event that such indemnified party is required to repay such refund to such Governmental Authority. Notwithstanding anything to the contrary in this clause (g), in no event will the indemnified party be required to pay any amount to an indemnifying party pursuant to this clause (g) the payment of which would place the indemnified party in a less favorable net after-Tax position than the indemnified party would have been in if the Tax subject to indemnification and giving rise to such refund had not been deducted, withheld or otherwise imposed and the indemnification payments or additional amounts with respect to such refund had never been paid. This clause shall not be construed to require any indemnified party to make available its Tax returns (or any other information relating to its Taxes that it deems confidential) to the indemnifying party or any other Person.

(h) Each party’s obligations under this Section shall survive the resignation or replacement of the Administrative Agent or any assignment of rights by, or the replacement of, a Lender, the termination of the Commitments and the repayment, satisfaction or discharge of all obligations under any Loan Document.

SECTION 2.21. Assignment of Commitments Under Certain Circumstances; Duty to Mitigate. (a) In the event (i) any Lender delivers a certificate requesting compensation pursuant to Section 2.14, (ii) any Lender delivers a notice described in Section 2.15, (iii) the Borrower is required to pay any additional amount to any Lender or any Governmental Authority on account of any Lender pursuant to Section 2.20, (iv) any Lender refuses to consent to any amendment, waiver or other modification of any Loan Document requested by the Borrower that requires the consent of a greater percentage of the Lenders than the Required Lenders and such amendment, waiver or other modification is consented to by the Required Lenders, or (v) any Lender is a Defaulting Lender, then, in each case, the Borrower may, at its sole expense and effort (including with respect to the processing and recordation fee referred to in Section 9.04(b)), upon notice to such Lender and the Administrative Agent, require such Lender to transfer and assign, without recourse (in accordance with and subject to the restrictions contained in Section 9.04), all of its interests, rights and obligations under this Agreement (or, in the case of clause (iv) above, all of its interests, rights and obligation with respect to the Loans or Commitments that is the subject of the related consent, amendment, waiver or other modification) to an Eligible Assignee that shall assume such assigned obligations and, with respect to clause (iv) above, shall consent to such requested amendment, waiver or other modification of any Loan Documents (which assignee may be another Lender, if a Lender accepts such assignment); provided that (x) such assignment shall not conflict with any law, rule or regulation or order of any court or other Governmental Authority having jurisdiction, (y) the Borrower shall have received the prior written consent of the Administrative Agent, which consent shall not unreasonably be withheld or delayed, and (z) the Borrower or such assignee shall have paid to the affected Lender in immediately available funds an amount equal to the sum of the principal of and interest accrued to the date of such payment on the outstanding Loans of such Lender, plus all Fees and other amounts accrued for the account of

 

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such Lender hereunder with respect thereto (including any amounts under Sections 2.14 and 2.16 and any Early Payment Fee pursuant to Section 2.05(c), with such assignment being deemed to be a voluntary prepayment for purposes of determining the applicability of Section 2.05(c), such amount to be payable by the Borrower); provided, further that, if prior to any such transfer and assignment the circumstances or event that resulted in such Lender’s claim for compensation under Section 2.14, notice under Section 2.15 or the amounts paid pursuant to Section 2.20, as the case may be, cease to cause such Lender to suffer increased costs or reductions in amounts received or receivable or reduction in return on capital, or cease to have the consequences specified in Section 2.15, or cease to result in amounts being payable under Section 2.20, as the case may be (including as a result of any action taken by such Lender pursuant to clause (b) below), or if such Lender shall waive its right to claim further compensation under Section 2.14 in respect of such circumstances or event or shall withdraw its notice under Section 2.15 or shall waive its right to further payments under Section 2.20 in respect of such circumstances or event or shall consent to the proposed amendment, waiver, consent or other modification or shall cease to be a Defaulting Lender, as the case may be, then such Lender shall not thereafter be required to make any such transfer and assignment hereunder. Each Lender hereby grants to the Administrative Agent an irrevocable power of attorney (which power is coupled with an interest) to execute and deliver, on behalf of such Lender, as assignor, any Assignment and Acceptance necessary to effectuate any assignment of such Lender’s interests hereunder in the circumstances contemplated by this Section.

(b) If (i) any Lender shall request compensation under Section 2.14, (ii) any Lender delivers a notice described in Section 2.15 or (iii) the Borrower is required to pay any additional amount to any Lender or any Governmental Authority on account of any Lender, pursuant to Section 2.20, then such Lender shall use reasonable efforts (which shall not require such Lender to incur an unreimbursed loss or unreimbursed cost or expense or otherwise take any action inconsistent with its internal policies or legal or regulatory restrictions or suffer any disadvantage or burden deemed by it to be significant) (x) to file any certificate or document reasonably requested in writing by the Borrower or (y) to assign its rights and delegate and transfer its obligations hereunder to another of its offices, branches or affiliates, if such filing or assignment would reduce its claims for compensation under Section 2.14 or enable it to withdraw its notice pursuant to Section 2.15 or would reduce amounts payable pursuant to Section 2.20, as the case may be, in the future. The Borrower hereby agrees to pay all reasonable costs and expenses incurred by any Lender in connection with any such filing or assignment, delegation and transfer.

SECTION 2.22. Defaulting Lenders. (a) Notwithstanding anything to the contrary contained in this Agreement, if any Lender becomes a Defaulting Lender, then, until such time as such Lender is no longer a Defaulting Lender, to the extent permitted by applicable law:

(i) Such Defaulting Lender’s right to approve or disapprove any amendment, waiver or consent with respect to this Agreement shall be restricted as set forth in the definition of Required Lenders.

(ii) Any payment of principal, interest, fees or other amounts received by the Administrative Agent for the account of such Defaulting Lender (whether voluntary or mandatory, at maturity, pursuant to Article VII or otherwise) or received by the Administrative Agent from a Defaulting Lender pursuant to Section 9.06 shall be applied

 

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at such time or times as may be determined by the Administrative Agent as follows: first, to the payment of any amounts owing by such Defaulting Lender to the Administrative Agent hereunder; second, as the Borrower may request (so long as no Default or Event of Default exists), to the funding of any Loan in respect of which such Defaulting Lender has failed to fund its portion thereof as required by this Agreement, as determined by the Administrative Agent; third, if so determined by the Administrative Agent and the Borrower, to be held in a deposit account and released pro rata in order to satisfy such Defaulting Lender’s potential future funding obligations with respect to Loans under this Agreement; fourth, to the payment of any amounts owing to the Lenders as a result of any judgment of a court of competent jurisdiction obtained by any Lender against such Defaulting Lender as a result of such Defaulting Lender’s breach of its obligations under this Agreement; fifth, so long as no Default or Event of Default exists, to the payment of any amounts owing to the Borrower as a result of any judgment of a court of competent jurisdiction obtained by the Borrower against such Defaulting Lender as a result of such Defaulting Lender’s breach of its obligations under this Agreement; and sixth, to such Defaulting Lender or as otherwise directed by a court of competent jurisdiction; provided that if (x) such payment is a payment of the principal amount of any Loans in respect of which such Defaulting Lender has not fully funded its appropriate share, and (y) such Loans were made at a time when the conditions set forth in Sections 4.01 and 4.02 were satisfied or waived, such payment shall be applied solely to pay the Loans of all Non-Defaulting Lenders on a pro rata basis prior to being applied to the payment of any Loans of such Defaulting Lender until such time as all Loans are held by the Lenders pro rata in accordance with the applicable Commitments. Any payments, prepayments or other amounts paid or payable to a Defaulting Lender that are applied (or held) to pay amounts owed by a Defaulting Lender shall be deemed paid to and redirected by such Defaulting Lender, and each Lender irrevocably consents hereto.

(b) If the Borrower and the Administrative Agent agree in writing that a Lender is no longer a Defaulting Lender, the Administrative Agent will so notify the parties hereto, whereupon as of the effective date specified in such notice and subject to any conditions set forth therein, that Lender will, to the extent applicable, purchase at par that portion of outstanding Loans of the other Lenders or take such other actions as the Administrative Agent may determine to be necessary to cause the Loans to be held pro rata by the Lenders in accordance with the applicable Commitments, whereupon such Lender will cease to be a Defaulting Lender; provided that no adjustments will be made retroactively with respect to fees accrued or payments made by or on behalf of the Borrower while that Lender was a Defaulting Lender; and provided, further, that except to the extent otherwise expressly agreed by the affected parties, no change hereunder from Defaulting Lender to Lender will constitute a waiver or release of any claim of any party hereunder arising from that Lender’s having been a Defaulting Lender.

ARTICLE III

Representations and Warranties

The Borrower represents and warrants to the Administrative Agent and each of the Lenders that:

 

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SECTION 3.01. Organization; Powers. The Borrower and each of the Subsidiaries (a) is duly organized, validly existing and in good standing under the laws of the jurisdiction of its organization, (b) has all requisite power and authority to own its property and assets and to carry on its business as now conducted and as proposed to be conducted, (c) is qualified to do business in, and is in good standing in, every jurisdiction where such qualification is required, except where the failure so to qualify could not reasonably be expected to result in a Material Adverse Effect, and (d) has the power and authority to execute, deliver and perform its obligations under each of the Loan Documents and each other agreement or instrument contemplated thereby to which it is or will be a party and, in the case of the Borrower, to borrow hereunder.

SECTION 3.02. Authorization. The Transactions (a) have been duly authorized by all requisite corporate and, if required, stockholder action and (b) will not (i) violate (A) any provision of law, statute, rule or regulation in any material respect, (B) the certificate or articles of incorporation or other constitutive documents or by-laws of the Borrower or any Subsidiary, (B) any order of any Governmental Authority or (C) any provision of any material indenture, agreement or other instrument to which the Borrower or any Subsidiary is a party or by which any of them or any of their property is or may be bound, (ii) be in conflict with, result in a breach of or constitute (alone or with notice or lapse of time or both) a default under, or give rise to any right to accelerate or to require the prepayment, repurchase or redemption of any obligation under any such material indenture, agreement or other instrument or (iii) result in the creation or imposition of any Lien upon or with respect to any property or assets now owned or hereafter acquired by the Borrower or any Subsidiary (other than any Lien created hereunder or under the Security Documents).

SECTION 3.03. Enforceability. This Agreement has been duly executed and delivered by the Borrower and constitutes, and each other Loan Document when executed and delivered by each Loan Party that is a party thereto will constitute, a legal, valid and binding obligation of such Loan Party enforceable against such Loan Party in accordance with its terms.

SECTION 3.04. Governmental Approvals. No action, consent or approval of, registration or filing with or any other action by any Governmental Authority is or will be required in connection with the Transactions, except for (a) the filing of Uniform Commercial Code financing statements and filings with the United States Patent and Trademark Office and the United States Copyright Office and (b) such as have been made or obtained and are in full force and effect.

SECTION 3.05. Financial Statements. (a) The Borrower has heretofore furnished to the Lenders its consolidated balance sheets and related statements of income, stockholder’s equity and cash flows (i) as of and for the fiscal year ended December 31, 2019, audited by and accompanied by the opinion of Deloitte & Touche LLP, independent public accountants, (ii) as of and for the fiscal quarter and the portion of the fiscal year ended June 30, 2020, certified by its chief financial officer and (iii) as of and for the fiscal month ended July 31, 2020, certified by its chief financial officer. Such financial statements present fairly the financial condition and results of operations and cash flows of the Borrower and its consolidated Subsidiaries as of such dates and for such periods in all material respects. Such balance sheets and the notes thereto disclose all material liabilities, direct or contingent, of the Borrower and its consolidated Subsidiaries as of the dates thereof. Such financial statements were prepared in accordance with GAAP applied on a consistent basis, subject, in the case of unaudited financial statements, to year-end audit adjustments and the absence of footnotes.

 

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(b) The Statutory Statements of each of the Regulated Insurance Companies (including the provisions made therein for investments and the valuation thereof, reserves, policy and contract claims and statutory liabilities) as filed with the Applicable Insurance Regulatory Authority of the state in which such Regulated Insurance Company is domiciled and delivered to the Administrative Agent prior to the Closing Date have been prepared in accordance with SAP consistently applied. Each such Statutory Statement was in material compliance with applicable law when filed.

SECTION 3.06. No Material Adverse Change. No event, change or condition has occurred that has had, or could reasonably be expected to have, a Material Adverse Effect, since December 31, 2019.

SECTION 3.07. Title to Properties; Possession Under Leases. (a) Each of the Borrower and the Subsidiaries has good and marketable title to, or valid leasehold interests in, all its material properties and assets, except for minor defects in title that do not interfere with its ability to conduct its business as currently conducted or to utilize such properties and assets for their intended purposes. All such material properties and assets are free and clear of Liens, other than Liens expressly permitted by Section 6.02.

(b) Each of the Borrower and the Subsidiaries has complied in all material respects with all obligations under all material leases to which it is a party and all such leases are in full force and effect. Each of the Borrower and the Subsidiaries enjoys peaceful and undisturbed possession under all such material leases.

SECTION 3.08. Subsidiaries. Schedule 3.08 sets forth as of the Closing Date a list of all Subsidiaries and the percentage ownership interest of the Borrower therein. The shares of capital stock or other ownership interests so indicated on Schedule 3.08 are fully paid and non-assessable and are owned by the Borrower, directly or indirectly, free and clear of all Liens (other than Liens created under the Security Documents).

SECTION 3.09. Litigation; Compliance With Laws. (a) Except as set forth on Schedule 3.09, there are no actions, suits or proceedings at law or in equity or by or before any Governmental Authority now pending or, to the knowledge of the Borrower, threatened against or affecting the Borrower or any Subsidiary or any business, property or rights of any such Person (i) that involve any Loan Document or the Transactions or (ii) as to which there is a reasonable possibility of an adverse determination and that, if adversely determined, could reasonably be expected, individually or in the aggregate, to result in a Material Adverse Effect.

(b) Since the date of this Agreement, there has been no change in the status of the matters disclosed on Schedule 3.09 that, individually or in the aggregate, has resulted in, or materially increased the likelihood of, a Material Adverse Effect.

(c) None of the Borrower or any of the Subsidiaries or any of their respective material properties or assets is in violation of, nor will the continued operation of their material properties and assets as currently conducted violate, any law, rule or regulation (including any Healthcare Law, any zoning, building, Environmental Law, ordinance, code or approval or any building permits), or is in default with respect to any judgment, writ, injunction, decree or order of any Governmental Authority.

 

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SECTION 3.10. Agreements. (a) None of the Borrower or any of the Subsidiaries is a party to any agreement or instrument or subject to any corporate restriction that has resulted or could reasonably be expected to result in a Material Adverse Effect.

(b) None of the Borrower or any of the Subsidiaries is in default in any manner under any provision of any indenture or other agreement or instrument evidencing Indebtedness, or any other material agreement or instrument to which it is a party or by which it or any of its properties or assets are or may be bound, where such default could reasonably be expected to result in a Material Adverse Effect.

SECTION 3.11. Federal Reserve Regulations. (a) None of the Borrower or any of the Subsidiaries is engaged principally, or as one of its important activities, in the business of extending credit for the purpose of buying or carrying Margin Stock.

(b) No part of the proceeds of any Loan will be used, whether directly or indirectly, and whether immediately, incidentally or ultimately, for any purpose that entails a violation of, or that is inconsistent with, the provisions of the Regulations of the Board, including Regulation T, U or X.

SECTION 3.12. Investment Company Act. None of the Borrower or any Subsidiary is an “investment company” as defined in, or subject to regulation under, the Investment Company Act of 1940.

SECTION 3.13. Use of Proceeds. The Borrower will use the proceeds of the Loans only for the purposes specified in the introductory statement to this Agreement.

SECTION 3.14. Tax Returns. Each of the Borrower and the Subsidiaries has filed or caused to be filed all Federal, state, local and foreign tax returns or materials required to have been filed by it and has paid or caused to be paid all taxes due and payable by it and all assessments received by it, except (i) taxes that are being contested in good faith by appropriate proceedings and for which the Borrower or such Subsidiary, as applicable, shall have set aside on its books adequate reserves; and (ii) taxes the non-payment of which would not reasonably be expected to have any material effect on the Borrower and its Subsidiaries.

SECTION 3.15. No Material Misstatements. No information, report, financial statement, exhibit or schedule furnished by or on behalf of the Borrower to the Administrative Agent or any Lender in connection with the negotiation of any Loan Document or included therein or delivered pursuant thereto contained, contains or will contain any material misstatement of fact or omitted, omits or will omit to state any material fact necessary to make the statements therein, in the light of the circumstances under which they were, are or will be made, not misleading; provided that to the extent any such information, report, financial statement, exhibit or schedule was based upon or constitutes a forecast or projection, the Borrower represents only that it acted in good faith and utilized reasonable assumptions (based upon accounting principles consistent with the historical audited financial statements of the Borrower) and due care in the preparation of such information, report, financial statement, exhibit or schedule.

 

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SECTION 3.16. Employee Benefit Plans. Each of the Borrower and its ERISA Affiliates is in compliance in all material respects with the applicable provisions of ERISA and the Code and the regulations and published interpretations thereunder. No ERISA Event has occurred or is reasonably expected to occur that, when taken together with all other such ERISA Events, could reasonably be expected to result in material liability to the Borrower or any of its ERISA Affiliates. The present value of all benefit liabilities of all underfunded Plans (based on the assumptions used for purposes of Statement of Financial Accounting Standards No. 87, as amended) did not, as of the last annual valuation dates applicable thereto, exceed by more than $2,500,000 the fair market value of the assets of all such underfunded Plans.

SECTION 3.17. Environmental Matters. (a) Except as set forth in Schedule 3.17 and except with respect to any other matters that, individually or in the aggregate, could not reasonably be expected to result in a Material Adverse Effect, none of the Borrower or the Subsidiaries (i) has failed to comply with any Environmental Law or to obtain, maintain or comply with any permit, license or other approval required under any Environmental Law, (ii) has become subject to any Environmental Liability, (iii) has received notice of any claim with respect to any Environmental Liability or (iv) knows of any basis for any Environmental Liability.

(b) Since the date of this Agreement, there has been no change in the status of the matters disclosed on Schedule 3.17 that, individually or in the aggregate, has resulted in, or materially increased the likelihood of, a Material Adverse Effect.

SECTION 3.18. Insurance. Schedule 3.18 sets forth a true, complete and correct description of all insurance maintained by the Borrower or by the Borrower for its Subsidiaries as of the date hereof and the Closing Date. As of each such date, such insurance is in full force and effect and all premiums have been duly paid. The Borrower and its Subsidiaries have insurance in such amounts and covering such risks and liabilities as are in accordance with normal industry practice.

SECTION 3.19. Security Documents. (a) The Guarantee and Collateral Agreement, upon execution and delivery thereof by the parties thereto, will create in favor of the Administrative Agent, for the ratable benefit of the Secured Parties, a legal, valid and enforceable security interest in the Collateral (as defined in the Guarantee and Collateral Agreement) and the proceeds thereof and (i) when the Pledged Collateral (as defined in the Guarantee and Collateral Agreement) is delivered to the Administrative Agent, the Lien created under the Guarantee and Collateral Agreement shall constitute a fully perfected first priority Lien on, and security interest in, all right, title and interest of the Loan Parties in such Pledged Collateral, in each case prior and superior in right to any other Person, and (ii) when financing statements in appropriate form are filed in the offices specified on Schedule 3.19(a), the Lien created under the Guarantee and Collateral Agreement will constitute a fully perfected Lien on, and security interest in, all right, title and interest of the Loan Parties in such Collateral (other than Intellectual Property, as defined in the Guarantee and Collateral Agreement), in each case prior and superior in right to any other Person, other than with respect to Liens expressly permitted by Section 6.02.

(b) Upon the recordation of the Guarantee and Collateral Agreement (or a short-form security agreement in form and substance reasonably satisfactory to the Borrower and the Administrative Agent) with the United States Patent and Trademark Office and the United States

 

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Copyright Office, together with the financing statements in appropriate form filed in the offices specified on Schedule 3.19(a), the Lien created under the Guarantee and Collateral Agreement shall constitute a fully perfected Lien on, and security interest in, all right, title and interest of the Loan Parties in the Intellectual Property (as defined in the Guarantee and Collateral Agreement) in which a security interest may be perfected by filing in the United States and its territories and possessions, in each case prior and superior in right to any other Person (it being understood that subsequent recordings in the United States Patent and Trademark Office and the United States Copyright Office may be necessary to perfect a Lien on registered trademarks and patents, trademark and patent applications and registered copyrights acquired by the Loan Parties after the date hereof).

SECTION 3.20. Location of Real Property and Leased Premises. (a) Schedule 3.20(a) lists completely and correctly as of the Closing Date all real property owned by the Borrower and the Subsidiaries and the addresses thereof. The Borrower and the Subsidiaries own in fee all the real property set forth on Schedule 3.20(a).

(b) Schedule 3.20(b) lists completely and correctly as of the Closing Date all real property leased by the Borrower and the Subsidiaries and the addresses thereof. The Borrower and the Subsidiaries have valid leases in all the real property set forth on Schedule 3.20(b).

SECTION 3.21. Labor Matters. As of the date hereof and the Closing Date, there are no strikes, lockouts or slowdowns against the Borrower or any Subsidiary pending or, to the knowledge of the Borrower, threatened. Except as could not reasonably be expected to result in a Material Adverse Effect, the hours worked by and payments made to employees of the Borrower and the Subsidiaries have not been in violation of the Fair Labor Standards Act or any other applicable Federal, state, local or foreign law dealing with such matters, except as could not reasonably be expected to result in a Material Adverse Effect. The consummation of the Transactions will not give rise to any right of termination or right of renegotiation on the part of any union under any collective bargaining agreement to which the Borrower or any Subsidiary is bound.

SECTION 3.22. Solvency. Immediately after the consummation of the Transactions to occur on the Closing Date and immediately following the making of each Loan and after giving effect to the application of the proceeds of each Loan, (a) the fair value of the assets of the Borrower and its Subsidiaries, on a consolidated basis, at a fair valuation, will exceed their debts and liabilities, subordinated, contingent or otherwise; (b) the present fair saleable value of the property of the Borrower and its Subsidiaries, on a consolidated basis, will be greater than the amount that will be required to pay the probable liability of their debts and other liabilities, subordinated, contingent or otherwise, as such debts and other liabilities become absolute and matured; (c) the Borrower and its Subsidiaries, on a consolidated basis, will be able to pay their debts and liabilities, subordinated, contingent or otherwise, as such debts and liabilities become absolute and matured; and (d) the Borrower and its Subsidiaries, on a consolidated basis, will not have unreasonably small capital with which to conduct the business in which they are engaged as such business is now conducted and is proposed to be conducted following the Closing Date.

SECTION 3.23. Insurance Licenses. To the extent required by applicable law, each Regulated Insurance Company holds a License and is authorized to transact Insurance Business in

 

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(a) the line or lines of insurance it is engaged in and (b) the state, states or jurisdictions it transacts business in. No such License is the subject of a proceeding for suspension, limitation or revocation and to the Borrower’s knowledge, no such suspension, limitation or revocation has been threatened by any Applicable Insurance Regulatory Authority or other Governmental Authority. The Regulated Insurance Companies do not transact any business, directly or indirectly, requiring any license, permit, governmental approval, consent or other authorization other than those currently obtained. As of the Closing Date, Schedule 3.23 sets forth a list of all jurisdictions where each Regulated Insurance Company holds Licenses and the lines of insurance associated with such Licenses.

SECTION 3.24. Sanctioned Persons. None of the Borrower or any Subsidiary nor, to the knowledge of the Borrower, any director, officer, agent, employee or Affiliate of the Borrower or any Subsidiary is currently subject to any U.S. sanctions administered by the Office of Foreign Assets Control of the U.S. Treasury Department (“OFAC”); and the Borrower will not directly or indirectly use the proceeds of the Loans or otherwise make available such proceeds to any Person, for the purpose of financing the activities of any Person currently subject to any U.S. sanctions administered by OFAC.

SECTION 3.25. Foreign Corrupt Practices Act. Each of the Borrower and the Subsidiaries and their respective directors, officers, agents, employees and any Person acting for or on behalf of the Borrower or any Subsidiary, has complied with, and will comply with, the U.S. Foreign Corrupt Practices Act, as amended from time to time (the “FCPA”), or any other applicable anti-bribery or anti-corruption law, and it and they have not made, offered, promised or authorized, and will not make, offer, promise or authorize, whether directly or indirectly, any payment, of anything of value to a Government Official while knowing or having a reasonable belief that all or some portion will be used for the purpose of: (a) influencing any act, decision or failure to act by a Government Official in his or her official capacity, (b) inducing a Government Official to use his or her influence with a government or instrumentality to affect any act or decision of such government or entity or (c) securing an improper advantage, in each case in order to obtain, retain or direct business.

ARTICLE IV

Conditions of Lending

The obligations of the Lenders to make Loans hereunder are subject to the satisfaction of the following conditions:

SECTION 4.01. All Borrowings. On the date of each Borrowing (other than a conversion or a continuation of a Borrowing):

(a) The Administrative Agent shall have received a Borrowing Request as required by Section 2.03.

(b) The representations and warranties set forth in Article III and in each other Loan Document shall be true and correct in all material respects on and as of the date of such Borrowing with the same effect as though made on and as of such date, except to the extent such representations and warranties expressly relate to an earlier date.

 

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(c) At the time of and immediately after such Borrowing, no Default or Event of Default shall have occurred and be continuing.

Each Borrowing shall be deemed to constitute a representation and warranty by the Borrower on the date of such Borrowing as to the matters specified in clauses (b) and (c) of this Section.

SECTION 4.02. First Borrowing. On the Closing Date:

(a) The Administrative Agent shall have received, on behalf of itself and the Lenders, a favorable written opinion of Latham & Watkins LLP, counsel for the Borrower, (A) dated the Closing Date, (B) addressed to the Administrative Agent and the Lenders and (C) covering such other matters relating to the Loan Documents and the Transactions as the Administrative Agent shall reasonably request, and the Borrower hereby requests such counsel to deliver such opinions.

(b) All legal matters incident to this Agreement, the Borrowings and extensions of credit hereunder and the other Loan Documents shall be satisfactory to the Lenders and the Administrative Agent.

(c) The Administrative Agent shall have received (i) a copy of the certificate or articles of incorporation, including all amendments thereto, of each Loan Party, certified as of a recent date by the Secretary of State of the state of its organization, and a certificate as to the good standing of each Loan Party as of a recent date, from such Secretary of State; (ii) a certificate of the Secretary or Assistant Secretary of each Loan Party dated the Closing Date and certifying (A) that attached thereto is a true and complete copy of the by-laws of such Loan Party as in effect on the Closing Date and at all times since a date prior to the date of the resolutions described in clause (B) below, (B) that attached thereto is a true and complete copy of resolutions duly adopted by the Board of Directors of such Loan Party authorizing the execution, delivery and performance of the Loan Documents to which such Person is a party and, in the case of the Borrower, the borrowings hereunder, and that such resolutions have not been modified, rescinded or amended and are in full force and effect, (C) that the certificate or articles of incorporation of such Loan Party have not been amended since the date of the last amendment thereto shown on the certificate of good standing furnished pursuant to sub-clause (i) above, and (D) as to the incumbency and specimen signature of each officer executing any Loan Document or any other document delivered in connection herewith on behalf of such Loan Party; (iii) a certificate of another officer as to the incumbency and specimen signature of the Secretary or Assistant Secretary executing the certificate pursuant to sub-clause (ii) above; and (iv) such other documents as the Lenders or the Administrative Agent may reasonably request.

(d) The Administrative Agent shall have received a certificate, dated the Closing Date and signed by a Financial Officer of the Borrower, confirming compliance with the conditions precedent set forth in clauses (b) and (c) of Section 4.01.

(e) The Administrative Agent shall have received all Fees and other amounts due and payable on or prior to the Closing Date, including, to the extent invoiced, reimbursement or payment of all reasonable and documented out-of-pocket expenses required to be reimbursed or paid by the Borrower hereunder or under any other Loan Document.

 

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(f) The Security Documents shall have been duly executed by each Loan Party that is to be a party thereto and shall be in full force and effect on the Closing Date. The Administrative Agent on behalf of the Secured Parties shall have a security interest in the Collateral of the type and priority described in each Security Document.

(g) The Administrative Agent shall have received a Perfection Certificate with respect to the Loan Parties dated the Closing Date and duly executed by a Responsible Officer of the Borrower, and shall have received the results of a search of the Uniform Commercial Code filings (or equivalent filings) made with respect to the Loan Parties in the states (or other jurisdictions) of formation of such Persons, in which the chief executive office of each such Person is located and in the other jurisdictions in which such Persons maintain property, in each case as indicated on such Perfection Certificate, together with copies of the financing statements (or similar documents) disclosed by such search, and accompanied by evidence satisfactory to the Administrative Agent that the Liens indicated in any such financing statement (or similar document) would be permitted under Section 6.02 or have been or will be contemporaneously released or terminated.

(h) The Administrative Agent shall have received a copy of, or a certificate as to coverage under, the insurance policies required by Section 5.02 and the applicable provisions of the Security Documents, each of which (i) shall be reasonably acceptable to the Administrative Agent and (ii) except as otherwise agreed by the Administrative Agent in its sole discretion, shall be endorsed or otherwise amended to include a customary lender’s loss payable endorsement and to name the Administrative Agent as additional insured, in form and substance reasonably satisfactory to the Administrative Agent.

(i) Immediately after giving effect to the Transactions and the other transactions contemplated hereby, the Borrower and the Subsidiaries shall have outstanding no Indebtedness or preferred stock other than (a) Indebtedness outstanding under this Agreement, and (b) Indebtedness set forth on Schedule 6.01.

(j) The Lenders shall have received the financial statements and opinion referred to in Section 3.05, none of which shall demonstrate a material adverse change in the financial condition of the Borrower from (and shall not otherwise be materially inconsistent with) the financial statements or forecasts previously provided to the Lenders.

(k) The Administrative Agent shall have received a certificate from the chief financial officer of the Borrower certifying that each of the Loan Parties after giving effect to the Transactions to occur on the Closing Date, is solvent.

(l) The Administrative Agent shall have received, in form and substance satisfactory to the Administrative Agent, a management rights letter in favor of the Lenders.

(m) All requisite Governmental Authorities (including any Applicable Insurance Regulatory Authority) and third parties shall have approved or consented to the Transactions and the other transactions contemplated hereby to the extent required, all applicable appeal periods shall have expired and there shall not be any pending or threatened litigation, governmental, administrative or judicial action that could reasonably be expected to restrain, prevent or impose burdensome conditions on the Transactions or the other transactions contemplated hereby.

 

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(n) The Administrative Agent and the Lenders shall have received, to the extent requested, at least five Business Days prior to the Closing Date, all documentation, including the applicable IRS Form W-9, an appropriate IRS Form W-8 or such other documentation, and other information required by regulatory authorities under applicable “know your customer” and anti-money laundering rules and regulations, including the USA PATRIOT Act.

ARTICLE V

Affirmative Covenants

The Borrower covenants and agrees with each Lender that so long as this Agreement shall remain in effect and until the Commitments have been terminated and the principal of and interest on each Loan, all Fees and all other expenses or amounts payable under any Loan Document shall have been paid in full, unless the Required Lenders shall otherwise consent in writing, the Borrower will, and will cause each of the Subsidiaries to:

SECTION 5.01. Existence; Compliance with Laws; Businesses and Properties.

(a) Do or cause to be done all things necessary to preserve, renew and keep in full force and effect its legal existence, except as otherwise expressly permitted by Section 6.05.

(b) Do or cause to be done all things necessary to obtain, preserve, renew, extend and keep in full force and effect the rights, Licenses, permits, franchises, authorizations, patents, copyrights, trademarks and trade names material to the conduct of its business; maintain and operate such business in substantially the manner in which it is presently conducted and operated; comply in all material respects with all applicable laws, rules, regulations and decrees and orders of any Governmental Authority, whether now in effect or hereafter enacted; and at all times maintain and preserve all property material to the conduct of such business and keep such property in good repair, working order and condition and from time to time make, or cause to be made, all needful and proper repairs, renewals, additions, improvements and replacements thereto necessary in order that the business carried on in connection therewith may be properly conducted at all times.

(c) Comply in all respects with all Contractual Obligations and Requirements of Law (including ERISA, the USA PATRIOT Act, the FCPA, all Healthcare Laws, any Applicable Insurance Code and all applicable Environmental Laws), except as could not reasonably be expected have any material effect on the Borrower and its Subsidiaries taken as a whole.

SECTION 5.02. Insurance. (a) Keep its insurable properties adequately insured at all times by financially sound and reputable insurers; maintain such other insurance, to such extent and against such risks, including fire and other risks insured against by extended coverage, as is customary with companies in the same or similar businesses operating in the same or similar locations, including public liability insurance against claims for personal injury or death or property damage occurring upon, in, about or in connection with the use of any properties owned, occupied or controlled by it; and maintain such other insurance as may be required by law.

 

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(b) Cause all such policies covering any Collateral to (in each case, unless otherwise agreed to by the Administrative Agent in its sole discretion) (i) name the Administrative Agent, on behalf of the Secured Parties, as an additional insured thereunder, (ii) in the case of each casualty insurance policy, contain a loss payable clause or mortgagee endorsement that names the Administrative Agent, on behalf of the Secured Parties, as the loss payee or mortgagee thereunder and (iii) be endorsed or otherwise amended to provide that, from and after the Closing Date, if the insurance carrier shall have received written notice from the Administrative Agent of the occurrence of an Event of Default, the insurance carrier shall pay all proceeds otherwise payable to the Borrower or any other Loan Party under such policies directly to the Administrative Agent, in each case, in form and substance reasonably satisfactory to the Administrative Agent; provided that the Borrower shall use commercially reasonable efforts to cause each such policy to provide that it shall not be canceled, modified or not renewed (x) by reason of nonpayment of premium upon not less than ten days’ prior written notice thereof by the insurer to the Administrative Agent (giving the Administrative Agent the right to cure defaults in the payment of premiums) or (y) for any other reason upon not less than 30 days’ prior written notice thereof by the insurer to the Administrative Agent; provided, further, that the Borrower shall deliver to the Administrative Agent prior to the cancellation, modification or nonrenewal of any such policy of insurance, a copy of a renewal or replacement policy (or other evidence of renewal of a policy previously delivered to the Administrative Agent) together with evidence satisfactory to the Administrative Agent of payment of the premium therefor.

(c) If at any time the area in which the Premises (as defined in the Mortgages) are located is designated (i) a “flood hazard area” in any Flood Insurance Rate Map published by the Federal Emergency Management Agency (or any successor agency), obtain flood insurance in such total amount as the Administrative Agent or the Required Lenders may from time to time require, and otherwise comply with the National Flood Insurance Program as set forth in the Flood Disaster Protection Act of 1973, as it may be amended from time to time, or (ii) a “Zone 1” area, obtain earthquake insurance in such total amount as the Administrative Agent or the Required Lenders may from time to time require.

(d) With respect to any Mortgaged Property, carry and maintain comprehensive general liability insurance including the “broad form CGL endorsement” and coverage on an occurrence basis against claims made for personal injury (including bodily injury, death and property damage) and umbrella liability insurance against any and all claims, in no event for a combined single limit of less than that which is customary for companies in the same or similar businesses operating in the same or similar locations, naming the Administrative Agent as an additional insured, on forms satisfactory to the Administrative Agent.

(e) Notify the Administrative Agent promptly whenever any separate insurance concurrent in form or contributing in the event of loss with that required to be maintained under this Section is taken out by any Loan Party; and promptly deliver to the Administrative Agent a duplicate original copy of such policy or policies.

SECTION 5.03. Obligations and Taxes. Pay its Indebtedness and other obligations promptly and in accordance with their terms and pay and discharge promptly when due all material taxes, assessments and governmental charges or levies imposed upon it or upon its income or profits or in respect of its property, before the same shall become delinquent or in default, as well

 

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as all lawful claims for labor, materials and supplies or otherwise that, if unpaid, might give rise to a Lien upon such properties or any part thereof; provided that such payment and discharge shall not be required with respect to any such tax, assessment, charge, levy or claim so long as the validity or amount thereof shall be contested in good faith by appropriate proceedings and the Borrower shall have set aside on its books adequate reserves with respect thereto in accordance with GAAP and such contest operates to suspend collection of the contested obligation, tax, assessment or charge and enforcement of a Lien and, in the case of a Mortgaged Property, there is no risk of forfeiture of such property.

SECTION 5.04. Financial Statements, Reports, Etc.. In the case of the Borrower, furnish to the Administrative Agent, which shall furnish to each Lender:

(a) within 120 days after the end of each fiscal year, its consolidated balance sheet and related statements of income, stockholders’ equity and cash flows showing the financial condition of the Borrower and its consolidated Subsidiaries as of the close of such fiscal year and the results of its operations and the operations of such Subsidiaries during such year, together with comparative figures for the immediately preceding fiscal year, all audited by Deloitte & Touche LLP or other independent public accountants of recognized national standing and accompanied by an opinion of such accountants (which opinion shall not include (i) an explanatory paragraph expressing substantial doubt about the ability of the Borrower and its consolidated Subsidiaries to continue as a going concern or (ii) any qualification or exception as to the scope of such audit, other than solely as a result of the upcoming maturity of any Obligations or any prospective inability to satisfy the covenants set forth in Section 6.10 on a future date or for a future period) to the effect that such consolidated financial statements fairly present the financial condition and results of operations of the Borrower and its consolidated Subsidiaries on a consolidated basis in accordance with GAAP consistently applied, together with a customary “management discussion and analysis” provision;

(b) within 60 days after each fiscal quarter of each fiscal year, its consolidated balance sheet and related statements of income, stockholders’ equity and cash flows showing the financial condition of the Borrower and its consolidated Subsidiaries as of the close of such fiscal quarter and the results of its operations and the operations of such Subsidiaries during such fiscal quarter and the then elapsed portion of the fiscal year, and comparative figures for the same periods in the immediately preceding fiscal year, all certified by one of its Financial Officers as fairly presenting the financial condition and results of operations of the Borrower and its consolidated Subsidiaries on a consolidated basis in accordance with GAAP consistently applied, subject to normal year-end audit adjustments, together with, commencing with the fiscal quarter ended March 31, 2021, a customary “management discussion and analysis” provision;

(c) commencing with the fiscal month ending January 31, 2021, within 30 days after the end of each fiscal month (or with respect to each fiscal month ending on or prior to December 31, 2021, 45 days), its consolidated balance sheet and related statements of income and cash flows showing the financial condition of the Borrower and its consolidated Subsidiaries during such fiscal month and the then elapsed portion of the fiscal year, all certified by one of its Financial Officers as fairly presenting the financial condition and results of operations of the Borrower and its consolidated Subsidiaries on a consolidated basis in accordance with GAAP consistently applied, subject to normal year-end audit adjustments;

 

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(d) concurrently with any delivery of financial statements under clause (a) or (b) above, a certificate of a Financial Officer in the form of Exhibit E (i) certifying that no Event of Default or Default has occurred or, if such an Event of Default or Default has occurred, specifying the nature and extent thereof and any corrective action taken or proposed to be taken with respect thereto and (ii) setting forth computations in reasonable detail satisfactory to the Administrative Agent demonstrating compliance with the covenants contained in Section 6.10;

(e) within the time periods required by the Applicable Insurance Regulatory Authority, the Statutory Financial Statement of such Regulated Insurance Company for such fiscal year as filed with the Applicable Insurance Regulatory Authority in such Regulated Insurance Company’s state of domicile, as certified by one of its Financial Officers as fairly presenting the financial condition and results of operations of such Regulated Insurance Company in accordance with SAP, all audited by Deloitte & Touche LLP or other independent public accountants of recognized national standing and accompanied by an opinion of such accountants (which opinion shall not include (i) an explanatory paragraph expressing substantial doubt about the ability of such Regulated Insurance Company to continue as a going concern or (ii) any qualification or exception as to the scope of such audit, other than solely as a result of the upcoming maturity of any Obligations or the prospective inability to satisfy the covenants set forth in Section 6.10 on a future date or for a future period) to the effect that such financial statements fairly present the financial condition and results of operations of such Regulated Insurance Company, but only to the extent such Regulated Insurance Company is required by applicable law to obtain, or otherwise elects to obtain, such an audit and opinion;

(f) within the time periods required by the Applicable Regulatory Authority, the Statutory Financial Statement of such Regulated Insurance Company for such fiscal quarter as filed with the Applicable Insurance Regulatory Authority in such Regulated Insurance Company’s state of domicile, as certified by one of its Financial Officers as fairly presenting the financial condition and results of operations of such Regulated Insurance Company in accordance with SAP;

(g) within 60 days after the beginning of each fiscal year of the Borrower, a detailed consolidated budget for such fiscal year (including a projected consolidated balance sheet and related statements of projected operations and cash flows as of the end of and for such fiscal year and setting forth the assumptions used for purposes of preparing such budget) and, promptly when available and to the extent prepared by the Borrower, any significant revisions of such budget;

(h) promptly after the same become publicly available, copies of all periodic and other reports, proxy statements and other materials filed by the Borrower or any Subsidiary with the Securities and Exchange Commission, or any Governmental Authority succeeding to any or all of the functions of said Commission, or with any national securities exchange, or distributed to its shareholders, as the case may be;

(i) promptly after the receipt thereof by the Borrower or any of its Subsidiaries, a copy of any “management letter” received by any such Person from its certified public accountants and the management’s response thereto;

(j) promptly after the request by any Lender, all documentation and other information that such Lender reasonably requests in order to comply with its ongoing obligations under applicable “know your customer” and anti-money laundering rules and regulations, including the USA PATRIOT Act; and

 

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(k) promptly, from time to time, such other information regarding the operations, business affairs and financial condition of the Borrower or any Subsidiary, or compliance with the terms of any Loan Document, as the Administrative Agent or any Lender may reasonably request.

Notwithstanding anything to the contrary herein, nothing in this Article V shall require the Borrower to provide such information (x) in respect of which disclosure is prohibited by applicable law or (y) which is subject to attorney-client or similar privilege or constitutes attorney work product.

SECTION 5.05. Litigation and Other Notices. Furnish to the Administrative Agent and each Lender prompt written notice of the following:

(a) any Event of Default or Default, specifying the nature and extent thereof and the corrective action (if any) taken or proposed to be taken with respect thereto;

(b) the filing or commencement of, any threat or notice of intention of any Person to file or commence, or any judgment, ruling, substantive order or settlement with respect to, any action, suit or proceeding, whether at law or in equity or by or before any Governmental Authority, against the Borrower or any Affiliate thereof that (i) involves any Loan Document or the Transactions or (ii) could reasonably be expected to result in a Material Adverse Effect;

(c) the occurrence of any ERISA Event that, alone or together with any other ERISA Events that have occurred since the date of this Agreement, could reasonably be expected to result in liability of the Borrower and the Subsidiaries in an aggregate amount that could reasonably be expected to exceed $2,500,000;

(d) the discovery or Release to the environment of Hazardous Materials or occurrence of violations of Environmental Law, including receipt of claims or notices of potential liability therefor, that in any such case could reasonably be expected to result in losses, expenses, fines or penalties asserted against or payable by the Borrower or any of its Subsidiaries in an aggregate amount that could reasonably be expected to exceed $2,500,000;

(e) any change in any Applicable Insurance Code that could reasonably be expected result in a Material Adverse Effect; and

(f) any other development that has resulted in, or could reasonably be expected to result in, a Material Adverse Effect.

SECTION 5.06. Information Regarding Collateral. (a) Furnish to the Administrative Agent at least 20 Business Days’ prior written notice (or such other period as may be agreed by the Administrative Agent) of any change (i) in any Loan Party’s corporate name, (ii) in the jurisdiction of organization or formation of any Loan Party, (iii) in any Loan Party’s identity or corporate structure or (iv) in any Loan Party’s Federal Taxpayer Identification Number. The Borrower agrees not to effect or permit any change referred to in the preceding sentence unless all filings have been made under the Uniform Commercial Code or otherwise that are required in

 

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order for the Administrative Agent to continue at all times following such change to have a valid, legal and perfected security interest in all the Collateral. The Borrower also agrees promptly to notify the Administrative Agent if any material portion of the Collateral is damaged or destroyed.

(b) In the case of the Borrower, each year, at the time of delivery of the annual financial statements with respect to the preceding fiscal year pursuant to Section 5.04(a), deliver to the Administrative Agent a certificate of a Financial Officer setting forth the information required pursuant to Section 2 of the Perfection Certificate or confirming that there has been no change in such information since the date of the Perfection Certificate delivered on the Closing Date or the date of the most recent certificate delivered pursuant to this Section.

SECTION 5.07. Maintaining Records; Access to Properties and Inspections. Keep proper books of record and account in which full, true and correct entries in conformity with GAAP and all requirements of law, in all material respects, are made of all dealings and transactions in relation to its business and activities. Each Loan Party will, and will cause each of its subsidiaries to, permit at any reasonable time and upon reasonable notice, any representatives designated by the Administrative Agent (accompanied by any Lender) to visit and inspect the financial records and the properties of such Person at reasonable times and as often as reasonably requested and to make extracts from and copies of such financial records, and permit any representatives designated by the Administrative Agent to discuss the affairs, finances and condition of such Person with the officers thereof and independent accountants therefor; provided that, so long as no Event of Default exists at the time of such visit, such inspection rights may be exercised no more than once per fiscal year and the Loan Parties shall not be required to pay the costs of more than one such visit and inspection by the Administrative Agent and the Lenders in any fiscal year.

SECTION 5.08. Use of Proceeds. Use the proceeds of the Loans only for the purposes specified in the introductory statement to this Agreement.

SECTION 5.09. Employee Benefits. Comply with the applicable provisions of ERISA and the Code and the laws applicable to any Foreign Pension Plan, except as could not reasonably be expected to result in a Material Adverse Effect .

SECTION 5.10. Compliance with Environmental Laws. Comply, and cause all lessees and other Persons occupying its properties to comply, in all material respects with all Environmental Laws applicable to its operations and properties; obtain and renew all material permits necessary for its operations and properties under Environmental Laws; and conduct in accordance with Environmental Laws any remedial action agreed to be undertaken by the Borrower or any of its Subsidiaries, or otherwise required to be undertaken pursuant to Environmental Law; provided that neither the Borrower nor any of its Subsidiaries shall be required to undertake any remedial action required by Environmental Laws to the extent that its obligation to do so is being contested in good faith and by proper proceedings and appropriate reserves are being maintained with respect to such circumstances in accordance with GAAP.

SECTION 5.11. Preparation of Environmental Reports. If a Default caused by reason of a breach of Section 3.17 or Section 5.10 shall have occurred and be continuing for more than 20 days without the Borrower or any of its Subsidiaries commencing activities reasonably

 

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likely to cure such Default, at the written request of the Required Lenders through the Administrative Agent, provide to the Lenders within 45 days after such request, at the expense of the Loan Parties, an environmental site assessment report regarding the matters which are the subject of such Default prepared by an environmental consulting firm reasonably acceptable to the Administrative Agent and reviewing the basis for or origin of any such Default, including any violations of Environmental Law or the presence or absence of Hazardous Materials, and describing recommended corrective actions to be taken to remedy such Default, including the estimated cost of any compliance or remedial action required to correct such Default. At the request of the Required Lenders, the Loan Parties shall commence such recommended corrective actions using methods and personnel reasonably acceptable to the Required Lenders and shall diligently pursue such corrective actions until the basis for the Default is cured.

SECTION 5.12. Further Assurances. (a) Execute any and all further documents, financing statements, agreements and instruments, and take all further action (including filing Uniform Commercial Code and other financing statements, mortgages and deeds of trust) that may be required under applicable law, or that the Required Lenders or the Administrative Agent may reasonably request, in order to effectuate the transactions contemplated by the Loan Documents and in order to grant, preserve, protect and perfect the validity and first priority of the security interests created or intended to be created by the Security Documents.

(b) The Borrower will cause any subsequently acquired or organized Subsidiary (other than an Excluded Subsidiary) to become a Loan Party by executing the Guarantee and Collateral Agreement and each applicable Security Document in favor of the Administrative Agent within thirty days of such acquisition or formation (or such longer period as may be agreed by the Administrative Agent). In addition, from time to time, the Borrower will, at its cost and expense, promptly secure the Obligations by pledging or creating, or causing to be pledged or created, perfected security interests with respect to such of its assets and properties as the Administrative Agent or the Required Lenders shall designate to the extent required by the Security Documents (it being understood that it is the intent of the parties that the Obligations shall be secured by substantially all the assets of the Borrower and its Subsidiaries (other than Excluded Subsidiaries), including real and other properties acquired subsequent to the Closing Date); provided that notwithstanding anything else in any Loan Document, in no event will any Loan Party be required to pledge or offer security in any Excluded Assets. Such security interests and Liens will be created under the Security Documents and other security agreements, mortgages, deeds of trust and other instruments and documents in form and substance reasonably satisfactory to the Administrative Agent, and the Borrower shall deliver or cause to be delivered to the Lenders all such instruments and documents (including legal opinions, title insurance policies and lien searches) as the Administrative Agent shall reasonably request to evidence compliance with this Section. The Borrower agrees to provide such evidence as the Administrative Agent shall reasonably request as to the perfection and priority status of each such security interest and Lien. In furtherance of the foregoing, the Borrower will give prompt notice to the Administrative Agent of the acquisition by it or any of the Subsidiaries (other than any Excluded Subsidiary) of any Material Real Property.

SECTION 5.13. Post-Closing Requirements. The Borrower shall, and shall cause each other Loan Party to, satisfy the requirements set forth on Schedule 5.13 in the time periods set forth in such Schedule. Notwithstanding anything herein to the contrary, all conditions, representations, warranties and covenants of the Loan Documents with respect to the taking of such actions are qualified by the noncompletion of such actions until such time as they are completed or required to be completed in accordance with this Section 5.13.

 

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ARTICLE VI

Negative Covenants

The Borrower covenants and agrees with each Lender that, so long as this Agreement shall remain in effect and until the Commitments have been terminated and the principal of and interest on each Loan, all Fees and all other expenses or amounts payable under any Loan Document have been paid in full, unless the Required Lenders shall otherwise consent in writing, the Borrower will not, nor will it cause or permit any of the Subsidiaries to:

SECTION 6.01. Indebtedness. Incur, create, assume or permit to exist any Indebtedness, except:

(a) Indebtedness existing on the date hereof and set forth in Schedule 6.01(a) and any extensions, renewals or replacements of such Indebtedness to the extent the principal amount of such Indebtedness is not increased, neither the final maturity nor the weighted average life to maturity of such Indebtedness is decreased, such Indebtedness, if subordinated to the Obligations, remains so subordinated on terms no less favorable to the Lenders, and the original obligors in respect of such Indebtedness remain the only obligors thereon;

(b) Indebtedness created hereunder and under the other Loan Documents;

(c) intercompany Indebtedness of the Borrower and the Subsidiaries to the extent permitted by Section 6.04(c) so long as such Indebtedness is subordinated to the Obligations pursuant to an Affiliate Subordination Agreement;

(d) Indebtedness of the Borrower or any Subsidiary incurred to finance the acquisition, construction or improvement of any fixed or capital assets, and extensions, renewals and replacements of any such Indebtedness that do not increase the outstanding principal amount thereof; provided that (i) such Indebtedness is incurred prior to or within 90 days after such acquisition or the completion of such construction or improvement and (ii) the aggregate principal amount of Indebtedness permitted by this Section), when combined with the aggregate principal amount of all Capital Lease Obligations incurred pursuant to Section 6.01(e) shall not exceed $10,000,000 at any time outstanding;

(e) Capital Lease Obligations in an aggregate principal amount, when combined with the aggregate principal amount of all Indebtedness incurred pursuant to Section 6.01(d), not in excess of $10,000,000 at any time outstanding;

(f) Indebtedness under performance bonds or with respect to workers’ compensation claims, in each case incurred in the ordinary course of business;

 

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(g) Indebtedness under letters of credit, bank guaranties or similar obligations issued in the ordinary course of business in an aggregate principal amount not to exceed $12,500,000 at any one time outstanding;

(h) Indebtedness incurred by any Excluded Subsidiary described in clause (b) of the definition thereof and owing to the partners in such Joint Venture; provided that (x) the aggregate principal amount of such Indebtedness shall not exceed $20,000,000 outstanding at any time and (y) without the prior written consent of the Required Lenders (such consent not to be unreasonably withheld or delayed), no additional Indebtedness shall be incurred under this clause (h) after the Springing Maturity Exercise Date other than pursuant to a binding agreement executed prior to the Springing Maturity Exercise Date;

(i) Indebtedness of any Person that becomes a Subsidiary after the date hereof; provided that (i) such Indebtedness exists at the time such Person becomes a Subsidiary and is not created in contemplation of or in connection with such Person becoming a Subsidiary, (ii) immediately before and after such Person becomes a Subsidiary, no Default or Event of Default shall have occurred and be continuing and (iii) the aggregate principal amount of Indebtedness permitted by this Section shall not exceed $5,000,000 at any time outstanding;

(j) Indebtedness in respect of those Hedging Agreements incurred in the ordinary course of business and consistent with prudent business practice in an aggregate notional amount not to exceed $5,000,000 at any time outstanding;

(k) Indebtedness in respect of cash management services, including treasury, depository, overdraft, credit or debit card, electronic funds transfer, credit card processing and other cash management arrangements in the aggregate principal amount not exceeding $5,000,000 at any time outstanding; and

(l) other unsecured Indebtedness of any Loan Party in an aggregate principal amount not exceeding $10,000,000 at any time outstanding.

SECTION 6.02. Liens. Create, incur, assume or permit to exist any Lien on any property or assets (including Equity Interests or other securities of any Person, including the Borrower or any Subsidiary) now owned or hereafter acquired by it or on any income or revenues or rights in respect of any thereof, except:

(a) Liens on property or assets of the Borrower and its Subsidiaries existing on the date hereof and set forth in Schedule 6.02(a); provided that such Liens shall secure only those obligations that they secure on the date hereof and extensions, renewals and replacements thereof permitted hereunder;

(b) any Lien created under the Loan Documents;

(c) any Lien existing on any property or asset prior to the acquisition thereof by the Borrower or any Subsidiary or existing on any property or assets of any Person that becomes a Subsidiary after the date hereof prior to the time such Person becomes a Subsidiary, as the case may be; provided that (i) such Lien is not created in contemplation of or in connection with such acquisition or such Person becoming a Subsidiary, (ii) such Lien does not apply to any other

 

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property or assets of the Borrower or any Subsidiary and (iii) such Lien secures only those obligations which it secures on the date of such acquisition or the date such Person becomes a Subsidiary, as the case may be;

(d) Liens for taxes not yet due or which are being contested in compliance with Section 5.03 or which secure taxes of less than $250,000;

(e)    carriers’, warehousemen’s, mechanics’, materialmen’s, repairmen’s or other like Liens arising in the ordinary course of business and securing obligations that are not due and payable or which are being contested in compliance with Section 5.03;

(f) pledges and deposits made in the ordinary course of business in compliance with workmen’s compensation, unemployment insurance and other social security laws or regulations;

(g) deposits to secure the performance of bids, trade contracts (other than for Indebtedness), leases (other than Capital Lease Obligations), statutory obligations, surety and appeal bonds, performance bonds and other obligations of a like nature incurred in the ordinary course of business;

(h) zoning restrictions, easements, rights-of-way, restrictions on use of real property and other similar encumbrances incurred in the ordinary course of business which, in the aggregate, are not substantial in amount and do not materially detract from the value of the property subject thereto or interfere with the ordinary conduct of the business of the Borrower or any of its Subsidiaries;

(i) purchase money security interests in real property, improvements thereto or equipment hereafter acquired (or, in the case of improvements, constructed) by the Borrower or any Subsidiary or in respect of any Capital Lease Obligations; provided that (i) such security interests secure Indebtedness permitted by Section 6.01, (ii) such security interests are incurred, and the Indebtedness secured thereby is created, within 90 days after such acquisition (or construction), (iii) the Indebtedness secured thereby does not exceed the lesser of the cost or the fair market value of such real property, improvements or equipment at the time of such acquisition (or construction) and (iv) such security interests do not apply to any other property or assets of the Borrower or any Subsidiary other than any proceeds thereof;

(j) judgment Liens securing judgments not constituting an Event of Default under Article VII;

(k) Liens on assets of Excluded Subsidiaries; provided that (i) such Liens do not extend to, or encumber, assets that constitute Collateral or the Equity Interests of the Borrower or any of the Subsidiaries, and (ii) such Liens extending to the assets of any Foreign Subsidiary secure only Indebtedness incurred by such Subsidiary pursuant to Section 6.01(h);

(l) Liens securing Indebtedness permitted under Section 6.01(g);

(m) licenses, sub-licenses and other similar encumbrances incurred in the ordinary course of business that do not materially detract from the value of the property subject thereto or materially interfere with the ordinary conduct of the business of the Borrower or any of its Subsidiaries;

 

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(n) Liens, arising in the ordinary course of business (i) of a collection bank arising under Section 4-210 of the Uniform Commercial Code on items in the course of collection or (ii) in favor of a banking institution encumbering deposits (including brokers’ Liens, bankers’ Liens, rights of set-off and other similar Liens) that are customary in the banking industry;

(o) Liens (i) on cash advances or escrow deposits in favor of the seller of any property to be acquired in a Permitted Acquisition to be applied against the purchase price for such Permitted Acquisition or otherwise in connection with any escrow arrangements with respect to any such Permitted Acquisition (including any letter of intent or purchase agreement with respect to such Permitted Acquisition) or (ii) consisting of an agreement to dispose of any property in an Asset Sale permitted under Section 6.05(b), in each case solely to the extent such Permitted Acquisition or Asset Sale, as the case may be, would have been permitted on the date of the creation of such Lien; and

(p) other Liens securing liabilities permitted hereunder in an aggregate amount not to exceed $10,000,000 at any time outstanding.

SECTION 6.03. Sale and Lease-Back Transactions. Enter into any arrangement, directly or indirectly, with any Person whereby it shall sell or transfer any property, real or personal, used or useful in its business, whether now owned or hereafter acquired, and thereafter it or its Affiliate shall rent or lease such property or other property which it intends to use for substantially the same purpose or purposes as the property being sold or transferred unless (a) the sale or transfer of such property is permitted by Section 6.05 and (b) any Capital Lease Obligations or Liens arising in connection therewith, if any, are permitted by Sections 6.01 and 6.02, as the case may be.

SECTION 6.04. Investments. Make or permit to exist any Investment except:

(a) (i) investments by the Borrower and the Subsidiaries existing on the date hereof in the Equity Interests of the Borrower and the Subsidiaries and (ii) additional investments by the Borrower and the Subsidiaries in the Equity Interests of the Borrower and the Subsidiaries; provided that (A) any such Equity Interests (other than Excluded Assets) held by a Loan Party shall be pledged, subject to the terms of the Guarantee and Collateral Agreement and (B) investments made after the Closing Date by Loan Parties in, and loans and advances made after the Closing Date by Loan Parties to, Subsidiaries that are not Loan Parties (determined without regard to any write-downs or write-offs of such investments, loans and advances) shall be limited to the amount necessary to satisfy regulatory requirements of such non-Loan Party Subsidiaries (or any Subsidiaries of such non-Loan Party Subsidiaries) promulgated by any Applicable Insurance Regulatory Authority or any reasonably anticipated regulatory requirements of such non-Loan Party Subsidiaries (or their Subsidiaries), including any such regulatory requirements in connection with the formation of any new non-Loan Party Subsidiaries; provided, further that without the prior written consent of the Required Lenders (such consent not to be unreasonably withheld or delayed), no investments shall be made in any new non-Loan Party Subsidiaries after the Springing Maturity Exercise Date other than pursuant to a binding agreement executed prior to the Springing Maturity Exercise Date;

 

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(b) (i) Permitted Investments and (ii) with respect to any Regulated Insurance Subsidiary, debt securities or debt instruments with an Investment Grade Rating;

(c) loans or advances made by the Borrower to any Subsidiary and made by any Subsidiary to the Borrower or any other Subsidiary; provided that (i) any such loans and advances made by a Loan Party shall be evidenced by a promissory note pledged to the Administrative Agent for the ratable benefit of the Secured Parties pursuant to the Guarantee and Collateral Agreement, (ii) such loans and advances shall be unsecured and subordinated to the Obligations pursuant to an Affiliate Subordination Agreement and (iii) the amount of such loans and advances made by Loan Parties to Subsidiaries that are not Loan Parties shall be subject to the limitation set forth in clause (a) above;

(d) investments received in connection with the bankruptcy or reorganization of, or settlement of delinquent accounts and disputes with, customers and suppliers, in each case in the ordinary course of business;

(e) the Borrower and the Subsidiaries may make loans and advances in the ordinary course of business to their respective employees so long as the aggregate principal amount thereof at any time outstanding (determined without regard to any write-downs or write-offs of such loans and advances) shall not exceed $1,000,000;

(f) the Borrower and the Subsidiaries may enter into Hedging Agreements that are not speculative in nature and are in the ordinary course of business;

(g) the Borrower or any Subsidiary may acquire all or substantially all the assets of a Person or line of business of such Person, or not less than 100% of the Equity Interests (other than directors’ qualifying shares) of a Person (referred to herein as the “Acquired Entity”); provided that (i) such acquisition was not preceded by an unsolicited tender offer for such Equity Interests by, or proxy contest initiated by, the Borrower or any Subsidiary; (ii) the Acquired Entity shall be in a similar line of business or a reasonable extension thereof as that of the Borrower and the Subsidiaries as conducted during the current and most recent calendar year; and (iii) at the time of such transaction (A) both before and after giving effect thereto, no Default or Event of Default shall have occurred and be continuing; (B) the Borrower would be in compliance with the covenants set forth in Section 6.10 as of the most recently completed period of four consecutive fiscal quarters ending prior to such transaction for which the financial statements and certificates required by Section 5.04(a) or 5.04(b), as the case may be, and 5.04(d) have been delivered, after giving pro forma effect to such transaction and to any other event occurring after such period as to which pro forma recalculation is appropriate (including any other transaction described in this Section occurring after such period) as if such transaction had occurred as of the first day of such period; (C) the Borrower shall have delivered a certificate of a Financial Officer, certifying as to the foregoing and containing reasonably detailed calculations in support thereof, in form and substance satisfactory to the Administrative Agent; (D) if the Springing Maturity Exercise Date has occurred, the Required Lenders have provided their prior written consent (such consent not to be unreasonably withheld or delayed) to such acquisition (other than acquisitions pursuant to a

 

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binding agreement executed prior to the Springing Maturity Exercise Date) and (E) the Borrower shall comply, and shall cause the Acquired Entity to comply, with the applicable provisions of Section 5.12 and the Security Documents within the time periods set forth therein (any acquisition of an Acquired Entity meeting all the criteria of this Section being referred to herein as a

Permitted Acquisition”);

(h) Investments made in, or in connection with, any Joint Venture; provided that without the prior written consent of the Required Lenders (such consent not to be unreasonably withheld or delayed), no additional Investments shall be made under this clause (h) after the Springing Maturity Exercise Date other than pursuant to a binding agreement executed prior to the Springing Maturity Exercise Date;

(i) Investments by the Borrower in Hedging Agreements permitted under Section 6.01(i); and

(j) in addition to investments permitted by clauses (a) through (h) above, additional investments, loans and advances by the Borrower and the Subsidiaries so long as (x) the aggregate amount invested, loaned or advanced pursuant to this clause (i) (determined without regard to any write-downs or write-offs of such investments, loans and advances) does not exceed $25,000,000 in the aggregate, (y) no investments, loans or advances under this clause (i) are made in Excluded Subsidiaries (other than Excluded Subsidiaries described in clause (b) of the definition thereof) and (z) without the prior written consent of the Required Lenders (such consent not to be unreasonably withheld or delayed), no investments, loans or advances under this clause (j) shall be made after the Springing Maturity Exercise Date other than pursuant to a binding agreement executed prior to the Springing Maturity Exercise Date.

Notwithstanding anything herein to the contrary, in no event shall any Loan Party make investments of, or otherwise transfer or dispose of, any material Intellectual Property to any Excluded Subsidiary.

SECTION 6.05. Mergers, Consolidations, Sales of Assets and Acquisitions. (a) Merge into or consolidate with any other Person, or permit any other Person to merge into or consolidate with it, or sell, transfer, lease or otherwise dispose of (in one transaction or in a series of transactions) all or substantially all the assets (whether now owned or hereafter acquired) of the Borrower, or purchase, lease or otherwise acquire (in one transaction or a series of transactions) all or any substantial part of the assets of any other Person, except that (i) the Borrower and any Subsidiary may purchase and sell inventory in the ordinary course of business and (ii) if at the time thereof and immediately after giving effect thereto no Event of Default or Default shall have occurred and be continuing (1) any Wholly Owned Subsidiary may merge into the Borrower in a transaction in which the Borrower is the surviving corporation, (2) any Wholly Owned Subsidiary may merge into or consolidate with any other Wholly Owned Subsidiary in a transaction in which the surviving entity is a Wholly Owned Subsidiary and no Person other than the Borrower or a Wholly Owned Subsidiary receives any consideration (provided that if any party to any such transaction is a Loan Party, the surviving entity of such transaction shall be a Loan Party), (3) the Borrower and the Subsidiaries may make Permitted Acquisitions and other acquisitions expressly permitted under Section 6.04, (4) the Borrower and the Subsidiaries may engage in any transaction(s) undertaken in good faith to improve the tax efficiency of the Borrower and its

 

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Affiliates so long as the Lenders are not adversely affected by such transactions (other than de minimis adverse effects) and (5) the Borrower may, in connection with an IPO, (x) enter into a transaction by which the Equity Interests in the Borrower are transferred to a parent entity that will own 100% of the Equity Interests of the Borrower or (y) the Equity Interests of the Borrower are directly or indirectly acquired (including by way of merger with a parent entity of the Borrower) by a Person described in clause (ii) of the definition of IPO, provided that (A) any such parent entity shall become a Loan Party by executing the Guarantee and Collateral Agreement and each applicable Security Document in favor of the Administrative Agent on or prior to the date the Equity Interests of the Borrower are so transferred or acquired, (B) such transfer or acquisition of Equity Interests of the Borrower shall not constitute a Change in Control and (C) such parent entity shall not engage in any business activities or have any assets or liabilities other than its ownership of the Equity Interests of the Borrower and liabilities incidental thereto.

(b) Make any Asset Sale otherwise permitted under clause (a) above unless (i) such Asset Sale is for consideration at least 85% of which is cash, (ii) such consideration is at least equal to the fair market value of the assets being sold, transferred, leased or disposed of and (iii) the fair market value of all assets sold, transferred, leased or disposed of pursuant to this clause (b) shall not exceed (i) $20,000,000 in any fiscal year or (ii) $50,000,000 in the aggregate.

SECTION 6.06. Restricted Payments; Restrictive Agreements. (a) Declare or make, or agree to declare or make, directly or indirectly, any Restricted Payment (including pursuant to any Synthetic Purchase Agreement), or incur any obligation (contingent or otherwise) to do so; provided that (i) any Subsidiary may declare and pay dividends or make other distributions ratably to its equity holders, (ii) so long as no Event of Default or Default shall have occurred and be continuing or would result therefrom, the Borrower may repurchase its Equity Interests owned by employees of the Borrower or the Subsidiaries or make payments to employees of the Borrower or the Subsidiaries in connection with the exercise or vesting of stock options, stock appreciation rights, restricted stock units, restricted stock or similar equity incentives or equity based incentives pursuant to equity compensation plans in an aggregate amount not to exceed $5,000,000 in any fiscal year (in each case other than repurchase of Equity Interests from, or any payments to, Mario Schlosser), (iii) the Borrower and its Subsidiaries may make Permitted Tax Distributions and (iv) the Borrower and its Subsidiaries may make Restricted Payments, the proceeds of which will be used to pay operating costs and expenses of a parent entity incurred in the ordinary course of business that are solely attributable to the operations of the Borrower and its Subsidiaries.

(b) Enter into, incur or permit to exist any agreement or other arrangement that prohibits, restricts or imposes any condition upon (i) the ability of the Borrower or any Subsidiary to create, incur or permit to exist any Lien upon any of its property or assets, or (ii) the ability of any Subsidiary to pay dividends or other distributions with respect to any of its Equity Interests or to make or repay loans or advances to the Borrower or any other Subsidiary or to Guarantee Indebtedness of the Borrower or any other Subsidiary; provided that (A) the foregoing shall not apply to restrictions and conditions imposed by law, regulation or order of any Governmental Authority or by any Loan Document, (B) the foregoing shall not apply to customary restrictions and conditions contained in agreements relating to the sale of a Subsidiary pending such sale, provided such restrictions and conditions apply only to the Subsidiary that is to be sold and such sale is permitted hereunder, (C) the foregoing shall not apply to restrictions and conditions

 

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imposed on any Foreign Subsidiary by the terms of any Indebtedness of such Foreign Subsidiary permitted to be incurred hereunder, (D) clause (i) of the foregoing shall not apply to restrictions or conditions imposed by any agreement relating to secured Indebtedness permitted by this Agreement if such restrictions or conditions apply only to the property or assets securing such Indebtedness (E) clause (i) of the foregoing shall not apply to customary provisions in leases and other contracts restricting the assignment thereof, (F) the foregoing shall not apply to any agreement in effect at the time any Subsidiary becomes a Subsidiary of the Borrower, so long as such agreement was not entered into in connection with or in contemplation of such person becoming a Subsidiary of the Borrower and such agreement does not extend to the Borrower or any other Subsidiary, (G) the foregoing shall not apply to restrictions in documents governing Indebtedness expressly permitted by this Agreement so long as no such restrictions are more restrictive to the Borrower and its Subsidiaries than those contained in the Loan Documents at the time such Indebtedness is incurred and (H) customary provisions in joint venture agreements and other similar agreements applicable to joint ventures permitted hereunder and applicable solely to such joint venture entered into in the ordinary course of business.

SECTION 6.07. Transactions With Affiliates. Except for transactions between or among Loan Parties, sell or transfer any property or assets to, or purchase or acquire any property or assets from, or otherwise engage in any other transactions with, any of its Affiliates, except that the Borrower or any Subsidiary may (a) engage in any transaction permitted under Section 6.06(a), (b) engage in any of the foregoing transactions in the ordinary course of business at prices and on terms and conditions not less favorable to the Borrower or such Subsidiary than could be obtained on an arm’s-length basis from unrelated third parties and (c) pay compensation or any employee benefit allowance paid or provided to officers, directors and employees for actual services rendered to the Borrower (including severance) and its Subsidiaries, including the maintenance of benefit programs or arrangements for employees, officers or directors, including vacation plans, health and life insurance plans, deferred compensation plans, and retirement or savings plans and similar plans and indemnification of officers and employees, in each case, in the ordinary course of business.

SECTION 6.08. Business of the Borrower and Subsidiaries. Engage at any time in any business or business activity other than the business currently conducted by it and business activities reasonably incidental thereto and reasonable extensions thereof.

SECTION 6.09. Other Indebtedness and Agreements. (a) Permit any waiver, supplement, modification, amendment, termination or release of (i) any indenture, instrument or agreement pursuant to which any Material Indebtedness of the Borrower or any of the Subsidiaries is outstanding if the effect of such waiver, supplement, modification, amendment, termination or release would materially increase the obligations of the obligor or confer additional material rights on the holder of such Indebtedness in a manner adverse to the Borrower, any of the Subsidiaries or the Lenders or (ii) its certificate of incorporation, by-laws, operating, management or partnership agreement or other organizational documents, in each case to the extent any such waiver, supplement, modification, amendment, termination or release would be adverse to the Lenders in any material respect.

(b) (i) Make any distribution, whether in cash, property, securities or a combination thereof, other than regular scheduled payments of principal and interest as and when due (to the

 

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extent not prohibited by applicable subordination provisions), in respect of, or pay, or commit to pay, or directly or indirectly (including pursuant to any Synthetic Purchase Agreement) redeem, repurchase, retire or otherwise acquire for consideration, or set apart any sum for the aforesaid purposes, any Indebtedness except (A) the payment of the Indebtedness created hereunder, (B) refinancings of Indebtedness permitted by Section 6.01 and (C) the payment of secured Indebtedness that becomes due as a result of the voluntary sale or transfer of the property or assets securing such Indebtedness, and (D) payments in respect of Indebtedness expressly permitted under Sections 6.01(c) and (k), or (ii) pay in cash any amount in respect of any Indebtedness or preferred Equity Interests that may at the obligor’s option be paid in kind or in other securities.

SECTION 6.10. Financial Covenants.

(a) Permit Gross Premiums for any period ending as of the last day of any fiscal quarter set forth below to be less than the amount set forth opposite such fiscal quarter:

 

Fiscal Quarter Ending

  

Gross Premiums

 

December 31, 2020

   $ 382,100,000  

March 31, 2021

   $ 619,300,000  

June 30, 2021

   $ 609,900,000  

September 30, 2021

   $ 579,100,000  

December 31, 2021

   $ 565,200,000  

March 31, 2022

   $ 858,500,000  

June 30, 2022

   $ 845,400,000  

September 30, 2022

   $ 802,700,000  

December 31, 2022

   $ 783,500,000  

March 31, 2023

   $ 1,184,500,000  

June 30, 2023

   $ 1,166,300,000  

September 30, 2023

   $ 1,107,500,000  

December 31, 2023

   $ 1,081,000,000  

March 31, 2024

   $ 1,603,200,000  

June 30, 2024

   $ 1,578,600,000  

September 30, 2024

   $ 1,498,900,000  

(b) At any time after the two-year anniversary of the Closing Date, permit the Combined Ratio as of the last day of any fiscal quarter (commencing December 31, 2022) ending on a date or during a period set forth below to be less than the percentage set forth opposite such period:

 

Date or Period

  

Percentage

 

December 31, 2022

     106.7

March 31, 2023 through and including December 31, 2023

     101.5

March 31, 2024 and thereafter

     97.6

(c) Permit Liquidity at any time to be less than $60,000,000.

 

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SECTION 6.11. Fiscal Year. With respect to the Borrower, change its fiscal year-end to a date other than December 31.

SECTION 6.12. Joint Ventures. Permit at any time greater than 15% of Consolidated Total Assets to be owned (whether directly or through a percentage interest, profit sharing or similar arrangement) by any Person that is not the Borrower or a Subsidiary.

ARTICLE VII

Events of Default

In case of the happening of any of the following events (“Events of Default”):

(a) any representation or warranty made or deemed made in or in connection with any Loan Document or the borrowings hereunder, or any representation, warranty, statement or information contained in any report, certificate, financial statement or other instrument furnished in connection with or pursuant to any Loan Document, shall prove to have been false or misleading in any material respect when so made, deemed made or furnished;

(b) default shall be made in the payment of any principal of any Loan when and as the same shall become due and payable, whether at the due date thereof or at a date fixed for prepayment thereof or by acceleration thereof or otherwise;

(c) default shall be made in the payment of any interest on any Loan or any Fee or any other amount (other than an amount referred to in clause (b) above) due under any Loan Document, when and as the same shall become due and payable, and such default shall continue unremedied for a period of three Business Days;

(d) default shall be made in the due observance or performance by the Borrower or any Subsidiary of any covenant, condition or agreement contained in Section 5.01(a), 5.02, 5.05, 5.08 or 5.13 or in Article VI;

(e) default shall be made in the due observance or performance by the Borrower or any Subsidiary of any covenant, condition or agreement contained in any Loan Document (other than those specified in clause (b), (c) or (d) above) and such default shall continue unremedied for a period of 30 days after the earlier of (i) notice thereof from the Administrative Agent to the Borrower (which notice shall also be given at the request of any Lender) or (ii) knowledge thereof of the Borrower;

(f) (i) the Borrower or any Subsidiary shall fail to pay any principal or interest, regardless of amount, due in respect of any Material Indebtedness, when and as the same shall become due and payable, or (ii) any other event or condition occurs that results in any Material Indebtedness becoming due prior to its scheduled maturity or that enables or permits (with or without the giving of notice, the lapse of time or both) the holder or holders of any Material Indebtedness or any trustee or agent on its or their behalf to cause any Material Indebtedness to become due, or to require the prepayment, repurchase, redemption or defeasance thereof, prior to its scheduled maturity; provided that this clause (ii) shall not apply to secured Indebtedness that becomes due as a result of the voluntary sale or transfer of the property or assets securing such Indebtedness;

 

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(g) an involuntary proceeding (including any liquidation or rehabilitation proceeding) shall be commenced or an involuntary petition shall be filed in a court of competent jurisdiction seeking (i) relief in respect of the Borrower or any Subsidiary), or of a substantial part of the property or assets of the Borrower or a Subsidiary, under Title 11 of the United States Code, as now constituted or hereafter amended, or any other Federal, state or foreign bankruptcy, insolvency, receivership or similar law, (ii) the appointment of a receiver, trustee, rehabilitator, liquidator, custodian, sequestrator, conservator or similar official for the Borrower or any Subsidiary or for a substantial part of the property or assets of the Borrower or a Subsidiary or (iii) the winding-up or liquidation of the Borrower or any Subsidiary; and such proceeding or petition shall continue undismissed for 60 days or an order or decree approving or ordering any of the foregoing shall be entered;

(h) the Borrower or any Subsidiary shall (i) voluntarily commence any proceeding (including any liquidation or rehabilitation proceeding) or file any petition seeking relief under Title 11 of the United States Code, as now constituted or hereafter amended, or any other Federal, state or foreign bankruptcy, insolvency, receivership or similar law, (ii) consent to the institution of, or fail to contest in a timely and appropriate manner, any proceeding or the filing of any petition described in (g) above, (iii) apply for or consent to the appointment of a receiver, trustee, rehabilitator, liquidator, custodian, sequestrator, conservator or similar official for the Borrower or any Subsidiary or for a substantial part of the property or assets of the Borrower or any Subsidiary, (iv) file an answer admitting the material allegations of a petition filed against it in any such proceeding, (v) make a general assignment for the benefit of creditors, (vi) become unable, admit in writing its inability or fail generally to pay its debts as they become due or (vii) take any action for the purpose of effecting any of the foregoing;

(i) one or more judgments shall be rendered against the Borrower, any Subsidiary or any combination thereof and the same shall remain undischarged for a period of 30 consecutive days during which execution shall not be effectively stayed, or any action shall be legally taken by a judgment creditor to levy upon assets or properties of the Borrower or any Subsidiary to enforce any such judgment and such judgment either (i) is for the payment of money in an aggregate amount in excess of $5,000,000 or (ii) is for injunctive relief and could reasonably be expected to result in a Material Adverse Effect;

(j) an ERISA Event shall have occurred that, when taken together with all other such ERISA Events, could reasonably be expected to result in liability of the Borrower and the Subsidiaries in an aggregate amount exceeding $5,000,000;

(k) any License of any Regulated Insurance Company held by such Regulated Insurance Company on the Closing Date or acquired by such Regulated Insurance Company thereafter, the loss of which could reasonably be expected to have a Material Adverse Effect, (i) shall be revoked by a final non-appealable order by the state which shall have issued such License, or any action (whether administrative or judicial) to revoke such License shall have been commenced against such Regulated Insurance Company which shall not have been dismissed or contested in good faith within 30 days of the commencement thereof, (ii) shall be suspended by

 

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such state for a period in excess of 30 days or (iii) shall not be reissued or renewed by such state upon the expiration thereof following application for such reissuance or renewal by such Regulated Insurance Company;

(l) any Guarantee under the Guarantee and Collateral Agreement for any reason shall cease to be in full force and effect (other than in accordance with its terms), or any Guarantor shall deny in writing that it has any further liability under the Guarantee and Collateral Agreement (other than as a result of the discharge of such Guarantor in accordance with the terms of the Loan Documents);

(m) any security interest in any material assets purported to be created by any Security Document shall cease to be, or shall be asserted by the Borrower or any other Loan Party not to be, a valid, perfected, first priority (except as otherwise expressly provided in this Agreement or such Security Document) security interest in the securities, assets or properties covered thereby; or

(n) there shall have occurred a Change in Control;

then, and in every such event (other than an event with respect to the Borrower described in clause (g) or (h) above), and at any time thereafter during the continuance of such event, the Administrative Agent may, and at the request of the Required Lenders shall, by notice to the Borrower, take either or both of the following actions, at the same or different times: (i) terminate forthwith the Commitments and (ii) declare the Loans then outstanding to be forthwith due and payable in whole or in part, whereupon the principal of the Loans so declared to be due and payable, together with accrued interest thereon, any unpaid accrued fees, any Early Payment Fee and all other liabilities of the Borrower accrued hereunder and under any other Loan Document, shall become forthwith due and payable, without presentment, demand, protest or any other notice of any kind, all of which are hereby expressly waived by the Borrower, anything contained herein or in any other Loan Document to the contrary notwithstanding; and in any event with respect to the Borrower described in clause (g) or (h) above, the Commitments shall automatically terminate and the principal of the Loans then outstanding, together with accrued interest thereon and any unpaid accrued fees, any Early Payment Fee and all other liabilities of the Borrower accrued hereunder and under any other Loan Document, shall automatically become due and payable, without presentment, demand, protest or any other notice of any kind, all of which are hereby expressly waived by the Borrower, anything contained herein or in any other Loan Document to the contrary notwithstanding.

Notwithstanding anything to the contrary contained herein or in any other Loan Document, any foreclosure on, sale, transfer or other disposition of any Collateral or any other action taken or proposed to be taken hereunder that would affect the operational, voting or other control of any Regulated Entity or affect the ownership of any Regulated Entity shall be pursuant to the applicable law and regulation and, if and to the extent required thereby, subject to the prior consent of the Applicable Insurance Regulatory Authority and any other applicable Governmental Authority. Notwithstanding anything to the contrary contained herein, no party, including the Administrative Agent and the Lenders, shall take any action pursuant hereto that would constitute or result in any assignment or transfer of control of any Regulated Entity if such assignment or transfer of control would require, under then existing law, the prior approval of the Applicable Insurance Regulatory

 

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Authority and any other applicable Governmental Authority, without first obtaining such approval of the Applicable Insurance Regulatory Authority or such other applicable Governmental Authority and notifying the Applicable Insurance Regulatory Authority or such other applicable Governmental Authority of the consummation of such assignment or transfer of control (to the extent required to do so).

ARTICLE VIII

The Administrative Agent; Etc.

SECTION 8.01. Appointment and Authorization. Each Lender hereby irrevocably appoints, designates and authorizes the Administrative Agent to take such action on its behalf under the provisions of this Agreement and each other Loan Document and to exercise such powers and perform such duties as are expressly delegated to the Administrative Agent by the terms of this Agreement or any other Loan Document. Each Lender hereby acknowledges and agrees that the Administrative Agent shall not have any duties or responsibilities except those expressly set forth herein and in the other Loan Documents. The Administrative Agent shall not have or be deemed to have any fiduciary relationship with any Lender or any other Person, and no implied covenants, functions, responsibilities, duties, obligations or liabilities shall be read into this Agreement or any other Loan Document or otherwise exist against the Administrative Agent. Without limiting the generality of the foregoing, the use of the term “agent” herein and in the other Loan Documents with reference to the Administrative Agent is not intended to connote any fiduciary or other implied (or express) obligations arising under agency doctrine of any applicable law. Instead, such term is used merely as a matter of market custom, and is intended to create or reflect only an administrative relationship between independent contracting parties. The permissive authorizations, entitlements, powers and rights (including the right to request that the Borrower take an action or deliver a document and the exercise of remedies following an Event of Default) granted to the Administrative Agent herein shall not be construed as duties. The Administrative Agent shall not have any responsibility for interest or income on any funds held by it hereunder and any funds so held shall be held un-invested pending distribution thereof. Whether or not explicitly set forth therein, the rights, powers, protections, immunities and indemnities granted to the Administrative Agent herein shall apply to any document entered into by the Administrative Agent in connection with its role as Administrative Agent under the Loan Documents. Except to the extent expressly provided otherwise herein, the Required Lenders shall have the right to direct the Administrative Agent in all matters concerning the Loan Documents.

SECTION 8.02. Delegation of Duties. The Administrative Agent may execute any and all of its duties and exercise its rights and powers under this Agreement or any other Loan Document by or through agents, sub-agents, employees or attorneys in fact and shall be entitled to advice of counsel and other consultants or experts concerning all matters pertaining to such duties. The Administrative Agent shall not be responsible for the supervision, negligence or misconduct of any agent or attorney in fact that it selects with due care. Any such delegation made shall not preclude the subsequent exercise of those rights and powers by the Administrative Agent, any revocation of such delegation or any subsequent delegation of any such rights, powers, authorities and discretions.

 

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SECTION 8.03. Default; Collateral. (a) Upon the occurrence and continuance of a Default or an Event of Default, the Lenders agree that Required Lenders shall have the sole right to determine a course of action for the enforcement of the rights of the Lenders, and the Administrative Agent shall be entitled to refrain from taking any action (without incurring any liability to any Person for so refraining) unless and until the Administrative Agent shall have received instructions from the Required Lenders. All rights of action under the Loan Documents and all right to the Collateral, if any, hereunder may be enforced by the Administrative Agent (at the direction of the Required Lenders) and any suit or proceeding instituted by the Administrative Agent in furtherance of such enforcement shall be brought in its name as the Administrative Agent without the necessity of joining as plaintiffs or defendants any Lender, and the recovery of any judgment shall be for the benefit of the Lenders subject to the fees, expenses and other amounts payable to the Administrative Agent. In actions with respect to any Collateral or other property or assets of the Borrower or any of its Subsidiaries, the Administrative Agent is acting for the benefit of each Lender. Any and all agreements to subordinate (whether made heretofore or hereafter) other Indebtedness or obligations of the Loan Parties to the Loans or the Obligations shall be construed as being for the benefit of each Lender.

(b) Each Lender authorizes and directs the Administrative Agent to enter into the Loan Documents to which it is a party on the date hereof on behalf of and for the benefit of the Lenders.

(c) Except to the extent that the consent of such Lender is required under Section 9.08, each Lender agrees that any action taken by the Required Lenders in accordance with the provisions of the Loan Documents, and the exercise by the Required Lenders of the powers set forth herein or therein, together with such other powers as are reasonably incidental thereto, shall be authorized by and binding upon, all of the Lenders.

(d) The Administrative Agent is hereby authorized (but not obligated) on behalf of the Lenders, without the necessity of any notice to or further consent from any Lender, from time to time to take any action with respect to any property, Collateral or Loan Documents which may be necessary to create, perfect and maintain perfected Liens upon the Collateral and the properties granted pursuant to the Loan Documents.

(e) The Administrative Agent shall not have any obligation whatsoever to any Lender or to any other Person to assure that the Collateral exists or is owned (whether in fee or by leasehold) by the Person purporting to own it or is cared for, protected, or insured or has been encumbered or that the Liens granted to the Administrative Agent pursuant to the Loan Documents have been properly or sufficiently or lawfully created, perfected, protected or enforced, or are entitled to any particular priority, or to exercise at all or in any particular manner or under any duty of care, disclosure or fidelity, or to continue exercising, any of the rights granted or available to the Administrative Agent in any of the Loan Documents; IT BEING UNDERSTOOD AND AGREED THAT IN RESPECT OF THE LOAN OR ANY LOAN DOCUMENT, OR ANY ACT, OMISSION OR EVENT RELATED THERETO, THE ADMINISTRATIVE AGENT SHALL NOT HAVE ANY DUTY OR LIABILITY WHATSOEVER WITH RESPECT TO ANY LOAN OR THE LOAN DOCUMENTS TO ANY PERSON IN THE ABSENCE OF ITS OWN GROSS NEGLIGENCE OR WILLFUL MISCONDUCT AS DETERMINED BY A COURT OF COMPETENT JURISDICTION IN A FINAL AND NON-APPEALABLE JUDGMENT. Notwithstanding anything contained in the Loan Documents or otherwise to the contrary, the

 

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Administrative Agent shall not have any duty to (i) file or prepare any financing or continuation statements or record any documents or instruments in any public office for purposes of creating, perfecting or maintaining any Lien or security interest created under the Loan Documents; (ii) take any necessary steps to preserve rights against any parties with respect to any Collateral; or (iii) take any action to protect against any diminution in value of the Collateral.

(f) The Lenders hereby irrevocably authorize the Administrative Agent to release any Lien granted to or held by the Administrative Agent upon any Collateral: (i) upon the payment in full of the Obligations (other than contingent obligations for which no claim has been asserted) and termination of the Commitments; (ii) constituting property being sold or disposed of to a Person that is not a Loan Party if any Loan Party certifies in an officer’s certificate of such Loan Party to the Administrative Agent, in a form acceptable to the Administrative Agent, that the sale or disposition is permitted under this Agreement (and the Administrative Agent may rely conclusively on any such certificate, without further inquiry); (iii) constituting property in which no Loan Party owned an interest at the time the Lien was granted or at any time thereafter; (iv) constituting property leased to any Loan Party under a lease which has expired or been terminated in a transaction permitted under the Loan Documents or is about to expire and which has not been, and is not intended by the Loan Parties to be, renewed; or (v) consisting of an instrument or other possessory loan evidencing Indebtedness or other obligations pledged to the Administrative Agent (for the benefit of the Lenders), if the Indebtedness or obligations evidenced thereby has been paid in full or otherwise superseded. In addition, the Lenders irrevocably authorize the Administrative Agent to release Liens upon the Collateral as otherwise contemplated herein and in the other Loan Documents if approved and authorized by the Lenders in accordance with Section 9.08. Upon request by the Administrative Agent at any time, the Lenders will confirm in writing the Administrative Agent’s authority, and will direct the Administrative Agent, to release particular types or items of the Collateral pursuant to this Section and the Administrative Agent shall be entitled to conclusively rely, and shall be fully protected in so relying, upon the authorization of the Lenders. In the absence of such authorization, the Administrative Agent shall be entitled to refrain from granting any release under this Section.

(g) In furtherance of the authorizations set forth in this Section, each Lender hereby irrevocably appoints the Administrative Agent as its attorney-in-fact, with full power of substitution, for and on behalf of and in the name of each such Lender (i) to enter into Loan Documents, (ii) to take action with respect to the Collateral and Loan Documents to create, perfect, maintain and preserve the Administrative Agent’s Liens therein, and (iii) to execute instruments of release or to take other action necessary to release Liens upon any Loan or to release any Guarantor to the extent authorized herein or in the other Loan Documents. This power of attorney shall be liberally, not restrictively, construed so as to give the greatest latitude to the Administrative Agent’s power, as attorney, relative to the matters described in this Section. The powers and authorities herein conferred on the Administrative Agent may be exercised by the Administrative Agent through any Person who, at the time of the execution of a particular instrument, is an officer of the Administrative Agent (or any Person acting on behalf of the Administrative Agent pursuant to a valid power of attorney). The power of attorney conferred by this Section to the Administrative Agent is granted for valuable consideration and is coupled with an interest and is irrevocable so long as the Obligations, or any part thereof, shall remain unpaid or the Lenders are obligated to make any Loan under the Loan Documents.

 

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SECTION 8.04. Liability of Administrative Agent. (a) Neither the Administrative Agent nor any of its Related Parties shall:

(i) BE LIABLE FOR ANY ACTION TAKEN OR OMITTED TO BE TAKEN BY ANY OF THEM UNDER OR IN CONNECTION WITH THIS AGREEMENT OR ANY OTHER LOAN DOCUMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY (EXCEPT FOR ITS OWN GROSS NEGLIGENCE OR WILLFUL MISCONDUCT IN CONNECTION WITH ITS DUTIES EXPRESSLY SET FORTH HEREIN AS DETERMINED BY A COURT OF COMPETENT JURISDICTION IN A FINAL AND NONAPPEALABLE JUDGMENT), or

(ii) be responsible in any manner to any Lender or any other Person for any recital, statement, representation or warranty made by the Borrower, any Guarantor or any officer thereof, contained herein or in any other Loan Document, or in any certificate, report, statement or other document referred to or provided for in, or received by the Administrative Agent under or in connection with, this Agreement or any other Loan Document, or the validity, effectiveness, genuineness, enforceability or sufficiency of this Agreement or any other Loan Document, or for the creation, perfection or priority of any Liens purported to be created by any of the Loan Documents, or the validity, genuineness, enforceability, existence, value or sufficiency of any Collateral, or to make any inquiry respecting the performance by the Borrower of its obligations hereunder or under any other Loan Document, or for any failure of the Borrower, any Guarantor or any other party to any Loan Document to perform its obligations hereunder or thereunder. The Administrative Agent shall not be under any obligation to ascertain or to inquire as to the observance or performance of any of the agreements contained in, or conditions of, this Agreement or any other Loan Document, or to inspect the properties, books or records of the Borrower, any of its Subsidiaries, any Guarantor or any Affiliate thereof.

(b) The Administrative Agent shall not be required to use, risk or advance its own funds or otherwise incur financial liability in the performance of any of its duties or the exercise of any of its rights and powers hereunder. In no event shall the Administrative Agent be liable, directly or indirectly, for any special, indirect, punitive or consequential damages, even if the Administrative Agent has been advised of the possibility of such damages and regardless of the form of action. The Administrative Agent shall not be responsible for delays or failures in performance resulting from acts beyond its control. Such acts may include acts of God, strikes, lockouts, riots, acts of war, epidemics, governmental regulations superimposed after the fact, fire, communication line failures, computer viruses, power failures, earthquakes, terrorist attacks or other disasters.

(c) Notwithstanding any other provision of this Agreement or the other Loan Documents, the Administrative Agent shall not be liable for any action taken or not taken by it with the consent or at the request or direction of the Required Lenders (or such other number or percentage of the Lenders as shall be necessary, or as the Administrative Agent shall believe in good faith shall be necessary, to give such request or direction hereunder). The Administrative Agent shall not be subject to any fiduciary or other implied duties, regardless of whether a Default or Event of Default has occurred and is continuing. The Administrative Agent shall not be required to take any action that, in its opinion or the opinion of its counsel, may expose the Administrative Agent to liability or that is contrary to any Loan Document or applicable law.

 

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SECTION 8.05. Reliance by Administrative Agent. (a) The Administrative Agent shall be entitled to rely, and shall be fully protected in relying, upon any writing, communication, signature, resolution, representation, notice, consent, certificate, affidavit, letter, facsimile, e-mail or telephone message, statement or other document or conversation believed by it to be genuine and correct and to have been signed, sent or made by the proper Person or Persons, and shall be entitled to consult and seek advice and statements of legal counsel (including counsel to the Borrower), independent accountants and other experts selected by the Administrative Agent. Delivery of reports, documents and other information to the Administrative Agent is for informational purposes only and the Administrative Agent’s receipt of the foregoing shall not constitute constructive knowledge of any event or circumstance or any information contained therein or determinable from information contained therein. Information contained in notices, reports or other documents delivered to the Administrative Agent and other publicly available information shall not constitute actual or constructive knowledge. Knowledge of or notices or other documents delivered to the Administrative Agent in any capacity shall not constitute knowledge of or delivery to the Administrative Agent in any other capacity under the Loan Documents or to any affiliate or other division of the Administrative Agent.

(b) Notwithstanding any provision of this Agreement or the other Loan Documents to the contrary, before taking or omitting any action to be taken or omitted by the Administrative Agent under the terms of this Agreement and the other Loan Documents, the Administrative Agent may seek the written direction of the Lenders (which written direction may be in the form of an e-mail), and the Administrative Agent is entitled to rely (and is fully protected in so relying) upon such direction. If the Administrative Agent requests such direction with respect to any action, the Administrative Agent shall be entitled to refrain from such action unless and until the Administrative Agent has received such direction, and the Administrative Agent does not incur liability to any Person by reason of so refraining. In the absence of an express statement in the Loan Documents regarding which Lenders shall direct in any circumstance, the direction of the Required Lenders shall apply and be sufficient for all purposes. If the Administrative Agent so requests, it must first be indemnified to its satisfaction by the Lenders against any and all fees, losses, liabilities and expenses which may be incurred by the Administrative Agent by reason of taking or continuing to take, or omitting, any action directed by any Lender. Any provision of this Agreement or the other Loan Documents authorizing the Administrative Agent to take any action does not obligate the Administrative Agent to take such action.

(c) Each Lender that has funded its pro rata share of the Loans shall be deemed to have consented to, approved or accepted, or to be satisfied with, each document or other matter sent by the Borrower or the Administrative Agent to such Lender for consent, approval, acceptance or satisfaction, or required hereunder to be consented to or approved by or acceptable or satisfactory to a Lender. In determining compliance with any condition hereunder or under the other Loan Documents to the closing of this Agreement, the making of a Loan or any disbursement or any withdrawal from any account, the Administrative Agent may presume that such condition is satisfactory to each Lender unless the Administrative Agent has received written notice to the contrary from such Lender prior to the closing, the making of such Loan, any such disbursement or any such withdrawal.

 

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(d) The Administrative Agent shall be entitled to rely upon advice of counsel concerning legal matters and such advice shall be full protection and authorization for any action taken by the Administrative Agent in good faith thereon.

(e) If at any time the Administrative Agent is served with any judicial or administrative order, judgment, decree, writ or other form of judicial or administrative process (including orders of attachment or garnishment or other forms of levies or injunctions or stays relating to the transfer of any Collateral), the Administrative Agent is authorized to comply therewith in any manner as it or its legal counsel of its own choosing deems appropriate, and if the Administrative Agent complies with any such judicial or administrative order, judgment, decree, writ or other form of judicial or administrative process, the Administrative Agent shall not be liable to any of the parties hereto or to any other Person even though such order, judgment, decree, writ or process may be subsequently modified or vacated or otherwise determined to have been without legal force or effect.

(f) In connection with the delivery of any information to the Administrative Agent by any other Person to be used in connection with the preparation or distribution of calculations or reports, the Administrative Agent is entitled to conclusively rely on the accuracy of any such information and shall not be required to investigate or reconfirm its accuracy and shall not be liable in any manner whatsoever for any errors, inaccuracies or incorrect information resulting from the use of this information.

(g) If the Administrative Agent shall reasonably require any information to perform its duties under the Loan Documents, the Borrower shall, to the extent it has such information, provide such information promptly upon request; provided that nothing shall require the Borrower to provide such other information (x) in respect of which disclosure is prohibited by applicable law or (y) which is subject to attorney-client or similar privilege or constitutes attorney work-product.

(h) Whether or not so expressly stated therein, in entering into, or taking (or forbearing from) any action under pursuant to, the Loan Documents, the Administrative Agent shall have all of the rights, immunities, indemnities and other protections granted to it under this Agreement (in addition to those that may be granted to it under the terms of such other agreement or agreements).

(i) Not less than four Business Days (or such shorter period as may be agreed to by the Administrative Agent) prior to any payment, distribution or transfer of funds by the Administrative Agent to any Person under the Loan Documents, the payee shall provide to the Administrative Agent such documentation and information as may be requested by the Administrative Agent (unless such Person has previously provided the documentation or information, and so long as such documentation or information remain accurate and true). The Administrative Agent shall not have any duty, obligation or liability to make any payment to any Person unless it has timely received such documentation and information with respect to such Person, which documentation and information shall be reasonably satisfactory to the Administrative Agent.

(j) The Administrative Agent shall not be liable for any loss, including any loss of principal or interest, or for any breakage fees or penalties in connection with the purchase or liquidation of any investment made in accordance with the terms of the Loan Documents.

 

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(k) The Administrative Agent shall act as the withholding agent under this Agreement with respect to U.S. withholding. The Administrative Agent shall have the right to withhold amounts from any payments under the Loan Documents as are determined in the good faith discretion of the Administrative Agent to be required to comply with applicable law (and the Administrative Agent shall not be required to gross-up or indemnify any other party for amounts it is required to withhold to comply with applicable law). The Borrower and the Lenders, as applicable, shall provide to the Administrative Agent any additional IRS forms (or updated versions of any previously submitted IRS forms) or other documentation at such time or times required by applicable law or upon the reasonable request of the Administrative Agent as may be necessary to (i) determine the nature of the income and whether any tax or withholding obligations apply, (ii) reduce or eliminate the imposition of U.S. withholding taxes and (iii) permit the Administrative Agent to fulfill its tax reporting obligations under applicable law with respect to this Agreement or any amounts paid to the Lenders. The Administrative Agent, both in its individual capacity and in its capacity as Administrative Agent, shall have no liability to the Borrower, the Lenders or any other Person in connection with any tax withholding amounts paid or withheld pursuant to applicable law arising from the Borrower’s or a Lender’s failure, as applicable, to timely provide an accurate, correct and complete IRS Form W-9, an appropriate IRS Form W-8 or such other documentation contemplated under this Agreement (provided, for the avoidance of doubt, that in no event will this sentence or this Section 8.05(k) be interpreted to require the Loan Parties or any of its affiliates to gross-up or indemnify any person for any Excluded Taxes). In the event any IRS form, certification or other documentation that a person is required to provide to the Administrative Agent under the terms of this Agreement expires or becomes obsolete or inaccurate in any respect, the Borrower or any Lender shall promptly provide to the Administrative Agent an updated version of such form, certificate or other documentation or promptly notify the Administrative Agent in writing of its legal inability to do so.

(l) The Lenders and any transferees or assignees after the Closing Date will be required to provide to the Administrative Agent or its agents all information, documentation or certifications reasonably requested by the Administrative Agent to permit the Administrative Agent to comply with its tax reporting obligations under applicable laws, including any applicable cost basis reporting obligations.

SECTION 8.06. Notice of Default. The Administrative Agent shall be deemed not to have knowledge or notice of the occurrence of any Default or Event of Default unless a Responsible Officer of the Administrative Agent shall have received written notice from a Lender or the Borrower referring to this Agreement, describing such Default or Event of Default and stating that such notice is a “notice of default”. The Administrative Agent shall promptly notify the Lenders of its receipt of any such notice. The Administrative Agent shall take such action with respect to such Default or Event of Default as may be directed by the Required Lenders.

SECTION 8.07. Credit Decision; Disclosure of Information by Administrative Agent. Each Lender acknowledges that neither the Administrative Agent nor any Related Party of the Administrative Agent has made any representation or warranty to it, and that no act by the Administrative Agent or any Related Party thereof shall be deemed to constitute any representation or warranty by the Administrative Agent or such Related Party to any Lender as to any matter, including whether the Administrative Agent or the Related Parties thereof have disclosed material information in their possession. Each Lender represents to the Administrative Agent that it has,

 

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independently and without reliance upon the Administrative Agent or any Related Party thereof made its own appraisal of, and investigation into the business, prospects, operations, property, financial and other condition and creditworthiness of the Borrower, the Guarantors and their respective Affiliates, and all applicable bank or other regulatory laws relating to the transactions contemplated hereby, and made its own decision to enter into this Agreement and to extend credit to the Borrower hereunder. Each Lender also represents that it will, independently and without reliance upon the Administrative Agent or any Related Party thereof and based on such documents and information as it shall deem appropriate at the time, continue to make its own credit analysis, appraisals and decisions in taking or not taking action under this Agreement and the other Loan Documents, and to make such investigations as it deems necessary to inform itself as to the business, prospects, operations, property, financial and other condition and creditworthiness of the Borrower and the other Loan Parties. Except for notices, reports and other documents expressly required to be furnished to the Lenders by the Administrative Agent herein, the Administrative Agent shall not have any duty or responsibility to provide any Lender with any credit or other information concerning the business, prospects, operations, property, financial and other condition or creditworthiness of any of the Loan Parties or any of their respective Affiliates which may come into the possession of the Administrative Agent or any Related Party thereof.

SECTION 8.08. Administrative Agent in Its Individual Capacity. The Administrative Agent and its Affiliates may make loans to, accept deposits from, acquire equity interests in and generally engage in any kind of banking, trust, financial advisory, underwriting or other business with the parent entities of the Borrower and its Affiliates as though such Person were not the Administrative Agent and without notice to or consent of the Lenders. The Lenders acknowledge that, pursuant to such activities, the Administrative Agent or its Affiliates may receive information regarding the Borrower or its Affiliates (including information that may be subject to confidentiality obligations in favor of the Borrower or such Affiliate) and acknowledge that the Administrative Agent shall not be under any obligation to provide such information to them. To the extent the Administrative Agent makes any portion of the Loans hereunder, the terms “Lender” and “Lenders” include the Administrative Agent in its individual capacity as such, and the Administrative Agent shall have the same rights and powers under this Agreement as any other Lender and may exercise such rights and powers as though it were not the Administrative Agent.

SECTION 8.09. Successor Agent. The Administrative Agent may resign at any time upon 30 days’ notice to the Lenders with a written copy of such notice to the Borrower. If the Administrative Agent resigns under this Agreement, the Required Lenders shall appoint a successor agent, subject to the consent of the Borrower other than during the continuance of an Event of Default under Section 7.01(b), (c), (g) or (h). Upon the acceptance of its appointment as successor agent hereunder, such successor agent shall succeed to all the rights, powers and duties of the retiring Administrative Agent, the retiring Administrative Agent shall be discharged from all of its duties and obligations hereunder or under the Loan Documents and the term “Administrative Agent” shall mean such successor agent and the retiring Administrative Agent’s appointment, powers and duties as Administrative Agent shall be terminated. After any retiring Administrative Agent’s resignation hereunder, the provisions of this Article VIII shall inure to the benefit of such retiring Administrative Agent, its sub-agents or attorneys in fact and such Administrative Agent’s Related Parties as to any actions taken or omitted to be taken by any of them while the retiring Administrative Agent was the Administrative Agent under this Agreement. If no successor agent has accepted appointment as the Administrative Agent by the date which is

 

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30 days following the retiring Administrative Agent’s notice of resignation, the retiring Administrative Agent’s resignation shall nevertheless thereupon become effective and the Lenders shall perform all of the duties of the Administrative Agent hereunder until such time, if any, as the Required Lenders appoint a successor agent as provided for above; provided that in the case of any security held by the Administrative Agent on behalf of the Lenders under the Loan Documents, the retiring Administrative Agent shall continue to hold such security in a custodial capacity only until such time as a successor agent is appointed or deposit such security with a court of competent jurisdiction (at the expense of Lenders). Any Person into which the Administrative Agent may be merged or converted or with which it may be consolidated, or any Person resulting from any merger, conversion or consolidation to which the Administrative Agent shall be a party, or any Person succeeding to the business of the Administrative Agent shall be the successor of the Administrative Agent without the execution or filing of any paper with any party hereto or any further act on the part of any of the parties hereto, except where an instrument of transfer or assignment is required by law to effect such succession, anything herein to the contrary notwithstanding.

SECTION 8.10. Proof of Claim. In case of the pendency of any receivership, insolvency, liquidation, bankruptcy, reorganization, arrangement, adjustment, composition or other judicial proceeding relative to any Loan Party, the Administrative Agent (irrespective of whether the principal of any Loan shall then be due and payable as herein expressed or by declaration or otherwise and irrespective of whether the Administrative Agent shall have made any demand on the Borrower) shall be entitled and empowered, by intervention in such proceeding or otherwise:

(a) at the direction of the Required Lenders, to file and prove a claim for the whole amount of the principal and interest owing and unpaid in respect of the Loan and all other Obligations that are owing and unpaid and to file such other documents as may be necessary or advisable in order to have the claims of the Lenders and the Administrative Agent (including any claim for the reasonable compensation, expenses, disbursements and advances of the Lenders and the Administrative Agent and their respective agents and counsel and all other amounts due the Lenders and the Administrative Agent pursuant to the terms of the Loan Documents) allowed in such judicial proceeding; and

(b) to collect and receive any monies or other property payable or deliverable on any such claims and to distribute the same.

Any custodian, receiver, receiver-manager, monitor, assignee, trustee, liquidator, sequestrator or other similar official in any such judicial proceeding is hereby authorized by each Lender to make such payments to the Administrative Agent and, in the event that the Administrative Agent shall consent to the making of such payments directly to the Lenders, to pay to the Administrative Agent any amount due for compensation, expenses, disbursements and advances of the Administrative Agent and its agents and counsel, and any other amounts due to the Administrative Agent pursuant to the Loan Documents. Nothing contained herein shall be deemed to authorize the Administrative Agent to authorize or consent to or accept or adopt on behalf of any Lender any plan of reorganization, arrangement, adjustment or composition affecting the Loans or the rights of any Lender or to authorize the Administrative Agent to vote in respect of the claim of any Lender in any such proceeding.

 

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SECTION 8.11. Modifications to Article VIII. The Borrower, the Administrative Agent and each Lender acknowledge and agree that, except as otherwise expressly set forth, the provisions of this Article VIII solely govern the relationship among the Lenders and the Administrative Agent and do not alter or otherwise modify the provisions of this Agreement applicable to the Borrower or the other Loan Parties or otherwise apply to the Borrower or the other Loan Parties. The provisions of this Article VIII may be modified without the Borrower’s or any Loan Party’s consent, but with notice thereafter to the Borrower, so long as such modifications do not alter any of the Borrower’s rights or obligations under this Agreement or any of the other Loan Documents or otherwise alter the economic terms of the Loan or the Loan Documents in any manner.

SECTION 8.12. Discretionary Acts and Solicitation of Lender Consent. Notwithstanding anything else to the contrary herein or in the other Loan Documents, whenever reference is made in this Agreement or any other Loan Document to any discretionary action by, consent, designation, specification, requirement or approval of, notice, request or other communication from, or other direction given or action to be undertaken or to be (or not to be) suffered or omitted by the Administrative Agent or to any election, decision, opinion, acceptance, use of judgment, expression of satisfaction or other exercise of discretion, rights or remedies to be made (or not to be made) by the Administrative Agent, it is understood that the Administrative Agent shall be acting at the direction of the Lenders and shall be fully protected in acting pursuant to such directions.

ARTICLE IX

Miscellaneous

SECTION 9.01. Notices; Electronic Communications. Notices and other communications provided for herein shall be in writing and shall be delivered by hand or overnight courier service, mailed by certified or registered mail, or sent by e-mail, as follows:

(a) if to the Borrower, to it at:

75 Varick Street, 5th Floor

New York, NY 10013

Attention of Cornelia Miller

E-mail: cornelia@hioscar.com

Telephone: (917) 880-0315

(b) if to the Administrative Agent, to it at:

40 West 57th Street – 33rd Floor

New York, NY 10019

Attention of Jake Blair, Aman Malik and Alexey Pazukha

E-mail: jake.blair@hpspartners.com; aman.malik@hpspartners.com;

alexey.pazukha@hpspartners.com; hpsagency@alterdomus.com

Telephone: (212) 287-6845

 

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(c) if to a Lender, to it at its address (or e-mail address) set forth on Schedule 2.01 or in the Assignment and Acceptance pursuant to which such Lender became a party hereto.

All notices and other communications given to any party hereto in accordance with the provisions of this Agreement shall be deemed to have been given on the date of receipt if delivered by hand or overnight courier service or sent by e-mail or on the date five Business Days after dispatch by certified or registered mail if mailed, in each case delivered, sent or mailed (properly addressed) to such party as provided in this Section or in accordance with the latest unrevoked direction from such party given in accordance with this Section.

The Borrower hereby acknowledges that the Administrative Agent may make available to the Lenders materials and/or information provided by or on behalf of the Borrower hereunder (collectively, the “Borrower Materials”) by posting the Borrower Materials on Intralinks or another similar electronic system (the “Platform”).

THE PLATFORM IS PROVIDED “AS IS” AND “AS AVAILABLE”. NEITHER THE ADMINISTRATIVE AGENT NOR ANY OF ITS RELATED PARTIES WARRANTS THE ACCURACY OR COMPLETENESS OF THE COMMUNICATIONS OR THE ADEQUACY OF THE PLATFORM AND EACH EXPRESSLY DISCLAIMS LIABILITY FOR ERRORS OR OMISSIONS IN THE COMMUNICATIONS. NO WARRANTY OF ANY KIND, EXPRESS, IMPLIED OR STATUTORY, INCLUDING ANY WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT OF THIRD PARTY RIGHTS OR FREEDOM FROM VIRUSES OR OTHER CODE DEFECTS IS MADE BY THE ADMINISTRATIVE AGENT OR ANY OF ITS RELATED PARTIES IN CONNECTION WITH THE COMMUNICATIONS OR THE PLATFORM. IN NO EVENT SHALL THE ADMINISTRATIVE AGENT OR ANY OF ITS RELATED PARTIES HAVE ANY LIABILITY TO ANY LOAN PARTY, ANY LENDER OR ANY OTHER PERSON FOR DAMAGES OF ANY KIND, WHETHER OR NOT BASED ON STRICT LIABILITY AND INCLUDING DIRECT OR INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, LOSSES OR EXPENSES (WHETHER IN TORT, CONTRACT OR OTHERWISE) ARISING OUT OF ANY LOAN PARTY’S OR THE ADMINISTRATIVE AGENT’S TRANSMISSION OF COMMUNICATIONS THROUGH THE INTERNET, EXCEPT TO THE EXTENT THE LIABILITY OF ANY SUCH PERSON IS FOUND IN A FINAL RULING BY A COURT OF COMPETENT JURISDICTION TO HAVE RESULTED PRIMARILY FROM SUCH PERSON’S GROSS NEGLIGENCE OR WILLFUL MISCONDUCT.

Each Lender agrees that receipt of notice to it (as provided in the next sentence) specifying that any communications have been posted to the Platform shall constitute effective delivery of such communications to such Lender for purposes of the Loan Documents. Each Lender agrees to notify the Administrative Agent in writing (including by e-mail) from time to time of such Lender’s e-mail address to which the foregoing notice may be sent.

Nothing herein shall prejudice the right of the Administrative Agent or any Lender to give any notice or other communication pursuant to any Loan Document in any other manner specified in such Loan Document.

 

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SECTION 9.02. Survival of Agreement. All covenants, agreements, representations and warranties made by the Borrower herein and in the certificates or other instruments prepared or delivered in connection with or pursuant to this Agreement or any other Loan Document shall be considered to have been relied upon by the Lenders and shall survive the making by the Lenders of the Loans, regardless of any investigation made by the Lenders or on their behalf, and shall continue in full force and effect as long as the principal of or any accrued interest on any Loan or any Fee or any other amount payable under this Agreement or any other Loan Document is outstanding and unpaid and so long as the Commitments have not been terminated. The provisions of Sections 2.14, 2.16, 2.20 and 9.05 shall remain operative and in full force and effect regardless of the expiration of the term of this Agreement, the consummation of the transactions contemplated hereby, the repayment of any of the Loans, the expiration of the Commitments, the invalidity or unenforceability of any term or provision of this Agreement or any other Loan Document, or any investigation made by or on behalf of the Administrative Agent or any Lender.

SECTION 9.03. Binding Effect. This Agreement shall become effective when it shall have been executed by the Borrower and the Administrative Agent and when the Administrative Agent shall have received counterparts hereof which, when taken together, bear the signatures of each of the other parties hereto.

SECTION 9.04. Successors and Assigns. (a) Whenever in this Agreement any of the parties hereto is referred to, such reference shall be deemed to include the permitted successors and assigns of such party, and all covenants, promises and agreements by or on behalf of the Borrower, the Administrative Agent or the Lenders that are contained in this Agreement shall bind and inure to the benefit of their respective successors and assigns.

(b) Each Lender may assign to one or more Eligible Assignees all or a portion of its interests, rights and obligations under this Agreement (including all or a portion of its Commitment and the Loans at the time owing to it), with notice to the Borrower (failure to provide or delay in providing such notice shall not invalidate such assignment) and the prior written consent of the Administrative Agent (not to be unreasonably withheld or delayed); provided that (i) the amount of the Commitment or Loans of the assigning Lender subject to each such assignment (determined as of the date the Assignment and Acceptance with respect to such assignment is delivered to the Administrative Agent) shall be in an integral multiple of, and not less than, $1,000,000 (or, if less, the entire remaining amount of such Lender’s Commitment or Loans); provided that simultaneous assignments by two or more Related Funds shall be combined for purposes of determining whether the minimum assignment requirement is met, (ii) the parties to each assignment shall (A) execute and deliver to the Administrative Agent an Assignment and Acceptance via an electronic settlement system acceptable to the Administrative Agent or (B) if previously agreed with the Administrative Agent, manually execute and deliver to the Administrative Agent an Assignment and Acceptance, and, in each case, shall pay to the Administrative Agent a processing and recordation fee of $3,500 (which fee may be waived or reduced in the sole discretion of the Administrative Agent), and (iii) the assignee, if it shall not be a Lender, shall deliver to the Administrative Agent an Administrative Questionnaire (in which the assignee shall designate one or more credit contacts to whom all syndicate-level information (which may contain material non-public information about the Loan Parties and their respective Related Parties or their respective securities) will be made available and who may receive such information in accordance with the

 

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assignee’s compliance procedures and applicable laws, including Federal and state securities laws), information necessary to satisfy the Administrative Agent’s “know your customer” requirements and all applicable tax forms. Upon acceptance and recording pursuant to clause (e) of this Section, from and after the recordation date of each Assignment and Acceptance, (A) the assignee thereunder shall be a party hereto and, to the extent of the interest assigned by such Assignment and Acceptance, have the rights and obligations of a Lender under this Agreement and (B) the assigning Lender thereunder shall, to the extent of the interest assigned by such Assignment and Acceptance, be released from its obligations under this Agreement (and, in the case of an Assignment and Acceptance covering all or the remaining portion of an assigning Lender’s rights and obligations under this Agreement, such Lender shall cease to be a party hereto but shall continue to be entitled to the benefits of Sections 2.14, 2.16, 2.20 and 9.05, as well as to any Fees accrued for its account and not yet paid); provided that, except to the extent otherwise expressly agreed by the affected parties, no assignment by a Defaulting Lender will constitute a waiver or release of any claim of any party hereunder arising from that Lender’s having been a Defaulting Lender. No assignment shall be made to any Defaulting Lender or any of its subsidiaries, or any Person who, upon becoming a Lender hereunder, would constitute a Defaulting Lender or one of its subsidiaries.

(c) By executing and delivering an Assignment and Acceptance, the assigning Lender thereunder and the assignee thereunder shall be deemed to confirm to and agree with each other and the other parties hereto as follows: (i) such assigning Lender warrants that it is the legal and beneficial owner of the interest being assigned thereby free and clear of any adverse claim and that its Term Loan Commitment, and the outstanding balances of its Term Loans, in each case without giving effect to assignments thereof which have not become effective, are as set forth in such Assignment and Acceptance, (ii) except as set forth in clause (i) above, such assigning Lender makes no representation or warranty and assumes no responsibility with respect to any statements, warranties or representations made in or in connection with this Agreement, or the execution, legality, validity, enforceability, genuineness, sufficiency or value of this Agreement, any other Loan Document or any other instrument or document furnished pursuant hereto, or the financial condition of the Borrower or any Subsidiary or the performance or observance by the Borrower or any Subsidiary of any of its obligations under this Agreement, any other Loan Document or any other instrument or document furnished pursuant hereto; (iii) such assignee represents and warrants that it is an Eligible Assignee legally authorized to enter into such Assignment and Acceptance; (iv) such assignee confirms that it has received a copy of this Agreement, together with copies of the most recent financial statements referred to in Section 3.05(a) or delivered pursuant to Section 5.04 and such other documents and information as it has deemed appropriate to make its own credit analysis and decision to enter into such Assignment and Acceptance; (v) such assignee will independently and without reliance upon the Administrative Agent, such assigning Lender or any other Lender and based on such documents and information as it shall deem appropriate at the time, continue to make its own credit decisions in taking or not taking action under this Agreement; (vi) such assignee appoints and authorizes the Administrative Agent to take such action as agent on its behalf and to exercise such powers under this Agreement as are delegated to the Administrative Agent by the terms hereof, together with such powers as are reasonably incidental thereto; and (vii) such assignee agrees that it will perform in accordance with their terms all the obligations which by the terms of this Agreement are required to be performed by it as a Lender.

 

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(d) The Administrative Agent, acting for this purpose as a non-fiduciary agent of the Borrower, shall maintain at one of its offices in The City of New York a copy of each Assignment and Acceptance delivered to it and a register for the recordation of the names and addresses of the Lenders, and the Commitment of, and principal amount of and interest on the Loans owing to, each Lender pursuant to the terms hereof from time to time (the “Register”). The entries in the Register shall be conclusive absent manifest error and the Borrower, the Administrative Agent and the Lenders shall treat each Person whose name is recorded in the Register pursuant to the terms hereof as a Lender hereunder for all purposes of this Agreement, notwithstanding notice to the contrary. The Register shall be available for inspection by the Borrower and any Lender at any reasonable time and from time to time upon reasonable prior written notice.

(e) Upon its receipt of, and consent to, a duly completed Assignment and Acceptance executed by an assigning Lender and an assignee, an Administrative Questionnaire completed in respect of the assignee (unless the assignee shall already be a Lender hereunder), the processing and recordation fee referred to in clause (b) above, if applicable, the completion of the Administrative Agent’s “know your customer” requirements and the written consent of the Administrative Agent and, if required, the Borrower to such assignment and any applicable tax forms, the Administrative Agent shall (i) accept such Assignment and Acceptance and (ii) record the information contained therein in the Register. No assignment shall be effective unless it has been recorded in the Register as provided in this clause (e).

(f) Each Lender may without the consent of the Borrower or the Administrative Agent sell participations to one or more banks or other Persons in all or a portion of its rights and obligations under this Agreement (including all or a portion of its Commitment and the Loans owing to it); provided that (i) such Lender’s obligations under this Agreement shall remain unchanged, (ii) such Lender shall remain solely responsible to the other parties hereto for the performance of such obligations, (iii) the participating banks or other Persons shall be entitled to the benefit of the cost protection provisions contained in Sections 2.14, 2.16 and 2.20 to the same extent as if they were Lenders (but, with respect to any particular participant, to no greater extent than the Lender that sold the participation to such participant, except to the extent such entitlement to receive a greater payment results from a Change in Law that occurs after the participant acquired the applicable participation) and (iv) the Borrower, the Administrative Agent and the Lenders shall continue to deal solely and directly with such Lender in connection with such Lender’s rights and obligations under this Agreement, and such Lender shall retain the sole right to enforce the obligations of the Borrower relating to the Loans and to approve any amendment, modification or waiver of any provision of this Agreement (other than amendments, modifications or waivers decreasing any fees payable to such participating bank or Person hereunder or the amount of principal of or the rate at which interest is payable on the Loans in which such participating bank or Person has an interest, extending any scheduled principal payment date or date fixed for the payment of interest on the Loans in which such participating bank or Person has an interest, increasing or extending the Commitments in which such participating bank or Person has an interest or releasing any Guarantor (other than in connection with the sale of such Guarantor in a transaction permitted by Section 6.05) or all or substantially all of the Collateral). To the extent permitted by law, each participating bank or other Person also shall be entitled to the benefits of Section 9.06 as though it were a Lender, provided such participating bank or other Person agrees to be subject to Section 2.18 as though it were a Lender. Each Lender that sells a participation shall, acting solely for this purpose as an agent of the Borrower, maintain a register on which it

 

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enters the name and address of each participant and the principal amounts (and stated interest) of each participant’s interest in the Loans or other obligations under the Loan Documents (the “Participant Register”); provided that no Lender shall have any obligation to disclose all or any portion of the Participant Register (including the identity of any participant or any information relating to a Participant’s interest in any commitments, loans or its other obligations under any Loan Document) to any Person except to the extent that such disclosure is necessary to establish that such commitment, loan or other obligation is in registered form under Section 5f.103-1(c) of the United States Treasury Regulations. The entries in the Participant Register shall be conclusive absent manifest error, and such Lender shall treat each Person whose name is recorded in the Participant Register as the owner of such participation for all purposes of this Agreement notwithstanding any notice to the contrary. For the avoidance of doubt, the Administrative Agent (in its capacity as Administrative Agent) shall not have any responsibility for maintaining a Participant Register.

(g) Any Lender or participant may, in connection with any assignment or participation or proposed assignment or participation pursuant to this Section, disclose to the assignee or participant or proposed assignee or participant any information relating to the Borrower furnished to such Lender by or on behalf of the Borrower; provided that, prior to any such disclosure of information designated by the Borrower as confidential, each such assignee or participant or proposed assignee or participant shall execute an agreement whereby such assignee or participant shall agree (subject to customary exceptions) to preserve the confidentiality of such confidential information on terms no less restrictive than those applicable to the Lenders pursuant to Section 9.16.

(h) Any Lender may at any time assign all or any portion of its rights under this Agreement to secure extensions of credit to such Lender or in support of obligations owed by such Lender; provided that no such assignment shall release a Lender from any of its obligations hereunder or substitute any such assignee for such Lender as a party hereto.

(i) Notwithstanding anything to the contrary contained herein, any Lender (a “Granting Lender”) may grant to a special purpose funding vehicle (an “SPV”), identified as such in writing from time to time by the Granting Lender to the Administrative Agent and the Borrower, the option to provide to the Borrower all or any part of any Loan that such Granting Lender would otherwise be obligated to make to the Borrower pursuant to this Agreement; provided that (i) nothing herein shall constitute a commitment by any SPV to make any Loan and (ii) if an SPV elects not to exercise such option or otherwise fails to provide all or any part of such Loan, the Granting Lender shall be obligated to make such Loan pursuant to the terms hereof. The making of a Loan by an SPV hereunder shall utilize the Commitment of the Granting Lender to the same extent, and as if, such Loan were made by such Granting Lender. Each party hereto hereby agrees that no SPV shall be liable for any indemnity or similar payment obligation under this Agreement (all liability for which shall remain with the Granting Lender). In furtherance of the foregoing, each party hereto hereby agrees (which agreement shall survive the termination of this Agreement) that, prior to the date that is one year and one day after the payment in full of all outstanding commercial paper or other senior indebtedness of any SPV, it will not institute against, or join any other Person in instituting against, such SPV any bankruptcy, reorganization, arrangement, insolvency or liquidation proceedings under the laws of the United States or any State thereof. In addition, notwithstanding anything to the contrary contained in this Section, any

 

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SPV may (i) with notice to, but without the prior written consent of, the Borrower and the Administrative Agent and without paying any processing fee therefor, assign all or a portion of its interests in any Loans to the Granting Lender or to any financial institutions (consented to by the Borrower and the Administrative Agent) providing liquidity and/or credit support to or for the account of such SPV to support the funding or maintenance of Loans and (ii) disclose on a confidential basis any non-public information relating to its Loans to any rating agency, commercial paper dealer or provider of any surety, guarantee or credit or liquidity enhancement to such SPV.

(j) The Borrower shall not assign or delegate any of its rights or duties hereunder without the prior written consent of the Administrative Agent and each Lender, and any attempted assignment without such consent shall be null and void.

(k) In connection with any assignment of rights and obligations of any Defaulting Lender hereunder, no such assignment shall be effective unless and until, in addition to the other conditions thereto set forth herein, the parties to the assignment shall make such additional payments to the Administrative Agent in an aggregate amount sufficient, upon distribution thereof as appropriate (which may be outright payment, purchases by the assignee of participations or subparticipations, or other compensating actions, including funding, with the consent of the Borrower and the Administrative Agent, the applicable pro rata share of Loans previously requested but not funded by the Defaulting Lender, to each of which the applicable assignee and assignor hereby irrevocably consent), to pay and satisfy in full all payment liabilities then owed by such Defaulting Lender to the Administrative Agent and each other Lender hereunder (and interest accrued thereon). Notwithstanding the foregoing, in the event that any assignment of rights and obligations of any Defaulting Lender hereunder shall become effective under applicable law without compliance with the provisions of this clause, then the assignee of such interest shall be deemed to be a Defaulting Lender for all purposes of this Agreement until such compliance occurs.

SECTION 9.05. Expenses; Indemnity. (a) The Borrower agrees, jointly and severally, to pay all reasonable and documented out-of-pocket expenses incurred by the Administrative Agent in connection with the preparation and administration of this Agreement and the other Loan Documents or in connection with any amendments, modifications or waivers of the provisions hereof or thereof (whether or not the transactions hereby or thereby contemplated shall be consummated) or incurred by the Administrative Agent or any Lender in connection with the enforcement or protection of its rights in connection with this Agreement and the other Loan Documents or in connection with the Loans made hereunder, limited to, in the case of the Administrative Agent, the reasonable counsel fees, charges and disbursements of a single counsel plus, to the extent reasonably necessary, one local counsel in each applicable material jurisdiction, and any specialty counsel, and, in the case of the Lenders, the reasonable counsel fees, charges and disbursements of a single counsel for all such Lenders plus, to the extent reasonably necessary, one local counsel in each applicable material jurisdiction, and any specialty counsel, for all the Lenders taken as a whole (and, if any Lender shall have advised the Borrower that there is an actual or perceived conflict of interest, one additional firm of primary counsel and, if reasonably necessary, one additional firm of local counsel in each applicable material jurisdiction and specialty counsel for each group of affected Lenders that are similarly situated).

 

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(b) The Borrower agrees to indemnify the Administrative Agent, each Lender and each Related Party of any of the foregoing Persons (each such Person being called an “Indemnitee”) against, and to hold each Indemnitee harmless from, any and all losses, claims, damages, liabilities and related expenses (limited to reasonable counsel fees, charges and disbursements of a single counsel plus, to the extent reasonably necessary, one local counsel in each applicable material jurisdiction, and any specialty counsel, for all the Indemnitees (and, if any Indemnitee shall have advised the Borrower that there is an actual or perceived conflict of interest, one additional firm of primary counsel and, if reasonably necessary, one additional firm of local counsel in each applicable material jurisdiction and specialty counsel for each group of affected Indemnitees that are similarly situated)), incurred by or asserted against any Indemnitee arising out of, in any way connected with, or as a result of (i) the execution or delivery of this Agreement or any other Loan Document or any agreement or instrument contemplated thereby, the performance by the parties thereto of their respective obligations thereunder or the consummation of the Transactions and the other transactions contemplated thereby, (ii) the use of the proceeds of the Loans, (iii) any claim, litigation, investigation or proceeding relating to any of the foregoing, whether or not any Indemnitee is a party thereto (and regardless of whether such matter is initiated by a third party or by the Borrower, any other Loan Party or any of their respective Affiliates), or (iv) any actual or alleged presence or Release of Hazardous Materials on any property currently or formerly owned or operated by the Borrower or any of the Subsidiaries, or any Environmental Liability related in any way to the Borrower or the Subsidiaries; provided that such indemnity shall not, as to any Indemnitee, be available to the extent that such losses, claims, damages, liabilities or related expenses are determined by a court of competent jurisdiction by final and nonappealable judgment to have resulted primarily from the gross negligence, bad faith or willful misconduct of such Indemnitee or a material breach of such Indemnitee’s obligations hereunder.

(c) To the extent that the Borrower fails to pay any amount required to be paid by them to the Administrative Agent or a related party thereof under clause (a) or (b) of this Section, each Lender severally agrees to pay to the Administrative Agent such Lender’s pro rata share (determined as of the time that the applicable unreimbursed expense or indemnity payment is sought) of such unpaid amount; provided that the unreimbursed expense or indemnified loss, claim, damage, liability or related expense, as the case may be, was incurred by or asserted against the Administrative Agent in its capacity as such. For purposes hereof, a Lender’s “pro rata share” shall be determined based upon its share of the sum of the outstanding Term Loans and unused Commitments (if any) at the time (in each case, determined as if no Lender were a Defaulting Lender).

(d) To the extent permitted by applicable law, the Borrower shall not assert, and each hereby waives, any claim against any Indemnitee, on any theory of liability, for special, indirect, consequential or punitive damages (as opposed to direct or actual damages) arising out of, in connection with, or as a result of, this Agreement or any agreement or instrument contemplated hereby, the Transactions, any Loan or the use of the proceeds thereof.

(e) The provisions of this Section shall survive, remain operative and in full force and effect regardless of the expiration of the term of this Agreement, the consummation of the transactions contemplated hereby, the repayment of any of the Loans, the expiration of the Commitments, the invalidity or unenforceability of any term or provision of this Agreement or any other Loan Document, or any investigation made by or on behalf of the Administrative Agent any

 

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Lender. All amounts due under this Section shall be payable on written demand therefor. The payment, indemnification and reimbursement provisions of this Section 9.05 shall not apply to claims for Taxes, except for claims for Taxes that represent damages in respect of a non-Tax claim

SECTION 9.06. Right of Setoff. If an Event of Default shall have occurred and be continuing, each Lender is hereby authorized at any time and from time to time, except to the extent prohibited by law, to set off and apply any and all deposits (general or special, time or demand, provisional or final) at any time held and other indebtedness at any time owing by such Lender to or for the credit or the account of the Borrower against any of and all the obligations of the Borrower now or hereafter existing under this Agreement and other Loan Documents held by such Lender, irrespective of whether or not such Lender shall have made any demand under this Agreement or such other Loan Document and although such obligations may be unmatured; provided that in the event that any Defaulting Lender shall exercise any such right of setoff, (a) all amounts so set off shall be paid over immediately to the Administrative Agent for further application in accordance with the provisions of Section 2.22 and, pending such payment, shall be segregated by such Defaulting Lender from its other funds and deemed held in trust for the benefit of the Administrative Agent and the Lenders, and (b) the Defaulting Lender shall provide promptly to the Administrative Agent a statement describing in reasonable detail the Obligations owing to such Defaulting Lender as to which it exercised such right of setoff. The rights of each Lender and their respective Affiliates under this Section are in addition to other rights and remedies (including other rights of setoff) that such Lender or its Affiliates may have, but shall not apply to any Excluded Assets. Each Lender agrees to notify the Borrower and the Administrative Agent promptly after any such setoff and application; provided that the failure to give such notice shall not affect the validity of such setoff and application.

SECTION 9.07. Applicable Law. THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS (OTHER THAN AS EXPRESSLY SET FORTH IN OTHER LOAN DOCUMENTS) SHALL BE CONSTRUED IN ACCORDANCE WITH AND GOVERNED BY THE LAWS OF THE STATE OF NEW YORK.

SECTION 9.08. Waivers; Amendment. (a) No failure or delay of the Administrative Agent or any Lender in exercising any power or right hereunder or under any other Loan Document shall operate as a waiver thereof, nor shall any single or partial exercise of any such right or power, or any abandonment or discontinuance of steps to enforce such a right or power, preclude any other or further exercise thereof or the exercise of any other right or power. The rights and remedies of the Administrative Agent and the Lenders hereunder and under the other Loan Documents are cumulative and are not exclusive of any rights or remedies that they would otherwise have. No waiver of any provision of this Agreement or any other Loan Document or consent to any departure by the Borrower or any other Loan Party therefrom shall in any event be effective unless the same shall be permitted by clause (b) below, and then such waiver or consent shall be effective only in the specific instance and for the purpose for which given. No notice or demand on the Borrower in any case shall entitle the Borrower to any other or further notice or demand in similar or other circumstances.

(b) Neither this Agreement nor any provision hereof may be waived, amended or modified except pursuant to an agreement or agreements in writing entered into by the Borrower and the Required Lenders; provided that no such agreement shall (i) decrease the principal amount

 

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of, or extend the maturity of or any scheduled principal payment date or date for the payment of any interest on any Loan, or waive or excuse any such payment or any part thereof, or decrease the rate of interest on any Loan, without the prior written consent of each Lender directly adversely affected thereby (other than a waiver of default interest, which shall only require the consent of the Required Lenders), (ii) increase or extend the Commitment or decrease or extend the date for payment of any Fees of any Lender without the prior written consent of such Lender, (iii) amend or modify the pro rata requirements of Section 2.17, the provisions of Section 9.04(j) or the provisions of this Section or release any Guarantor (other than in connection with the sale of such Guarantor in a transaction permitted by Section 6.05) or all or substantially all of the Collateral or value thereof without the prior written consent of each Lender, (iv) modify the protections afforded to an SPV pursuant to the provisions of Section 9.04(i) without the written consent of such SPV or (v) reduce the percentage contained in the definition of the term “Required Lenders” without the prior written consent of each Lender (it being understood that with the consent of the Required Lenders, additional extensions of credit pursuant to this Agreement may be included in the determination of the Required Lenders on substantially the same basis as the Term Loan Commitments on the date hereof); provided further that no such agreement shall amend, modify or otherwise affect the rights or duties of the Administrative Agent hereunder or under any other Loan Document without the prior written consent of the Administrative Agent.

(c) The Administrative Agent and the Borrower may amend any Loan Document to correct administrative errors or omissions, or to effect administrative changes that are not adverse to any Lender. Notwithstanding anything to the contrary contained herein, such amendment shall become effective without any further consent of any other party to such Loan Document.

SECTION 9.09. Interest Rate Limitation. Notwithstanding anything herein to the contrary, if at any time the interest rate applicable to any Loan, together with all fees, charges and other amounts which are treated as interest on such Loan under applicable law (collectively the “Charges”), shall exceed the maximum lawful rate (the “Maximum Rate”) which may be contracted for, charged, taken, received or reserved by the Lender holding such Loan or participation in accordance with applicable law, the rate of interest payable in respect of such Loan or participation hereunder, together with all Charges payable in respect thereof, shall be limited to the Maximum Rate and, to the extent lawful, the interest and Charges that would have been payable in respect of such Loan or participation but were not payable as a result of the operation of this Section shall be cumulated and the interest and Charges payable to such Lender in respect of other Loans or participations or periods shall be increased (but not above the Maximum Rate therefor) until such cumulated amount, together with interest thereon at the Federal Funds Effective Rate to the date of repayment, shall have been received by such Lender.

SECTION 9.10. Entire Agreement. This Agreement and the other Loan Documents constitute the entire contract between the parties relative to the subject matter hereof. Any other previous agreement among the parties with respect to the subject matter hereof is superseded by this Agreement and the other Loan Documents. Nothing in this Agreement or in the other Loan Documents, expressed or implied, is intended to confer upon any Person (other than the parties hereto and thereto, their respective successors and assigns permitted hereunder and, to the extent expressly contemplated hereby, the Related Parties of each of the Administrative Agent and the Lenders) any rights, remedies, obligations or liabilities under or by reason of this Agreement or the other Loan Documents.

 

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SECTION 9.11. WAIVER OF JURY TRIAL. EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF, UNDER OR IN CONNECTION WITH THIS AGREEMENT OR ANY OF THE OTHER LOAN DOCUMENTS. EACH PARTY HERETO (A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND (B) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS, AS APPLICABLE, BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION.

SECTION 9.12. Severability. In the event any one or more of the provisions contained in this Agreement or in any other Loan Document should be held invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions contained herein and therein shall not in any way be affected or impaired thereby (it being understood that the invalidity of a particular provision in a particular jurisdiction shall not in and of itself affect the validity of such provision in any other jurisdiction). The parties shall endeavor in good-faith negotiations to replace the invalid, illegal or unenforceable provisions with valid provisions the economic effect of which comes as close as possible to that of the invalid, illegal or unenforceable provisions.

SECTION 9.13. Counterparts; Electronic Execution.

(a) This Agreement may be executed in counterparts (and by different parties hereto on different counterparts), each of which shall constitute an original but all of which when taken together shall constitute a single contract, and shall become effective as provided in Section 9.03. Delivery of an executed signature page to this Agreement by e-mail or electronic (pdf) transmission shall be as effective as delivery of a manually signed counterpart of this Agreement.

(b) The words “execution,” “signed,” “signature,” and words of like import in any this Agreement and the other Loan Documents, including any Assignment and Acceptance shall be deemed to include electronic signatures or electronic records, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any applicable law including the New York State Electronic Signatures and Records Act, or any other similar state laws on the Uniform Electronic Transactions Act.

SECTION 9.14. Headings. Article and Section headings and the Table of Contents used herein are for convenience of reference only, are not part of this Agreement and are not to affect the construction of, or to be taken into consideration in interpreting, this Agreement.

SECTION 9.15. Jurisdiction; Consent to Service of Process. (a) Each party hereto hereby irrevocably and unconditionally submits, for itself and its property, to the exclusive jurisdiction of any New York State court or Federal court of the United States of America sitting in the Borough of Manhattan in New York City, and any appellate court from any thereof, in any

 

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action or proceeding arising out of or relating to this Agreement or the other Loan Documents, or for recognition or enforcement of any judgment, and each of the parties hereto hereby irrevocably and unconditionally agrees that all claims in respect of any such action or proceeding may be heard and determined in such New York State or, to the extent permitted by law, in such Federal court. Each of the parties hereto agrees that a final judgment in any such action or proceeding shall be conclusive and may be enforced in other jurisdictions by suit on the judgment or in any other manner provided by law.

(b) Each party hereto hereby irrevocably and unconditionally waives, to the fullest extent it may legally and effectively do so, any objection which it may now or hereafter have to the laying of venue of any suit, action or proceeding arising out of or relating to this Agreement or the other Loan Documents in any New York State or Federal court. Each of the parties hereto hereby irrevocably waives, to the fullest extent permitted by law, the defense of an inconvenient forum to the maintenance of such action or proceeding in any such court.

(c) Each party to this Agreement irrevocably consents to service of process in the manner provided for notices in Section 9.01. Nothing in this Agreement will affect the right of any party to this Agreement to serve process in any other manner permitted by law.

SECTION 9.16. Confidentiality. Each of the Administrative Agent and the Lenders agrees to maintain the confidentiality of the Information (as defined below), except that Information may be disclosed (a) to its and its Affiliates’ officers, directors, employees and agents, including accountants, legal counsel and other advisors (it being understood that the Persons to whom such disclosure is made will be informed of the confidential nature of such Information and instructed to keep such Information confidential), (b) to the extent requested by any regulatory authority or quasi-regulatory authority (such as the National Association of Insurance Commissioners), (c) to the extent required by applicable laws or regulations or by any subpoena or similar legal process, (d) in connection with the exercise of any remedies hereunder or under the other Loan Documents or any suit, action or proceeding relating to the enforcement of its rights hereunder or thereunder, (e) to its financing sources (it being understood that the Persons to whom such disclosure is made will be informed of the confidential nature of such Information and instructed to keep such Information confidential), (f) subject to an agreement containing provisions substantially the same as those of this Section, to (i) any actual or prospective assignee of or participant in any of its rights or obligations under this Agreement and the other Loan Documents or (ii) any actual or prospective counterparty (or its advisors) to any swap or derivative transaction relating to the Borrower or any Subsidiary or any of their respective obligations, (g) on a confidential basis to any rating agency in connection with rating the Borrower or the Subsidiaries or the credit facilities provided hereunder, (h) with the consent of the Borrower or (i) to the extent such Information becomes publicly available other than as a result of a breach of this Section. For the purposes of this Section, “Information” shall mean all information received from the Borrower and related to the Borrower or its business, other than any such information that was available to the Administrative Agent or any Lender on a nonconfidential basis prior to its disclosure by the Borrower. Any Person required to maintain the confidentiality of Information as provided in this Section shall be considered to have complied with its obligation to do so if such Person has exercised the same degree of care to maintain the confidentiality of such Information as such Person would accord its own confidential information.

 

97


SECTION 9.17. Lender Action. Each Lender agrees that it shall not take or institute any actions or proceedings, judicial or otherwise, for any right or remedy against any Loan Party or any other obligor under any of the Loan Documents (including the exercise of any right of setoff, rights on account of any banker’s lien or similar claim or other rights of self-help), or institute any actions or proceedings, or otherwise commence any remedial procedures, with respect to any Collateral or any other property of any such Loan Party, unless expressly provided for herein or in any other Loan Document, without the prior written consent of the Administrative Agent. The provisions of this Section are for the sole benefit of the Lenders and shall not afford any right to, or constitute a defense available to, any Loan Party.

SECTION 9.18. USA PATRIOT Act Notice. Each Lender and the Administrative Agent (for itself and not on behalf of any Lender) hereby notifies the Borrower that pursuant to the requirements of the USA PATRIOT Act, it is required to obtain, verify and record information that identifies the Borrower, which information includes the name and address of the Borrower and other information that will allow such Lender or the Administrative Agent, as applicable, to identify the Borrower in accordance with the USA PATRIOT Act.

SECTION 9.19. Certain ERISA Matters. (a) Each Lender (x) represents and warrants, as of the date such Person became a Lender party hereto, to, and (y) covenants, from the date such Person became a Lender party hereto to the date such Person ceases being a Lender party hereto, for the benefit of the Administrative Agent and its Affiliates, and not, for the avoidance of doubt, to or for the benefit of the Borrower or any other Loan Party, that at least one of the following is and will be true:

(i) such Lender is not using “plan assets” (within the meaning of 29 CFR § 2510.3-101, as modified by Section 3(42) of ERISA or otherwise) of one or more Benefit Plans in connection with the Loans or the Commitments;

(ii) the transaction exemption set forth in one or more PTEs, such as PTE 84-14 (a class exemption for certain transactions determined by independent qualified professional asset managers), PTE 95-60 (a class exemption for certain transactions involving insurance company general accounts), PTE 90-1 (a class exemption for certain transactions involving insurance company pooled separate accounts), PTE 91-38 (a class exemption for certain transactions involving bank collective investment funds) or PTE 96-23 (a class exemption for certain transactions determined by in-house asset managers), is applicable with respect to such Lender’s entrance into, participation in, administration of and performance of the Loans, the Commitments and this Agreement;

(iii) (A) such Lender is an investment fund managed by a “Qualified Professional Asset Manager” (within the meaning of Part VI of PTE 84-14), (B) such Qualified Professional Asset Manager made the investment decision on behalf of such Lender to enter into, participate in, administer and perform the Loans, the Commitments and this Agreement, (C) the entrance into, participation in, administration of and performance of the Loans, the Commitments and this Agreement satisfies the requirements of sub-sections (b) through (g) of Part I of PTE 84-14 and (D) to the best knowledge of such Lender, the requirements of subsection (a) of Part I of PTE 84-14 are satisfied with respect to such Lender’s entrance into, participation in, administration of and performance of the Loans, the Commitments and this Agreement; or

 

98


(iv) such other representation, warranty and covenant as may be agreed in writing between the Administrative Agent, in its sole discretion, and such Lender.

(b) In addition, unless either (1) sub-clause (i) in the immediately preceding clause (a) is true with respect to a Lender or such a Lender has not provided another representation, warranty and covenant as provided in accordance with sub-clause (iv) in the immediately preceding clause (a), such Lender further (x) represents and warrants, as of the date such Person became a Lender party hereto, to, and (y) covenants, from the date such Person became a Lender party hereto to the date such Person ceases being a Lender party hereto, for the benefit of, the Administrative Agent and its Affiliates, and not, for the avoidance of doubt, to or for the benefit of the Borrower or any other Loan Party, that: none of the Administrative Agent or any of its Affiliates is a fiduciary with respect to the assets of such Lender involved in the Loans, the Commitments and this Agreement (including in connection with the reservation or exercise of any rights by the Administrative Agent under this Agreement, any Loan Document or any documents related to hereto or thereto).

SECTION 9.20. Acknowledgement and Consent to Bail-In of EEA Financial Institutions. Notwithstanding anything to the contrary in any Loan Document or in any other agreement, arrangement or understanding among any such parties, each party hereto acknowledges that any liability of any Affected Institution arising under any Loan Document, to the extent such liability is unsecured, may be subject to the Write-Down and Conversion Powers of the applicable Resolution Authority and agrees and consents to, and acknowledges and agrees to be bound by:

(a) the application of any Write-Down and Conversion Powers by the applicable Resolution Authority to any such liabilities arising hereunder which may be payable to it by any party hereto that is an Affected Financial Institution; and

(b) the effects of any Bail-in Action on any such liability, including, if applicable:

(i) a reduction in full or in part or cancellation of any such liability;

(ii) a conversion of all, or a portion of, such liability into shares or other instruments of ownership in such Affected Financial Institution, its parent undertaking, or a bridge institution that may be issued to it or otherwise conferred on it, and that such shares or other instruments of ownership will be accepted by it in lieu of any rights with respect to any such liability under this Agreement or any other Loan Document; or

(iii) the variation of the terms of such liability in connection with the exercise of the write-down and conversion powers of the applicable Resolution Authority.

 

99


IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed by their respective authorized officers as of the day and year first above written.

 

MULBERRY HEALTH INC.,
by   /s/ Mario Schlosser
  Name: Mario Schlosser
  Title: Chief Executive Officer

Signature Page to Credit Agreement


HPS INVESTMENT PARTNERS, LLC, as
Administrative Agent
by  

/s/ Jake Blair

  Name: Jake Blair
  Title: Managing Director

Signature Page to Credit Agreement


HPS SPECIALTY LOAN FUND V, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

HPS SPECIALTY LOAN FUND V-L, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

SLIF V-L HOLDINGS, LLC, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

SPECIALTY LOAN FUND 2016, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


SPECIALITY LOAN ONTARIO FUND 2016, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

SLF 2016 INSTITUTIONAL HOLDINGS, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

CST SPECIALTY LOAN FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

MORENO STREET DIRECT LENDING FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


SPECIALTY LOAN VG FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

HPS DPT DIRECT LENDING FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

FALCON CREDIT FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

RELIANCE STANDARD LIFE INSURANCE COMPANY, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


SAFETY NATIONAL CASUALTY CORPORATION, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

PHILADELPHIA INDEMNITY INSURANCE COMPANY, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

TMD-DL HOLDINGS, LLC, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

SPECIALTY LOAN FUND – CX – 2, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


CACTUS DIRECT LENDING FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

PRIVATE LOAN OPPORTUNITIES FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

PACIFIC INDEMNITY COMPANY, as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

 

PRESIDIO LOAN FUND, L.P., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


LINCOLN INVESTMENT SOLUTIONS, INC., as a Lender

 

By: HPS Investment Partners, LLC, its Investment Manager
by        

/s/ Jake Blair

 

 

Name: Jake Blair

Title: Managing Director

Signature Page to Credit Agreement


SCHEDULE 1.01(b)

Guarantors

 

Guarantor

   Type of
Organization
     Jurisdiction of
Organization/
Formation
     Chief Executive Office    Organizational
Identification
Number
 

Mulberry Health Inc.

     Corporation        Delaware      75 Varick Street, New York,
NY 10013
     5230394  

Mulberry Management Corporation

     Corporation        Delaware      75 Varick Street, New York,
NY 10013
     5584228  


SCHEDULE 1.01(c)

Specified ACA Provisions

Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119-1025 (Mar. 23, 2010)

 

1.

Title I, Subtitle C, Part I

Sec. 1201: Amendment to the Public Health Service Act (“PHSA”), as follows:

 

   

PHSA Sec. 2704: Prohibition of preexisting condition exclusions or other discrimination based on health status

 

   

PHSA Sec. 2701, as amended by ACA Section 10103: Fair health insurance premiums

 

   

PHSA Sec. 2702: Guaranteed availability of coverage

 

   

PHSA Sec. 2705: Prohibiting discrimination against individual participants and beneficiaries based on health status

 

   

PHSA Sec. 2707: Comprehensive health insurance coverage

 

2.

Title I, Subtitle D, Part II

Sec. 1312: Consumer choice

 

3.

Title I, Subtitle D, Part III

Sec. 1321: State flexibility in operation and enforcement of Exchanges and related requirements

 

4.

Title I, Subtitle E, Part I

Sec. 1401: Refundable tax credit providing premium assistance for coverage under a qualified health plan

Sec. 1412: Advance determination and payment of premium tax credits and cost-sharing reductions

Sec. 1414: Disclosures to carry out eligibility requirements for certain programs


SCHEDULE 1.01(d)

Permitted Investors

 

Thrive

  
  

Thrive Capital Partners II, L.P.

  

Thrive Capital Partners III, L.P.

  

Thrive Capital Partners V, L.P.

  

Thrive Capital Partners VI Growth, L.P.

  

Claremount TW, L.P.

  

Claremount VI Associates, L.P.

  

Claremount V Associates, L.P.

Google/Alphabet

  
  

CapitalG 2015 LP

  

Google Ventures 2014, L.P.

  

Alphabet Holdings LLC

  

Verily Life Sciences LLC

Founders Fund

  
  

The Founders Fund IV, LP

  

The Founders Fund IV Principals Fund, LP

  

The Founders Fund V, LP

  

The Founders Fund V Principals Fund, LP

  

The Founders Fund V Entrepreneurs Fund, LP

  

The Founders Fund VI, LP

  

The Founders Fund VI Principals Fund, LP

  

The Founders Fund VI Entrepreneurs Fund, LP

  

Napoleon Ta

  

Pai Family Trust

  

Neil Ruthven and Julia Ruthven, Trustees of the Ruthven Family Trust, Dated October 1, 2012

  

John Luttig

General Catalyst

  
  

General Catalyst Group VI, L.P.

  

General Catalyst Group X - Growth Venture, L.P.

Khosla

  
  

Khosla Ventures IV, LP

  

Khosla Ventures IV (CF), LP

  

Khosla Ventures VI, LP

Formation8

  
  

Formation8 Partners Fund I, L.P.

  

8VC Opal SPV, L.P.


   F8 Oscar SPV, L.P.
   F8 Oscar II SPV, L.P.
   8VC Co-Invest Fund I, L.P.

Glynn Partners

  
   Glynn Partners III, L.P.
   Glynn Partners IV, L.P.

Lakestar

  
   Lakestar Growth I LP
   Lakestar I LP
   Lakestar II LP

Fidelity

  
   Powhatan & Co., LLC fbo Fidelity Mt. Vernon Street Trust: Fidelity Growth Company Fund
   Mag & Co fbo Fidelity Growth Company Commingled Pool
   FLAPPER CO fbo FIAM Target Date Blue Chip Growth Commingled Pool
   M Gardiner & Co fbo Fidelity Securities Fund: Fidelity Blue Chip Growth Fund
   Wavechart & Co fbo Fidelity Securities Fund: Fidelity Series Blue Chip Growth Fund
   Mag & Co fbo Fidelity Blue Chip Growth Commingled Pool
   Mag & Co fbo Fidelity Contrafund: Fidelity Advisor New Insights Fund
   Mag & Co fbo Fidelity Contrafund: Fidelity Contrafund
   Mag & Co fbo Fidelity Contrafund Commingled Pool
   Mag & Co. fbo Fidelity Mt. Vernon Street Trust: Fidelity Series Growth Company Fund
   Mag & Co fbo Fidelity Contrafund: Fidelity Series Opportunistic Insights Fund


SCHEDULE 2.01

Lenders and Commitments

 

Lender

   Term Loan
Commitment
Amount
     Term Loan
Commitment
Percentage
 

HPS Specialty Loan Fund V, L.P

   $ 24,015,665.91        16.010

HPS Specialty Loan Fund V-L, L.P

   $ 10,883,846.90        7.256

SLIF V-L Holdings, LLC

   $ 8,599,811.04        5.733

Specialty Loan Fund 2016, L.P.

   $ 22,132,541.06        14.755

Specialty Loan Ontario Fund 2016, L.P.

   $ 3,190,765.81        2.127

SLF 2016 Institutional Holdings, L.P.

   $ 14,945,181.81        9.963

CST Specialty Loan Fund, L.P.

   $ 5,360,307.88        3.574

Moreno Street Direct Lending Fund, L.P.

   $ 3,796,884.75        2.531

Specialty Loan VG Fund, L.P.

   $ 5,908,037.75        3.939

HPS DPT Direct Lending Fund, L.P.

   $ 5,317,765.75        3.545

Falcon Credit Fund, L.P.

   $ 3,222,566.05        2.148

Reliance Standard Life Insurance Company

   $ 4,041,501.96        2.694

Safety National Casualty Corporation

   $ 2,020,750.98        1.347

Philadelphia Indemnity Insurance Company

   $ 2,020,750.98        1.347

TMD-DL Holdings, LLC

   $ 2,020,750.98        1.347

Specialty Loan Fund – CX – 2, L.P.

   $ 5,349,885.06        3.567

Cactus Direct Lending Fund, L.P.

   $ 9,594,578.86        6.396

Private Loan Opportunities Fund, L.P.

   $ 6,916,286.14        4.611

Pacific Indemnity Company

   $ 3,722,436.03        2.482

Presidio Loan Fund, L.P.

   $ 2,685,471.70        1.790

Lincoln Investment Solutions, Inc.

   $ 4,254,212.60        2.836
  

 

 

    

 

 

 

TOTALS

   $ 150,000,000.00        100.000
  

 

 

    

 

 

 


SCHEDULE 3.08

Subsidiaries

 

Guarantor

  

Subsidiary

  

Certificate No.

  

No. Shares/Percentage Interest

Mulberry Health Inc.    Mulberry Insurance Agency, Inc.    1    1,000/100%
Mulberry Health Inc.    Mulberry Management Corporation
(f/k/a Oscar Management Corporation)
   001    1,000/100%
Mulberry Health Inc.    Oscar Health Plan, Inc.    1    1/100%
Mulberry Health Inc.    Oscar Buckeye State Insurance Corporation    1    10,000/100%
Mulberry Health Inc.    Oscar Health Plan of California    1    1,000/100%
Mulberry Health Inc.    Oscar Health Plan of Georgia    1    1,000/100%
Mulberry Health Inc.        Oscar Golden State Managed Care    1    1,000/100%
Mulberry Health Inc.    Oscar Health Plan of New York, Inc.    1    100/100%
Mulberry Health Inc.    Oscar Insurance Corporation    1    20,000,000/100%


Guarantor

  

Subsidiary

  

Certificate No.

  

No. Shares/Percentage Interest

Mulberry Health Inc.    

   Oscar Insurance Corporation of Ohio    1    10,000/100%

Mulberry Health Inc.

   Oscar Health Plan of Pennsylvania Inc    1    1,000/100%

Mulberry Health Inc.

   Oscar Insurance Company of Texas    3    289,889/100%

Mulberry Health Inc.

   Oscar Health Plan of North Carolina, Inc.    1    100,000/100%

Mulberry Health Inc.

   Oscar Insurance Company of Florida    1    100,000/100%

Mulberry Health Inc.

   Oscar Managed Care of South Florida    1    100,000/100%

Mulberry Health Inc.

   Oscar Insurance Corporation of New Jersey    1    14,000/100%

Mulberry Health Inc.

   Oscar Garden State Insurance Corporation    1    140,000/100%


SCHEDULE 3.09

Litigation

 

  1.

Cedars-Sinai Medical Center v. Oscar Health Plan of California.

 

  2.

The Regents of the University of California, a public trust corporation, on behalf of the University of California, Irvine Medical Center v. Oscar Health Plan of California.

 

  3.

Orlando Health, Inc., Orlando Health Central, Inc. and South Lake Hospital, Inc. v. Oscar Insurance Company of Florida.

 

  4.

Orlando Health, Inc., Orlando Health Central, Inc. and South Lake Hospital, Inc. v. Oscar Insurance Company of Florida.

 

  5.

Long Beach Memorial Medical Center, et al. v. Oscar Health Plan of California.

 

  6.

BrainBuilders, LLC v. Oscar Garden State Insurance Corporation.

Potential Disputes & Pending or Threatened Provider Claims:

 

  7.

Potential dispute regarding Baptist Hospital of Miami, Inc.

 

  8.

Trademark infringement allegations brought by Centene Corporation against Oscar Buckeye State Insurance Corporation

 

  9.

Mount Sinai Medical Center of Florida, Inc.

 

  10.

Providence Health Network

 

  11.

Vanderbilt University Medical Center

 

  12.

NYU Winthrop Hospital

 

  13.

Tenet Healthcare Corporation

 

  14.

Northwell Health, Inc.


SCHEDULE 3.17

Environmental Matters

None.


SCHEDULE 3.18

Insurance

 

Broker

   Type    Policy Number    Term

Starr Indemnity & Liability Company

   D&O    1000621071191    8/14/2020 - 8/14/2021

Lloyds of London

   D&O Excess    B0146ERUSA19    8/14/2020 - 8/14/2021

Illinois Union Insurance Company

   Managed Care
Errors &
Omissions
   MSPG7116911A002    8/14/2020 - 8/14/2021

Starr Indemnity & Liability Company

   401(k) - Fiduciary
Liability
   1000621079191    8/14/2020 - 8/14/2021

Hartford Insurance Group

   Commercial
General Liability
   10 SBA PI2280    7/1/2020 - 7/1/2021

Endurance American Specialty Insurance Co.

   Independent
Agent E&O
   APL30001907500    8/7/2020 - 8/7/2021

Allied World Surplus Lines Insurance Co.

   Medical
Malpractice
Excess
   3120564    7/1/2020 - 7/1/2021

Allied World Surplus Lines Insurance Co.

   Medical
Malpractice
   3103746    7/1/2020 - 7/1/2021

At-Bay Insurance Services LLC

   Cyber Liability    6600792    5/13/2020 - 5/13/2021

AXIS Surplus Insurance Company

   Cyber Excess    P00100006640701    5/13/2020 - 5/13/2021


SCHEDULE 3.19(a)

UCC Filing Office

 

Grantor

  

Filing Jurisdiction / Filing Office

Mulberry Health Inc.    Delaware Secretary of State
Mulberry Management Corporation    Delaware Secretary of State


SCHEDULE 3.20(a)

Owned Real Property

None.


SCHEDULE 3.20(b)

Leased Real Property

 

1.

(i) Agreement of Lease, dated July 12, 2019, between Trinity Reit, Inc., as Landlord, and Mulberry Management Corporation, as Tenant, for that certain premises located at 75 Varick Street, 4th Floor, New York, NY 10013, and (ii) Consent to Sublease, dated June 7, 2018, between Trinity Reit, Inc., as Landlord, Getty Images (US), Inc., as Tenant, and Mulberry Management Corporation, as Subtenant, for that certain sublet premises located as 75 Varick Street, 5th Floor, New York, NY 10013.

 

2.

Commercial Lease Agreement, effective April 1, 2019, by and between Paro South LLC, as Lessor, and Mulberry Management Corporation, as Lessee, for that certain premises located at 625 Main Street, Nashville, TN 37206.

 

3.

Assignment and Assumption of Lease, dated August 15, 2016, by and among Independent Worker Services, Inc., as Assignor, Oscar Insurance Corporation, as Assignee, and Jay Street Realty Associates, as Landlord, for that certain premises located at 408 Jay Street, Brooklyn, New York, NY 11201.

 

4.

Lease Agreement, dated October 17, 2018, by and between Quadrant Saint Paul Owner, LP, as Landlord, and Mulberry Management Corporation, as Tenant, for that certain premises located at 750 North St. Paul Street, Suite No. 1340, Dallas, TX 75201.

 

5.

Sublease, dated as of May 30, 2019, between Arup North America Limited, as Sublandlord, and Mulberry Management Corporation, as Subtenant for that certain premises located on the 1st and 2nd Floors of 12777 West Jefferson Blvd, Los Angeles, CA 90066.

 

6.

Occupancy/Sublease Agreement, effective August 1, 2016, between Travelers Haven, LLC, as Grantor, and Oscar Insurance Corp, as Customer, for that certain premises located at 1500 East Broadway Road, Tempe, AZ 85282.


SCHEDULE 3.23

Insurance Licenses

 

Regulated Insurance Company

  

Jurisdiction of Licenses

  

Type of License

Oscar Health Plan, Inc.

  

State of Arizona Department of

Insurance

   Health Care Services

Oscar Health Plan, Inc.

  

State of Illinois Department of

Insurance

   HMO Business

Oscar Buckeye State Insurance Corporation

  

State of Ohio Department of

Insurance

   Basic & Supplemental Insurance

Oscar Health Plan of California

   State of California Health and Human Services Agency    Health Care Service Plan

Oscar Insurance Company of Florida

  

Florida Office of Insurance

Regulation

   Life and Health Insurance Certificate of Authority

Oscar Health Plan of Georgia

  

State of Georgia Office of

Insurance and Safety Fire

Commissioner Certificate of

Authority

   Health Maintenance Organization

Oscar Garden State Insurance Corporation

  

State of New Jersey Department

of Banking and Insurance Office

of the Commissioner

   Life and Health Insurance

Oscar Health Plan of New York, Inc.

   New York State Department of Health -Division of Health Plan Contracting and Oversight    Health Maintenance Organization Certificate of Authority

Oscar Insurance Corporation

   State of New York Department of Financial Services    Accident and Health Insurance

Oscar Insurance Corporation of Ohio

  

State of Ohio Department of

Insurance

   Basic & Supplemental Insurance

Oscar Health Plan of PA, Inc.

   Commonwealth of Pennsylvania Department of Health and Insurance Department    Health Maintenance

Oscar Insurance Company

   Texas Department of Insurance    Accident, Health, Health Maintenance, Life

Oscar Insurance Company

   State of Arkansas Insurance Commissioner    Accident and Health

Oscar Insurance Company

  

State of Colorado Division of

Insurance

   Accident and Health

Oscar Insurance Company

  

State of Iowa Certificate of

Authority

   Accident, Accident and Health, Group Accident and Health, Non- Cancellable Accident and Health

Oscar Insurance Company

  

State of Kansas, Insurance

Department

   Accident and Health


Regulated Insurance Company

  

Jurisdiction of Licenses

  

Type of License

Oscar Insurance Company

   State of Michigan Department of Insurance and Financial Services    Insurance

Oscar Insurance Company

   State of Missouri Department of Insurance    Accident and Health

Oscar Insurance Company

   State of Oklahoma Insurance Commissioner   

Accident & Health or

Sickness

Oscar Insurance Company

   State of Tennessee Department of Commerce and Insurance    Accident and Health

Oscar Insurance Company

   Commonwealth of Virginia State Corporation Commission    Accident & Sickness

Oscar Managed Care of South Florida, Inc.

  

Florida Office of Insurance

Regulation

  

Health Maintenance Organization (HMO)

Certificate of Authority

Oscar Insurance Company

  

State of Nevada Department of

Business and Industry Division of Insurance

  

Nevada Certificate of

Authority

Oscar Health Plan of North Carolina, Inc.

  

North Carolina Department of

Insurance

   HMO Authority


SCHEDULE 5.13

Post-Closing Requirements

 

1.

Within twenty (20) days following the Closing Date (or such later date as the Administrative Agent may agree in its reasonable discretion), each Loan Party shall make its respective deposit accounts and securities accounts, other than any Excluded Account (as defined in the Guarantee and Collateral Agreement), subject to an account control agreement that is in form and substance satisfactory to the Administrative Agent.

 

2.

Within forty-five (45) days after the Closing Date (or, such longer period as agreed to by the Administrative Agent in its reasonable discretion), the Borrower shall deliver original stock certificates for any certificated Pledged Equity Interests (as defined in the Guarantee and Collateral Agreement), accompanied by duly executed instruments or transfer or assignment (including, without limitation, irrevocable stock powers) in blank, in form and substance reasonably satisfactory to Administrative Agent.

 

3.

Within twenty (20) days following the Closing Date (or such later date as the Administrative Agent may agree in its reasonable discretion), the Loan Parties shall deliver, or cause to be delivered, to the Administrative Agent, duly executed and effective endorsements to each applicable insurance policy naming Administrative Agent as an additional insured or loss payee, as applicable, in respect of such policy as required by Section 5.02(b) of the Credit Agreement.


SCHEDULE 6.01(a)

Existing Indebtedness

None.


SCHEDULE 6.02(a)

Existing Liens

 

Debtor

  

Secured Party

  

Filing Number

  

Description

Oscar Health Plan of California   

HALLWAY

INVESTMENTS

LLC

   197741340339   

All right, title and interest in the 2016 Claims

 

Health Republic Insurance Company v. The United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259 and the case captioned Common Ground Healthcare Cooperative v. The United States of America, in the United States Court of Federal Claims, Case No. I:17-cv-00877

Oscar Insurance Company   

HALLWAY

INVESTMENTS

LLC

   17-0042908364   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Company   

HALLWAY

INVESTMENTS

LLC

   19-0038903982   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. The United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259 and the case captioned Common Ground Healthcare Cooperative v. The United States of America, in the United States Court of Federal Claims, Case No. I:17-cv-00877

Oscar Insurance Corporation   

HALLWAY

INVESTMENTS

LLC

   201712220622258   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Corporation   

HALLWAY

INVESTMENTS

LLC

   201712220622311    All right, title and interest in the 2016 Claims.


Debtor

  

Secured Party

  

Filing Number

  

Description

         Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Corporation

  

HALLWAY INVESTMENTS

LLC

   201910150474575   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Corporation

  

HALLWAY INVESTMENTS

LLC

   201910150474626   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Corporation of New Jersey

  

HALLWAY INVESTMENTS

LLC

   52564611   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. 1he United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259

Oscar Insurance Corporation of New Jersey

  

HALLWAY INVESTMENTS

LLC

   53640013   

All right, title and interest in the 2016 Claims.

 

Health Republic Insurance Company v. The United States of America, in the United States Court of Federal Claims, Case No. I:16-cv-00259 and the case captioned Common Ground Healthcare Cooperative v. The United States of America, in the United States Court of Federal Claims, Case No. I:17-cv-00877


EXHIBIT A

FORM OF ADMINISTRATIVE QUESTIONNAIRE

 

Deal Name:    Mulberry Health Inc.
Agent:   

HPS Investment

Partners, LLC

   Return To:    Deal Execution
Address:   

40 West 57th Street,

33rd Floor

New York, NY 10019

   Phone:    (212) 287-5589
   E-mail:   

deal-execution@hpspartners.com

     

LENDER INFORMATION:

 

Legal Name of Lender:

Legal Address:

Fund Manager:

ADMINISTRATIVE/OPERATIONS/NOTICES CONTACTS:

 

    

Primary Contact

  

Secondary Contact

Name:      
Company:      
Title:      
Address:      
     
     
     
Phone:      
Fax:      
E-Mail Address:      

CREDIT CONTACTS:    

 

    

Primary Contact

  

Secondary Contact

Name:      
Company:      
Title:      
Address:      
     
     
     
Phone:      


Fax:
E-Mail Address:

DOMESTIC WIRE INSTRUCTIONS:

 

Currency:
Bank Name:
Swift/Routing No.:
Account Name:
Account No.:
FCC Account Name:
FCC Account No.:
Attention:

FOREIGN WIRE INSTRUCTIONS:

 

Currency:
Bank Name:
Swift/Routing No.:
Account Name:
Account No.:
FCC Account Name:
FCC Account No.:
Attention:
Reference:

 

Currency:
Bank Name:
Swift/Routing No.:
Account Name:
Account No.:
FCC Account Name:
FCC Account No.:
Attention:
Reference:

 

Currency:
Bank Name:
Swift/Routing No.:
Account Name:
Account No.:
FCC Account Name:

 

Exhibit A - 2


FCC Account No.:
Attention:
Reference:

TAX FORM PROVIDED:

 

W-9      
W-8BEN      
W-8IMY      
W-8ECI      
W-8EXP      
Other      

 

Exhibit A - 3


EXHIBIT B

FORM OF ASSIGNMENT AND ACCEPTANCE

This Assignment and Acceptance (the “Assignment and Acceptance”) is dated as of the Effective Date set forth below and is entered into by and between [the][each]1 Assignor identified in item 1 below ([the][each, an] “Assignor”) and [the][each]2 Assignee identified in item 2 below ([the][each, an] “Assignee”). [It is understood and agreed that the rights and obligations of [the Assignors][the Assignees] hereunder are several and not joint.]3 Capitalized terms used but not defined herein shall have the meanings given to them in the Credit Agreement identified below (as amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), receipt of a copy of which is hereby acknowledged by [the][each] Assignee. The Standard Terms and Conditions set forth in Annex 1 attached hereto are hereby agreed to and incorporated herein by reference and made a part of this Assignment and Assumption as if set forth herein in full.

For an agreed consideration, [the][each] Assignor hereby irrevocably sells and assigns to [the Assignee][the respective Assignees], and [the][each] Assignee hereby irrevocably purchases and assumes from [the Assignor][the respective Assignors], subject to and in accordance with the Standard Terms and Conditions and the Credit Agreement, as of the Effective Date inserted by the Administrative Agent as contemplated below (i) all of [the Assignor’s][the respective Assignors’] rights and obligations in [its capacity as a Lender][their respective capacities as Lenders] under the Credit Agreement and any other documents or instruments delivered pursuant thereto to the extent related to the amount and percentage interest identified below of all of such outstanding rights and obligations of [the Assignor][the respective Assignors] under the respective facilities identified below (including any guarantees included in such facilities), and (ii) to the extent permitted to be assigned under applicable law, all claims, suits, causes of action and any other right of [the Assignor (in its capacity as a Lender)][the respective Assignors (in their respective capacities as Lenders)] against any Person, whether known or unknown, arising under or in connection with the Credit Agreement, any other documents or instruments delivered pursuant thereto or the loan transactions governed thereby or in any way based on or related to any of the foregoing, including contract claims, tort claims, malpractice claims, statutory claims and all other claims at law or in equity related to the rights and obligations sold and assigned pursuant to clause (i) above (the rights and obligations sold and assigned by [the][any] Assignor to [the][any] Assignee pursuant to clauses (i) and (ii) above being referred to herein collectively as [the][an] “Assigned Interest”). Each such sale and assignment is without recourse to [the][any] Assignor and, except as expressly provided in this Assignment and Assumption, without representation or warranty by [the][any] Assignor.

 

1 

For bracketed language here and elsewhere in this form relating to the Assignor(s), if the assignment is from a single Assignor, choose the first bracketed language. If the assignment is from multiple Assignors, choose the second bracketed language.

2 

For bracketed language here and elsewhere in this form relating to the Assignee(s), if the assignment is to a single Assignee, choose the first bracketed language. If the assignment is to multiple Assignees, choose the second bracketed language.

3 

Include bracketed language if there are either multiple Assignors or multiple Assignees.

 

Exhibit B - 1


1.   

Assignor[s]:

    
2.   

Assignee[s]:

    
       
       

               [Assignee is an[Affiliate][Related Fund] of [identify Lender]]

 

3.            Borrower:   Mulberry Health Inc., a Delaware corporation.
5.    Administrative Agent:               HPS Investment Partners, LLC, including any successor thereto, as Administrative Agent under the Credit Agreement.
6.    Credit Agreement:   Credit Agreement, dated as of October 30, 2020 (as amended, restated, amended and restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Borrower, HPS Investment Partners, LLC, as Administrative Agent for the Lenders, and the Lenders party thereto from time to time.
7.    Assigned Interest[s]:  

 

Assignor[s]4

  

Assignee[s]5

   Aggregate Amount of
Commitment/Loans for
all Lenders6
     Amount of
Commitment/
Loans Assigned8
     Percentage Assigned
of Commitment/
Loans7
 
      $                    $                                  
      $        $                      
      $        $                      

[8.Trade Date:                        ]8

 

 

4 

List each Assignor, as appropriate.

5 

List each Assignee, as appropriate.

6 

Amount to be adjusted by the counterparties to take into account any payments or prepayments made between the Trade Date and the Effective Date.

7 

Set forth, to at least 9 decimals, as a percentage of the Commitment/Loans of all Lenders thereunder.

8 

To be completed if the Assignor(s) and the Assignee(s) intend that the minimum assignment amount is to be determined as of the Trade Date.

 

Exhibit B - 2


Effective Date:                           , 20     [TO BE INSERTED BY ADMINISTRATIVE AGENT AND WHICH SHALL BE THE EFFECTIVE DATE OF RECORDATION OF TRANSFER IN THE REGISTER THEREFOR.]

The terms set forth in this Assignment and Assumption are hereby agreed to:

 

ASSIGNOR[S]9
[NAME OF ASSIGNOR]
By:  

 

  Name:
  Title:
[NAME OF ASSIGNOR]
By:  

 

  Name:
  Title:
ASSIGNEE[S] 10
[NAME OF ASSIGNEE]
By:  

 

  Name:
  Title:
[NAME OF ASSIGNEE]
By:  

 

  Name:
  Title:

 

9 

Add additional signature blocks as needed. Include both Fund/Pension Plan and manager making the trade (if applicable).

10 

Add additional signature blocks as needed. Include both Fund/Pension Plan and manager making the trade (if applicable).

 

Exhibit B - 3


Accepted:  

HPS INVESTMENT PARTNERS, LLC, as Administrative Agent

By:                                                                                            

Name:

Title:

[MULBERRY HEALTH INC., as

Borrower]11

By:                                                                                            

Name:

Title:

 

11 

To be completed to the extent consents are required under Section 9.04(b) of the Credit Agreement.


ANNEX 1

TO ASSIGNMENT AND ACCEPTANCE

STANDARD TERMS AND CONDITIONS FOR

ASSIGNMENT AND ASSUMPTION

1. Representations and Warranties.

1.1 Assignor[s]. [The][Each] Assignor (a) represents and warrants that (i) it is the legal and beneficial owner of [the][the relevant] Assigned Interest, (ii) [the][such] Assigned Interest is free and clear of any lien, encumbrance or other adverse claim, (iii) it has full power and authority, and has taken all action necessary, to execute and deliver this Assignment and Assumption and to consummate the transactions contemplated hereby and (iv) it is not a Defaulting Lender; and (b) assumes no responsibility with respect to (i) any statements, warranties or representations made in or in connection with the Credit Agreement or any other Loan Document, (ii) the execution, legality, validity, enforceability, genuineness, sufficiency or value of the Loan Documents or any Collateral thereunder, (iii) the financial condition of the Borrower, any of its Subsidiaries or Affiliates or any other Person obligated in respect of any Loan Document, or (iv) the performance or observance by the Borrower, any of its Subsidiaries or Affiliates or any other Person of any of their respective obligations under any Loan Document.

1.2 Assignee[s]. [The][Each] Assignee (a) represents and warrants that (i) it has full power and authority, and has taken all action necessary, to execute and deliver this Assignment and Assumption and to consummate the transactions contemplated hereby and to become a Lender under the Credit Agreement, (ii) it meets all the requirements to be an assignee under the definition of “Eligible Assignee” and under Section 9.04 of the Credit Agreement (subject to such consents, if any, as may be required thereunder), (iii) from and after the Effective Date, it shall be bound by the provisions of the Credit Agreement as a Lender thereunder and, to the extent of [the][the relevant] Assigned Interest, shall have the obligations of a Lender thereunder, (iv) it is sophisticated with respect to decisions to acquire assets of the type represented by the Assigned Interest and either it, or the Person exercising discretion in making its decision to acquire the Assigned Interest, is experienced in acquiring assets of such type, (v) it has received a copy of the Credit Agreement, and has received or has been accorded the opportunity to receive copies of the most recent financial statements delivered pursuant to Section 5.04 thereof, as applicable, and such other documents and information as it deems appropriate to make its own credit analysis and decision to enter into this Assignment and Assumption and to purchase [the][such] Assigned Interest, (vi) it has, independently and without reliance upon the Administrative Agent or any other Lender and based on such documents and information as it has deemed appropriate, made its own credit analysis and decision to enter into this Assignment and Assumption and to purchase [the][such] Assigned Interest, and (vii) if it is a Foreign Lender attached to the Assignment and Assumption is any documentation required to be delivered by it pursuant to the terms of the Credit Agreement, duly completed and executed by [the][such] Assignee; and (b) agrees that (i) it will, independently and without reliance on the Administrative Agent, [the][any] Assignor or any other Lender, and based on such documents and information as it shall deem appropriate at the time, continue to make its own credit decisions in taking or not taking action under the Loan Documents, and (ii) it will perform in accordance with their terms all of the obligations which by the terms of the Loan Documents are required to be performed by it as a Lender.


2. Payments. From and after the Effective Date, the Administrative Agent shall make all payments in respect of [the][each] Assigned Interest (including payments of principal, interest, fees and other amounts) to [the][the relevant] Assignor for amounts which have accrued to but excluding the Effective Date and to [the][the relevant] Assignee for amounts that have accrued from and after the Effective Date.

3. General Provisions. This Assignment and Assumption shall be binding upon, and inure to the benefit of, the parties hereto and their respective successors and assigns. This Assignment and Assumption may be executed in any number of counterparts, which together shall constitute one instrument. Delivery of an executed counterpart of a signature page of this Assignment and Assumption by telecopy shall be effective as delivery of a manually executed counterpart of this Assignment and Assumption. This Assignment and Assumption shall be construed in accordance with and governed by the laws of the State of New York.


EXHIBIT C

FORM OF BORROWING REQUEST

 

Date:                         , 20    
To:    HPS Investment Partners, LLC, as Administrative Agent
   40 West 57th Street
   New York, NY 10019
   Attention of Jake Blair, Aman Malik and Alexey Pazukha
   E-mail: jake.blair@hpspartners.com; aman.malik@hpspartners.com;
   alexey.pazukha@hpspartners.com

Ladies and Gentlemen:

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, amended and restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not otherwise defined herein have the meanings assigned to them in the Credit Agreement.

The Borrower hereby requests a Borrowing to be made on the terms set forth below:

 

  (A)    Date of Borrowing, which is a Business Day (such date, the “Proposed Borrowing Date”)                                          
  (B)    Principal amount of Borrowing    $                                    
  (C)    Type of Loans1 comprising Borrowing                                          
  (D)    Interest Period and the last day thereof2                                          
  (E)    Wire instructions for the Borrower’s account:   
     Bank:   
     ABA Routing Transit Number:   
     Account Number:   
     Account Name:   
     FFC:   
     Reference:   

 

1 

Specify Eurodollar Rate or ABR.

2 

Applicable for Eurodollar Loans only (select from one (1), three (3) or six (6) month Interest Periods).


The Borrower represents and warrants that the representations and warranties set forth in Article III of the Credit Agreement and in each other Loan Document are true and correct in all material respects on and as of the Proposed Borrowing Date with the same effect as though made on and as of such date, except to the extent such representations and warranties expressly relate to an earlier date.

At the time of and immediately after the Proposed Borrowing Date, no Default or Event of Default has occurred and is continuing.

Immediately after giving effect to such Borrowing, the aggregate amount of all Loans made under the Credit Agreement (whether or not outstanding), including the Loans made as part of such Borrowing, does not exceed the aggregate used and unused Commitments of the Lenders.

[The remainder of this page is intentionally left blank.]


MULBERRY HEALTH INC., as the Borrower
By:
        

 

  Name:
  Title:

[Signature Page to Borrowing Notice]


EXHIBIT D

 

 

GUARANTEE AND COLLATERAL AGREEMENT

dated as of

October 30, 2020

among

MULBERRY HEALTH, INC., as Borrower

the Subsidiaries of the Borrower

from time to time party hereto

and

HPS INVESTMENT PARTNERS, LLC,

as Administrative Agent

 

 

 


ARTICLE I DEFINITIONS

     1  

SECTION 1.01 Defined Terms in Credit Agreement and UCC; Construction.

     1  

SECTION 1.02 Other Defined Terms

     1  

ARTICLE II GUARANTEE

     4  

SECTION 2.01 Guarantee

     4  

SECTION 2.02 Guarantee of Payment

     5  

SECTION 2.03 No Limitations, Etc.

     5  

SECTION 2.04 Reinstatement

     6  

SECTION 2.05 Agreement To Pay; Subrogation

     6  

SECTION 2.06 Information

     6  

SECTION 2.07 Subordination of Other Obligations

     7  

SECTION 2.08 Payment Free and Clear of Taxes

     7  

SECTION 2.09 Maximum Liability

     7  

ARTICLE III PLEDGE OF SECURITIES

     7  

SECTION 3.01 Pledge

     7  

SECTION 3.02 Delivery of the Pledged Collateral.

     8  

SECTION 3.03 Representations, Warranties and Covenants

     9  

SECTION 3.04 Certification of Limited Liability Company Interests and Limited Partnership Interests

     10  

SECTION 3.05 Registration in Nominee Name; Denominations

     10  

SECTION 3.06 Voting Rights; Dividends and Interest, Etc.

     10  

SECTION 3.07 Admission of Substitute Partner or Member

     12  

ARTICLE IV SECURITY INTERESTS IN PERSONAL PROPERTY

     12  

SECTION 4.01 Security Interest.

     12  

SECTION 4.02 Representations and Warranties

     14  

SECTION 4.03 Covenants.

     16  

SECTION 4.04 Other Actions

     19  

SECTION 4.05 Covenants Regarding Patent, Trademark and Copyright Collateral.

     21  

ARTICLE V REMEDIES

     22  

SECTION 5.01 Remedies Upon Default

     23  

SECTION 5.02 Application of Proceeds

     25  


SECTION 5.03 Grant of License to Use Intellectual Property

     25  

SECTION 5.04 Securities Act, Etc

     26  

ARTICLE VI INDEMNITY, SUBROGATION AND SUBORDINATION

     26  

SECTION 6.01 Indemnity and Subrogation

     27  

SECTION 6.02 Contribution and Subrogation

     27  

SECTION 6.03 Subordination

     27  

ARTICLE VII MISCELLANEOUS

     27  

SECTION 7.01 Notices

     28  

SECTION 7.02 Security Interest Absolute

     28  

SECTION 7.03 Survival of Agreement

     28  

SECTION 7.04 Binding Effect; Several Agreement

     28  

SECTION 7.05 Successors and Assigns

     29  

SECTION 7.06 Administrative Agent’s Fees and Expenses; Indemnification.

     29  

SECTION 7.07 Administrative Agent Appointed Attorney-in-Fact

     29  

SECTION 7.08 Applicable Law

     30  

SECTION 7.09 Waivers; Amendment.

     30  

SECTION 7.10 WAIVER OF JURY TRIAL

     31  

SECTION 7.11 Severability

     31  

SECTION 7.12 Counterparts

     31  

SECTION 7.13 Headings

     31  

SECTION 7.14 Jurisdiction; Consent to Service of Process.

     31  

SECTION 7.15 Termination or Release.

     32  

SECTION 7.16 Additional Subsidiaries

     33  

SECTION 7.17 Right of Setoff

     33  

 

Schedules

  

        Schedule I

  

Guarantors

        Schedule II

  

Equity Interests; Pledged Debt Securities

        Schedule III

  

Intellectual Property

        Schedule IV

  

Commercial Tort Claims

Exhibits

  

        Exhibit A

  

Form of Supplement

        Exhibit B

  

Form of Perfection Certificate

 

-ii-


GUARANTEE AND COLLATERAL AGREEMENT dated as of October 30, 2020 (this “Agreement”), among MULBERRY HEALTH, INC., a Delaware corporation (the “Borrower”), the Subsidiaries of the Borrower from time to time party hereto and HPS INVESTMENT PARTNERS, LLC, as administrative agent (in such capacity, together with its successors and assigns, the “Administrative Agent”).

PRELIMINARY STATEMENT

Reference is made to the Credit Agreement dated as of October 30, 2020 (as amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Borrower, the lenders from time to time party thereto (the “Lenders”) and the Administrative Agent.

The Lenders have agreed to extend credit to the Borrower pursuant to, and upon the terms and conditions specified in, the Credit Agreement. The obligations of the Lenders to extend credit to the Borrower are conditioned upon, among other things, the execution and delivery of this Agreement by the Borrower and each Guarantor (such term and each other capitalized term used but not defined in this preliminary statement having the meaning given or ascribed to it in Article I). Each Guarantor is an affiliate of the Borrower, will derive substantial benefits from the extension of credit to the Borrower pursuant to the Credit Agreement and is willing to execute and deliver this Agreement in order to induce the Lenders to extend such credit. Accordingly, the parties hereto agree as follows:

ARTICLE I

Definitions

SECTION 1.01 Defined Terms in Credit Agreement and UCC; Construction.

(a) Capitalized terms used in this Agreement and not otherwise defined herein have the meanings set forth in the Credit Agreement. All capitalized terms defined in the New York UCC (as such term is defined herein) and not defined in this Agreement have the meanings specified therein. All references to the Uniform Commercial Code shall mean the New York UCC or, when the context implies or is required, the Uniform Commercial Code as in effect from time to time in any other applicable jurisdiction.

(b) The rules of construction specified in Section 1.02 of the Credit Agreement also apply to this Agreement.

SECTION 1.02 Other Defined Terms. As used in this Agreement, the following terms have the meanings specified below:

Administrative Agent” shall have the meaning assigned to such term in the preamble.

Agreement” shall have the meaning assigned to such term in the preamble.

Article 9 Collateral” shall have the meaning assigned to such term in Section 4.01.

 

1


Borrower” shall have the meaning assigned to such term in the preamble.

Claiming Guarantor” shall have the meaning assigned to such term in Section 6.02.

Collateral” shall mean the Article 9 Collateral and the Pledged Collateral.

Contributing Guarantor” shall have the meaning assigned to such term in Section 6.02.

Copyright License” shall mean any written agreement, now or hereafter in effect, granting any right to any third Person under any Copyright now or hereafter owned by any Grantor or that such Grantor otherwise has the right to license, or granting any right to any Grantor under any Copyright now or hereafter owned by any third Person, and all rights of such Grantor under any such agreement.

Copyrights” shall mean all of the following now owned, licensed or hereafter acquired by any Grantor and all of such Grantor’s rights in: (a) all copyright rights in any work registered under the copyright laws of the United States, whether as author, assignee, transferee, licensee or otherwise, and (b) all registrations and applications for registration of any such copyright in the United States, including registrations, recordings, supplemental registrations and pending applications for registration in the United States Copyright Office (or any successor office), including those listed on Schedule III.

Credit Agreement” shall have the meaning assigned to such term in the preliminary statement.

Excluded Accountshall mean any tax accounts, payroll accounts, employee benefit accounts, trust accounts or other tax or fiduciary accounts.

Excluded Asset shall mean (a) any Excluded Contract; (b) any United States federal “intent to use” trademark application to the extent that, and solely during the period that, the grant of a security interest therein would impair the validity or enforceability or render void or result in the cancellation of, any registration issued as a result of such “intent to use” trademark application under any Requirement of Law; provided that upon the submission to and acceptance by the United States Patent and Trademark Office of an amendment to allege or a verified statement of use pursuant to 15 U.S.C. Section 1060, such “intent to use” trademark application shall no longer constitute an Excluded Asset; (c) any property of a Grantor to the extent that the grant of a security interest by such Grantor therein is prohibited by any Requirement of Law or a Governmental Authority or requires a consent not obtained of any Governmental Authority pursuant to such Requirement of Law (but only to the extent that such prohibition would not be rendered ineffective pursuant to Section 9-406, 9-407, 9-408 or 9-409 of the Uniform Commercial Code), (d) any asset to the extent that the grant of a security interest in such asset could reasonably be expected to result in material and adverse Tax consequences as determined by the Borrower in good faith, and (e) any Excluded Account; provided that Excluded Assets will not include any Proceeds, substitutions or replacements of any Excluded Assets referred to in clauses (a) through (e) (unless such Proceeds, substitutions or replacements would constitute Excluded Assets referred to in clauses (a) through (e)).

 

2


Excluded Contract” shall mean, at any date, any rights or interest of any Grantor under any agreement, contract, license, lease, instrument, document or other general intangible (referred to solely for purposes of this definition as a “Contract”) to the extent that such Contract by the terms of a restriction in favor of a Person who is not a Grantor or a Subsidiary of a Grantor (a) prohibits, requires any consent or establishes any other condition for, (b) could or would be terminated, abandoned, invalidated, or rendered unenforceable by or (c) would be breached or rendered in default as the result of the grant of the Security Interest therein by such Grantor (but only to the extent that any such term would not be rendered ineffective pursuant to Section 9-406, 9-407, 9-408 or 9-409 of the Uniform Commercial Code (or any successor provision or provisions) or any other Requirement of Law or any principles of equity); provided that: (i) rights to payment under any such Contract otherwise constituting an Excluded Contract by virtue of this definition shall be included in the Collateral to the extent permitted thereby by Section 9-406 or Section 9-408 of the Uniform Commercial Code and (ii) all Proceeds paid or payable to any Grantor from any sale, transfer or assignment of such contract and all rights to receive such Proceeds shall be included in the Collateral.

Federal Securities Laws” shall have the meaning assigned to such term in Section 5.04.

Grantors” shall mean the Borrower and the Guarantors.

Guarantors” shall mean (a) the Subsidiaries identified on Schedule I hereto as Guarantors and (b) each other Subsidiary that is required, pursuant to the Credit Agreement, or to which the Borrower elects to become a party to this Agreement as a Guarantor after the Closing Date.

Intellectual Property” shall mean all intellectual and similar property of any Grantor of every kind and nature now owned or hereafter acquired by any Grantor, including inventions, designs, Patents, Copyrights, Licenses, Trademarks, trade secrets, domain names, confidential or proprietary technical and business information, know-how, show-how or other data or information, software and databases and all embodiments or fixations thereof and related documentation, registrations and franchises, and all additions, improvements and accessions to, and books and records describing or used in connection with, any of the foregoing.

License” shall mean any Patent License, Trademark License, Copyright License or other license or sublicense agreement relating to Intellectual Property to which any Grantor is a party, including those listed on Schedule III.

New York UCC” shall mean the Uniform Commercial Code as from time to time in effect in the State of New York.

Obligee Guarantor” shall have the meaning assigned to such term in Section 2.07.

Patent License” shall mean any written agreement, now or hereafter in effect, granting to any third Person any right to make, use or sell any invention on which a Patent, now or hereafter owned by any Grantor or that any Grantor otherwise has the right to license, is in existence, or granting to any Grantor any right to make, use or sell any invention on which a Patent, now or hereafter owned by any third Person, is in existence, and all rights of any Grantor under any such agreement.

 

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Patents” shall mean all of the following now owned, licensed or hereafter acquired by any Grantor and all of such Grantor’s rights in: (a) all letters patent of the United States, all registrations and recordings thereof, and all applications for letters patent of the United States, including registrations, recordings and pending applications in the United States Patent and Trademark Office (or any successor office), including those listed on Schedule III, and (b) all reissues, continuations, divisions, continuations-in-part, renewals or extensions thereof, and the inventions disclosed or claimed therein, including the right to make, use and/or sell the inventions disclosed or claimed therein.

Pledged Collateral” shall have the meaning assigned to such term in Section 3.01.

Pledged Debt Securities” shall have the meaning assigned to such term in Section 3.01.

Pledged Equity Interests” shall have the meaning assigned to such term in Section 3.01.

Security Interest” shall have the meaning assigned to such term in Section 4.01.

Trademark License” shall mean any written agreement, now or hereafter in effect, granting to any third Person any right to use any Trademark now or hereafter owned by any Grantor or that any Grantor otherwise has the right to license, or granting to any Grantor any right to use any Trademark now or hereafter owned by any third Person, and all rights of any Grantor under any such agreement.

Trademarks” shall mean all of the following now owned, licensed or hereafter acquired by any Grantor and all of such Grantor’s rights in: (a) all registered trademarks, service marks, trade names, corporate names, company names, business names, fictitious business names, trade styles, trade dress, logos, other source or business identifiers, designs and general intangibles of like nature, now existing or hereafter adopted or acquired, all registrations and recordings thereof, and all registrations, recordings and pending applications filed in connection therewith, including registrations and registration applications in the United States Patent and Trademark Office (or any successor office), and all extensions or renewals thereof, including those listed on Schedule III, (b) all goodwill associated therewith or symbolized thereby and (c) all other assets, rights and interests that uniquely reflect or embody such goodwill.

ARTICLE II

Guarantee

SECTION 2.01 Guarantee. Each Guarantor unconditionally guarantees, jointly with the other Guarantors and severally, as a primary obligor and not merely as a surety, the due and punctual payment and performance of the Obligations. Each Guarantor further agrees that the Obligations may be extended or renewed, in whole or in part, without notice to or further assent from it, and that it will remain bound upon its guarantee notwithstanding any extension or renewal

 

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of any Obligation. Each Guarantor waives presentment to, demand of payment from and protest to the Borrower or any other Loan Party of any Obligation, and also waives notice of acceptance of its guarantee and notice of protest for nonpayment.

SECTION 2.02 Guarantee of Payment. Each Guarantor further agrees that its guarantee hereunder constitutes a guarantee of payment when due (whether at maturity, by acceleration upon one or more dates set for prepayment or otherwise) and not of collection, and waives any right to require that any resort be had by the Administrative Agent or any other Secured Party to any security held for the payment of the Obligations or to any balance of any Deposit Account or credit on the books of the Administrative Agent or any other Secured Party in favor of the Borrower or any other Person.

SECTION 2.03 No Limitations, Etc.

(a) Except for termination or release of a Guarantor’s obligations hereunder as expressly provided in Section 7.15, the obligations of each Guarantor hereunder shall not be subject to any reduction, limitation, impairment or termination for any reason, including any claim of waiver, release, surrender, alteration or compromise, and shall not be subject to any defense or setoff, counterclaim, recoupment or termination whatsoever by reason of the invalidity, illegality or unenforceability of the Obligations or otherwise. Without limiting the generality of the foregoing, the obligations of each Guarantor hereunder shall not be discharged or impaired or otherwise affected by, and each Guarantor hereby waives any defense to the enforcement hereof by reason of: (i) the failure of the Administrative Agent or any other Secured Party to assert any claim or demand or to exercise or enforce any right, power or remedy under the provisions of any Loan Document or otherwise, (ii) any rescission, waiver, amendment or modification of, increase in the Obligations with respect to, or any release from any of the terms or provisions of, any Loan Document or any other agreement, including with respect to any other Guarantor under this Agreement, (iii) the release of, or any impairment of or failure to perfect any Lien on or security interest in, any security held by the Administrative Agent or any other Secured Party for the Obligations or any of them, (iv) any default, failure or delay, willful or otherwise, in the performance of the Obligations, (v) any other act or omission that may or might in any manner or to any extent vary the risk of any Guarantor or otherwise operate as a discharge of any Guarantor as a matter of law or equity (other than the indefeasible payment in full in cash of all the Obligations), (vi) any illegality, lack of validity or enforceability of any Obligation, (vii) any change in the corporate existence, structure or ownership of any Loan Party or any Subsidiary, or any insolvency, bankruptcy, reorganization or other similar proceeding affecting any Loan Party, any Subsidiary or their respective assets or any resulting release or discharge of any Obligation, (viii) the existence of any claim, set-off or other rights that the Guarantors may have at any time against the Borrower, the Administrative Agent, any other Secured Party or any other Person, whether in connection herewith or any unrelated transactions, (ix) any action permitted or authorized hereunder, or (x) any other circumstance (including without limitation, any statute of limitations) or any existence of or reliance on any representation by the Administrative Agent or any other Secured Party that might otherwise constitute a defense to, or a legal or equitable discharge of, the Borrower or any Guarantor or any other guarantor or surety. Each Guarantor expressly authorizes the Administrative Agent to take and hold security for the payment and performance of the Obligations, to exchange, waive or release any or all such security (with or without consideration), to enforce or apply such security and direct the order and manner of any

 

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sale thereof in its sole discretion or to release or substitute any one or more other guarantors or obligors upon or in respect of the Obligations, all without affecting the obligations of any Guarantor hereunder.

(b) To the fullest extent permitted by applicable law, each Guarantor waives any defense based on or arising out of any defense of the Borrower or any other Loan Party or the unenforceability of the Obligations or any part thereof from any cause, or the cessation from any cause of the liability of the Borrower or any other Loan Party, other than the indefeasible payment in full in cash of all the Obligations. The Administrative Agent and the other Secured Parties may, at their election, foreclose on any security held by one or more of them by one or more judicial or nonjudicial sales, accept an assignment of any such security in lieu of foreclosure, compromise or adjust any part of the Obligations, make any other accommodation with the Borrower or any other Loan Party or exercise any other right or remedy available to them against the Borrower or any other Loan Party, without affecting or impairing in any way the liability of any Guarantor hereunder except to the extent the Obligations have been fully and indefeasibly paid in full in cash. To the fullest extent permitted by applicable law, each Guarantor waives any defense arising out of any such election even though such election operates, pursuant to applicable law, to impair or to extinguish any right of reimbursement or subrogation or other right or remedy of such Guarantor against the Borrower or any other Loan Party, as the case may be, or any security.

SECTION 2.04 Reinstatement. Each Guarantor agrees that its guarantee hereunder shall continue to be effective or be reinstated, as the case may be, if at any time payment, or any part thereof, of any Obligation is rescinded or must otherwise be restored by the Administrative Agent or any other Secured Party upon the bankruptcy or reorganization of the Borrower, any other Loan Party, any Subsidiary or otherwise.

SECTION 2.05 Agreement To Pay; Subrogation. In furtherance of the foregoing and not in limitation of any other right that the Administrative Agent or any other Secured Party has at law or in equity against any Guarantor by virtue hereof, upon the failure of the Borrower or any other Loan Party to pay any Obligation when and as the same shall become due, whether at maturity, by acceleration, after notice of prepayment or otherwise, each Guarantor hereby promises to and will forthwith pay, or cause to be paid, to the Administrative Agent for distribution to the applicable Secured Parties in cash the amount of such unpaid Obligation. Upon payment by any Guarantor of any sums to the Administrative Agent as provided above, all rights of such Guarantor against the Borrower or any other Guarantor arising as a result thereof by way of right of subrogation, contribution, reimbursement, indemnity or otherwise shall in all respects be subject to Article VI.

SECTION 2.06 Information. Each Guarantor assumes all responsibility for being and keeping itself informed of the Borrower’s and each other Loan Party’s financial condition and assets and of all other circumstances bearing upon the risk of nonpayment of the Obligations and the nature, scope and extent of the risks that such Guarantor assumes and incurs hereunder, and agrees that neither the Administrative Agent nor any other Secured Party will have any duty to advise such Guarantor of information known to it or any of them regarding such circumstances or risks.

 

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SECTION 2.07 Subordination of Other Obligations. Any Indebtedness of the Borrower or any other Guarantor now or hereafter held by any other Guarantor (the “Obligee Guarantor”) whether as original creditor, assignee, or by way of subrogation, restitution or otherwise, is hereby subordinated in right of payment to the guaranteed Obligations, and if the Administrative Agent so requests while a Default or an Event of Default has occurred and is continuing (any such request, a “Turnover Request”) (provided that no request shall be required in the case of any proceeding described in clause (g) or (h) of Article VII of the Credit Agreement commenced by or against any Grantor), any such Indebtedness collected or received by the Obligee Guarantor shall be held in trust for the Administrative Agent on behalf of the Secured Parties and shall forthwith be paid over to the Administrative Agent on behalf of the Secured Parties to be credited and applied against the Obligations but without affecting, impairing or limiting in any manner the liability of the Obligee Guarantor under any other provision hereof.

SECTION 2.08 Payment Free and Clear of Taxes. Any and all payments by or on account of any obligation of any Guarantor hereunder or under any other Loan Document shall be made free and clear of, and without deduction for, any Indemnified Taxes or Other Taxes on the same terms and to the same extent that payments by any Loan Party are required to be made pursuant to the terms of Section 2.20 of the Credit Agreement. The provisions of Section 2.20 of the Credit Agreement shall apply to each Guarantor mutatis mutandis.

SECTION 2.09 Maximum Liability. Anything herein or in any other Loan Document to the contrary notwithstanding, the maximum liability of each Guarantor hereunder and under the other Loan Documents shall in no event exceed the maximum amount that can be guaranteed by such Guarantor under (including the maximum amount that can be guaranteed by such Guarantor without rendering such Guarantor “insolvent” within the meaning of, leaving such Guarantor with unreasonably small capital or assets, within the meaning of, or leaving such Guarantor unable to pay its debts as they become due within the meaning of) applicable federal and state laws relating to the insolvency of debtors (after giving effect to the rights of subrogation and contribution established in Section 6.02 or otherwise available to such Guarantor under applicable law).

ARTICLE III

Pledge of Securities

SECTION 3.01 Pledge. As security for the payment or performance, as the case may be, in full of the Obligations, each Grantor hereby assigns and pledges to the Administrative Agent, for the benefit of the Secured Parties, and hereby grants to the Administrative Agent, for the benefit of the Secured Parties, a security interest in, all of such Grantor’s right, title and interest in, to and under (a)(i) the Equity Interests owned or held by such Grantor on the date hereof (including all such Equity Interests listed on Schedule II), (ii) any other Equity Interests obtained in the future by such Grantor and (iii) the certificates representing all such Equity Interests (all the foregoing collectively referred to herein as the “Pledged Equity Interests”), (b)(i) the debt securities owned or held by such Grantor on the date hereof (including all such debt securities listed opposite the name of such Grantor on Schedule II), (ii) any debt securities in the future issued to such Grantor and (iii) the promissory notes and any other instruments evidencing such debt securities (all the foregoing collectively referred to herein as the “Pledged Debt Securities”), (c) all

 

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other property that may be delivered to and held by the Administrative Agent pursuant to the terms of this Section 3.01, (d) subject to Section 3.06, all payments of principal or interest, dividends, cash, instruments and other property from time to time received, receivable or otherwise distributed in respect of, in exchange for or upon the conversion of, and all other Proceeds received in respect of, the securities referred to in clauses (a) and (b) above, (e) subject to Section 3.06, all rights and privileges of such Grantor with respect to the securities and other property referred to in clauses (a), (b), (c) and (d) above, including all governance rights, including all rights to vote, consent to action and otherwise participate in the management of the issuer of any Pledged Equity Interests, and (f) all Proceeds of any of the foregoing (the items referred to in clauses (a) through (f) above being collectively referred to as the “Pledged Collateral”); provided that notwithstanding anything else in this Agreement, neither “Pledged Collateral,” “Pledged Equity Interests,” “Pledged Debt Securities,” nor any component thereof, nor any defined term used in the items constituting Pledged Collateral shall include any Excluded Asset, and no security interest in any Excluded Asset will be granted pursuant to this Agreement.

TO HAVE AND TO HOLD the Pledged Collateral, together with all right, title, interest, powers, privileges and preferences pertaining or incidental thereto, unto the Administrative Agent, for the benefit of the Secured Parties, forever; subject, however, to the terms, covenants and conditions hereinafter set forth.

SECTION 3.02 Delivery of the Pledged Collateral.

(a) Each Grantor agrees to promptly deliver or cause to be delivered on the Closing Date (or, in the case of any item acquired or received after the Closing Date, within ten days thereafter (or such longer period as may be agreed by the Administrative Agent in its reasonable discretion)) to the Administrative Agent any and all certificates, instruments or other documents representing or evidencing Pledged Collateral.

(b) Each Grantor agrees to promptly deliver or cause to be delivered on the Closing Date (or, in the case of any item acquired or received after the Closing Date, within ten days thereafter (or such longer period as may be agreed by the Administrative Agent in its reasonable discretion)) to the Administrative Agent any and all Pledged Debt Securities.

(c) Upon delivery to the Administrative Agent, (i) any certificate, instrument or document representing or evidencing Pledged Collateral shall be accompanied by undated stock powers duly executed in blank or other undated instruments of transfer reasonably satisfactory to the Administrative Agent and duly executed in blank and by such other instruments and documents as the Administrative Agent may reasonably request and (ii) all other property comprising part of the Pledged Collateral shall be accompanied by instruments of assignment duly executed by the applicable Grantor and such other instruments or documents as the Administrative Agent may reasonably request. Each delivery of Pledged Collateral shall be accompanied by a schedule describing the applicable securities, which schedule shall be attached hereto as Schedule II and made a part hereof; provided that failure to attach any such schedule hereto shall not affect the validity of the pledge of such Pledged Collateral. Each schedule so delivered shall supplement any prior schedules so delivered.

 

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SECTION 3.03 Representations, Warranties and Covenants. The Grantors jointly and severally represent, warrant and covenant to and with the Administrative Agent, for the benefit of the Secured Parties, that:

(a) Schedule II correctly sets forth the percentage of the issued and outstanding shares of each class of the Equity Interests of the issuer thereof represented by such Pledged Equity Interests and includes all Equity Interests, debt securities and promissory notes required to be pledged hereunder;

(b) the Pledged Equity Interests and Pledged Debt Securities have been duly and validly authorized and issued by the issuers thereof and (i) in the case of Pledged Equity Interests, are fully paid and nonassessable and (ii) in the case of Pledged Debt Securities, are legal, valid and binding obligations of the issuers thereof;

(c) except for the security interests granted hereunder (or otherwise expressly permitted under Section 6.02 of the Credit Agreement), each Grantor (i) is and, subject to any transfers made in compliance with the Credit Agreement, will continue to be the direct owner, beneficially and of record, of the Pledged Debt Securities indicated on Schedule II as owned by such Grantor, (ii) holds the same free and clear of all Liens (other than any Lien created or expressly permitted by the Loan Documents), (iii) will make no assignment, pledge, hypothecation or transfer of, or create or permit to exist any security interest in or other Lien on, the Pledged Collateral, other than as expressly permitted under the Credit Agreement, and (iv) subject to Section 3.06, will cause any and all Pledged Collateral, whether for value paid by such Grantor or otherwise, to be forthwith deposited with the Administrative Agent and pledged or assigned hereunder;

(d) except for restrictions and limitations imposed by the Loan Documents or securities laws generally, the Pledged Collateral is and will continue to be freely transferable and assignable, and none of the Pledged Collateral is or will be subject to any option, right of first refusal, shareholders agreement, charter or by-law provisions or contractual restriction of any nature that might prohibit, impair, delay or otherwise affect the pledge of such Pledged Collateral hereunder, the sale or disposition thereof pursuant hereto or the exercise by the Administrative Agent of rights and remedies hereunder;

(e) each Grantor (i) has the power and authority to pledge the Pledged Collateral pledged by it hereunder in the manner hereby done or contemplated and (ii) will defend its title or interest thereto or therein against any and all Liens (other than any Lien created or expressly permitted by the Loan Documents), however arising, of all Persons whomsoever;

(f) no consent or approval of any Governmental Authority, any securities exchange or any other Person was or is necessary to the validity of the pledge effected hereby (other than such as have been obtained and are in full force and effect);

(g) by virtue of the execution and delivery by each Grantor of this Agreement, when any Pledged Collateral is delivered to the Administrative Agent in accordance with this Agreement, the Administrative Agent will obtain a legal, valid and perfected first priority lien upon and security interest in such Pledged Collateral as security for the payment and performance of the Obligations; and

 

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(h) the pledge effected hereby is effective to vest in the Administrative Agent, for the ratable benefit of the Secured Parties, the rights of the Administrative Agent in the Pledged Collateral as set forth herein and all action by any Grantor necessary to protect and perfect the Lien on the Pledged Collateral has been duly taken.

SECTION 3.04 Certification of Limited Liability Company Interests and Limited Partnership Interests. No interest in any limited liability company or limited partnership which is a Subsidiary and pledged hereunder shall be represented by a certificate, nor shall be a “security” within the meaning of Article 8 of the New York UCC unless such certificate has been pledged hereunder and delivered to the Administrative Agent pursuant to Section 3.02. The Grantors shall not amend, or permit to be amended, the limited liability company agreement or partnership agreement of any Grantor whose Equity Interests are not, or are required by this Section 3.04 not to be, “securities” within the meaning of Article 8 of the Uniform Commercial Code in a manner to cause such Equity Interests to constitute “securities” within the meaning of Article 8 of the Uniform Commercial Code.

SECTION 3.05 Registration in Nominee Name; Denominations. The Administrative Agent, on behalf of the Secured Parties, shall have the right (in its reasonable discretion) to hold the Pledged Collateral in its own name as pledgee, the name of its nominee (as pledgee or as sub-agent) or the name of the applicable Grantor, endorsed or assigned in blank or in favor of the Administrative Agent. Each Grantor will promptly give to the Administrative Agent copies of any notices or other communications received by it with respect to Pledged Collateral in its capacity as the registered owner thereof. The Administrative Agent shall at all times have the right to exchange the certificates representing Pledged Collateral for certificates of smaller or larger denominations for any reasonable purpose consistent with this Agreement.

SECTION 3.06 Voting Rights; Dividends and Interest, Etc.

(a) Unless and until an Event of Default shall have occurred and be continuing and the Administrative Agent shall have given the Grantors prior written notice of its intent to exercise its rights under this Agreement (which notice shall be deemed to have been given immediately upon the occurrence of an Event of Default under clause (g) or (h) of Article VII of the Credit Agreement):

(i) Each Grantor shall be entitled to exercise any and all voting and/or other consensual rights and powers inuring to an owner of Pledged Collateral or any part thereof for any purpose consistent with the terms of this Agreement, the Credit Agreement and the other Loan Documents; provided that such rights and powers shall not be exercised in any manner that could materially and adversely affect the rights inuring to a holder of any Pledged Collateral or the rights and remedies of any of the Administrative Agent or the other Secured Parties under this Agreement or the Credit Agreement or any other Loan Document or the ability of the Secured Parties to exercise the same.

 

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(ii) The Administrative Agent shall execute and deliver to each Grantor, or cause to be executed and delivered to each Grantor, all such proxies, powers of attorney and other instruments as such Grantor may reasonably request (at the sole expense of the Borrower) for the purpose of enabling such Grantor to exercise the voting and/or consensual rights and powers it is entitled to exercise pursuant to clause (i) above.

(iii) Each Grantor shall be entitled to receive and retain any and all dividends, interest, principal and other distributions paid on or distributed in respect of the Pledged Collateral to the extent and only to the extent that such dividends, interest, principal and other distributions are expressly permitted by, and otherwise paid or distributed in accordance with, the terms and conditions of the Credit Agreement, the other Loan Documents and applicable law; provided that any noncash dividends, interest, principal or other distributions that would constitute Pledged Equity Interests or Pledged Debt Securities, whether resulting from a subdivision, combination or reclassification of the outstanding Equity Interests of the issuer of any Pledged Collateral or received in exchange for Pledged Collateral or any part thereof, or in redemption thereof, or as a result of any merger, consolidation, acquisition or other exchange of assets to which such issuer may be a party or otherwise, shall be and become part of the Pledged Collateral, and, if received by any Grantor, shall not be commingled by such Grantor with any of its other funds or property but shall be held separate and apart therefrom, shall be held in trust for the benefit of the Secured Parties and shall be forthwith delivered to the Administrative Agent in the same form as so received (with any necessary endorsement or instrument of assignment). This clause (iii) shall not apply to dividends between or among the Borrower and the Guarantors only of property subject to a perfected security interest under this Agreement.

(b) Upon the occurrence and during the continuance of an Event of Default, after the Administrative Agent shall have notified (or shall be deemed to have notified pursuant to Section 3.06(a)) the Grantors of the suspension of their rights under clause (a)(iii) of this Section 3.06, then all rights of any Grantor to dividends, interest, principal or other distributions that such Grantor is authorized to receive pursuant to clause (a)(iii) of this Section 3.06 shall cease, and all such rights shall thereupon become vested in the Administrative Agent, which shall have the sole and exclusive right and authority to receive and retain such dividends, interest, principal or other distributions. All dividends, interest, principal or other distributions received by any Grantor contrary to the provisions of this Section 3.06 shall be held in trust for the benefit of the Administrative Agent, shall be segregated from other property or funds of such Grantor and shall be forthwith delivered to the Administrative Agent upon demand in the same form as so received (with any necessary endorsement or instrument of assignment). Any and all money and other property paid over to or received by the Administrative Agent pursuant to the provisions of this clause (b) shall be retained by the Administrative Agent in an account to be established by the Administrative Agent upon receipt of such money or other property and shall be applied in accordance with the provisions of Section 5.02. After all Events of Default have been cured or waived and each applicable Grantor has delivered to the Administrative Agent certificates to that effect, the Administrative Agent shall, promptly after all such Events of Default have been cured or waived, repay to each applicable Grantor (without interest) all dividends, interest, principal or other distributions that such Grantor would otherwise be permitted to retain pursuant to the terms of clause (a)(iii) of this Section 3.06 and that remain in such account.

 

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(c) Upon the occurrence and during the continuance of an Event of Default, after the Administrative Agent shall have notified (or shall be deemed to have notified pursuant to Section 3.06(a)) the Grantors of the suspension of their rights under clause (a)(i) of this Section 3.06, then all rights of any Grantor to exercise the voting and consensual rights and powers it is entitled to exercise pursuant to clause (a)(i) of this Section 3.06, and the obligations of the Administrative Agent under clause (a)(ii) of this Section 3.06, shall cease, and all such rights shall thereupon become vested in the Administrative Agent, which shall have the sole and exclusive right and authority to exercise such voting and consensual rights and powers; provided that, unless otherwise directed by the Required Lenders, the Administrative Agent shall have the right from time to time following and during the continuance of an Event of Default to permit the Grantors to exercise such rights.

(d) Any notice given by the Administrative Agent to the Grantors exercising its rights under clause (a) of this Section 3.06 (i) may be given by telephone if promptly confirmed in writing, (ii) may be given to one or more of the Grantors at the same or different times and (iii) may suspend the rights of the Grantors under clause (a)(i) or clause (a)(iii) in part without suspending all such rights (as specified by the Administrative Agent in its sole and absolute discretion) and without waiving or otherwise affecting the Administrative Agent’s rights to give additional notices from time to time suspending other rights so long as an Event of Default has occurred and is continuing.

SECTION 3.07 Admission of Substitute Partner or Member. Each Grantor consents to the grant by each other Grantor to the Administrative Agent of a security interest in all Pledged Collateral and, without limiting the foregoing and notwithstanding anything in the contrary in any partnership agreement or limited liability company agreement governing any Pledged Equity Interests, consents to the transfer of any Pledged Collateral to the Administrative Agent or its nominee following an Event of Default and prior written notice and to the substitution of the Administrative Agent or its nominee as a partner in any partnership or as a member in any limited liability company with all the rights and powers related thereto.

ARTICLE IV

Security Interests in Personal Property

SECTION 4.01 Security Interest.

(a) As security for the payment or performance, as the case may be, in full of the Obligations, each Grantor hereby assigns and pledges to the Administrative Agent, for the benefit of the Secured Parties, and hereby grants to the Administrative Agent, for the benefit of the Secured Parties, a security interest (the “Security Interest”), in all right, title or interest in or to any and all of the following assets and properties now owned or at any time hereafter acquired by such Grantor or in which such Grantor now has or at any time in the future may acquire any right, title or interest (collectively, the “Article 9 Collateral”):

(i) all Accounts;

(ii) all Chattel Paper, including all Electronic Chattel Paper;

 

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(iii) all Commercial Tort Claims (including all Commercial Tort Claims listed on Schedule IV);

(iv) all cash, Deposit Accounts and all other bank accounts;

(v) all Documents;

(vi) all General Intangibles, including Intellectual Property;

(vii) all Goods;

(viii) all Inventory;

(ix) all Equipment;

(x) all Fixtures;

(xi) all Instruments;

(xii) all Investment Property;

(xiii) all Letter-of-Credit Rights;

(xiv) all monies, whether or not in the possession or under the control of any Secured Party, or a bailee or Affiliate or branch of any Secured Party, including any cash;

(xv) all books and records pertaining to the Article 9 Collateral; and

(xvi) to the extent not otherwise included, all Proceeds and products of, and all Supporting Obligations for, any and all of the foregoing and all collateral security and guarantees given by any Person with respect to any of the foregoing.

(b) Notwithstanding the above or anything else in this Agreement, the Collateral shall not include any Excluded Assets.

(c) Each Grantor hereby irrevocably authorizes the Administrative Agent for the benefit of the Secured Parties at any time and from time to time to file in any relevant jurisdiction any initial financing statements or continuation statements (including fixture filings) with respect to the Article 9 Collateral or any part thereof and amendments thereto that (i) indicate the Article 9 Collateral as “all assets” of such Grantor or words of similar effect, and (ii) contain the information required by Article 9 of the Uniform Commercial Code of each applicable jurisdiction for the filing of any financing statement or amendment, including (A) whether such Grantor is an organization, the type of organization and any organizational identification number issued to such Grantor and (B) in the case of a financing statement filed as a fixture filing, a sufficient description of the real property to which such Article 9 Collateral relates. Each Grantor agrees to provide such information to the Administrative Agent promptly upon request.

 

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Each Grantor also ratifies its authorization for the Administrative Agent to file in any relevant jurisdiction any initial financing statements or amendments thereto if filed prior to the date hereof.

The Administrative Agent is further authorized to file with the United States Patent and Trademark Office or United States Copyright Office (or any successor office) such documents as may be necessary or advisable for the purpose of perfecting, confirming, continuing, enforcing or protecting the Security Interest granted by each Grantor, without the signature of any Grantor, and naming any Grantor or the Grantors as debtors and the Administrative Agent as secured party.

(d) The Security Interest is granted as security only and shall not subject the Administrative Agent or any other Secured Party to, or in any way alter or modify, any obligation or liability of any Grantor with respect to or arising out of the Article 9 Collateral.

(e) Notwithstanding anything to the contrary herein, in no event shall the Grantors be required to (A) enter into landlord, mortgagee and bailee waivers, (B) send notice to account debtors or other contractual third parties prior to an Event of Default, or (C)  enter into mortgages with respect to any interest in real property that is not Material Real Property.

SECTION 4.02 Representations and Warranties. The Grantors jointly and severally represent and warrant to the Administrative Agent and the Secured Parties that as of the Closing Date:

(a) Each Grantor has good and valid rights in and title to the Article 9 Collateral with respect to which it has purported to grant a Security Interest hereunder and has full power and authority to grant to the Administrative Agent, for the benefit of the Secured Parties, the Security Interest in such Article 9 Collateral pursuant hereto and to execute, deliver and perform its obligations in accordance with the terms of this Agreement, without the consent or approval of any other Person other than any consent or approval that has been obtained and is in full force and effect.

(b) The Perfection Certificate has been duly prepared, completed and executed and the information set forth therein (including (x) the exact legal name of each Grantor and (y) the jurisdiction of organization of each Grantor) is correct and complete as of the Closing Date. Uniform Commercial Code financing statements (including fixture filings, as applicable) or other appropriate filings, recordings or registrations containing a description of the Article 9 Collateral have been prepared by counsel to the Administrative Agent based upon the information provided to the Administrative Agent and the Secured Parties in the Perfection Certificate for filing in each governmental, municipal or other office specified in Section 2 of the Perfection Certificate (or specified by notice from the Borrower to the Administrative Agent after the Closing Date in the case of filings, recordings or registrations required by Sections 5.06 or 5.12 of the Credit Agreement), which are all the filings, recordings and registrations (other than filings required to be made in the United States Patent and Trademark Office and the United States Copyright Office in order to perfect the Security Interest in the Article 9 Collateral consisting of United States Patents, Trademarks and Copyrights) that are necessary to publish notice of and protect the validity of and to establish a legal, valid and perfected security interest in favor of the Administrative Agent (for the benefit of the Secured Parties) in respect of all Article 9

 

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Collateral in which the Security Interest may be perfected by filing, recording or registration in the United States (or any political subdivision thereof) and its territories and possessions, and no further or subsequent filing, refiling, recording, rerecording, registration or reregistration is necessary in any such jurisdiction, except as provided under applicable law with respect to the filing of continuation statements. Each Grantor represents and warrants that a fully executed agreement in the form hereof (or a fully executed short form agreement in form and substance reasonably satisfactory to the Administrative Agent), and containing a description of all Article 9 Collateral consisting of Intellectual Property with respect to United States Patents and United States registered Trademarks (and Trademarks for which United States registration applications are pending), United States registered Copyrights has been delivered to the Administrative Agent for recording by the United States Patent and Trademark Office and the United States Copyright Office pursuant to 35 U.S.C. §261, 15 U.S.C. §1060 or 17 U.S.C. §205 and the regulations thereunder, as applicable, to protect the validity of and to establish a legal, valid and perfected security interest in favor of the Administrative Agent (for the ratable benefit of the Secured Parties) in respect of all Article 9 Collateral consisting of Patents, Trademarks and Copyrights in which a security interest may be perfected by filing, recording or registration in the United States (or any political subdivision thereof) and its territories and possessions, and no further or subsequent filing, refiling, recording, rerecording, registration or reregistration is necessary (other than such actions as are necessary to perfect the Security Interest with respect to any Article 9 Collateral consisting of Patents, Trademarks and Copyrights (or registration or application for registration thereof) acquired or developed after the date hereof).

(c) The Security Interest constitutes (i) a legal and valid security interest in all Article 9 Collateral securing the payment and performance of the Obligations, (ii) subject to the filings described in Section 4.02(b), a perfected security interest in all Article 9 Collateral in which a security interest may be perfected by filing, recording or registering a financing statement or analogous document in the United States (or any political subdivision thereof) and its territories and possessions pursuant to the Uniform Commercial Code and (iii) a security interest that shall be perfected in all Article 9 Collateral in which a security interest may be perfected upon the receipt and recording of this Agreement (or a fully executed short form agreement in form and substance reasonably satisfactory to the Administrative Agent) with the United States Patent and Trademark Office and the United States Copyright Office, as applicable. The Security Interest is and shall be prior to any other Lien on any of the Article 9 Collateral, other than Liens expressly permitted pursuant to Section 6.02 of the Credit Agreement that have priority as a matter of law or are permitted to have priority pursuant to the terms thereof.

(d) The Article 9 Collateral is owned by the Grantors free and clear of any Lien, except for Liens expressly permitted pursuant to Section 6.02 of the Credit Agreement. No Grantor has filed or consented to the filing of (i) any financing statement or analogous document under the Uniform Commercial Code or any other applicable laws covering any Article 9 Collateral, (ii) any assignment in which any Grantor assigns any Collateral or any security agreement or similar instrument covering any Article 9 Collateral with the United States Patent and Trademark Office or the United States Copyright Office, (iii) any notice under the Assignment of Claims Act, or (iv) any assignment in which any Grantor assigns any Article 9 Collateral or any security agreement or similar instrument covering any Article 9 Collateral with any foreign governmental, municipal or other office, which financing statement or analogous document, assignment, security agreement or similar instrument is still in

 

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effect, except, in each case, for Liens expressly permitted pursuant to Section 6.02 of the Credit Agreement. No Grantor holds any Commercial Tort Claims except as indicated on Schedule IV.

SECTION 4.03 Covenants.

(a) Each Grantor agrees to furnish to the Administrative Agent at least 20 Business Days’ (or such other period as the Administrative Agent may agree in its reasonable discretion) prior written notice of any change in (i) its legal name, (ii) its identity or type of organization or corporate structure, (iii) its Federal Taxpayer Identification Number or organizational identification number or (iv) its jurisdiction of organization. Each Grantor agrees promptly to provide the Administrative Agent with certified organizational documents reflecting any of the changes described in the first sentence of this clause (a). Each Grantor agrees not to effect or permit any change referred to in the preceding sentence unless all filings will be made under the Uniform Commercial Code or otherwise that are required in order for the Administrative Agent to continue at all times following such change to have a valid, legal and perfected first priority security interest in all the Article 9 Collateral within 5 Business Days of such change (or such longer period as the Administrative Agent may agree in its reasonable discretion). Each Grantor agrees promptly to notify the Administrative Agent in writing if any material portion of the Article 9 Collateral owned or held by such Grantor is damaged or destroyed.

(b) Each Grantor agrees to maintain, at its own cost and expense, such complete and accurate records with respect to the Article 9 Collateral owned by it as is consistent with its current practices and in accordance with such prudent and standard practices used in industries that are the same as or similar to those in which such Grantor is engaged, but in any event to include complete accounting records indicating all payments and proceeds received with respect to any part of the Article 9 Collateral, and, at such time or times as the Administrative Agent may reasonably request, promptly to prepare and deliver to the Administrative Agent a duly certified schedule or schedules in form and detail reasonably satisfactory to the Administrative Agent showing the identity, amount and location of any and all Article 9 Collateral.

(c) Each year, at the time of delivery of annual financial statements with respect to the preceding fiscal year pursuant to Section 5.04(a) of the Credit Agreement, the Borrower shall deliver to the Administrative Agent a supplement to Schedule III identifying all Intellectual Property of any Grantor in existence on the date thereof and not then listed on such Schedule or previously so identified to the Administrative Agent.

(d) Each Grantor shall, at its own expense, take any and all actions necessary to defend title to the Article 9 Collateral against all Persons and to defend the Security Interest of the Administrative Agent in the Article 9 Collateral and the priority thereof against any Lien not expressly permitted pursuant to Section 6.02 of the Credit Agreement.

(e) Each Grantor agrees, at its own expense, promptly to execute, acknowledge, deliver and cause to be duly filed all such further instruments and documents and take all such actions as the Administrative Agent may from time to time reasonably request to better assure, obtain, preserve, protect and perfect the Security Interest and the rights and remedies created hereby, including the payment of any fees and Taxes required in connection with the execution

 

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and delivery of this Agreement, the granting of the Security Interest and the filing of any financing or continuation statements (including fixture filings, as applicable) or other documents in connection herewith or therewith. If any amount payable to any Grantor under or in connection with any of the Article 9 Collateral shall be or become evidenced by any promissory note or other instrument with a value, either individually or in the aggregate, exceeding $250,000, such note or instrument shall be promptly pledged and delivered to the Administrative Agent, duly endorsed in a manner reasonably satisfactory to the Administrative Agent.

Without limiting the generality of the foregoing, each Grantor hereby authorizes the Administrative Agent, with prompt written notice thereof to the Grantors, to supplement this Agreement by supplementing Schedule III to identify specifically any asset or item of a Grantor that may, in the Administrative Agent’s reasonable judgment, constitute Copyrights, Licenses, Patents or Trademarks; provided that any Grantor shall have the right, exercisable within twenty days (or such longer period as the Administrative Agent may agree in its reasonable discretion) after it has been notified by the Administrative Agent of the specific identification of such Collateral, to advise the Administrative Agent in writing of any inaccuracy of the representations and warranties made by such Grantor hereunder with respect to such Collateral. Each Grantor agrees that it will use its reasonable best efforts to take such action as shall be necessary in order that all representations and warranties hereunder shall be true and correct with respect to such Collateral within thirty days (or such longer period as the Administrative Agent may agree in its reasonable discretion) after the date it has been notified by the Administrative Agent of the specific identification of such Collateral.

(f) [Reserved].

(g) At its option, the Administrative Agent may (but shall have no obligation to) discharge past due Taxes, assessments, charges, fees, Liens, security interests or other encumbrances at any time levied or placed on the Article 9 Collateral and not expressly permitted pursuant to Section 5.03 or Section 6.02 of the Credit Agreement, and may pay for the maintenance and preservation of the Article 9 Collateral to the extent any Grantor fails to do so as required by the Credit Agreement or this Agreement, and each Grantor jointly and severally agrees to reimburse the Administrative Agent on demand for any payment made or any expense incurred by the Administrative Agent pursuant to the foregoing authorization; provided that nothing in this clause (g) shall be interpreted as excusing any Grantor from the performance of, or imposing any obligation on the Administrative Agent or any Secured Party to cure or perform, any covenants or other promises of any Grantor with respect to Taxes, assessments, charges, fees, Liens, security interests or other encumbrances and maintenance as set forth herein or in the other Loan Documents. All sums disbursed by the Administrative Agent in connection with this clause (g), including attorneys’ fees, court costs, expenses and other charges relating thereto, shall be additional Obligations secured hereby.

(h) If at any time any Grantor shall take a security interest in any property of an Account Debtor or any other Person to secure payment and performance of an Account, such Grantor shall promptly assign such security interest to the Administrative Agent for the ratable benefit of the Secured Parties. Such assignment need not be filed of public record unless necessary to continue the perfected status of the security interest against creditors of and transferees from the Account Debtor or other Person granting the security interest.

 

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(i) Each Grantor shall remain liable to observe and perform all the conditions and obligations to be observed and performed by it under each contract, agreement or instrument relating to the Article 9 Collateral, all in accordance with the terms and conditions thereof, and each Grantor jointly and severally agrees to indemnify and hold harmless the Administrative Agent and the Secured Parties from and against any and all liability for such performance.

(j) No Grantor shall make or permit to be made an assignment, pledge or hypothecation of the Article 9 Collateral or shall grant any other Lien in respect of the Article 9 Collateral or permit any notice to be filed under the Assignment of Claims Act, except, in each case, as expressly permitted by Section 6.02 of the Credit Agreement. No Grantor shall make or permit to be made any transfer of the Article 9 Collateral and each Grantor shall remain at all times in possession or otherwise in control of the Article 9 Collateral owned by it, except as expressly permitted by the Credit Agreement.

(k) No Grantor will, without the Administrative Agent’s prior written consent, grant any extension of the time of payment of any Accounts with a value, either individually or in the aggregate, exceeding $250,000, and included in the Article 9 Collateral, compromise, compound or settle the same for less than the full amount thereof, release, wholly or partly, any Person liable for the payment thereof or allow any credit or discount whatsoever thereon, other than extensions, credits, discounts, compromises, compoundings or settlements granted or made in the ordinary course of business and consistent with its current practices and in accordance with such prudent and standard practice used in industries that are the same as or similar to those in which such Grantor is engaged.

(l) Each Grantor, at its own expense, shall maintain or cause to be maintained insurance covering physical loss or damage to the Inventory and Equipment in accordance with the requirements set forth in Section 5.02 of the Credit Agreement. Each Grantor irrevocably makes, constitutes and appoints the Administrative Agent (and all officers, employees or agents designated by the Administrative Agent) as such Grantor’s true and lawful agent (and attorney-in-fact) for the purpose, upon the occurrence and during the continuance of an Event of Default, of making, settling and adjusting claims in respect of Article 9 Collateral under policies of insurance, endorsing the name of such Grantor on any check, draft, instrument or other item of payment for the proceeds of such policies of insurance and for making all determinations and decisions with respect thereto. In the event that any Grantor at any time or times shall fail to obtain or maintain any of the policies of insurance required hereby or under the Credit Agreement or to pay any premium in whole or part relating thereto, the Administrative Agent may, without waiving or releasing any obligation or liability of any Grantor hereunder or any Default or Event of Default, in its reasonable discretion, obtain and maintain such policies of insurance and pay such premium and take any other actions with respect thereto as the Administrative Agent deems advisable. All sums disbursed by the Administrative Agent in connection with this clause (l), including attorneys’ fees, court costs, expenses and other charges relating thereto, shall be payable, upon demand, by the Grantors to the Administrative Agent and shall be additional Obligations secured hereby.

(m) Each Grantor shall maintain, in form and manner reasonably satisfactory to the Administrative Agent, records of its Chattel Paper and its books, records and documents evidencing or pertaining thereto.

 

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SECTION 4.04 Other Actions. In order to further ensure the attachment, perfection and priority of, and the ability of the Administrative Agent to enforce, the Security Interest in the Article 9 Collateral, each Grantor agrees, in each case at such Grantor’s own expense, to take the following actions with respect to the following Article 9 Collateral:

(a) Instruments. If any Grantor shall at any time hold or acquire any Instruments with a value, either individually or in the aggregate, exceeding $250,000, such Grantor shall forthwith endorse, assign and deliver the same to the Administrative Agent within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion), accompanied by such undated instruments of endorsement, transfer or assignment duly executed in blank as the Administrative Agent may from time to time specify in its reasonable discretion.

(b) Deposit Accounts. Each Grantor shall promptly (or in any event, within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion)) notify the Administrative Agent in writing if such Grantor opens or maintains any Deposit Account, and for each such Deposit Account that any Grantor at any time opens or at any time maintains (including Deposit Accounts maintained as of the Closing Date), such Grantor shall cause the depositary bank to agree to comply at any time with instructions from the Administrative Agent to such depositary bank directing the disposition of funds from time to time credited to such Deposit Account, without further consent of such Grantor or any other Person, pursuant to an agreement in form and substance reasonably satisfactory to the Administrative Agent. The Administrative Agent agrees with each Grantor that the Administrative Agent shall not give any such instructions or withhold any withdrawal rights from any Grantor, unless an Event of Default has occurred and is continuing, or, after giving effect to any withdrawal, would occur. The provisions of this clause (b) shall not apply to any Deposit Account for which any Grantor, the depositary bank and the Administrative Agent have entered into a cash collateral agreement specially negotiated among such Grantor, the depositary bank and the Administrative Agent for the specific purpose set forth therein.

(c) Investment Property. Except to the extent otherwise provided in Article III, if any Grantor shall at any time hold or acquire any certificated securities with a value, either individually or in the aggregate, exceeding $250,000, such Grantor shall forthwith endorse, assign and deliver the same to the Administrative Agent within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion), accompanied by such undated instruments of transfer or assignment duly executed in blank as the Administrative Agent may from time to time specify in its reasonable discretion. If any securities now or hereafter acquired by any Grantor are uncertificated and are issued to such Grantor or its nominee directly by the issuer thereof, such Grantor shall promptly notify the Administrative Agent thereof in writing and, at the Administrative Agent’s reasonable request and option, pursuant to an agreement in form and substance reasonably satisfactory to the Administrative Agent, either (i) cause the issuer (or, with respect to an issuer that is not a Subsidiary of a Grantor, to use commercially reasonable efforts to cause the issuer) to agree to comply with instructions originated by the Administrative Agent as to such securities, without further consent of any Grantor or such nominee, or (ii) arrange for the Administrative Agent to become the registered owner of the securities. Each Grantor that is an issuer of any securities included in the Collateral agrees to comply with instructions originated by the Administrative Agent as to such securities, without further consent of the registered owner of such securities. If any securities, whether certificated or uncertificated, or other Investment

 

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Property now or hereafter acquired by any Grantor are held by such Grantor or its nominee through a Securities Intermediary or Commodity Intermediary, such Grantor shall promptly notify the Administrative Agent thereof in writing and, at the Administrative Agent’s reasonable request and option, pursuant to an agreement in form and substance reasonably satisfactory to the Administrative Agent, either (i) cause such Securities Intermediary or Commodity Intermediary, as the case may be, (x) to agree to comply with Entitlement Orders from the Administrative Agent to such Securities Intermediary as to such securities or other Investment Property, or (as the case may be) (y) to apply any value distributed on account of any commodity contract as directed by the Administrative Agent to such Commodity Intermediary, in each case without further consent of any Grantor or such nominee, or (ii) in the case of Financial Assets (as governed by Article 8 of the Uniform Commercial Code) or other Investment Property held through a Securities Intermediary, arrange for the Administrative Agent to become the Entitlement Holder with respect to such Investment Property, with the Grantor being permitted, only with the consent of the Administrative Agent, to exercise rights to withdraw or otherwise deal with such Investment Property. The Administrative Agent agrees with each Grantor that the Administrative Agent shall not give any such Entitlement Orders or instructions or directions to any such issuer, Securities Intermediary or Commodity Intermediary, and shall not withhold its consent to the exercise of any withdrawal or dealing rights by any Grantor, unless an Event of Default has occurred and is continuing, or, after giving effect to any such investment and withdrawal rights would occur. The provisions of this clause (c) shall not apply to any Financial Assets credited to a Securities Account for which the Administrative Agent is the Securities Intermediary.

(d) Electronic Chattel Paper and Transferable Records. If any Grantor at any time holds or acquires an interest in any Electronic Chattel Paper or any “transferable record” with a value, either individually or in the aggregate, exceeding $250,000, as that term is defined in Section 201 of the Federal Electronic Signatures in Global and National Commerce Act, or in Section 16 of the Uniform Electronic Transactions Act as in effect in any relevant jurisdiction, such Grantor shall promptly (or in any event, within 20 Business Days (or such longer time as the Administrative Agent may agree in its reasonable discretion)) notify the Administrative Agent thereof in writing and, at the request of the Administrative Agent, shall take such action as the Administrative Agent may reasonably request to vest in the Administrative Agent control of such Electronic Chattel Paper under Section 9-105 of the Uniform Commercial Code or Section 201 of the Federal Electronic Signatures in Global and National Commerce Act or, as the case may be, Section 16 of the Uniform Electronic Transactions Act, as so in effect in such jurisdiction, of such transferable record. The Administrative Agent agrees with such Grantor that the Administrative Agent will arrange, pursuant to procedures reasonably satisfactory to the Administrative Agent and so long as such procedures will not result in the Administrative Agent’s loss of control, for the Grantor to make alterations to the Electronic Chattel Paper or transferable record permitted under Section 9-105 of the Uniform Commercial Code or, as the case may be, Section 201 of the Federal Electronic Signatures in Global and National Commerce Act or Section 16 of the Uniform Electronic Transactions Act for a party in control to allow without loss of control, unless an Event of Default has occurred and is continuing or would occur after taking into account any action by such Grantor with respect to such Electronic Chattel Paper or transferable record.

(e) Letter-of-Credit Rights. If any Grantor is at any time a beneficiary under a letter of credit with a value, either individually or in the aggregate, exceeding $250,000, now or hereafter issued in favor of such Grantor, such Grantor shall promptly (or in any event within 20

 

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Business Days (or such longer period as may be agreed by the Administrative Agent in its reasonable discretion)) notify the Administrative Agent thereof in writing and, at the reasonable request and option of the Administrative Agent, such Grantor shall, pursuant to an agreement in form and substance reasonably satisfactory to the Administrative Agent, either (i) use commercially reasonable efforts to arrange for the issuer and any confirmer of such letter of credit to consent to an assignment to the Administrative Agent of the proceeds of any drawing under the letter of credit or (ii) arrange for the Administrative Agent to become the transferee beneficiary of the letter of credit, with the Administrative Agent agreeing, in each case, that the proceeds of any drawing under the letter of credit are to be paid to the applicable Grantor unless an Event of Default has occurred or is continuing.

(f) Commercial Tort Claims. If any Grantor shall at any time hold or acquire a Commercial Tort Claim in an amount reasonably estimated to exceed $1,000,000 the Grantor shall promptly (or in any event, within 20 Business Days (or such longer period as may be agreed by the Administrative Agent in its reasonable discretion)) notify the Administrative Agent thereof in a writing signed by such Grantor, including a summary description of such claim, and grant to the Administrative Agent, for the ratable benefit of the Secured Parties, in such writing a security interest therein and in the proceeds thereof, all upon the terms of this Agreement, with such writing to be in form and substance reasonably satisfactory to the Administrative Agent.

SECTION 4.05 Covenants Regarding Patent, Trademark and Copyright Collateral.

(a) Each Grantor agrees that it will not, and will not permit any of its licensees or sublicensees to, do any act, or omit to do any act, whereby any Patent that is material to the conduct of such Grantor’s business may become invalidated or dedicated to the public, and agrees that it shall continue to mark any products covered by a Patent with the relevant patent number as necessary and sufficient to establish and preserve its maximum rights under applicable patent laws.

(b) Each Grantor (either itself or through its licensees or its sublicensees) will, for each Trademark material to the conduct of such Grantor’s business, (i) maintain such Trademark in full force free from any claim of abandonment or invalidity for non-use, (ii) maintain the quality of products and services offered under such Trademark, (iii) display such Trademark with notice of Federal or foreign registration to the extent necessary and sufficient to establish and preserve its maximum rights under applicable law and (iv) not knowingly use or knowingly permit the use of such Trademark in violation of any third party rights.

(c) Each Grantor (either itself or through its licensees or sublicensees) will, for each work covered by a material Copyright, continue to publish, reproduce, display, adopt and distribute the work with appropriate copyright notice as necessary and sufficient to establish and preserve its maximum rights under applicable copyright laws.

(d) Each Grantor shall notify the Administrative Agent promptly (or in any event, within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion)) in writing if it knows or has reason to know that any Patent, Trademark or Copyright material to the conduct of its business may become abandoned, lost or dedicated to the public, or of any adverse determination or development (including the institution of, or any such

 

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determination or development in, any proceeding in the United States Patent and Trademark Office or the United States Copyright Office) regarding such Grantor’s ownership of any Patent, Trademark or Copyright, its right to register the same, or its right to keep and maintain the same.

(e) In no event shall any Grantor, either itself or through any agent, employee, licensee or designee, file an application for any Patent, Trademark or Copyright (or for the registration of any Trademark or Copyright) with the United States Patent and Trademark Office, United States Copyright Office or any office or agency in any political subdivision of the United States, unless it promptly (or in any event, within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion)) notifies the Administrative Agent in writing, and, upon the reasonable request of the Administrative Agent, executes and delivers any and all agreements, instruments, documents and papers as the Administrative Agent may reasonably request to evidence the Security Interest in such Patent, Trademark or Copyright, and each Grantor hereby appoints the Administrative Agent as its attorney-in-fact to execute and file such writings for the foregoing purposes, all acts of such attorney being hereby ratified and confirmed; such power, being coupled with an interest, is irrevocable.

(f) Each Grantor will take all necessary steps that are consistent with the practice in any proceeding before the United States Patent and Trademark Office, United States Copyright Office or any office or agency in any political subdivision of the United States, to maintain and pursue each material application relating to the Patents, Trademarks and/or Copyrights (and to obtain the relevant grant or registration) and to maintain each issued Patent and each registration of the Trademarks and Copyrights that is material to the conduct of any Grantor’s business, including timely filings of applications for renewal, affidavits of use, affidavits of incontestability and payment of maintenance fees, and, if consistent with good business judgment, to initiate opposition, interference and cancellation proceedings against third parties.

(g) In the event that any Grantor knows that any Article 9 Collateral consisting of a Patent, Trademark or Copyright material to the conduct of any Grantor’s business has been or is about to be infringed, misappropriated or diluted by a third Person, such Grantor promptly shall promptly (or in any event, within 20 Business Days (or such longer period as the Administrative Agent may agree in its reasonable discretion)) notify the Administrative Agent in writing and shall, if consistent with good business judgment, promptly sue for infringement, misappropriation or dilution and to recover any and all damages for such infringement, misappropriation or dilution, and take such other actions as are appropriate under the circumstances to protect such Article 9 Collateral.

(h) Upon the occurrence and during the continuance of an Event of Default, each Grantor shall use its reasonable best efforts to obtain all requisite consents or approvals by the licensor of each Copyright License, Patent License or Trademark License, and each other material License, to effect the assignment of all such Grantor’s right, title and interest thereunder to the Administrative Agent, for the ratable benefit of the Secured Parties, or its designee.

ARTICLE V

Remedies

 

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SECTION 5.01 Remedies Upon Default. Upon the occurrence and during the continuance of an Event of Default, each Grantor agrees to deliver each item of Collateral to the Administrative Agent on demand, and it is agreed that the Administrative Agent shall have the right to take any of or all the following actions at the same or different times: (a) with respect to any Article 9 Collateral consisting of Intellectual Property, on demand, to cause the Security Interest to become an assignment, transfer and conveyance of any of or all such Article 9 Collateral by the applicable Grantor to the Administrative Agent, or to license or sublicense, whether general, special or otherwise, and whether on an exclusive or nonexclusive basis, any such Article 9 Collateral on such terms and conditions and in such manner as the Administrative Agent shall determine (other than in violation of any then-existing licensing arrangements to the extent that waivers cannot be obtained), and (b) with or without legal process and with or without prior notice or demand for performance, to take possession of the Article 9 Collateral and without liability for trespass to enter any premises where the Article 9 Collateral may be located for the purpose of taking possession of or removing the Article 9 Collateral and, generally, to exercise any and all rights afforded to a secured party under the Uniform Commercial Code or other applicable law.

Without limiting the generality of the foregoing, each Grantor agrees (a) at the Administrative Agent’s request, to assemble the Collateral and make it available to the Administrative Agent at places which the Administrative Agent shall reasonably select, whether at such Grantor’s premises or elsewhere, and (b) that the Administrative Agent shall have the right, subject to the mandatory requirements of applicable law, to sell or otherwise dispose of all or any part of the Collateral at a public or private sale or at any broker’s board or on any securities exchange, for cash, upon credit or for future delivery as the Administrative Agent shall deem appropriate. The Administrative Agent shall be authorized at any such sale (if it deems it advisable to do so) to restrict the prospective bidders or purchasers to Persons who will represent and agree that they are purchasing the Collateral for their own account for investment and not with a view to the distribution or sale thereof, and upon consummation of any such sale the Administrative Agent shall have the right to assign, transfer and deliver to the purchaser or purchasers thereof the Collateral so sold. Each such purchaser at any such sale shall hold the property sold absolutely, free from any claim or right on the part of any Grantor, and each Grantor hereby waives (to the extent permitted by law) all rights of redemption, stay and appraisal which such Grantor now has or may at any time in the future have under any rule of law or statute now existing or hereafter enacted.

The Administrative Agent shall give each applicable Grantor ten days’ written notice (which each Grantor agrees is reasonable notice within the meaning of Section 9-611 and Section 9-612 of the Uniform Commercial Code) of the Administrative Agent’s intention to make any sale of Collateral. Such notice, in the case of a public sale, shall state the time and place for such sale and, in the case of a sale at a broker’s board or on a securities exchange, shall state the board or exchange at which such sale is to be made and the day on which the Collateral, or portion thereof, will first be offered for sale at such board or exchange. Any such public sale shall be held at such time or times within ordinary business hours and at such place or places as the Administrative Agent may fix and state in the notice (if any) of such sale. At any such sale, the Collateral, or portion thereof, to be sold may be sold in one lot as an entirety or in separate parcels, as the Administrative Agent may (in its sole and absolute discretion) determine. The Administrative Agent shall not be obligated to make any sale of any Collateral if it shall determine

 

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not to do so, regardless of the fact that notice of sale of such Collateral shall have been given. The Administrative Agent may, without notice or publication, adjourn any public or private sale or cause the same to be adjourned from time to time by announcement at the time and place fixed for sale, and such sale may, without further notice, be made at the time and place to which the same was so adjourned. In case any sale of all or any part of the Collateral is made on credit or for future delivery, the Collateral so sold may be retained by the Administrative Agent until the sale price is paid by the purchaser or purchasers thereof, but the Administrative Agent shall not incur any liability in case any such purchaser or purchasers shall fail to take up and pay for the Collateral so sold and, in case of any such failure, such Collateral may be sold again upon like notice. The Administrative Agent, on behalf of itself and the Secured Parties, shall have the right to credit bid and purchase for the benefit of the Administrative Agent and the Secured Parties all or any portion of Collateral at any sale thereof conducted by the Administrative Agent under the provisions of the Uniform Commercial Code, including pursuant to Sections 9-610 or 9-620 of the Uniform Commercial Code, at any sale thereof conducted under the provisions of the United States Bankruptcy Code, including Section 363 thereof, or at any other sale or foreclosure conducted by the Administrative Agent (whether by judicial action or otherwise) in accordance with applicable law. Such credit bid or purchase may be completed through one or more acquisition vehicles formed by the Administrative Agent to make such credit bid or purchase and, in connection therewith, the Administrative Agent is authorized, on behalf of itself and the other Secured Parties, to adopt documents providing for the governance of the acquisition vehicle or vehicles, and assign the applicable Obligations to any such acquisition vehicle in exchange for Equity Interests and/or debt issued by the applicable acquisition vehicle (which shall be deemed to be held for the ratable account of the applicable Secured Parties on the basis of the Obligations so assigned by each Secured Party); provided that any actions by the Administrative Agent with respect to such acquisition vehicle or vehicles, including any disposition of the assets or Equity Interests thereof, shall be governed, directly or indirectly, by the vote of the Required Lenders, irrespective of the termination of the Credit Agreement or any other Loan Documents and without giving effect to the limitations on actions by the Required Lenders contained in Section 9.08 of the Credit Agreement. Each Lender, by its acceptance of the benefits of this Agreement, hereby agrees, on behalf of itself and each of its Affiliates that is a Secured Party, that, except as otherwise provided in any Loan Document or with the written consent of the Administrative Agent and the Required Lenders, it will not take any enforcement action, accelerate obligations under any of the Loan Documents, or exercise any right that it might otherwise have under applicable law to credit bid at foreclosure sales, Uniform Commercial Code sales or other similar dispositions of Collateral.

For purposes of this Section 5.01, a written agreement to purchase the Collateral or any portion thereof shall be treated as a sale thereof; the Administrative Agent shall be free to carry out such sale pursuant to such agreement and no Grantor shall be entitled to the return of the Collateral or any portion thereof subject thereto, notwithstanding the fact that after the Administrative Agent shall have entered into such an agreement all Events of Default shall have been remedied and the Obligations paid in full. As an alternative to exercising the power of sale herein conferred upon it, the Administrative Agent may proceed by a suit or suits at law or in equity to foreclose this Agreement and to sell the Collateral or any portion thereof pursuant to a judgment or decree of a court or courts having competent jurisdiction or pursuant to a proceeding by a court-appointed receiver. Any sale pursuant to the provisions of this Section 5.01 shall be deemed to conform to the commercially reasonable standards as provided in Section 9-610(b) of the Uniform Commercial Code.

 

24


SECTION 5.02 Application of Proceeds. The Administrative Agent shall apply the proceeds of any collection, sale, foreclosure or other realization upon any Collateral, including any Collateral consisting of cash, as follows:

FIRST, to the payment of all costs and expenses incurred by the Administrative Agent (in its capacity as such hereunder or under any other Loan Document) in connection with such collection, sale, foreclosure or realization or otherwise in connection with this Agreement, any other Loan Document or any of the Obligations, including all court costs and the fees and expenses of its agents and legal counsel, the repayment of all advances made by the Administrative Agent hereunder or under any other Loan Document on behalf of any Grantor and any other costs or expenses incurred in connection with the exercise of any right or remedy hereunder or under any other Loan Document and all other fees, indemnities and other amounts owing or reimbursable to the Administrative Agent under any Loan Document in its capacity as such;

SECOND, to the payment of that portion of the Obligations constituting fees (other than the Early Payment Fee), indemnities and other amounts (other than principal and interest) payable to the Lenders under the Loan Documents, including attorney fees, ratably among the Lenders in proportion to the respective amounts described in this clause SECOND payable to them;

THIRD, to the payment of that portion of the Obligations constituting any Early Payment Fee payable to the Lenders and interest on the Loans, ratably among the Lenders in proportion to the respective amounts described in this clause THIRD payable to them;

FOURTH, to the payment of that portion of the Obligations constituting unpaid principal of the Loans, ratably among the Lenders in proportion to the respective amounts described in this clause FOURTH payable to them; and

LAST, the balance, if any, after all of the Obligations have been indefeasibly paid in full in cash, to the Grantors or as otherwise required by applicable law.

The Administrative Agent shall have absolute discretion as to the time of application of any such proceeds, moneys or balances in accordance with this Agreement. Upon any sale of Collateral by the Administrative Agent (including pursuant to a power of sale granted by statute or under a judicial proceeding), the receipt of the Administrative Agent or of the officer making the sale shall be a sufficient discharge to the purchaser or purchasers of the Collateral so sold and such purchaser or purchasers shall not be obligated to see to the application of any part of the purchase money paid over to the Administrative Agent or such officer or be answerable in any way for the misapplication thereof.

SECTION 5.03 Grant of License to Use Intellectual Property. For the purpose of enabling the Administrative Agent to exercise rights and remedies under this Agreement at such time as the Administrative Agent shall be lawfully entitled to exercise such rights and remedies, each Grantor hereby grants to the Administrative Agent an irrevocable, nonexclusive, worldwide license (exercisable without payment of royalty or other compensation to the Grantors), to use, license or sublicense any of the Article 9 Collateral consisting of Intellectual Property now owned

 

25


or hereafter acquired by such Grantor, and wherever the same may be located, and including in such license access to all media in which any of the licensed items may be recorded or stored and to all computer software and programs used for the compilation or printout thereof. The use of such license by the Administrative Agent may be exercised, at the option of the Administrative Agent, only upon the occurrence and during the continuation of an Event of Default; provided that any license, sublicense or other transaction entered into by the Administrative Agent in accordance herewith shall be binding upon each Grantor notwithstanding any subsequent cure of an Event of Default.

SECTION 5.04 Securities Act, Etc. In view of the position of the Grantors in relation to the Pledged Collateral, or because of other current or future circumstances, a question may arise under the U.S. Securities Act of 1933, as now or hereafter in effect, or any similar statute hereafter enacted analogous in purpose or effect (such Act and any such similar statute as from time to time in effect being called the “Federal Securities Laws”) with respect to any disposition of the Pledged Collateral permitted hereunder. Each Grantor understands that compliance with the Federal Securities Laws might strictly limit the course of conduct of the Administrative Agent if the Administrative Agent were to attempt to dispose of all or any part of the Pledged Collateral and might also limit the extent to which or the manner in which any subsequent transferee of any Pledged Collateral could dispose of the same. Similarly, there may be other legal restrictions or limitations affecting the Administrative Agent in any attempt to dispose of all or part of the Pledged Collateral under applicable “blue sky” or other state securities laws or similar laws analogous in purpose or effect. Each Grantor recognizes that in light of such restrictions and limitations the Administrative Agent may, with respect to any sale of the Pledged Collateral, limit the purchasers to those who will agree, among other things, to acquire such Pledged Collateral for their own account, for investment, and not with a view to the distribution or resale thereof. Each Grantor acknowledges and agrees that in light of such restrictions and limitations, the Administrative Agent, in its sole and absolute discretion, may (a) proceed to make such a sale whether or not a registration statement for the purpose of registering such Pledged Collateral or part thereof shall have been filed under the Federal Securities Laws or, to the extent applicable, “blue sky” or other state securities laws and (b) approach and negotiate with a limited number of potential purchasers (including a single potential purchaser) to effect such sale. Each Grantor acknowledges and agrees that any such sale might result in prices and other terms less favorable to the seller than if such sale were a public sale without such restrictions. In the event of any such sale, the Administrative Agent shall incur no responsibility or liability for selling all or any part of the Pledged Collateral at a price that the Administrative Agent, in its sole and absolute discretion, may in good faith deem reasonable under the circumstances, notwithstanding the possibility that a substantially higher price might have been realized if the sale were deferred until after registration as aforesaid or if more than a limited number of purchasers (or a single purchaser) were approached. The provisions of this Section 5.04 will apply notwithstanding the existence of a public or private market upon which the quotations or sales prices may exceed substantially the price at which the Administrative Agent sells.

ARTICLE VI

Indemnity, Subrogation and Subordination

 

26


SECTION 6.01 Indemnity and Subrogation. In addition to all such rights of indemnity and subrogation as the Guarantors may have under applicable law (but subject to Section 6.03), the Borrower agrees that (a) in the event a payment shall be made by any Guarantor under this Agreement, the Borrower shall indemnify such Guarantor for the full amount of such payment and such Guarantor shall be subrogated to the rights of the Person to whom such payment shall have been made to the extent of such payment and (b) in the event any assets of any Guarantor shall be sold pursuant to this Agreement or any other Security Document to satisfy in whole or in part a claim of any Secured Party, the Borrower shall indemnify such Guarantor in an amount equal to the greater of the book value or the fair market value of the assets so sold.

SECTION 6.02 Contribution and Subrogation. Each Guarantor (a “Contributing Guarantor”) agrees (subject to Section 6.03) that, in the event a payment shall be made by any other Guarantor hereunder in respect of any Obligation, or assets of any other Guarantor shall be sold pursuant to any Security Document to satisfy any Obligation, and such other Guarantor (the “Claiming Guarantor”) shall not have been fully indemnified by the Borrower as provided in Section 6.01, the Contributing Guarantor shall indemnify the Claiming Guarantor in an amount equal to (i) the amount of such payment or (ii) the greater of the book value or the fair market value of such assets, as the case may be, in each case multiplied by a fraction of which the numerator shall be the net worth of the Contributing Guarantor on the date hereof and the denominator shall be the aggregate net worth of all the Guarantors on the date hereof (or, in the case of any Guarantor becoming a party hereto pursuant to Section 7.16, the date of the supplement hereto executed and delivered by such Guarantor). Any Contributing Guarantor making any payment to a Claiming Guarantor pursuant to this Section 6.02 shall be subrogated to the rights of such Claiming Guarantor under Section 6.01 to the extent of such payment.

SECTION 6.03 Subordination. Notwithstanding any provision of this Agreement to the contrary, (a) all rights of the Guarantors under Sections 6.01 and 6.02 and all other rights of indemnity, contribution or subrogation under applicable law or otherwise shall be fully subordinated to, and may be exercised by such Guarantor solely after, the indefeasible payment in full in cash of the Obligations and (b) no Guarantor shall exercise any rights of subrogation, contribution, indemnity, reimbursement or other similar rights against (i) the Borrower or any other Grantor (including after payment in full of the Obligations), and each Guarantor shall be deemed to have waived all such rights and remedies, if all or any portion of the Obligations have been satisfied in connection with an exercise of remedies in respect of the Equity Interests of the Borrower or such other Guarantor whether pursuant to the Loan Documents or otherwise or (ii) the Secured Parties or any of their assignees or transferees of the Collateral.. No failure on the part of the Borrower or any Guarantor to make the payments required by Sections 6.01 and 6.02 (or any other payments required under applicable law or otherwise) shall in any respect limit the obligations and liabilities of any Guarantor with respect to its obligations hereunder, and each Guarantor shall remain liable for the full amount of its obligations hereunder. The Borrower and each Guarantor hereby agree that all Indebtedness and other monetary obligations owed by it to the Borrower or any Subsidiary shall be fully subordinated and junior to the indefeasible payment in full in cash of the Obligations.

ARTICLE VII

Miscellaneous

 

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SECTION 7.01 Notices. All communications and notices hereunder shall (except as otherwise expressly permitted herein) be in writing and given as provided in Section 9.01 of the Credit Agreement. All communications and notices hereunder to any Guarantor shall be given to it in care of the Borrower as provided in Section 9.01 of the Credit Agreement.

SECTION 7.02 Security Interest Absolute. All rights of the Administrative Agent hereunder, the Security Interest, the grant of a security interest in the Pledged Collateral and all obligations of each Grantor hereunder shall be absolute and unconditional irrespective of (a) any lack of validity or enforceability of the Credit Agreement, any other Loan Document, any agreement with respect to any of the Obligations or any other agreement or instrument relating to any of the foregoing, (b) any change in the time, manner or place of payment of, or in any other term of, all or any of the Obligations, or any other amendment or waiver of or any consent to any departure from the Credit Agreement, any other Loan Document or any other agreement or instrument relating to the foregoing, (c) any exchange, release or non-perfection of any Lien on other collateral, or any release or amendment or waiver of or consent under or departure from any guarantee, securing or guaranteeing all or any of the Obligations, or (d) any other circumstance that might otherwise constitute a defense available to, or a discharge of, any Grantor in respect of the Obligations or this Agreement.

SECTION 7.03 Survival of Agreement. All covenants, agreements, representations and warranties made by the Loan Parties in the Loan Documents and in the certificates or other instruments prepared or delivered in connection with or pursuant to this Agreement or any other Loan Document shall be considered to have been relied upon by the Secured Parties and shall survive the execution and delivery of the Loan Documents and the making of any Loans, regardless of any investigation made by, or on behalf of, any Secured Party and notwithstanding that the Administrative Agent or any Secured Party may have had notice or knowledge of any Default, Event of Default or incorrect representation or warranty at the time any credit is extended under the Credit Agreement, and shall continue in full force and effect as long as the principal of or any accrued interest on any Loan or any fee or any other amount payable under any Loan Document is outstanding and unpaid and so long as the Commitments have not expired or terminated.

SECTION 7.04 Binding Effect; Several Agreement. This Agreement shall become effective as to any Loan Party when a counterpart hereof, including by supplement, executed on behalf of such Loan Party shall have been delivered to the Administrative Agent and a counterpart hereof shall have been executed on behalf of the Administrative Agent, and thereafter shall be binding upon such Loan Party and the Administrative Agent and their respective permitted successors and assigns, and shall inure to the benefit of such Loan Party, the Administrative Agent and the other Secured Parties and their respective successors and assigns, except that no Loan Party shall have the right to assign or transfer its rights or obligations hereunder or any interest herein or in the Collateral (and any such assignment or transfer shall be void) except as expressly contemplated or permitted by this Agreement or the Credit Agreement. This Agreement shall be construed as a separate agreement with respect to each Loan Party and may be amended, modified, supplemented, waived or released with respect to any Loan Party without the approval of any other Loan Party and without affecting the obligations of any other Loan Party hereunder.

 

28


SECTION 7.05 Successors and Assigns. Whenever in this Agreement any of the parties hereto is referred to, such reference shall be deemed to include the permitted successors and assigns of such party, and all covenants, promises and agreements by or on behalf of any Grantor or the Administrative Agent that are contained in this Agreement shall bind and inure to the benefit of their respective successors and assigns.

SECTION 7.06 Administrative Agent’s Fees and Expenses; Indemnification.

(a) The parties hereto agree that the Administrative Agent shall be entitled to the expense reimbursement and indemnification provisions as provided in Section 9.05 of the Credit Agreement.

(b) Each Grantor, jointly and severally, agrees to pay all reasonable and documented out-of-pocket expenses incurred by the Administrative Agent and the Lenders to the same extent that the Borrower would be required to do so pursuant to Section 9.05 of the Credit Agreement.

(c) Each Grantor, jointly and severally, agrees to indemnify each Indemnitee to the same extent that the Borrower would be required to do so pursuant to Section 9.05 of the Credit Agreement.

(d) Any such amounts payable as provided hereunder shall be additional Obligations secured hereby and by the other Security Documents. The provisions of this Section 7.06 shall remain operative and in full force and effect regardless of the termination of this Agreement or any other Loan Document, the consummation of the transactions contemplated hereby, the repayment of any of the Obligations, the expiration of the Commitments, the invalidity or unenforceability of any term or provision of this Agreement or any other Loan Document, or any investigation made by or on behalf of the Administrative Agent or any other Secured Party. All amounts due under this Section 7.06 shall be payable on written demand therefor and shall bear interest, on and from the date of demand, at the rate specified in Section 2.06(a) of the Credit Agreement.

SECTION 7.07 Administrative Agent Appointed Attorney-in-Fact. Each Grantor hereby appoints the Administrative Agent as the attorney-in-fact of such Grantor, exercisable by the Administrative Agent whether or not an Event of Default exists, with full power of substitution, for the purpose of carrying out the provisions of this Agreement and taking any action and executing any instrument that the Administrative Agent may deem necessary or advisable to accomplish the purposes hereof, which appointment is irrevocable and coupled with an interest. Without limiting the generality of the foregoing, the Administrative Agent shall have the right, upon the occurrence and during the continuance of an Event of Default, with full power of substitution either in the Administrative Agent’s name or in the name of such Grantor to (a) receive, endorse, assign and/or deliver any and all notes, acceptances, checks, drafts, money orders or other evidences of payment relating to the Collateral or any part thereof, (b) request, demand, sue for, collect, receive payment of, give receipt for and give discharges and releases of all or any of the Collateral, including any monies due or to become due under or by virtue of any of the Collateral, (c) sign the name of any Grantor on any invoice or bill of lading relating to any of the Collateral, (d) send verifications of Accounts to any Account Debtor, (e) commence and prosecute

 

29


any and all suits, actions or proceedings at law or in equity in any court of competent jurisdiction to collect or otherwise realize on all or any of the Collateral or to enforce any rights in respect of any Collateral, (f) settle, compromise, compound, adjust or defend any actions, suits or proceedings relating to all or any of the Collateral, (g) notify, or to require any Grantor to notify, Account Debtors to make payment directly to the Administrative Agent, and (h) use, sell, assign, transfer, pledge, make any agreement with respect to or otherwise deal with all or any of the Collateral, and to do all other acts and things necessary to carry out the purposes of this Agreement in accordance with its terms, as fully and completely as though the Administrative Agent were the absolute owner of the Collateral for all purposes; provided that nothing herein contained shall be construed as requiring or obligating the Administrative Agent to make any commitment or to make any inquiry as to the nature or sufficiency of any payment received by the Administrative Agent, or to present or file any claim or notice, or to take any action with respect to the Collateral or any part thereof or the moneys due or to become due in respect thereof or any property covered thereby. The Administrative Agent and the other Secured Parties shall be accountable only for amounts actually received as a result of the exercise of the powers granted to them herein, and neither they nor their officers, directors, employees or agents shall be responsible to any Grantor for any act or failure to act hereunder, except for their own gross negligence or willful misconduct, in each case, as determined in a final and nonappealable judgment by a court of competent jurisdiction..

SECTION 7.08 Applicable Law. THIS AGREEMENT SHALL BE CONSTRUED IN ACCORDANCE WITH AND GOVERNED BY THE LAWS OF THE STATE OF NEW YORK.

SECTION 7.09 Waivers; Amendment.

(a) No failure or delay by the Administrative Agent or any Lender in exercising any right, power or remedy hereunder or under any other Loan Document shall operate as a waiver hereof or thereof, nor shall any single or partial exercise of any such right, power or remedy, or any abandonment or discontinuance of steps to enforce such a right, power or remedy, preclude any other or further exercise thereof or the exercise of any other right, power or remedy. The rights, powers and remedies of the Administrative Agent and the Lenders hereunder and under the other Loan Documents are cumulative and are not exclusive of any rights, powers or remedies that they would otherwise have. No waiver of any provision of any Loan Document or consent to any departure by any Loan Party therefrom shall in any event be effective unless the same shall be permitted by clause (b) of this Section 7.09, and then such waiver or consent shall be effective only in the specific instance and for the purpose for which given. Without limiting the generality of the foregoing, the making of a Loan shall not be construed as a waiver of any Default or Event of Default, regardless of whether the Administrative Agent or any Lender may have had notice or knowledge of such Default or Event of Default at the time. No notice or demand on any Loan Party in any case shall entitle any Loan Party to any other or further notice or demand in similar or other circumstances.

(b) Neither this Agreement nor any provision hereof may be waived, amended or modified except pursuant to an agreement or agreements in writing entered into by the Administrative Agent and the Loan Party or Loan Parties with respect to which such waiver, amendment or modification is to apply, subject to any consent or direction required in accordance with Section 9.08 of the Credit Agreement.

 

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SECTION 7.10 WAIVER OF JURY TRIAL. EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF, UNDER OR IN CONNECTION WITH THIS AGREEMENT OR ANY OF THE OTHER LOAN DOCUMENTS. EACH PARTY HERETO (A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND (B) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS, AS APPLICABLE, BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION 7.10.

SECTION 7.11 Severability. In the event any one or more of the provisions contained in this Agreement or in any other Loan Document should be held invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions contained herein and therein shall not in any way be affected or impaired thereby (it being understood that the invalidity of a particular provision in a particular jurisdiction shall not in and of itself affect the validity of such provision in any other jurisdiction). The parties shall endeavor in good-faith negotiations to replace the invalid, illegal or unenforceable provisions with valid provisions the economic effect of which comes as close as possible to that of the invalid, illegal or unenforceable provisions.

SECTION 7.12 Counterparts. This Agreement may be executed in counterparts (and by different parties hereto on different counterparts), each of which shall constitute an original but all of which when taken together shall constitute a single contract, and shall become effective as provided in Section 7.04. Delivery of an executed signature page to this Agreement by email or other electronic transmission shall be as effective as delivery of a manually signed counterpart of this Agreement.

SECTION 7.13 Headings. Article and Section headings and the Table of Contents used herein are for convenience of reference only, are not part of this Agreement and are not to affect the construction of, or to be taken into consideration in interpreting, this Agreement.

SECTION 7.14 Jurisdiction; Consent to Service of Process.

(a) Each of the Grantors hereby irrevocably and unconditionally submits, for itself and its property, to the exclusive jurisdiction of any New York State court or Federal court of the United States of America, sitting in the Borough of Manhattan in New York City, and any appellate court from any thereof, in any action or proceeding arising out of or relating to this Agreement or any other Loan Document, or for recognition or enforcement of any judgment, and each of the Loan Parties hereby irrevocably and unconditionally agrees that all claims in respect of any such action or proceeding may be heard and determined in such New York State court or, to the extent permitted by law, in such Federal court. Each of the Loan Parties agrees that a final judgment in any such action or proceeding shall be conclusive and may be enforced in other jurisdictions by suit on the judgment or in any other manner provided by law. Nothing in this Agreement or any other Loan Document shall affect any right that the Administrative Agent or any Lender may otherwise have to bring any action or proceeding relating to this Agreement or any other Loan Document against any Grantor or its properties in the courts of any jurisdiction.

 

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(b) Each of the Loan Parties hereby irrevocably and unconditionally waives, to the fullest extent it may legally and effectively do so, any objection which it may now or hereafter have to the laying of venue of any suit, action or proceeding arising out of or relating to this Agreement or any other Loan Document in any court referred to in clause (a) of this Section 7.14. Each of the Loan Parties hereby irrevocably waives, to the fullest extent permitted by law, the defense of an inconvenient forum to the maintenance of such action or proceeding in any such court.

(c) Each of the Loan Parties hereby irrevocably consents to service of process in the manner provided for notices in Section 7.01. Nothing in this Agreement or any other Loan Document will affect the right of the Administrative Agent to serve process in any other manner permitted by law.

SECTION 7.15 Termination or Release.

(a) This Agreement, the guarantees made herein, the Security Interest, the pledge of the Pledged Collateral and all other security interests granted hereby shall automatically terminate when all the Obligations (other than unmatured or inchoate indemnity obligations) have been indefeasibly paid in full in cash and the Lenders have no further commitment to lend under the Credit Agreement.

(b) A Guarantor shall automatically be released from its obligations hereunder and the Security Interests created hereunder in the Collateral of such Guarantor shall be automatically released upon the consummation of any transaction permitted by the Credit Agreement as a result of which such Guarantor ceases to be a Subsidiary or becomes an Excluded Subsidiary in a transaction permitted by the Credit Agreement.

(c) Upon any sale or other transfer by any Grantor of any Collateral that is permitted under the Credit Agreement to any Person that is not the Borrower or a Guarantor, or, upon the effectiveness of any written consent of the Lenders to the release of the Security Interest granted hereby in any Collateral pursuant to Section 9.08 of the Credit Agreement, the Security Interest in such Collateral shall be automatically released.

(d) In connection with any termination or release pursuant to clause (a), (b) or (c) above, the Administrative Agent shall promptly execute and deliver to any Grantor, solely at such Grantor’s expense, all Uniform Commercial Code termination statements and similar documents that such Grantor shall reasonably request to evidence such termination or release. Any execution and delivery of documents pursuant to this Section 7.15 shall be without recourse to or representation or warranty by the Administrative Agent or any Secured Party; provided that the Borrower shall have delivered a certificate executed by a Responsible Officer of the Borrower at least five Business Days prior to any such release pursuant to clause (a), (b) or (c) above, certifying that the applicable transaction is permitted under the Credit Agreement (and the Secured Parties, by accepting the benefits hereof, hereby direct and authorize the Administrative Agent to rely upon such certificate in performing its obligations under this Section 7.15(d)). Without limiting the

 

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provisions of Section 7.06, the Borrower shall reimburse the Administrative Agent upon demand for all reasonable and documented costs and out of pocket expenses, including the reasonable and documented fees, charges and out of pocket expenses of counsel, incurred by it in connection with any action contemplated by this Section 7.15.

SECTION 7.16 Additional Subsidiaries. Any Subsidiary that is required to become a party hereto pursuant to the Credit Agreement (including Section 5.12 of the Credit Agreement) shall enter into this Agreement as a Guarantor and a Grantor upon becoming such a Subsidiary. Upon execution and delivery by the Administrative Agent and such Subsidiary of a supplement in the form of Exhibit A hereto (which supplement shall be delivered by such Subsidiary within the time period specified in the Credit Agreement (or such longer period as the Administrative Agent may agree in its reasonable discretion)), such Subsidiary shall become a Guarantor and a Grantor hereunder with the same force and effect as if originally named as a Guarantor and a Grantor herein. The execution and delivery of any such instrument shall not require the consent of any other Loan Party hereunder. The rights and obligations of each Loan Party hereunder shall remain in full force and effect notwithstanding the addition of any new Loan Party as a party to this Agreement.

SECTION 7.17 Right of Setoff. If an Event of Default shall have occurred and is continuing, each Secured Party is hereby authorized at any time and from time to time, to the fullest extent permitted by law, to set off and apply any and all Collateral (including any deposits (general or special, time or demand, provisional or final)) at any time held and other obligations at any time owing by such Secured Party to or for the credit or the account of any Grantor against any and all of the obligations of such Grantor now or hereafter existing under this Agreement and the other Loan Documents held by such Secured Party, irrespective of whether or not such Secured Party shall have made any demand under this Agreement or any other Loan Document and although such obligations may be unmatured; provided that any right of setoff exercised by a Defaulting Lender shall be subject to Section 9.06 of the Credit Agreement.. The rights of each Secured Party under this Section 7.17 are in addition to other rights and remedies (including other rights of setoff) which such Secured Party may have but shall not apply to any Excluded Assets.

[Remainder of page intentionally left blank]

 

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IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the day and year first above written.

 

MULBERRY HEALTH, INC., as Borrower
    by  

 

  Name:

 

MULBERRY MANAGEMENT CORPORATION, as Guarantor

    by  

 

 

Name:

Title:

Signature Page to Guarantee and Collateral Agreement


HPS INVESTMENT PARTNERS, LLC, as
Administrative Agent,
    by  

 

 

Name:

Title:

Signature Page to Guarantee and Collateral Agreement


Schedule I to the Guarantee and

Collateral Agreement

GUARANTORS

 

Guarantor

  

Type of
Organization

  

Jurisdiction of
Organization/
Formation

  

Chief Executive Office

  

Organizational
Identification
Number

Mulberry Health Inc.    Corporation    Delaware    75 Varick Street, New York, NY 10013    5230394
Mulberry Management Corporation    Corporation    Delaware    75 Varick Street, New York, NY 10013    5584228


Schedule II to the Guarantee and

Collateral Agreement

EQUITY INTERESTS; PLEDGED DEBT SECURITIES

 

Grantor

  

Subsidiary

   Certificate No.   

No. Shares/Percentage Interest

Mulberry Health Inc.    Mulberry Insurance Agency, Inc.    1    1,000/100%
Mulberry Health Inc.    Mulberry Management Corporation
(f/k/a Oscar Management Corporation)
   001    1,000/100%
Mulberry Health Inc.    Oscar Health Plan, Inc.    1    1/100%
Mulberry Health Inc.    Oscar Buckeye State Insurance Corporation    1    10,000/100%
Mulberry Health Inc.    Oscar Health Plan of California    1    1,000/100%
Mulberry Health Inc.    Oscar Health Plan of Georgia    1    1,000/100%
Mulberry Health Inc.         Oscar Golden State Managed Care    1    1,000/100%
Mulberry Health Inc.    Oscar Health Plan of New York, Inc.    1    100/100%
Mulberry Health Inc.    Oscar Insurance Corporation    1    20,000,000/100%
Mulberry Health Inc.    Oscar Insurance Corporation of Ohio    1    10,000/100%
Mulberry Health Inc.    Oscar Health Plan of Pennsylvania Inc    1    1,000/100%
Mulberry Health Inc.    Oscar Insurance Company of Texas    3    289,889/100%
Mulberry Health Inc.    Oscar Health Plan of North Carolina, Inc.    1    100,000/100%


Schedule III to the Guarantee and

Collateral Agreement

INTELLECTUAL PROPERTY

Trademarks:

 

Grantor

  

            Mark             

  

        Reg. Number        

  

        Filing Date        

  

        Registration Date        

Mulberry Management Corporation    OSCAR HEALTH    6065287    02/27/2019    05/26/2020
Mulberry Management Corporation    OSCAR    4615253    12/20/2013    09/30/2014


Schedule IV to the Guarantee and

Collateral Agreement

COMMERCIAL TORT CLAIMS

None.


Exhibit A to the Guarantee and

Collateral Agreement

SUPPLEMENT NO. [●] (this “Supplement”) dated as of [●] to the Guarantee and Collateral Agreement dated as of October 30, 2020 (the “Guarantee and Collateral Agreement”), among MULBERRY HEALTH, INC., a Delaware corporation (the “Borrower”), each Guarantor from time to time party thereto (each such Guarantor individually a “Guarantor” and collectively, the “Guarantors”; the Guarantors and the Borrower are referred to collectively herein as the “Grantors”) and HPS INVESTMENT PARTNERS, LLC, as administrative agent (in such capacity, the “Administrative Agent”) for the Secured Parties (as defined therein).

A. Reference is made to the Credit Agreement dated as of October 30, 2020 (as amended, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Borrower, the lenders from time to time party thereto (the “Lenders”) and the Administrative Agent.

B. Capitalized terms used herein and not otherwise defined herein shall have the meanings assigned to such terms in the Credit Agreement or the Guarantee and Collateral Agreement referred to therein, as applicable.

C. The Grantors have entered into the Guarantee and Collateral Agreement in order to induce the Lenders to make Loans. Section 7.16 of the Guarantee and Collateral Agreement provides that additional Subsidiaries of the Borrower may become Guarantors and Grantors under the Guarantee and Collateral Agreement by execution and delivery of an instrument in the form of this Supplement. The undersigned Subsidiary (the “New Subsidiary”) is executing this Supplement in accordance with the requirements of the Credit Agreement to become a Guarantor and a Grantor under the Guarantee and Collateral Agreement as consideration for Loans previously made.

Accordingly, the Administrative Agent and the New Subsidiary agree as follows:

SECTION 1. In accordance with Section 7.16 of the Guarantee and Collateral Agreement, the New Subsidiary by its signature below becomes a Grantor and Guarantor under the Guarantee and Collateral Agreement with the same force and effect as if originally named therein as a Grantor and Guarantor and the New Subsidiary hereby (a) agrees to all the terms and provisions of the Guarantee and Collateral Agreement applicable to it as a Grantor and Guarantor thereunder and (b) represents and warrants that the representations and warranties made by it as a Grantor and Guarantor thereunder are true and correct on and as of the date hereof. In furtherance of the foregoing, the New Subsidiary, as security for the payment and performance in full of the Obligations, does hereby create and grant to the Administrative Agent for the benefit of the Secured Parties, a security interest in and lien on all of the New Subsidiary’s right, title and interest in and to the Collateral (as defined in the Guarantee and Collateral Agreement) of the New Subsidiary. Each reference to a “Grantor” or a “Guarantor” in the Guarantee and Collateral Agreement shall be deemed to include the New Subsidiary. The Guarantee and Collateral Agreement is hereby incorporated herein by reference.

SECTION 2. The New Subsidiary represents and warrants to the Administrative Agent and the other Secured Parties that this Supplement has been duly authorized, executed and delivered by it and constitutes its legal, valid and binding obligation, enforceable against it in accordance with its terms.


SECTION 3. This Supplement may be executed in counterparts (and by different parties hereto on different counterparts), each of which shall constitute an original, but all of which when taken together shall constitute a single contract. This Supplement shall become effective when the Administrative Agent shall have received counterparts of this Supplement that, when taken together, bear the signatures of the New Subsidiary and the Administrative Agent. Delivery of an executed signature page to this Supplement by electronic transmission shall be as effective as delivery of a manually signed counterpart of this Supplement.

SECTION 4. The New Subsidiary hereby represents and warrants that set forth on Schedule I attached hereto is (a) a true and correct schedule of (i) any and all Equity Interests and Pledged Debt Securities now owned by the New Subsidiary, (ii) any and all Intellectual Property now owned by the New Subsidiary, and (iii) any and all Commercial Tort Claims held by the New Subsidiary and (b) the true and correct legal name of the New Subsidiary and its jurisdiction of organization.

SECTION 5. Except as expressly supplemented hereby, the Guarantee and Collateral Agreement shall remain in full force and effect.

SECTION 6. THIS SUPPLEMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

SECTION 7. In case any one or more of the provisions contained in this Supplement should be held invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions contained herein and in the Guarantee and Collateral Agreement shall not in any way be affected or impaired thereby (it being understood that the invalidity of a particular provision in a particular jurisdiction shall not in and of itself affect the validity of such provision in any other jurisdiction). The parties hereto shall endeavor in good-faith negotiations to replace the invalid, illegal or unenforceable provisions with valid provisions the economic effect of which comes as close as possible to that of the invalid, illegal or unenforceable provisions.

SECTION 8. All communications and notices hereunder shall (except as otherwise expressly permitted by the Guarantee and Collateral Agreement) be in writing and given as provided in Section 9.01 of the Credit Agreement. All communications and notices hereunder to the New Subsidiary shall be given to it in care of the Borrower as provided in Section 9.01 of the Credit Agreement.

SECTION 9. The New Subsidiary agrees to reimburse the Administrative Agent for its reasonable and documented out-of-pocket expenses in connection with this Supplement, including the fees, other charges and disbursements of counsel for the Administrative Agent.

 

A-2


IN WITNESS WHEREOF, the New Subsidiary and the Administrative Agent have duly executed this Supplement to the Guarantee and Collateral Agreement as of the day and year first above written.

 

[NAME OF NEW SUBSIDIARY],
    by  

 

 

Name:

Title:

 

HPS INVESTMENT PARTNERS, LLC, as

Administrative Agent,

    by  

 

 

Name:

Title:

 

A-3


Schedule I to

Supplement No. [●] to the

Guarantee and Collateral Agreement

Collateral of the New Subsidiary    

EQUITY INTERESTS

 

Issuer

   Number of
Certificate
     Registered
Owner
     Number and
Class of
Equity Interest
     Percentage
of Equity
Interests
 
           

PLEDGED DEBT SECURITIES

 

Issuer

   Principal
Amount
     Date of Note      Maturity Date  
        

INTELLECTUAL PROPERTY

[Follow format of Schedule III to the Guarantee and Collateral Agreement.]

COMMERCIAL TORT CLAIMS

[Follow format of Schedule IV to the Guarantee and Collateral Agreement.]

NAME AND JURISDICTION OF ORGANIZATION OF NEW SUBSIDIARY

Name:                                                              

Jurisdiction of Organization:                                                               

 

A-4


Exhibit B to the

Guarantee and Collateral Agreement

FORM OF PERFECTION CERTIFICATE

[To be attached.]


EXHIBIT E

FORM OF COMPLIANCE CERTIFICATE

[Date]

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, amended and restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not otherwise defined herein have the meanings assigned to them in the Credit Agreement.

Pursuant to Section 5.04(d) of the Credit Agreement, the undersigned, solely in his or her capacity as the Chief Financial Officer of the Borrower, certifies as follows:

 

  1.

[Attached hereto as Exhibit A are the consolidated balance sheet and related statements of income, stockholders’ equity and cash flows showing the financial condition of the Borrower and its consolidated Subsidiaries as of the close of the fiscal year ended December 31, 20[●] and the results of its operations and the operations of such Subsidiaries during such year, together with comparative figures for the immediately preceding fiscal year, all audited by [●], and accompanied by an opinion of such accountants (which opinion shall not include (i) an explanatory paragraph expressing substantial doubt about the ability of the Borrower and its consolidated Subsidiaries to continue as a going concern or (ii) any qualification or exception as to the scope of such audit other than solely as a result of the upcoming maturity of any Obligations or any prospective inability to satisfy the covenants set forth in Section 6.10 on a future date or for a future period) to the effect that such consolidated financial statements fairly present the financial condition and results of operations of the Borrower and its consolidated Subsidiaries on a consolidated basis in accordance with GAAP consistently applied[, together with a customary “management discussion and analysis” provision]1.]2

 

  2.

[Attached hereto as Exhibit A are the consolidated balance sheet and related statements of income, stockholders’ equity and cash flows showing the financial condition of the Borrower and its consolidated Subsidiaries as of the close of the fiscal quarter ended [●], 20[●] and the results of its operations and the operations of such Subsidiaries during such fiscal quarter and the then elapsed portion of the fiscal year, and comparative figures for the same periods in the immediately preceding fiscal year, all certified by one of its

 

1 

To be included from and after the fiscal quarter ending March 31, 2021.

2 

To be included if accompanying annual financial statements


  Financial Officers as fairly presenting the financial condition and results of operations of the Borrower and its consolidated Subsidiaries on a consolidated basis in accordance with GAAP consistently applied, subject to normal year-end audit adjustments[, together with a customary “management discussion and analysis” provision]3.]4

 

  3.

[No Event of Default or Default has occurred and is continuing.] [If unable to provide the foregoing certification, attach an Annex A specifying the nature and extent of the Event of Default or Default that has occurred and is continuing and any corrective action taken or proposed to be taken with respect thereto.]

 

  4.

[The aggregate amount of Gross Premiums written by the Borrower and the Subsidiaries for the four fiscal quarter period ending on the last day of the fiscal quarter ending [●], 20[●] is $[●]]5.

 

  5.

[Attached hereto as Schedule 1 is a calculation of the Combined Ratio as of the last day of the fiscal quarter ending [●], 20[●], which calculation is true and correct.]6

 

  6.

Liquidity of the Loan Parties as of the date hereof is equal to $[●].

[The remainder of this page is intentionally left blank.]

 

3 

To be included from and after the fiscal quarter ending March 31, 2021.

4 

To be included if accompanying quarterly financial statements

5 

To be included through the two-year anniversary of the Closing Date

6 

To be included from and after the two-year anniversary of the Closing Date


IN WITNESS WHEREOF, the undersigned, solely in his or her capacity as Chief Financial Officer of the Borrower, has executed and delivered this certificate as of the date first set forth above.

 

MULBERRY HEALTH INC., as Borrower

By:  

 

 

Name:

Title: Chief Financial Officer


Exhibit A

Financial Reports


SCHEDULE I

Combined Ratio Calculation


EXHIBIT F

FORM OF AFFILIATE SUBORDINATION AGREEMENT

This Affiliate Subordination Agreement (this “Agreement”), dated as of [●], is entered into by and among each of the undersigned Loan Parties (each an “Obligor” and collectively, the “Obligors”), the parties identified as “Subordinated Creditors” on the signature pages hereto (the “Subordinated Creditors”) and HPS Investment Partners, LLC, in its capacity as Administrative Agent (in such capacity, including any successor thereto, the “Administrative Agent”) for the “Lenders” and the “Secured Parties”, as such terms are defined in the Credit Agreement defined below (such Secured Parties being referred to herein as the “Senior Creditors”) to set forth the respective rights, remedies and interests of the Subordinated Creditors, on the one hand, and the Administrative Agent and the other Senior Creditors, on the other hand. Capitalized terms used and not otherwise defined herein have the meanings assigned to them in the Credit Agreement.

RECITALS

A. The Subordinated Creditors may from time to time make unsecured loans to the Obligors.

B. Mulberry Health Inc., a Delaware corporation (the “Borrower”), the Administrative Agent and the Lenders are parties to that certain Credit Agreement, dated as of October 30, 2020 (as amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), whereby the Lenders have, among other things, made loans to the Borrower and appointed the Administrative Agent as such.

C. In order to induce the Lenders to extend financial accommodations to the Borrower under the Credit Agreement, the Subordinated Creditors have agreed to enter into this Agreement.

AGREEMENT

NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows:

1. Subordination. Any and all Indebtedness of an Obligor to the Subordinated Creditors, including any principal and interest payments thereon, whether such Indebtedness is direct or indirect, absolute or contingent, joint or several, secured or unsecured, due or to become due, now existing or later arising and whatever the amount and however evidenced (collectively, the “Subordinated Indebtedness”), is hereby subordinated in right of payment to the prior Payment in Full (as defined below) of all Obligations now or hereafter existing under the Credit Agreement and the other Loan Documents (collectively, the “Senior Indebtedness”).

2. No Payment on or Enforcement of Subordinated Indebtedness.

With respect to any Subordinated Indebtedness owed by any Obligor to any Subordinated Creditor that is not a Loan Party, until the Senior Indebtedness has been Paid in Full, such Subordinated Creditors will not ask for, schedule, accept, demand, sue for, take or receive (by way of voluntary payment, acceleration, set-off or counterclaim, foreclosure or other realization on


security, dividends in bankruptcy or otherwise) any payment of or on account of, or offer to make any discharge or release of, or cause any Obligor to honor any redemption, put or mandatory payment obligation with respect to, any of such Subordinated Indebtedness other than Permitted Payments (as defined below), nor shall such Subordinated Creditors exercise any rights of subrogation, reimbursement, contribution or other similar rights with respect to such Senior Indebtedness (other than with respect to Permitted Payments).

With respect to any Subordinated Indebtedness owed by any Obligor to any Subordinated Creditor that is a Loan Party, if any Event of Default has occurred and is continuing under the Credit Agreement and notice is given by the Administrative Agent to each such Subordinated Creditor, then such Subordinated Creditors will not ask for, schedule, accept, demand, sue for, take or receive (by way of voluntary payment, acceleration, set-off or counterclaim, foreclosure or other realization on security, dividends in bankruptcy or otherwise) any payment of or on account of, or offer to make any discharge or release of, or cause any Obligor to honor any redemption, put or mandatory payment obligation with respect to, any of such Subordinated Indebtedness, nor shall such Subordinated Creditors exercise any rights of subrogation, reimbursement, contribution or other similar rights with respect to such Senior Indebtedness, until (x) the Senior Indebtedness has been Paid in Full or (y) such Event of Default has been cured or waived in accordance with, and to the extent permitted by, the Credit Agreement).

As used in this Agreement:

Paid in Full” and “Payment in Full” shall mean the payment and satisfaction in full in cash or cash equivalents of all of the Senior Indebtedness (other than contingent indemnification obligations for which no claim has been made) and the termination of all Commitments under the Credit Agreement.

Permitted Payments” shall mean payments in cash of accrued interest on, and repayments in cash of the principal amount of, Subordinated Indebtedness, in each case so long as at the time of, and after giving effect to such payments, no Event of Default shall have occurred and be continuing.

3. Subordinated Indebtedness to be Unsecured. The Subordinated Indebtedness shall at all times be unsecured. The Subordinated Creditors shall not seek to obtain, and shall not take, accept, obtain or have, any lien or security interest in or on any asset of any Obligor as security for all or any part of the Subordinated Indebtedness. In the event that a Subordinated Creditor obtains any Liens or security interests in or on any asset of any Obligor, such Subordinated Creditor shall (or shall cause its agent to) promptly execute and deliver to the Administrative Agent such documents, agreements and instruments, and take such other actions, as the Administrative Agent may request to release and extinguish such Liens and security interests.

4. Instrument Legends. The faces of any instruments and documents evidencing Subordinated Indebtedness acquired after the date hereof will be forthwith inscribed with a legend conspicuously indicating that payment thereon is subordinated to the claims of the Administrative Agent and the Senior Creditors pursuant to the terms of this Agreement.


5. Authorization of Administrative Agent. The Subordinated Creditors authorize and empower the Administrative Agent on behalf of the Senior Creditors, at any time that an Event of Default has occurred and is continuing to demand, to enforce payment by legal proceedings, and to receive and give acquittances for the Subordinated Indebtedness; provided that neither the Administrative Agent nor any Senior Creditor has any obligation to the Subordinated Creditors to demand, to enforce payment by legal proceedings, and to receive and give acquittances for the Subordinated Indebtedness; provided, further, that by accepting the benefit of this Agreement, the Senior Creditors expressly acknowledge and agree that this Agreement may be enforced only by the action of the Administrative Agent and no Senior Creditor shall have the right individually to seek to enforce or to enforce this Agreement or to realize upon the rights granted hereunder. The Obligors and the Subordinated Creditors hereby acknowledge and agree that this Agreement shall be a Loan Document.

6. Turnover. Should any payment or distribution be received by any Subordinated Creditor upon or with respect to Subordinated Indebtedness in violation of Section 2, such Subordinated Creditor shall immediately deliver the same to the Administrative Agent for the account of the Senior Creditors in the form received (except for endorsement or assignment by the Subordinated Creditor where required by the Administrative Agent), to be held as Collateral or distributed by the Administrative Agent as payment or prepayment of the Senior Indebtedness in accordance with the Credit Agreement and the other Loan Documents and, until so delivered, the same shall be held in trust by the Subordinated Creditor as the property of the Administrative Agent and the Senior Creditors.

7. Covenants of the Subordinated Creditors. Each Subordinated Creditor covenants and agrees with the Administrative Agent and the Senior Creditors that so long as this Agreement is in effect it shall not make or permit, any assignment, transfer, pledge or disposition, for collateral purposes or otherwise, of all or any part of the Subordinated Indebtedness; provided that such Subordinated Creditor (or, following the death of such Subordinated Creditor or its beneficiary, as applicable, the executor of such Person’s estate) may transfer all or any part of the Subordinated Indebtedness if (a) the Administrative Agent consents or (b) the transferee is a Subsidiary and acknowledges in writing that it is bound by the terms of this Agreement as if it were originally named as a Subordinated Creditor herein. Any purported assignment, transfer, pledge or disposition, for collateral purposes or otherwise, of all or any part of the Subordinated Indebtedness that does not comply with this Section 7 shall be null and void.

8. Continuing Agreement. The terms of this Agreement, the subordination effected hereby, and the rights and the obligations of the Subordinated Creditors, the Obligors, the Administrative Agent and the Senior Creditors shall not be affected, modified or impaired in any manner or to any extent by (a) the validity or enforceability (or any lack thereof) of any of the Credit Agreement, the other Loan Documents, or any documents evidencing the Subordinated Indebtedness, or (b) any exercise or non-exercise of any right, power or remedy under or in respect of the Senior Indebtedness, the Credit Agreement, the other Loan Documents, the Subordinated Indebtedness or any documents evidencing the Subordinated Indebtedness. Each Subordinated Creditor hereby acknowledges that the provisions of this Agreement are intended to be enforceable at all times, whether before the commencement of, after the commencement of, in connection with or premised on the occurrence of any Reorganization (as defined below).


9. Non-Reliance by Subordinated Creditors. Each Subordinated Creditor delivers this Agreement based solely on such Subordinated Creditor’s independent investigation of (or decision not to investigate) the financial condition of the Obligors and is not relying on any information furnished by the Administrative Agent or any Senior Creditor. Each Subordinated Creditor assumes full responsibility for obtaining any further information concerning the Obligors’ financial condition, the status of the Senior Indebtedness or any other matter which such Subordinated Creditor may deem necessary or appropriate now or later. Each Subordinated Creditor waives any duty on the part of the Administrative Agent or any Senior Creditor and agrees that the Subordinated Creditor is not relying upon nor expecting the Administrative Agent or any Senior Creditor to disclose to such Subordinated Creditor any fact now or later known by the Administrative Agent or any Senior Creditor, whether relating to the operations or condition of any Obligor, the existence, liabilities or financial condition of any guarantor of the Senior Indebtedness, the occurrence of any default with respect to the Senior Indebtedness, or otherwise, notwithstanding any effect such fact may have upon such Subordinated Creditor’s risk or such Subordinated Creditor’s rights against any Obligor. Each Subordinated Creditor knowingly accepts the full range of risk encompassed in this Agreement, which risk includes, without limitation, the possibility that the Obligors may incur Senior Indebtedness to the Senior Creditors after the financial condition of the Obligors or their ability to pay their debts as they mature, has deteriorated. Each Subordinated Creditor acknowledges and agrees that the Administrative Agent’s and the Senior Creditors’ rights under this Agreement are not conditioned upon pursuit by the Administrative Agent or the Senior Creditors of any remedy the Administrative Agent or the Senior Creditors may have against the Obligors or any other person.

10. Modification of Senior Indebtedness. The Administrative Agent and the Senior Creditors shall have the right, without notice to or consent of any Subordinated Creditor and without impairing the terms of subordination set forth herein, to amend, restate, refinance, supplement, extend, increase or modify the Senior Indebtedness, in any manner whatsoever. Without limiting the generality of the foregoing, the Administrative Agent (acting at the written direction of the Required Lenders) and the Senior Creditors may (but shall be under no obligation to) from time to time and without notice to any Subordinated Creditor, take any or all of the following actions:

(a) retain or obtain a security interest in any assets of the Obligors, any of the Obligors’ subsidiaries or any third party to secure any of the Senior Indebtedness;

(b) retain or obtain the primary or secondary obligation of any Obligor or Obligors with respect to any of the Senior Indebtedness;

(c) extend or renew for one or more periods (whether or not longer than the original period), alter or exchange any of the Senior Indebtedness;

(d) waive, ignore or forbear from taking action or otherwise exercising any of its default rights or remedies with respect to any default by a Loan Party or any Subsidiaries under any documents evidencing the Senior Indebtedness;


(e) release, waive or compromise any obligation of the Obligors or any of their subsidiaries or any obligation of any nature of any other obligor primarily or secondarily obligated with respect to any of the Senior Indebtedness;

(f) release any security interest in, or surrender, release or permit any substitution or exchange for, all or any part of the Collateral now or hereafter securing all or a portion of the Senior Indebtedness, or extend or renew for one or more periods (whether or not longer than the original period) or release, waive, compromise, alter or exchange any obligations of any nature of any obligor with respect to any such property; and

(g) demand payment or performance of any of the Senior Indebtedness from the Obligors or any of the other Loan Parties when permitted to do so under the Credit Agreement or the other Loan Documents at any time or from time to time, whether or not the Administrative Agent or the Senior Creditors shall have exercised any of their rights or remedies with respect to any property securing any of the Senior Indebtedness or proceeded against any other obligor primarily or secondarily liable for payment or performance of any of the Senior Indebtedness.

11. Reinstatement of Agreement; Termination.

(a) Notwithstanding any prior revocation, termination, surrender or discharge of this Agreement in whole or in part, the effectiveness of this Agreement shall automatically continue or be reinstated in the event that any payment received or credit given by the Administrative Agent or any Senior Creditor in respect of the Senior Indebtedness is returned, disgorged or rescinded under any applicable state, foreign or federal law, including, without limitation, laws pertaining to bankruptcy or insolvency, in which case this Agreement shall be enforceable against the Subordinated Creditor as if the returned, disgorged or rescinded payment or credit had not been received or given by the Administrative Agent or any Senior Creditor, and whether or not the Administrative Agent or any Senior Creditor relied upon this payment or credit or changed its position as a consequence of it. In the event of continuation or reinstatement of this Agreement, each Subordinated Creditor agrees upon demand by the Administrative Agent to execute and deliver to the Administrative Agent those documents which the Administrative Agent determines are appropriate to further evidence (in the public records or otherwise) this continuation or reinstatement, although the failure of such Subordinated Creditor to do so shall not affect in any way the reinstatement or continuation.

(b) Subject to the foregoing provision of this Section 11, this Agreement shall automatically terminate in its entirety upon the date the Senior Indebtedness is Paid in Full. A Subordinated Creditor shall automatically be released from its obligations hereunder upon the consummation of any transaction permitted by the Credit Agreement, as a result of which such Subordinated Creditor ceases to be a Subsidiary. An Obligor shall automatically be released to the extent it ceases to be a Subsidiary in a transaction permitted under Section 6.05 of the Credit Agreement. In connection with any termination or release pursuant to this paragraph (b), the Administrative Agent shall promptly execute and deliver to any Obligor at such Obligor’s expense, all documents that such obligor shall reasonably request to evidence such termination or release and take all other actions reasonably requested by such Obligor, at such Obligor’s expense, in connection with such release (and the Administrative Agent is hereby directed by the Senior Creditors to enter into any such documents and take any such actions in connection with any termination or release pursuant to this paragraph (b)).


12. Bankruptcy.

(a) In the event of any Reorganization (as defined below), all of the Senior Indebtedness shall be Paid in Full before any payment or distribution is made with respect to the Subordinated Indebtedness, and in any such proceedings any payment or distribution of any kind or character, whether in cash or property or securities (other than (i) Qualified Capital Stock or (ii) any securities that are subordinated to the Senior Indebtedness at least to the same extent as the Subordinated Indebtedness), which may be payable or deliverable in respect of the Subordinated Indebtedness shall be paid or delivered directly to the Administrative Agent for the benefit of the Senior Creditors for application in payment of the Senior Indebtedness in accordance with the Credit Agreement, unless and until all such Senior Indebtedness shall have been Paid in Full. In the event that, notwithstanding the foregoing, upon any such Reorganization (as defined below) any payment or distribution on or in respect of Subordinated Indebtedness, whether in cash, property or securities (other than (i) Qualified Capital Stock or (ii) any securities that are subordinated to the Senior Indebtedness at least to the same extent as the Subordinated Indebtedness) shall be received by a holder of Subordinated Indebtedness before the date on which all Senior Indebtedness shall have been Paid in Full, such payment or distribution shall be promptly paid over to the Administrative Agent for the benefit of the Senior Creditors for application to the payment and satisfaction of all Senior Indebtedness remaining unpaid in accordance with the Credit Agreement until all such Senior Indebtedness shall have been Paid in Full. For purposes of this Agreement, “Reorganization” means any voluntary or involuntary dissolution, winding-up, total or partial liquidation or bankruptcy, insolvency, reorganization, receivership or other statutory or common law proceedings or arrangements involving the Loan Parties or any of their Subsidiaries or any of their assets or the readjustment of any of their liabilities or any assignment for the benefit of creditors or any marshaling of the assets or liabilities of any of them.

(b) Each Subordinated Creditor agrees, in connection with any such Reorganization, that while it shall retain any right to vote it would otherwise have in any such proceeding to accept or reject any plan of partial or complete liquidation, reorganization, arrangement, composition or extension, such Subordinated Creditor agrees it will: (i) not file any motion for relief from the automatic stay or for adequate protection or similar relief or protection without the Administrative Agent’s prior written consent; (ii) not oppose any motion by the Administrative Agent or any Senior Creditor for relief from the automatic stay or for adequate protection or similar relief or protection; (iii) not oppose any request by the representative of the bankruptcy estate to use collateral or cash collateral if the Administrative Agent has consented to such use; and (iv) not object to or oppose a sale or other disposition of any assets securing the Senior Indebtedness (or any portion thereof) free and clear of its security interests, liens or other claims if the Senior Creditors have consented to such sale or disposition of such assets. In furtherance thereof, each Subordinated Creditor agrees not to oppose any post-petition motion filed or supported by the Administrative Agent for (w) adequate protection in respect of the Senior Indebtedness, (x) relief from the automatic stay to enforce any of its liens or in connection with the implementation of any such motion for adequate protection (including any substitution of collateral), (y) the application of cash collateral for use in the ordinary course of the business of the Obligors or (z) post-petition borrowing from some or all of the Senior Creditors regardless of


amount and whether or not secured by security interests upon all or any part of the assets of any Obligor or the bankruptcy estate of the Borrower or any other Loan Party, which liens and security interests may also secure payments of all Senior Indebtedness (whether such Senior Indebtedness arose prior to the filing of the Reorganization petition or thereafter). Each Subordinated Creditor waives any claim it may now or hereafter have against the Administrative Agent and/or Senior Creditors arising out of the election of the application of Section 1111(b)(2) of the Bankruptcy Code. This Agreement is a “subordination agreement” under section 510(a) of the Bankruptcy Code and shall be enforceable in any Reorganization.

13. Waivers of the Subordinated Creditor. Each Subordinated Creditor waives any right to require the Administrative Agent or any Senior Creditor to: (a) proceed against any person or property; (b) give notice of the terms, time and place of any public or private sale of personal property security held from any Obligor; (c) marshal any Collateral the Administrative Agent or any Senior Creditor may at any time have as security for the Senior Indebtedness and waives all right to require the Administrative Agent or any Senior Creditor to first proceed against any guarantor or other person before proceeding against such Collateral or (d) pursue any other remedy in the Administrative Agent’s or the Senior Creditors’ power. Each Subordinated Creditor waives notice of acceptance of this Agreement and presentment, demand, protest, notice of protest, dishonor, notice of dishonor, notice of default, notice of intent to accelerate or demand payment of any Senior Indebtedness, and diligence in collecting any Senior Indebtedness, and agrees that the Administrative Agent and the Senior Creditors may, once or any number of times, modify the terms of any Senior Indebtedness, compromise, extend, increase, refinance, accelerate, renew or forbear to enforce payment of any or all Senior Indebtedness, or permit the Obligors to incur additional Senior Indebtedness, all without notice to any Subordinated Creditor and without affecting in any manner the unconditional obligations of the Subordinated Creditors under this Agreement. Each Subordinated Creditor waives any defense against the enforceability of this Agreement based upon or arising by reason of the application by an Obligor of the proceeds of any indebtedness for purposes other than the purposes represented by the Obligor to the Administrative Agent or the Senior Creditors.

14. Acknowledgment of Senior Creditors’ Rights to Sell, Assign etc. Senior Indebtedness. Each Subordinated Creditor acknowledges that the Senior Creditors have the right to sell, assign, transfer, negotiate or grant participations or any interest in, any or all of the Senior Indebtedness and any related obligations, including this Agreement, but subject to any restrictions set forth in the Credit Agreement or any of the other Loan Documents.

15. Subrogation. After and subject to the Payment in Full of the Senior Indebtedness, and prior to the irrevocable and indefeasible repayment in full in cash of the Subordinated Indebtedness, each Subordinated Creditor shall be subrogated to the rights of the Senior Creditors to the extent that payments and distributions otherwise payable to the Subordinated Creditors have been applied to the Senior Indebtedness in accordance with the provisions of this Agreement. For purposes of such subrogation, no payments or distributions to the Senior Creditors of any cash, property or securities to which the Subordinated Creditors would be entitled except for the provisions of this Agreement, and no payments pursuant to the provisions of this Agreement to the Senior Creditors by the Subordinated Creditors, shall, as among the Obligors, their creditors (other than the Senior Creditors) and the Subordinated Creditors be deemed to be a payment or distribution by such Obligor to or on account of the Senior Indebtedness; it being understood that


the provisions of this Agreement are and are intended solely for the purpose of defining the relative rights of the Subordinated Creditors, on the one hand, and the Administrative Agent and the Senior Creditors, on the other hand. The Administrative Agent and the Senior Creditors shall have no obligation or duty to protect the Subordinated Creditors’ rights of subrogation arising pursuant to this Agreement or under any applicable law, nor shall the Administrative Agent or the Senior Creditors be liable for any loss to, or impairment of, any subrogation rights held by the Subordinated Creditor.

16. Waivers; Modification. No waiver or modification of any of its rights or obligations of any party under this Agreement shall be effective unless the waiver or modification shall be in writing and signed by the Administrative Agent on behalf of the Senior Creditors, the Obligors and the Subordinated Creditors. Each waiver or modification shall be a waiver or modification only with respect to the specific matter to which the waiver or modification relates and shall in no way impair the rights of any party hereto or the obligations of any party hereto in any other respect.

17. Successors and Assigns. This Agreement shall bind and be for the benefit of the Subordinated Creditors, the Administrative Agent and the Senior Creditors and their respective successors and assigns. If this Agreement is executed by two or more persons, it shall bind each of them individually as well as jointly. The term “Obligor”, as used in this Agreement, includes any person, corporation, partnership or other entity which succeeds to the interests or business of any Obligor named above, the term “Senior Indebtedness”, as used in this Agreement, includes indebtedness of any successor Obligor to any one or more of the Administrative Agent or any Senior Creditor, and the term “Subordinated Indebtedness”, as used in this Agreement, includes indebtedness of any successor Obligor to the Subordinated Creditors.

18. Costs and Expenses of Administrative Agent and Senior Creditors. Each Subordinated Creditor jointly and severally agrees to reimburse the Administrative Agent and the Senior Creditors upon written demand for reasonable documented out-of-pocket costs and expenses (including court costs, legal fees and reasonable attorney fees, whether or not suit is instituted and, if instituted, whether at the trial or appellate level, in a bankruptcy, probate or administrative proceeding, or otherwise) incurred in enforcing any of the duties and obligations of the Subordinated Creditors under this Agreement following any breach by a Subordinated Creditor of its duties or obligations hereunder, but only if the Administrative Agent and the Senior Creditors are the prevailing parties in such enforcement action.

19. Notices. All communications and notices hereunder shall (except as otherwise expressly permitted herein) be in writing and given as provided in the Credit Agreement. All communications and notices hereunder to any Loan Party shall be given to it in care of the Borrower as provided in Section 9.01 of the Credit Agreement.

20. Counterparts. This Agreement may be executed in any number of identical counterparts, any set of which signed by all the parties hereto shall be deemed to constitute a complete, executed original for all purposes. Transmission by electronic mail in .pdf format of an executed counterpart of this Agreement shall be deemed to constitute due and sufficient delivery of such counterpart.


21. APPLICABLE LAW. THIS AGREEMENT SHALL BE CONSTRUED IN ACCORDANCE WITH AND GOVERNED BY THE LAWS OF THE STATE OF NEW YORK.

22. JURISDICTION; CONSENT TO SERVICE OF PROCESS. EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY AND UNCONDITIONALLY SUBMITS, FOR ITSELF AND ITS PROPERTY, TO THE EXCLUSIVE JURISDICTION OF ANY NEW YORK STATE COURT OR FEDERAL COURT OF THE UNITED STATES OF AMERICA SITTING IN THE BOROUGH OF MANHATTAN IN NEW YORK CITY, AND ANY APPELLATE COURT FROM ANY THEREOF, IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE OTHER LOAN DOCUMENTS, OR FOR RECOGNITION OR ENFORCEMENT OF ANY JUDGMENT, AND EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY AND UNCONDITIONALLY AGREES THAT ALL CLAIMS IN RESPECT OF ANY SUCH ACTION OR PROCEEDING MAY BE HEARD AND DETERMINED IN SUCH NEW YORK STATE OR, TO THE EXTENT PERMITTED BY LAW, IN SUCH FEDERAL COURT. EACH OF THE PARTIES HERETO AGREES THAT A FINAL JUDGMENT IN ANY SUCH ACTION OR PROCEEDING SHALL BE CONCLUSIVE AND MAY BE ENFORCED IN OTHER JURISDICTIONS BY SUIT ON THE JUDGMENT OR IN ANY OTHER MANNER PROVIDED BY LAW. EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY AND UNCONDITIONALLY WAIVES, TO THE FULLEST EXTENT IT MAY LEGALLY AND EFFECTIVELY DO SO, ANY OBJECTION WHICH IT MAY NOW OR HEREAFTER HAVE TO THE LAYING OF VENUE OF ANY SUIT, ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE OTHER LOAN DOCUMENTS IN ANY NEW YORK STATE OR FEDERAL COURT. EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY LAW, THE DEFENSE OF AN INCONVENIENT FORUM TO THE MAINTENANCE OF SUCH ACTION OR PROCEEDING IN ANY SUCH COURT. EACH OF THE PARTIES HERETO IRREVOCABLY CONSENTS TO SERVICE OF PROCESS IN THE MANNER PROVIDED FOR NOTICES IN SECTION 9.01 OF THE CREDIT AGREEMENT. NOTHING IN THIS AGREEMENT WILL AFFECT THE RIGHT OF ANY PARTY TO THIS AGREEMENT TO SERVE PROCESS IN ANY OTHER MANNER PERMITTED BY LAW.

23. WAIVER OF JURY TRIAL. EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF, UNDER OR IN CONNECTION WITH THIS AGREEMENT OR ANY OF THE OTHER LOAN DOCUMENTS. EACH PARTY HERETO (A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND (B) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS, AS APPLICABLE, BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION 23.

[Signature Pages Follow.]


IN WITNESS WHEREOF, the Subordinated Creditors and the Administrative Agent, on behalf of the Senior Creditors, have caused this Agreement to be executed as of the date first written above.

 

[], as a Subordinated Creditor    ADDRESS FOR NOTICES:   
By:  

 

      [●]   
Name:      
Title:      


[], as an Obligor      ADDRESS FOR NOTICES:   
By:  

     

     [●]   
Name:        
Title:        


HPS INVESTMENT PARTNERS, LLC, as

    

ADDRESS FOR NOTICES:

  

Administrative Agent

       
By:  

 

    

HPS INVESTMENT PARTNERS, LLC

  

Name:

    

40 West 57th Street, 33rd Floor

  

Title:

    

New York, NY 10019

  

                                             

      

Attn: Aman Malik, Jake Blair and Alexey Pazukha

  
      

Email: aman.malik@hpspartners.com;

  
      

jake.blair@hpspartners.com; and

  
      

alexey.pazukha@hpspartners.com

  
      

Telephone: (212) 287-6845

  


EXHIBIT G-1

FORM OF U.S. TAX COMPLIANCE CERTIFICATE

(For Foreign Lenders That Are Not Partnerships for U.S. Federal Income Tax Purposes)

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not defined herein have the meanings provided in the Credit Agreement.

The undersigned hereby certifies that (i) it is the sole record and beneficial owner of the Loan(s) (as well as any Note(s) evidencing such Loan(s)) in respect of which it is providing this certificate, (ii) it is not a bank within the meaning of Section 881(c)(3)(A) of the Code, (iii) it is not a ten percent shareholder of the Borrower within the meaning of Section 871(h)(3)(B) of the Code, and (iv) it is not a controlled foreign corporation related to the Borrower as described in Section 881(c)(3)(C) of the Code.

The undersigned has furnished the Administrative Agent and the Borrower with a certificate of its non-U.S. Person status on IRS Form W-8BEN-E or IRS Form W-8BEN. By executing this certificate, the undersigned agrees that (1) if the information provided on this certificate changes, expires, or becomes obsolete or inaccurate in any respect, the undersigned shall promptly so inform the Borrower and the Administrative Agent and (2) the undersigned shall have at all times furnished the Borrower and the Administrative Agent with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two calendar years preceding such payments.

 

[NAME OF LENDER]

By:    
 

Name:

Title:

Date:                     , 20        


EXHIBIT G-2

FORM OF U.S. TAX COMPLIANCE CERTIFICATE

(For Foreign Participants That Are Not Partnerships for U.S. Federal Income Tax Purposes)

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not defined herein have the meanings provided in the Credit Agreement.

The undersigned hereby certifies that (i) it is the sole record and beneficial owner of the participation in respect of which it is providing this certificate, (ii) it is not a bank within the meaning of Section 881(c)(3)(A) of the Code, (iii) it is not a ten percent shareholder of the Borrower within the meaning of Section 871(h)(3)(B) of the Code, and (iv) it is not a controlled foreign corporation related to the Borrower as described in Section 881(c)(3)(C) of the Code.

The undersigned has furnished its participating Lender with a certificate of its non-U.S. Person status on IRS Form W-8BEN-E or IRS Form W-8BEN. By executing this certificate, the undersigned agrees that (1) if the information provided on this certificate changes, expires, or becomes obsolete or inaccurate in any respect, the undersigned shall promptly so inform such Lender in writing and (2) the undersigned shall have at all times furnished such Lender with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two calendar years preceding such payments.

 

[NAME OF LENDER]

By:    
 

Name:

Title:

Date:                     , 20        


EXHIBIT G-3

FORM OF U.S. TAX COMPLIANCE CERTIFICATE

(For Foreign Participants That Are Partnerships for U.S. Federal Income Tax Purposes)

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not defined herein have the meanings provided in the Credit Agreement.

The undersigned hereby certifies that (i) it is the sole record owner of the participation in respect of which it is providing this certificate, (ii) its direct or indirect partners/members are the sole beneficial owners of such participation, (iii) with respect such participation, neither the undersigned nor any of its direct or indirect partners/members is a bank extending credit pursuant to a loan agreement entered into in the ordinary course of its trade or business within the meaning of Section 881(c)(3)(A) of the Code, (iv) none of its direct or indirect partners/members is a ten percent shareholder of the Borrower within the meaning of Section 871(h)(3)(B) of the Code, and (v) none of its direct or indirect partners/members is a controlled foreign corporation related to the Borrower as described in Section 881(c)(3)(C) of the Code.

The undersigned has furnished its participating Lender with IRS Form W-8IMY accompanied by one of the following forms from each of its partners/members that is claiming the portfolio interest exemption: (i) an IRS Form W-8BEN-E or IRS Form W-8BEN or (ii) an IRS Form W-8IMY accompanied by an IRS Form W-8BEN-E or IRS Form W-8BEN from each of such partner’s/member’s beneficial owners that is claiming the portfolio interest exemption. By executing this certificate, the undersigned agrees that (1) if the information provided on this certificate changes, expires, or becomes obsolete or inaccurate in any respect, the undersigned shall promptly so inform such Lender and (2) the undersigned shall have at all times furnished such Lender with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two calendar years preceding such payments.

 

[NAME OF PARTICIPANT]
By:  

 

 

Name:

 

Title:

Date:                     , 20    


EXHIBIT G-4

FORM OF U.S. TAX COMPLIANCE CERTIFICATE

(For Foreign Lenders That Are Partnerships for U.S. Federal Income Tax Purposes)

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners, LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not defined herein have the meanings provided in the Credit Agreement.

The undersigned hereby certifies that (i) it is the sole record owner of the Loan(s) (as well as any Note(s) evidencing such Loan(s)) in respect of which it is providing this certificate, (ii) its direct or indirect partners/members are the sole beneficial owners of such Loan(s) (as well as any Note(s) evidencing such Loan(s)), (iii) with respect to the extension of credit pursuant to this Credit Agreement or any other Loan Document, neither the undersigned nor any of its direct or indirect partners/members is a bank extending credit pursuant to a loan agreement entered into in the ordinary course of its trade or business within the meaning of Section 881(c)(3)(A) of the Code, (iv) none of its direct or indirect partners/members is a ten percent shareholder of the Borrower within the meaning of Section 871(h)(3)(B) of the Code, and (v) none of its direct or indirect partners/members is a controlled foreign corporation related to the Borrower as described in Section 881(c)(3)(C) of the Code.

The undersigned has furnished Administrative Agent and the Borrower with IRS Form W-8IMY accompanied by one of the following forms from each of its partners/members that is claiming the portfolio interest exemption: (i) an IRS Form W-8BEN-E or IRS Form W-8BEN or (ii) an IRS Form W-8IMY accompanied by an IRS Form W-8BEN-E or IRS Form W-8BEN from each of such partner’s/member’s beneficial owners that is claiming the portfolio interest exemption. By executing this certificate, the undersigned agrees that (1) if the information provided on this certificate changes, expires, or becomes obsolete or inaccurate in any respect, the undersigned shall promptly so inform the Borrower and the Administrative Agent, and (2) the undersigned shall have at all times furnished the Borrower and the Administrative Agent with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two calendar years preceding such payments.

 

[NAME OF LENDER]
By:    
 

Name:

 

Title:

Date:                     , 20    


EXHIBIT H

FORM OF NOTICE OF CONVERSION/CONTINUATION

Date:                     ,    

 

To:

HPS Investment Partners, LLC, as Administrative Agent

40 W. 57th Street – 33rd Floor

New York, NY 10019

Email: hpsagency@alterdomus.com

Ladies and Gentlemen:

Reference is made to the Credit Agreement, dated as of October 30, 2020 (as amended, restated, amended and restated, extended, supplemented or otherwise modified from time to time, the “Credit Agreement”), by and among Mulberry Health, Inc., a Delaware corporation (the “Borrower”), the lenders from time to time party thereto (the “Lenders”) and HPS Investment Partners LLC, as administrative agent for the Lenders (the “Administrative Agent”). Capitalized terms used but not otherwise defined herein have the meanings assigned to them in the Credit Agreement.

Pursuant to Section 2.10 of the Credit Agreement, the Borrower hereby gives you irrevocable notice of the [conversion][continuation] of the Loans specified herein, that:

 

(A)

  

Type of Loans1 comprising

[conversion][continuation]:

                                 

(B)

   Aggregate amount to be [converted][continued]:      $                          

(C)

  

Borrowing to be [converted into][continued as]

[Eurodollar][ABR] Borrowing:

     $                          

(D)

   Date of conversion, which is a Business Day:                                  

[Signature page follows.]

 

1 

Specify Eurodollar Borrowing or ABR Borrowing.

 

Exhibit H - 1


IN WITNESS WHEREOF, the undersigned has caused this notice to be duly executed and delivered by its proper and duly authorized officer as of the day and year first written above.

 

MULBERRY HEALTH, INC., as Borrower

By:

 

 

 

Name:

 

Title:

 

Exhibit H - 2

Exhibit 10.30

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF PUBLICLY DISCLOSED.

AMENDMENT 2 TO QUOTA SHARE REINSURANCE AGREEMENT BETWEEN

OSCAR INSURANCE CORPORATION

AND

AXA FRANCE VIE

This Amendment No. 2 to the Quota Share Reinsurance Agreement between OSCAR Insurance Corporation (the “Ceding Company”) and AXA France Vie (“AXA”), (this “Amendment”) is made as of July 1, 2020.

WHEREAS, the Ceding Company, on the one hand, and AXA, on the other hand, have entered into a quota share reinsurance agreement, dated as of December 21, 2017, and amended effective January 1, 2018 (together, the “Reinsurance Agreement”), pursuant to which AXA has agreed to provide quota share reinsurance to the Ceding Company on the terms set forth in the Reinsurance Agreement;

WHEREAS, the Ceding Company and AXA desire to enter into this Amendment to clarify the terms of their mutual understanding relating to certain provisions of the Reinsurance Agreement and correct typographical errors therein; and

WHEREAS, the Ceding Company and AXA wish to indicate their understanding of their respective rights and obligations with respect to the scope of any “excess of loss recoveries” referenced in Article 5.2 and Annex 7 of the Reinsurance Agreement;

WHEREAS, the Ceding Company and AXA wish to clarify their respective rights and obligations with respect to the calculation of their liability limitation referenced in Article 5.3; and

WHEREAS, the Ceding Company and AXA wish to clarify the definition of the Reinsurer’s Quota Share referenced in Article 34.3.

WHEREAS, this Amendment will not be effective until filed with and approved by the New York Department of Financial Services as provided in Article 26.2 of Reinsurance Agreement.

NOW THEREFORE, in consideration of the foregoing, and the representations, warranties, covenants and conditions set forth below, the parties hereto hereby agree as set forth herein.

 

  I.

Definitions. Capitalized terms used but not otherwise defined in this Amendment shall have the meanings ascribed to such terms in the Reinsurance Agreement, as may be amended from time to time.

 

  II.

Clarification of Article 5.2 and Annex 7. The parties hereto agree and confirm that the term “excess of loss recoveries” where it appears in Article 5.2 and Annex 7 of the Reinsurance Agreement includes, but is not limited to, any profit-share that may be received by the Ceding Company from any excess of loss reinsurance arrangement applicable to the Policies.

 

  III.

Modification of Article 5.3. Article 5.3 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:


“Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***].

An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O020-1002, between the Reinsurer and OSCAR Health Plan Of California;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation;

 

  iii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01X-1002, between the Reinsurer and Oscar Insurance Company;

 

  iv.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Insurance Company of Florida;

 

  v.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Buckeye State Insurance Corporation

 

  vi.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan, Inc.;

 

  vii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Georgia; and

 

  viii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Pennsylvania

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.


This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Contracts in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year; provided, that the Reinsurer shall not be liable for any losses incurred under such Contracts prior to the Effective Time.”

 

  IV.

Modification of Article 7.2. Article 7.2 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:

“ As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

[***]

[***]

= Net Reinsurance Premium

[***]

[***]

 

  V.

Original Earned Net Premium In Article 5.2 of the Reinsurance Agreement, the term “Original Earned Net Premium” is hereby deleted and replaced by “Gross Premiums Earned, as defined in Article 7.2”.

 

  VI.

Clarification of Article 12.2.

 

  a.

The table in Article 12.2 i is hereby deleted and replaced by the following:

 

          2017      2018      2019      July 1, 2020
and each
year
thereafter
 

C

  

OSCAR commissions (% of total Reinsurer Premium)

     [***      [***      [***      [***
  

Broker Commission

     [***      [***      [***      [***

F (Reinsurer fee (% of total Reinsurer Premium))

     [***      [***      [***      [***

r (distribution rate)

     [***      [***      [***      [***


  b.

The Profit Sharing Formula in Article 12.2 ii is hereby deleted and replaced by the following:

 

   The “Profit Sharing Formula” is as set forth below:

2017 to

2019

  

[***]

 

[***]

 

R [***]

July 1,

2020 and each year thereafter

  

[***]

 

[***]

 

[***]

 

R [***]

 

  c.

The Partial Reimbursement Formula in Article 12.2 iii is hereby deleted and replaced by the following:

 

   The “Partial Reimbursement Formula” is as set forth below:

2017 to

2019

   [***]

July 1,

2020 and each year thereafter

   [***]
  
  

 

  VII.

Modification of Article 34.3 xxxvii:

a. Article 34.3 xxxvii is hereby deleted and replaced by the following “Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017, [***]% for Subscription Years 2018 and 2019, [***]% for Subscription Period July 1, 2020 – December 31, 2020 and any Subscription Year subsequent to Subscription Period July 1, 2020 – December 31, 2020.


  VIII.

Modification of Article 34.3 to add a new subsection xl.: “Subscription Period” shall mean July 1, 2020 – December 31, 2020.

 

  IX.

Modification of Annex 3. Annex 3 of the Reinsurance Agreement is hereby deleted and replaced in its entirety with Exhibit A attached hereto

 

  X.

Modification of Annex 6. Annex 6 of the Reinsurance Agreement is hereby deleted and replaced in its entirety with Exhibit B attached hereto.

 

  XI.

Modification of Annex 7. Annex 7 of the Reinsurance Agreement is hereby deleted and replaced in its entirety with Exhibit C attached hereto, retroactive to October 1, 2017.

 

  XII.

Clarification of Article 4. The Ceding Company hereby agree to submit for approval to AXA any amendment to the Excess of Loss Agreements.

 

  XIII.

Miscellaneous.

 

  a.

Entire agreement; Third Parties. This Amendment and the other agreements referred to herein set forth the entire understanding among the parties with respect to the subject matter hereof. Except as expressly provided in this Amendment, nothing in this amendment is intended to confer upon any party, other than the parties hereto and their respective successors and permitted assigns, any rights under this Amendment.

 

  b.

Counterparts. This Amendment may be executed in any number of counterparts, each of which shall be deemed an original but all of which shall together constitute one and the same instrument.

The Parties have executed this Amendment as of October, 2020. Oscar Insurance Corporation

 

By:

  /s/ Siddhartha Sankaran
 

Siddhartha Sankaran

   
 

Printed Name

 

CFO

 

Title

 

10/9/2020

 

AXA FRANCE VIE
By:  

/s/ Jacques de Peretti

 

 

  Printed Name
  CEO OF AXA FRANCE VIE
  Title
  08/10/2020


Appendix

Exhibit A – REINSURANCE COMMISSIONS & PROFIT SHARE INFORMATION

 

MLR

   OSCAR    AXA    CoR incl
AXA
expense)
   Profit    Profit Share
(for Oscar)
   For Oscar    For AXA    Total Oscar    Total AXA
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]
[***]    [***]    [***]    [***]    [***]       [***]    [***]    [***]    [***]


Exhibit B – Current Year and Consolidated Medical Loss Ratio Formula

Medical Loss Ratio Definition

All claims and premiums refer to the current Subscription Year

Numerator: [***]

Denominator: [***]

Consolidated MLR Definition

Numerator: [***]

Denominator: [***]


Exhibit C:

(1) Income: quota share of:

[***]

(2) Outgo: quota share of:

[***]

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) – ((4) - (3)) – ((6) - (5))


Exhibit D: ANNEX 8 – LIMITATION OF LIABILITY CALCULATION

State A - [***]

 

     State A      State B      State C      Ceding Company      Total  

Gross Premiums

     [***]        [***]        [***]        [***]        [***]  

Gross Claims

     [***]        [***]        [***]        [***]        [***]  

MLR

     [***]        [***]        [***]        [***]        [***]  

Ceded Premiums

     [***]        [***]        [***]        [***]        [***]  

Ceded Claims

     [***]        [***]        [***]        [***]        [***]  

AXA Ceded MLR

     [***]        [***]        [***]        [***]        [***]  

Retained Premiums

     [***]        [***]        [***]        [***]        [***]  

Retained Claims

     [***]        [***]        [***]        [***]        [***]  
     Ceded      Claims Calculation         

Claims Ceded (up to local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Claims Ceded (above local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Allocation of Claims Retained

     [***]        [***]        [***]        [***]        [***]  

Total Claims

     [***]        [***]        [***]        [***]        [***]  


Exhibit 10.30

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF PUBLICLY DISCLOSED.

AMENDMENT NO. 1 TO QUOTA SHARE REINSURANCE AGREEMENT

This Amendment No. 1 (the “Amendment”) to the Quota Share Reinsurance Agreement, effective as of January 1, 2018 (the “Amendment Effective Date”), is entered into between Oscar Insurance Corporation (“Ceding Company”) and AXA France Vie (“Reinsurer” and together with tJrn Ceding Company, the “ Parties “, and each, a “Party”).

WHEREAS, the Parties entered into the Quota Share Reinsurance Agreement, dated December 21, 2017 (the “Agreement “);

WHEREAS, the priority of the excess of loss reinsurance obtained by the Ceding Company has been changed from USD [***] to USD [***], effective as of January 1, 2018;

WHEREAS, the Parties desire to reflect the change in excess of loss reinsurance priority in the Agreement;

WHEREAS, pursuant to Article 26, Section 2 of the Agreement, the amendment contemplated by the Parties requires the mutual written agreement of parties thereto.

NOW, THEREFORE, in consideration of the foregoing and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows :

1. Definitions. Capitalized terms used and not defined in this Amendment have the respective meanings assigned to them in the Agreement.

2. Amendments to the Agreement. As of the Amendment Effective Date, the Agreement is hereby amended or modified as follows:

 

  a.

Where the figure “USD [***]” appears in Article 4, Section 1 and in Article 5, Section 2 of the Agreement, the figure shall be replaced with “USD [***]”.

3. Limited Effect. Except as expressly provided in this Amendment, all of the terms and provisions of the Agreement are and will remain in full force and effect, and are hereby ratified and confirmed by the Parties. Without limiting the generality of the foregoing, the amendment contained herein will not be construed as an amendment to or waiver of any other provision of the Agreement or of any other agreement between the parties or their affiliates or as a waiver of or consent to any further or future action on the part of either Party that would require the waiver or consent of the other Patty. On and after the Amendment Effective Date, each reference in the Agreement to “this Agreement,” “the Agreement ,” “hereunder,” “hereof, “ “herein” or words of like import, and each reference to the Agreement in any other agreements, documents or instruments executed and delivered pursuant to, or in connection with, the Agreement, will mean and be a reference to the Agreement as amended by this Amendment.


4. Representations and Warranties. Each Party hereby represents and warrants to the other Party that:

 

  a.

It has the full right, power and authority to enter into this Amendment and to perform its obligations hereunder and under the Agreement as amended by this Amendment.

 

  b.

EXCEPT FOR THE EXPRESS REPRESENTATIONS AND WARRANTIES SET FORTH IN THE AGREEMENT AND IN THIS SECTION 4 OF THIS AMENDMENT, (A) NEITHER PARTY HERETO NOR ANY PERSON ON SUCH PARTY’S BEHALF HAS MADE OR MAKES ANY EXPRESS OR IMPLIED REPRESENTATION OR WARRANTY WHATSOEVER, EITHER ORAL OR WRITTEN, WHETHER ARISING BY LAW, COURSE OF DEALING, COURSE OF PERFORMANCE, USAGE OF TRADE OR OTHERWISE, ALL OF WHICH ARE EXPRESSLY DISCLAIM ED, AND (B) EACH PARTY HERETO ACKNOWLEDGES THAT IT 1-IAS NOT RELIED UPON ANY REPRESENTATION OR WARRANTY MADE BY THE OTHER PARTY, OR ANY OTHER PERSON ON SUCH OTHER PARTY’ S BEHALF, EXCEPT AS SPECIFICALLY PROVIDED IN THIS SECTION 4.

5. Miscellaneous.

 

  a.

This Amendment shall inure to the benefit of and be binding upon each of the Parties and each of their respective permitted successors and permitted assigns.

 

  b.

This Amendment constitutes the sole and entire agreement of the Parties with respect to the subject matter contained herein, and supersedes all prior and contemporaneous understanding s, agreements, representations and warranties, both written and oral, with respect to such subject matter.

[Signature Page Follows}


TN WITNESS W HEREOF, the Parties have executed this Amendment as of the Amendment Effective Date.

 

OSCAR INSURANCE CORPORATION    AXA FRANCE VIE
By: /s/ Sid Sankaran                    By: /s/ Mattieu Rouot                
Sid Sankaran    Mattieu Rouot
Printed Name    Printed Name
  
EVP and Chief Financial Officer    Head of International
Title    Title

 

[Signature Page to Quota Share Reinsurance Agreement Amendment]


CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF PUBLICLY DISCLOSED.

Execution Version

QUOTA SHARE REINSURANCE AGREEMENT BETWEEN

OSCAR INSURANCE CORPORATION AND

AXA FRANCE VIE

Dated December 21, 2017


TABLE OF CONTENTS

 

ARTICLE   1    OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT      1  
ARTICLE   2    EFFECTIVE TIME – DURATION      2  
ARTICLE   3    TERRITORIAL SCOPE      2  
ARTICLE   4    RETENTION OF THE CEDING COMPANY      2  
ARTICLE   5    LIABILITY AND SHARE OF THE REINSURER      3  
ARTICLE   6    CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES      4  
ARTICLE   7    REINSURER PREMIUMS      4  
ARTICLE   8    REINSURANCE COMMISSIONS      5  
ARTICLE   9    CLAIMS      5  
ARTICLE   10    RESERVES, REINSURANCE CREDIT      7  
ARTICLE   11    SUNSET CLAUSE      10  
ARTICLE   12    PROFIT SHARING AND PARTIAL REIMBURSEMENT      11  
ARTICLE   13    FOLLOW THE FORTUNES      14  
ARTICLE   14    INFORMATION      14  
ARTICLE   15    ACCOUNTS      14  
ARTICLE   16    CURRENCY      15  
ARTICLE   17    SET OFF      15  
ARTICLE   18    RIGHT OF INSPECTION, COORDINATION      15  
ARTICLE   19    ERRORS AND OMISSIONS      16  
ARTICLE   20    ARBITRATION      17  
ARTICLE   21    JURISDICTION - APPLICABLE LAW      19  
ARTICLE   22    NORMAL TERMINATION      19  
ARTICLE   23    SPECIAL TERMINATION      20  
ARTICLE   24    CONFIDENTIALITY      22  


ARTICLE   25    SEVERABILITY, LAPSE      23  
ARTICLE   26    ENTIRE AGREEMENT, ASSIGNMENT      24  
ARTICLE   27    UTMOST GOOD FAITH      24  
ARTICLE   28    SANCTION CLAUSE      24  
ARTICLE   29    ANTI BRIBERY      24  
ARTICLE   30    ANTI-MONEY LAUNDERING      25  
ARTICLE   31    DATA PRIVACY      25  
ARTICLE   32    CORPORATE RESPONSIBILITY      26  
ARTICLE   33    INSOLVENCY      27  
ARTICLE   34    NOTICES, CONSTRUCTION, DEFINITIONS      28  


QUOTA SHARE REINSURANCE AGREEMENT

This QUOTA SHARE REINSURANCE AGREEMENT (this “Agreement”) is made and entered into on December 21, 2017 and effective as of the Effective Time by and between OSCAR INSURANCE CORPORATION, a New York accident and health insurance company, (the “Ceding Company”) and AXA FRANCE VIE, a limited company registered in the Commercial Register of Nanterre under company number 310 499 959 00891, governed by the French Insurance Code (the “Reinsurer”). For purposes of this Agreement, the Ceding Company and the Reinsurer will each be deemed a “Party”, and collectively, the “Parties”.

ARTICLE 1

OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

 

  1)

This Agreement refers to all policies properly underwritten and issued by the Ceding Company as set out in the attached Annex 1 – Scope (the “Policies”). This Agreement does not apply to any other business underwritten by the Ceding Company.

 

  2)

This Agreement consists of this agreement, the Annexes hereto and any future amendments. The attached Annexes form and any future amendments will form integral parts of this Agreement and shall be equally binding. In the event of any discrepancy between this Agreement, an Annex or a future amendment, the terms of the respective Annex or future amendment will prevail.

 

  3)

Copies of current and accurate specimen policy forms, policy premium information, application forms and rate tables with respect to the Policies (“Policy Documentation”) shall be furnished to the Reinsurer. The Ceding Company shall provide the Reinsurer with the updated version of the Policy Documentation for each year beginning with calendar year 2019 as part of the governance process described in Article 1, Section 4 below. The Policies shall be issued in accordance with the requirements of the applicable Policy Documentation.

 

  4)

In the second calendar quarter of each calendar year beginning in 2018, the Ceding Company will provide to the Reinsurer the proposed rating plans, pricing and related targeted Medical Loss Ratio with respect to each individual health policy product to be written within the territorial scope for the subsequent calendar year (“Annual Business Update”). Within thirty (30) days following delivery of the Annual Business Update, the Parties will meet to discuss the Reinsurer’s views with respect thereto and the economic impact to the Reinsurer under this Agreement. The Ceding Company will take into account the Reinsurer’s reasonable views with respect to the finalization of the plans and rates to be submitted to the state insurance department for review and approval. Following the approval of the plan and rates by the state insurance department, which generally occurs in the third calendar quarter, the Ceding Company shall provide without any delay the Reinsurer with the final Annual Business update for the subsequent calendar year. The Parties agree that, if, in good faith, the Reinsurer is not satisfied with the final Annual Business Update for Subscription Year 2019, the Reinsurer shall have the right to terminate this Agreement on 31 December 2018 in accordance with Article 23.


  5)

This Agreement applies only to those Policies properly underwritten and issued directly by the Ceding Company. Insurance policies assumed by the Ceding Company through reinsurance, acquisitions, mergers or portfolio transfers will not be reinsured automatically under this Agreement. The inclusion, for purposes of this Agreement, of any such other insurance policies, requires prior approval by the Reinsurer and appropriate terms and conditions will be mutually agreed upon between the Parties.

ARTICLE 2

EFFECTIVE TIME – DURATION

 

  1)

This Agreement will take effect as of 12:01 a.m. Eastern Standard Time on October 1, 2017 (the “Effective Time”) and will remain in force for a duration of two (2) years and three (3) months from the Effective Time (the “Initial Term”).

 

  2)

This Agreement shall renew automatically each year for one (1) year after expiry of the Initial Term.

ARTICLE 3

TERRITORIAL SCOPE

This Agreement only covers Policies issued in the territories listed in Annex 2 – Territorial Scope.

ARTICLE 4

RETENTION OF THE CEDING COMPANY

 

  1)

Except as permitted by this Section, the Ceding Company is obligated to retain for its own account the share of the Policies not reinsured by the Reinsurer and is not entitled to adjust, sell, reinsure, assign, charge, or alienate its retention under this Agreement in any way without the Reinsurer’s prior written consent, which consent may be withheld in the Reinsurer’s sole discretion. If the Ceding Company seeks any such reinsurance, the Ceding Company shall inform and seek the Reinsurer’s prior written consent accordingly. The foregoing shall in no way apply to any excess of loss coverage covering the Policies in the excess of the limit of liability of USD [***] at [***]% per person per year including the Medical Per Person Excess of Loss Reinsurance Agreement and any replacement thereof.

 

  2)

If the Ceding Company is in breach of Article 4, Section 1, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty (30) days’ prior written notice to the Ceding Company.

 

2


ARTICLE 5

LIABILITY AND SHARE OF THE REINSURER

 

  1)

Pursuant to the terms and conditions of this Agreement, the Ceding Company shall cede to the Reinsurer and the Reinsurer shall accept and reinsure, automatically, the Reinsurer’s Quota Share of liabilities in respect of the Policies set forth in Annex 1 – Scope and in compliance with the Policy Documentation.

 

  2)

The Reinsurer’s Quota Share of liabilities ceded hereunder shall be protected by an excess of loss per person and per year underwritten by the Ceding Company with a priority of USD [***] at [***]% and unlimited capacity. The Reinsurer’s Quota Share of this Excess of Loss premium paid by the Ceding Company shall be deducted by the Ceding Company from the Original Earned Net Premium in accordance with Article 7, Section 2 below. The Reinsurer shall benefit from the Reinsurer’s Quota Share of the Excess of Loss recoveries.

 

  3)

Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***]. An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O020-1002, between the Reinsurer and Oscar Health Plan of California;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation; and

 

  iii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01X-1002, between the Reinsurer and Oscar Insurance Company of Texas.

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

 

3


This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Policies in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year, provided, that the Reinsurer shall not be liable for any losses incurred under such Policies prior to the Effective Time.

 

  4)

The maximum period of insurance of any one Policy shall not exceed [***]. Except as required by applicable law, no Policy may be issued for a period of insurance of less than [***] without the prior written approval of the Reinsurer, which approval may be withheld in the Reinsurer’s sole discretion. All Policies covered under this Agreement [***].

 

  5)

The Reinsurer shall not be liable under this Agreement for risks which are excluded under the Policy Documentation unless otherwise agreed in writing between the Reinsurer and the Ceding Company.

 

  6)

This Agreement is solely between the Ceding Company and the Reinsurer, and, subject to Articles 10, 26, 33 and 34, nothing in this Agreement is intended or shall be construed to give any person or entity, other than the Parties, any legal or equitable right, remedy or claim under or in respect of this Agreement or any provision contained herein. Such persons and entities include, but are not limited to, the intermediary (if any), policyholders of Policies, beneficiaries of Policies and other reinsurers of the Ceding Company or its affiliates.

ARTICLE 6

CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

ln the event of any change in the law, regulation or administrative practice applicable to this Agreement, the Policy Documentation or the Parties, whether arising from legislation, administrative acts, decisions of the courts or otherwise, at any time after commencement of this Agreement that materially increases or extends the Reinsurer’s liability during the then current calendar year, the Ceding Company shall so inform the Reinsurer immediately following the Ceding Company’s awareness of such change and the Ceding Company shall have thirty (30) days to cure the impact of such change on the Reinsurer. If the Ceding Company is unable to cure the impact of such change to the satisfaction of the Reinsurer within the thirty (30) day period, it is agreed that the Reinsurer shall have the right to terminate this Agreement with immediate effect on a cut-off basis in accordance with Article 23.

ARTICLE 7

REINSURER PREMIUMS

 

  1)

Corresponding to the ceded liability, the Reinsurer Premiums due by the Ceding Company to the Reinsurer shall be entered into the account for the relevant calendar quarter. The “Reinsurer Premium” shall mean the Reinsurer’s Quota Share of the Net Reinsurance Premiums.

 

  2)

As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

 

4


[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

ARTICLE 8

REINSURANCE COMMISSIONS

 

  1)

The Reinsurer shall pay the Ceding Company reinsurance commissions, based on the Reinsurer Premium, as set out for each applicable Subscription Year on Annex 3 – Reinsurance Commissions & Profit Share Information.

 

  2)

If any Reinsurer Premium or installments of Reinsurer Premium are returned to the Ceding Company, any corresponding reinsurance commissions previously credited to the Ceding Company shall be reimbursed to the Reinsurer.

ARTICLE 9

CLAIMS

 

  1)

A condition precedent to any settlement of a claim due by the Reinsurer hereunder (a “Reinsurance Claim”) is that the respective Reinsurer Premium has been paid to or entered into the relevant account of the Reinsurer in accordance with the terms of this Agreement.

 

  2)

Subject to Article 9, Section 1, the Reinsurer will reimburse the Ceding Company for the Reinsurer’s Quota Share of claims paid by the Ceding Company during the applicable calendar quarter in accordance with the settlement procedures set out in Article 15.

 

  3)

The Ceding Company is responsible for the assessment of claims in a prudent and professional way and in accordance with the underlying Policy Documentation. The Ceding Company is furthermore responsible for the fulfillment of the claims information requirements agreed upon and as set out in the Annex 4 – Data Reporting. Any claims payment made is binding on the Reinsurer to the extent of its liability for claims hereunder.

 

  4)

The Ceding Company shall provide the Reinsurer with claims data for the Policies in accordance with the template set forth at Annex 4 – Data Reporting and shall provide the Reinsurer with any further claims information upon request.

 

  5)

The Reinsurer shall follow the fortunes of the Ceding Company for the Reinsurer’s Quota Share of any Policy claim including interest and any legal costs and expenses incurred in investigating and assessing such claim (both medical and non-medical).

 

5


Any salaries and travel expenses of the Ceding Company’s employees or employees of any third party administrator designated by the Ceding Company as well as any internal Policy claims assessment costs are excluded.

 

  6)

Subject to the above provisions of this Article, the decisions of the Ceding Company on claims payments are binding on the Reinsurer with the exception of any payments made by the Ceding Company on an ex-gratia basis (i.e., those payments which the Ceding Company is not required to make according to the underlying Policy Documentation). Such payments will not be binding on the Reinsurer without its expressly stated prior written consent, which may be withheld in its sole discretion. Notwithstanding the foregoing, it is also acknowledged by the Reinsurer that due to the nature of the individual health insurance business, regulatory authorities may require the Ceding Company, from time to time, to pay claims for medically necessary services where coverage may otherwise have been denied. If the Ceding Company is formally required by a regulatory authority to make such a claims payment, such payment shall not be deemed as an “ex-gratia” payment and shall be reinsured hereunder. The Ceding Company shall provide the Reinsurer with a copy of the formal requirement by the regulatory authority.

 

  7)

Relief and recoveries, whether recovered or received prior or subsequent to loss settlement under this Agreement shall be shared proportionately with the Reinsurer based on the Reinsurer’s Quota Share.

 

  8)

The Reinsurer will not be liable for Extra-Contractual Obligations. For purposes of this Agreement, “Extra-Contractual Obligations” means all liabilities to any person or entity arising out of or relating to the Policies (other than liabilities arising under the express terms and conditions and within the policy limits of the Policies), including, without limitation, any loss in excess of the limits arising under or covered by any Policy, any liability for fines, penalties, taxes, fees, forfeitures, compensatory, consequential, punitive, exemplary, special, treble, bad faith, tort, statutory or any other form of extra-contractual damages, as well as all legal fees and expenses relating thereto, which liabilities arise out of, result from or relate to, any act, error or omission, whether or not intentional, negligent, fraudulent, in bad faith or otherwise (actual or alleged), arising out of or relating to the Policies, including, without limitation, (i) the form, sale, marketing, distribution, underwriting, production, issuance, cancellation or administration of the Policies, (ii) the investigation, defense, prosecution, trial, settlement (including the failure to settle) or handling of claims, benefits, or payments under the Policies, (iii) the failure to pay or the delay in payment or errors in calculating or administering the payment of benefits, claims or any other amounts due or alleged to be due under or in connection with the Policies or (iv) fines or other penalties associated with escheat and unclaimed property liabilities, including any interest thereon, arising under or relating to the Policies.

 

  9)

Except with respect to any third party administration arrangements in place as of the date hereof, the Ceding Company shall not delegate any administration with respect to the Policies to a third party without the Reinsurer’s prior written consent, such consent not to be unreasonably withheld. In the case of any such permitted delegation, the Ceding Company remains liable for the compliance with all the conditions stated in this Article 9.

 

6


  10)

If the Ceding Company is in breach of Article 9, Section 9, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty days’ prior written notice to the Ceding Company.

ARTICLE 10

RESERVES, REINSURANCE CREDIT

 

  1)

The Reinsurer shall provide to the Ceding Company acceptable forms of security to secure the Statutory Reserves corresponding to the Reinsurer’s Quota Share of the Policies reinsured pursuant to this Agreement and to provide full reinsurance reserve credit to the Ceding Company for the reinsurance hereunder. The Reinsurer’s obligation to provide acceptable forms of security shall be satisfied by holding assets in one or more credit for reinsurance trust accounts (pursuant to this Article 10). The Statutory Reserves shall be calculated on the basis set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  2)

MAINTENANCE OF THE RESERVE AND TRUST ACCOUNT.

 

  i.

The Ceding Company will provide to the Reinsurer a good faith written estimate of the Statutory Reserves (calculated in accordance with Annex 5 – Statutory Reserves & IBNR Calculation Methodology) by no later than the twentieth (20th) day of the last month of each calendar quarter for increase or decrease to the assets in the Trust Account and/or the Trusts Funds Withheld Account. If the Reinsurer disagrees with the estimated Statutory Reserves, it will within five (5) Business Days notify the Ceding Company. The Parties shall be expeditious and reasonable in resolving any such dispute; provided, that despite any continuing dispute between the Parties with respect to the estimated statutory reserve amount, the Reinsurer shall provide for the increase/decrease of assets in the Trust Account and/or the Trusts Funds Withheld Account as of the relevant calendar quarter end to ensure sufficient reserve credit to the Ceding Company; provided, further, that any such provision of assets shall not be deemed a waiver or release of any rights of the Reinsurer with respect to any continuing dispute hereunder.

 

  ii.

The Ceding Company will provide to the Reinsurer a written notice of the actual Statutory Reserves as of each calendar quarter end no later than the twentieth (20th) Business Days following the end of such calendar quarter. The amount of security provided by the Reinsurer through Qualifying Assets held in the Trust Account and the Trust Funds Withheld Account shall be adjusted appropriately to reflect the actual Statutory Reserves as of such calendar quarter end. If any such adjustment necessitates a decrease in the amount of Qualifying Assets held in the Trust Account, then the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute Qualifying Assets equaling the amount of any such decrease to the Reinsurer, as the designee of the Ceding Company.

 

7


  3)

STATUTORY TRUST AGREEMENT.

 

  i.

The Ceding Company and the Reinsurer will enter into a statutory trust agreement in compliance with the credit for reinsurance laws and regulations of the state of domicile of the Ceding Company in connection with reinsurance ceded to an unauthorized reinsurer (the “Trust Agreement”) with a trustee (the “Trustee”) establishing a trust account for the sole benefit of the Ceding Company (the “Trust Account”). The Trustee shall be a qualified United States financial institution authorized to act as a fiduciary of a trust. The institution shall not be a parent, subsidiary or affiliate of the Ceding Company or the Reinsurer. The Reinsurer and the Ceding Company may enter into more than one such Trust Agreement for purposes of providing reinsurance reserve credit to the Ceding Company.

 

  4)

QUALIFYING ASSETS.

 

  i.

The Reinsurer shall arrange for assets to be deposited into the Trust Account. Prior to depositing non-cash assets with the Trustee, the Reinsurer shall execute assignments, endorsements in blank or transfer legal title to the Trustee or the Trustee’s nominee of all shares, obligations or any other assets requiring assignment in order that the Ceding Company or the Trustee, upon direction of the Ceding Company, may, whenever necessary, negotiate any such assets without consent or signature from the Reinsurer or any other person or entity in accordance with the terms of the Trust Agreement.

 

  ii.

Assets deposited in the Trust Account shall be valued according to their current fair market value. The Trust Account shall consist only of the following (“Qualifying Assets”): cash (United States legal tender), certificates of deposit (issued by a United States bank and payable in United States legal tender), instruments that are acceptable to the commissioner of the insurance department of the Ceding Company’s state of domicile, and investments of the types specified in accordance with the requirements of the Ceding Company’s state of domicile insurance law and investments; provided that such investments are issued by an institution that is not the parent, subsidiary or affiliate of either the Ceding Company or the Reinsurer.

 

  5)

DRAWING ON THE TRUST ACCOUNT.

 

  i.

Qualifying Assets in the Trust Account established hereunder may be withdrawn by the Ceding Company at any time, notwithstanding any other provision of this Agreement, and shall be utilized and applied by the Ceding Company or any successor by operation of law of the Ceding Company including, without limitation, any liquidator, rehabilitator, receiver or conservator of the Ceding Company, without diminution because of insolvency on the part of the Ceding Company or the Reinsurer, only for the following purposes:

 

  A.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of premiums returned, but not yet recovered from the Reinsurer, to the owners of Policies reinsured under this Agreement on account of cancellations of such Policies;

 

8


  B.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of benefits or losses paid by the Ceding Company, but not yet recovered from the Reinsurer, pursuant to the provisions of the Policies reinsured under this Agreement;

 

  C.

To fund an account with the Ceding Company in an amount at least equal to the deduction, for reinsurance ceded, from the Ceding Company’s liabilities for the Policies reinsured hereunder. Such account shall include, but not be limited to, amounts for policy reserves, reserves for claims and losses incurred (including losses incurred but not reported), loss adjustment expenses and unearned premiums; and

 

  D.

To pay the Ceding Company for the Reinsurer’s Quota Share of any other amounts that the Ceding Company claims are due under this Agreement.

 

  ii.

The Ceding Company shall return to the Trust Account or to the Reinsurer assets withdrawn in excess of the actual amounts required in Article 10, Section 5(i)(A)-(C), or, in the case of Article 10, Section 5(D), assets that are subsequently determined not to be due.

 

  iii.

Any assets withdrawn by the Ceding Company pursuant to Article 10, Section 5(i)(C) and any assets withdrawn from any Trust Account in excess of the actual amounts required for Article 10, Section 5(i)(A) and (B) or, in the case of Article 10, Section 5(i)(D), any amounts that are subsequently determined not to be due shall be held by the Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) in trust for the benefit of the Reinsurer, subject to the Ceding Company’s right to apply such assets to amounts due and payable by the Reinsurer to the Ceding Company under this Agreement, and shall at all times be maintained separate and apart from any assets of the Ceding Company in one or more designated funds withheld accounts (collectively the “Trust Funds Withheld Account”) for the sole purpose of funding the payments and reimbursements described in subsections (i), (ii) and (iv). The Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) shall ensure that any assets held in the Trust Funds Withheld Account pursuant to this Article 10, Section 5 consist of Qualifying Assets in accordance with its fiduciary obligations as trustee with respect to such amounts.

 

9


  iv.

For withdrawals by the Ceding Company pursuant to Article 10, Section 5(i)(C) and, with respect to Article 10, Section 5(i)(A), (B) and (D), in excess of the actual amounts applied to payment or reimbursement under such subsections, the Ceding Company shall pay interest in cash to the Reinsurer on the amount withdrawn at the then current prime rate as reported in the Federal Reserve Bulletin. Notwithstanding the foregoing, this Agreement permits the award, by any arbitration panel or court of competent jurisdiction, of:

 

  A.

Interest at a rate different from that provided in this paragraph,

 

  B.

Court or arbitration costs,

 

  C.

Attorney’s fees, and

 

  D.

Any other reasonable expenses.

 

  v.

At the Reinsurer’s request, and the approval of the Ceding Company, which shall not be unreasonably or arbitrarily withheld, the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute to the Reinsurer, as the designee of the Ceding Company, all or any part of the assets contained in the Trust Account, provided:

 

  A.

The Reinsurer shall, at the time of such withdrawal, replace the withdrawn assets with other Qualifying Assets having a market value equal to the market value of the assets withdrawn, so as to maintain at all times the Reinsurer’s Quota Share of the Statutory Reserves; or

 

  B.

After such withdrawals and transfers, the aggregate market value of the Qualifying Assets in the Trust Account shall be no less than [***]% of the Reinsurer’s Quota Share of the Statutory Reserves less the aggregate amount of assets held pursuant Article 10, Section 5 in the Trust Funds Withheld Account.

 

  vi.

After all payments have been discharged in full by the Reinsurer under the terms of this Agreement, the Ceding Company shall not unreasonably or arbitrarily withhold its approval to remit any remaining balance of funds in the Trust Account and Trust Funds Withheld Account to the Reinsurer.

 

  6)

This Article 10 shall survive termination of this Agreement.

ARTICLE 11

SUNSET CLAUSE

Notwithstanding Article 19 – Errors and Omissions of this Agreement, the Reinsurer shall not be liable for any claim which the Ceding Company has not reported within 24 months from the date upon which the Ceding Company knew or should reasonably have known of circumstances likely to give rise to a claim covered under this Agreement.

 

10


ARTICLE 12

PROFIT SHARING AND PARTIAL REIMBURSEMENT

 

  1)

This Article 12 sets forth the methodology for calculating the following potential annual payments: (i) a profit share payment from the Reinsurer to the Ceding Company, if the result of the Profit Sharing Formula equals a positive number, and

(ii) a payment representing partial reimbursement of Reinsurance Claims, from the Ceding Company to the Reinsurer, if the result of the Partial Reimbursement Formula equals a positive number.

 

  2)

Formulas.

 

  i.

The following abbreviations, as used in the Profit Sharing Formula and the Partial Reimbursement Formula, have the respective meanings set forth below:

[***]

[***]

[***]

[***]

[***]

The values of C", F", and r, for any given Subscription Year, are as below, and as reflected in Annex 3 – Reinsurance Commissions & Profit Share Information:

 

11


     2017      2018      2019 and each
year thereafter
 

C (commissions (% of total Reinsurer Premium))

     [***      [***      [***

Broker Commission

     [***      [***      [***

F (Reinsurer fee (% of total Reinsurer Premium))

     [***      [***      [***

r (distribution rate)

     [***      [***      [***

 

  ii.

The “Profit Sharing Formula” is as set forth below:

 

[***]    [***]   

[***]

   [***]                                                                     
      [***]      
[***]      
[***]      
                              [***]      
[***]    [***]   

[***]

     
      [***]      

[***]

For the purposes of this Article 12, Section 2, “PR” means partial reimbursement and “PS” means profit sharing.

 

  3)

Within fifteen (15) Business Days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for the prior Subscription Year for this Agreement, using the available amounts of premiums, claims, risk adjustment, XOL premiums and claims and IBNR and in accordance with Annex 3 – Reinsurance Commissions & Profit Share Information, with each of the resulting amounts reduced by [***]% to arrive at the “Provisional Profit Share Amount” and the “Provisional Partial Reimbursement Amount”.

 

  4)

If such Provisional Profit Share Amount is a positive number, the Reinsurer shall pay to the Ceding Company the Provisional Profit Share Amount promptly following the calculation of the Provisional Profit Share Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

12


  5)

If such Provisional Partial Reimbursement Amount is a positive number, the Ceding Company shall remit to the Reinsurer the Provisional Partial Reimbursement Amount promptly following the Ceding Company’s receipt of the calculation of the Provisional Partial Reimbursement Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  6)

Within fifteen (15) Business Days after the confirmation of the accounts for the fourth quarter of the year following the Subscription Year, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year for this Agreement, using the then-current amounts of premiums, claims, risk adjustment, XOL premiums, claims and IBNR and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. The Provisional Profit Share Amount shall be deducted from the Profit Sharing Formula result for such Subscription Year to arrive at the “Profit Sharing Adjustment”. The Provisional Partial Reimbursement Amount shall be deducted from the Partial Reimbursement Formula result to arrive at the “Partial Reimbursement Adjustment”.

 

  7)

If such Profit Share Adjustment is a positive number, the Reinsurer shall pay to the Ceding Company the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  8)

If such Profit Share Adjustment is a negative number, the Ceding Company shall pay to the Reinsurer the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  9)

If such Partial Reimbursement Adjustment is a positive number, the Ceding Company shall remit to the Reinsurer the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  10)

If such Partial Reimbursement Adjustment is a negative number, the Reinsurer shall remit to the Ceding Company the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

13


  11)

The Ceding Company shall continue to provide the Reinsurer with quarterly accounts with respect to a given Subscription Year in accordance with Article 15 until the time of the first quarterly report that does not show any positive IBNR for such Subscription Year under this Agreement or any of the Companion Agreements. At such time, the Reinsurer shall deliver final calculations of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. For purposes of this Section, such terms shall be applied mutatis mutandis, except that references in Article 12, Section 6 to “Provisional Profit Share Amount” shall be understood to mean “Provisional Profit Share Amount plus any previously paid Profit Share Adjustment” and in Article 12, Section 6 “Provisional Partial Reimbursement Amount” shall be understood to mean “Provisional Partial Reimbursement Amount plus any previously paid Partial Reimbursement Adjustment”.

ARTICLE 13

FOLLOW THE FORTUNES

In proportion to the Reinsurer’s Quota Share the Reinsurer shall, subject to the terms and conditions of this Agreement, follow the fortunes of the Ceding Company in respect of risks which the Ceding Company has accepted under Policies covered under this Agreement.

ARTICLE 14

INFORMATION

The Ceding Company shall report to the Reinsurer all information in respect of the Policies as set out in Annex 4 – Data Reporting.

ARTICLE 15

ACCOUNTS

 

  1)

Within thirty (30) days after 31st March, 30th June, 30th September and 31st December of each year, the Ceding Company shall prepare and submit to the Reinsurer quarterly accounts showing the accounting items as specified in Annex 7 – Reinsurance Balance Calculation. For the avoidance of doubt, the quarterly account for any given Subscription Year shall continue to be submitted by the Ceding Company following the end of such Subscription Year for so long as there is still a positive amount of IBNR for such Subscription Year.

 

  2)

Accounts shall be confirmed by the Reinsurer within thirty (30) days upon receipt. This also applies if the confirmation can only be given for part of the accounts. Such partial confirmation shall also specify the objections to that part of the accounts on which confirmation cannot be given.

 

  3)

Any net balance of account, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Reinsurer shall be remitted by the Ceding Company promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts. Any balance, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Ceding Company shall be remitted by the Reinsurer promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts.

 

14


  4)

In case that confirmation can only be given for part of the accounts, the balance shall nevertheless be settled in full without delay. Should there be any items incorrect in or missing from a statement of account, such errors or omissions shall be corrected in the next statement of account, unless the discrepancy is material. In such a case, correction and settlement of the discrepancy shall be completed as promptly as possible.

 

  5)

If the balance is not paid in due time such outstanding balance shall accrue interest on late payment, calculated from the confirmation date due to the date of actual payment, at the interest rate equal to the greater of (i) [***] and (ii) [***] plus [***]. If for any reason such rate is no longer published in the Wall Street Journal, the Parties shall agree on a replacement index that most closely approximates such rate.

The Parties acknowledge and agree that settlement of all amounts due from one Party to another hereunder for the period covering the Effective Time to the date hereof shall be settled as part of the first quarterly settlement following the date hereof.

ARTICLE 16

CURRENCY

All payments made, all amounts advised and all accounts prepared by either Party in accordance with the terms of this Agreement shall be in U.S. Dollars, with all payments paid in cash via wire transfer to an account designated by the receiving Party.

ARTICLE 17

SET OFF

Any debits or credits incurred on and after the Effective Time in favor of or against either the Ceding Company or the Reinsurer with respect to this Agreement are deemed mutual debits or credits, as the case may be, and shall be set off and recouped, and only the net balance shall be allowed or paid. To the extent permitted by applicable law, this Article 17 shall apply notwithstanding the initiation or commencement of a liquidation, insolvency, rehabilitation, conservation, supervision or similar proceeding by or against the Ceding Company or the Reinsurer.

ARTICLE 18

RIGHT OF INSPECTION, COORDINATION

 

  1)

The Reinsurer shall have the right, at any time, to inspect, through any duly authorized person or entity named in advance, all papers, books, accounts, documents and other records referring to the business reinsured under this Agreement at the head office of the Ceding Company or at any other place mutually agreed upon during the Ceding Company’s normal business hours. Notification of such visits shall be given two (2) weeks in advance but in urgent cases at least forty- eight (48) hours in advance.

 

15


  2)

Upon request, the Ceding Company shall supply or cause to be supplied to the Reinsurer, at the Reinsurer’s expense, copies of the whole or any part of such papers, books, accounts, documents and ether records relating to the business covered under this Agreement. Notwithstanding a termination of this Agreement, the Reinsurer’s right of inspection under this Article 18 will continue until all of the Reinsurer’s obligations under this Agreement have been terminated or fully discharged.

 

  3)

For the avoidance of doubt, all rights of inspection and any records requested or disclosed under this Article 18 will be subject to Article 24.

 

  4)

The Reinsurer shall have full access to, and open lines of communications with, the senior management of the Ceding Company in connection with this Agreement. Each Party shall appoint an individual as its primary point of operational contact for the administration and operation of this Agreement. The Reinsurer hereby appoints #### to act as its primary point of operational contact (the “Reinsurer Manager”), who shall have overall responsibility for coordinating, on behalf of the Reinsurer, the performance of the Reinsurer’s obligations hereunder and acting as a day-to-day contact with the Ceding Company Manager (as defined below). The Ceding Company hereby appoints Bruce Gottlieb to act as its primary point of operational contact (the “Ceding Company Manager”), who shall have overall responsibility for coordinating, on behalf of the Ceding Company, the performance of the Ceding Company’s obligations hereunder and acting as a day- to-day contact with the Reinsurer Manager. Either Party may change its respective Manager hereunder by providing five (5) days advance written notice to the other Party, provided that at all times the Ceding Company Manager shall be a senior officer of the Ceding Company.

ARTICLE 19

ERRORS AND OMISSIONS

 

  1)

ln the event that any error, omission or delay should occur in connection with the performance of this Agreement, including any error or omission being reflected in the accounts, such error, omission or delay will not invalidate the rights and obligations of the Parties arising from this Agreement, even when this error or omission has been discovered after the settlement of the respective balance. Any errors and omissions shall be corrected by the Parties promptly upon discovery.

 

  2)

An error or omission is defined as an unintentional failure and the result of an innocent oversight or misunderstanding which needs to be demonstrated to the satisfaction of the Party not in default. Any unintentional failure and the result of an innocent oversight or misunderstanding which results from a faulty business organization or structure of a party is not considered to be an error or an omission for the purposes of this Article 19.

 

16


  3)

Any liability of the Reinsurer shall be subject to the Ceding Company neither having committed gross negligence and/or willful misconduct with respect to underwriting or claims assessment, but having complied with the usual business, insurance and reinsurance practices. Otherwise, the Reinsurer shall have the right to refuse its liability.

ARTICLE 20

ARBITRATION

 

  1)

If a dispute controversy or claim arises between the Parties in connection with or in relation to this Agreement, the Parties undertake in good faith to use all reasonable best efforts to settle such dispute by oral or written consent directly with each other.

 

  2)

Where the Parties are unable to reach agreement in accordance with Article 20. Section1 above, any dispute, controversy or claim arising between the Parties in connection with or in relation to this Agreement, including formation and validity, and whether arising before or after termination of this Agreement, shall be referred to an arbitration tribunal in the manner set out below.

 

  i.

To initiate arbitration, either Party shall notify the other Party in writing of its desire to arbitrate. The notice shall identify the claimant, the contract at issue, and the nature of the claims and/or issues. The arbitration will be deemed to have been commenced on the date the notice of arbitration is received

 

  ii.

There will be three arbitrators who will each have no less than ten (10) years of insurance or industry experience, who are knowledgeable regarding reinsurance and who are active or retired executive officers of insurance or reinsurance companies. The arbitrators shall not be under the control of any Party, shall not have ever worked for or performed substantial services for either Party, nor shall any member of the panel have a financial interest in the outcome of the dispute. Within thirty (30) days following the commencement of the arbitration proceedings, each Party will provide the other with the identification of their appointed arbitrator, and provide a copy of the arbitrator’s curriculum vitae. If either Party refuses or neglects to appoint an arbitrator within thirty (30) days, the other Party may appoint the second arbitrator to act as the appointed arbitrator for the defaulting Party by providing notice and a copy of the arbitrator’s curriculum vitae. Each Party’s appointed arbitrator shall propose a candidate to serve as a third arbitrator (the “Umpire”), which shall be subject to the other Party’s agreement. In the event the two Party-appointed arbitrators fail to reach an agreement on an Umpire within sixty (60) days of their appointment, then either Party may petition ARIAS-U.S. to appoint the Umpire and each Party shall cooperate and take whatever action is required to give effect to the ARIAS-U.S. umpire appointment procedures. Notwithstanding the previous sentence, the Parties may agree on an alternative Umpire appointment procedure. In the event any arbitrator fails, refuses, or becomes unable to act as such before an award has been rendered, a successor shall be selected in the same manner as the original arbitrator.

 

17


  iii.

The three (3) arbitrators shall decide by majority. If no majority can be reached the opinion of the Umpire shall prevail. He shall also act as chairman of the tribunal and conduct the arbitration proceedings.

 

  iv.

In the event of the death of an arbitrator or if an arbitrator is unable to continue, another shall in such case be appointed in such arbitrator’s stead by the Party who made the original appointment. In the event of the death of the Umpire, or if the Umpire is unable to continue, the arbitrators shall agree upon the appointment of a new chairman within thirty (30) days in accordance with the procedures set forth above.

 

  3)

The arbitration tribunal shall have power to fix all procedural rules for the holding of the arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, investigation of facts, the disclosure and inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the arbitration and may receive and act upon such evidence, whether oral or written, strictly admissible or not, as it shall in its discretion think fit.

 

  4)

The cost of the arbitration shall be borne by the non-prevailing Party. If a Party prevails in part, then the other Party shall bear the cost to that extent. Each Party shall, however, bear the costs of its own legal representation and assistance. The amount of the cost of the arbitration shall be determined as agreed between the Parties and the arbitrators prior to the arbitration. The arbitration tribunal shall, as a part of its award, specifically state the cost of the arbitration and the manner of its payment.

 

  5)

The arbitration shall take place in New York, New York (USA) and the arbitration tribunal shall apply the law of the State of New York as the proper law of this Agreement. In addition, the arbitration tribunal shall observe the customs and practices of the reinsurance business.

 

  6)

The award of the arbitration tribunal shall be in writing and state the reasons upon which it is based. Judgment upon the award may be entered in any court having jurisdiction thereof. The award shall be final and binding and not subject to appeal. The Parties undertake to carry out the same without delay. If either of the Parties should fail to carry out any award, the other may apply for its enforcement to a court of relevant jurisdiction in any territory in which the Party in default is domiciled or has assets or carries on business.

 

  7)

The arbitrators may consolidate an arbitration under this Agreement with any arbitration arising under or relating to any of the Companion Agreements or any other agreement between the Parties entered into pursuant hereto, as the case may be, provided that the subject of the disputes thereunder arise out of or relate to the same or substantially similar set of facts or transactions. Such consolidated arbitration shall be determined by the arbitrator appointed for the arbitration proceeding that was commenced first in time.

 

  8)

Notwithstanding the foregoing, a matter regarding the failure of a Party to settle a confirmed and undisputed balance may be brought before a court of relevant jurisdiction.

 

18


  9)

This Article 20 shall survive termination of this Agreement.

ARTICLE 21

JURISDICTION - APPLICABLE LAW

 

  1)

EXCEPT AS OTHERWISE SET FORTH HEREIN, THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS, INCLUDING AS TO VALIDITY, INTERPRETATION AND EFFECT, BY THE LAWS OF THE STATE OF NEW YORK WITHOUT GIVING EFFECT TO ITS PRINCIPLES OR RULES OF CONFLICT OF LAWS, TO THE EXTENT SUCH PRINCIPLES OR RULES ARE NOT MANDATORILY APPLICABLE BY STATUTE AND WOULD PERMIT OR REQUIRE THE APPLICATION OF THE LAWS OF ANOTHER JURISDICTION.

 

  2)

The Reinsurer shall (i) submit itself to the jurisdiction of any arbitration panel or court of competent jurisdiction within New York in accordance with Article 20, and (ii) comply with all the requirements necessary to give such court or arbitration panel jurisdiction over the Reinsurer. Furthermore, the Reinsurer shall designate the Superintendent of Financial Services in the State of New York as its true and lawful attorney upon whom service of process may be effected within New York and simultaneous notification may, at the Reinsurer’s election, be provided to a designated attorney in the event any such service of process is effected. The Reinsurer agrees to abide by the final decision of the arbitration panel in accordance with Article 20.

 

  3)

This Article 21 shall survive termination of this Agreement.

ARTICLE 22

NORMAL TERMINATION

 

  1)

This Agreement may be terminated [***].

 

  2)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

  3)

Termination of this Agreement at the end of the Initial Term or any renewal term shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after the Agreement termination date because all Policies terminate on 31 December of the Subscription Year and any renewal of a ceded Policy after the Agreement termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December.

 

19


  4)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

ARTICLE 23

SPECIAL TERMINATION

 

  1)

Either Party affected by one of the events mentioned in Article 23, Section 3 below shall notify the other Party in writing within thirty (30) days after its occurrence. The termination to be effective at the end of such thirty (30) days period.

 

  2)

Except in respect of termination by the Reinsurer pursuant to Article 23, Section 3(viii) or for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv), termination of this Agreement in accordance with this Article 23 shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional new Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after 31 December of the Subscription Year and any renewal of a ceded Policy after the termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December).

 

  3)

This Agreement may be terminated at any time (including during the Initial Term) on a run-off basis (except as otherwise stated in paragraphs (iv) and (viii) below which shall be terminated on a cut-off basis) with respect to Policies issued prior to the applicable termination date by giving written notice to the other Party:

 

  i.

If the Ceding Company has become insolvent or is unable to pay its debts or has a Risk-Based Capital ratio of less than [***]% of its Authorized Control Level Risk Based Capital (each term as defined in the insurance laws and regulations in the Ceding Company’s state of domicile) or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  ii.

If the Reinsurer has become insolvent or is unable to pay its debts or has lost [***] of its paid up capital or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  iii.

If the other Party ceases writing insurance and/or reinsurance and elects to run-off its existing business or if the performance of the whole or any part of this Agreement that materially affects the interests of either of the Parties is prohibited or rendered impossible de jure or de facto for a period exceeding ninety (90) days.

 

20


  iv.

If the other Party fails to fulfill its material obligations under this Agreement within two (2) months after being requested in writing to do so; provided, that this Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company if the Ceding Company fails to pay any Reinsurer Premium in accordance with Article 7, the Reinsurer notifies the Ceding Company in writing of such failure and such failure remains uncured five (5) days after such notice.

 

  v.

If the other Party merges with or becomes acquired or controlled by any company, corporation or individual(s) who did not control it directly or indirectly at the inception of this Agreement and if (i) such company’s, corporation’s, or individual(s)’ financial strength rating is below A- Standard & Poor’s or A- A.M. Best and/or (ii) if such company, corporation, or individual(s) is not rated.

 

  vi.

If the Reinsurer’s financial strength rating is downgraded below A- Standard & Poor’s or A- A.M. Best and/or the Reinsurer loses its rating.

 

  vii.

If the Party giving notice or the other Party is definitively prevented from performing its obligations under this Agreement because of a “force majeure” i.e. an event beyond the control of a Party, which could not reasonably have been foreseen at the time of the conclusion of this Agreement and whose effects cannot be avoided by appropriate measures. If the prevention is temporary, this Agreement may be terminated by either Party by notification to the other Party after ninety (90) days of non- performance due to a “force majeure”.

 

  viii.

This Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company pursuant to Article 6.

 

  ix.

If the Reinsurer terminates this Agreement pursuant to Article 9, Section 10 (with 30-day notice).

 

  x.

If the Reinsurer terminates this Agreement pursuant to Article 4, Section 2 (with 30-day notice).

 

  xi.

If the Reinsurer terminates this Agreement pursuant to Article 1, Section 4.

 

  xii.

If the Reinsurer terminates this Agreement, pursuant to Article 29, Section 3.

 

  4)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

21


  5)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

 

  6)

If this Agreement is terminated in accordance with the terms of this Article 23, the Reinsurer Premium due to the Reinsurer to the termination date will be calculated pro rata temporis to the Reinsurer Premium payable in respect of the annual period during which the termination date falls. In the event this Agreement is terminated pursuant to Article 23, Section 3(iv) or Section 3(viii), all figures relating to the Ceding Company used in the calculations set forth in Article 12 shall be based only on the period in which the Agreement is in effect.

 

  7)

For the avoidance of doubt if this Agreement is terminated by the Reinsurer for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv) and Section 3(viii), the Reinsurer shall remain liable for covered losses incurred up to and including the date of the Ceding Company’s failure to pay such Reinsurer Premium under this Agreement, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement.

 

  8)

Additionally, if any Companion Agreement is terminated, the Reinsurer shall have the right to terminate this Agreement on 31 December of the termination year of the Companion Agreement (including during the Initial Term) in accordance with Article 23, Section 2 above.

 

  9)

If this Agreement is terminated by the Reinsurer pursuant to Article 23, Section 3(viii) and/or (iv), the Reinsurer shall remain liable for covered losses incurred up to and including the termination date thereunder, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement and this Agreement shall be terminated on a cut-off basis.

ARTICLE 24

CONFIDENTIALITY

 

  1)

The Parties agree that the Confidential Information constitutes confidential or proprietary information of the disclosing party unless expressly indicated otherwise by the disclosing party and the Parties agree that they shall only use the Confidential Information for the purposes of this Agreement.

 

  2)

Neither Party, except with the express prior written consent of the other, shall directly or indirectly, communicate, disclose or divulge to any third party any Confidential Information, subject always to compliance with all applicable Privacy and Security Laws. A “third party” is anyone other than the Parties or their subsidiaries, affiliates, parent company, employees, retrocessionaire, agents, subcontractors, representatives, auditors or other professional advisers. For purposes of this Agreement, “Privacy and Security Laws” means any applicable data privacy, data security, or data protection law or regulation in the United States of America, including, without limitation, Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations, including, without limitation, the amendments and associated regulations enacted and implemented pursuant to the Health Information Technology for Economic and Clinical Health Act (HIPAA).

 

22


  3)

Each Party shall use their best efforts to ensure that its respective employees, retrocessionaires, agents, subcontractors, representatives and auditors and other professional advisors, are fully informed of the provisions of this Article 27 and that they will be bound by the provisions of this Article 27 as if a signatory hereto.

 

  4)

Where disclosure is required by a court order or by an arbitrator or by a regulatory, legal or regulatory authority, such disclosures will not constitute a breach of confidentiality, provided always that the Party from whom such disclosure is requested shall immediately advise the other Party in order to allow each Party the opportunity to take such protective steps as may be appropriate.

 

  5)

Notwithstanding the foregoing, the Parties are not required to keep confidential Confidential Information which:

 

  i.

was publicly known prior to the time of disclosure by one Party to the other Party;

 

  ii.

has become publicly known and made generally available after disclosure to one Party through no fault of such Party;

 

  iii.

was already in the lawful possession of one Party at the time of the disclosure by the other Party;

 

  iv.

has been obtained by a Party from a third party lawfully in possession of such information and without a breach of such Party’s obligations of confidentiality; or

 

  v.

has been independently developed by one Party without use of or reference to other Party’s Confidential Information.

 

  6)

The foregoing exceptions shall not apply to Personal Data.

 

  7)

Each of the Parties agrees that the other shall be fully informed of any breach in these confidentiality provisions of which either Party becomes aware.

 

  8)

This Article 24 shall survive termination of this Agreement.

ARTICLE 25

SEVERABILITY, LAPSE

If any provision of this Agreement is determined to be invalid or unenforceable, such determination shall not affect or impair the validity or the enforceability of the remaining provisions of the Agreement. The invalid or unenforceable provision shall be construed by the Parties hereto in such manner that the economic aim originally pursued with this provision without being invalid or unenforceable can be reached as far as it is possible. This Article 25 shall survive termination of this Agreement.

 

23


ARTICLE 26

ENTIRE AGREEMENT, ASSIGNMENT

 

  1)

This Agreement sets forth the entire agreement between the Parties with respect to its subject matter. This Agreement replaces and supersedes all other prior written, oral or electronic communications and treaties of any kind relating to the subject matter of this Agreement.

 

  2)

Any amendment to this Agreement shall be made by addendum attached to this Agreement, embodying such amendments as may be agreed upon, and will be regarded as part of this Agreement and be equally binding. Notwithstanding the above, any amendment may also be made by issuing a revised and restated version of this Agreement. Any amendment shall be null and void unless made in writing and signed by both Parties hereto. No amendment or addendum to this Agreement shall be effective without prior notification to and approval by the New York Department of Financial Services.

 

  3)

This Agreement shall be binding upon and inure to the benefit of the Parties and their respective successors, permitted assigns and legal representatives. Except as otherwise provided herein, neither this Agreement nor any right or obligation hereunder may be assigned or delegated by any Party (in whole or in part) to a third party without the prior written consent of the other Party hereto. Any purported assignment or delegation not in compliance with the provisions of this Agreement will be void ab initio and of no force or effect.

ARTICLE 27

UTMOST GOOD FAITH

This Agreement is governed by the principle of utmost good faith and was concluded on mutual trust leading the relationship between the Parties hereto as well as of usual insurance and reinsurance practice in terms of prudent and reasonable underwriting, claims assessment and administration.

ARTICLE 28

SANCTION CLAUSE

Neither the Reinsurer nor the Ceding Company shall be deemed to provide cover and neither the Reinsurer nor the Ceding Company shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose either the Reinsurer or the Ceding Company to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ARTICLE 29

ANTI BRIBERY

 

  1)

The parties acknowledge and agree that:

 

24


  i.

They are committed to prevent bribery; and

 

  ii.

They have implemented and will maintain within their organization policies to prevent any such actions by their officers, representatives, employees or any other third party acting on their behalf.

 

  2)

To the extent permitted by applicable law, each Party shall notify the other Party immediately upon becoming aware that an activity carried out in connection with this Agreement has or may have contravened this obligation or any applicable anti- bribery law or regulation.

 

  3)

Each party may terminate this Agreement on a run-off basis upon written notice - as of right and without any judicial authorization - if during the term of the Agreement the other Party is convicted of an act of bribery or fails to comply with any anti-bribery law or regulation even if not connected to this Agreement. To the extent permitted by applicable law, such Party shall indemnify the other Party, its officers, employees, affiliates, agents, subcontractors, or any other third party acting on its behalf, against any losses, liabilities, damages, costs (including legal fees) and expenses incurred related thereto.

ARTICLE 30

ANTI-MONEY LAUNDERING

 

  1)

The Reinsurer is not subject to anti-money laundering and counter-terrorist financing provisions. The Reinsurer will not however provide services to individuals or entities that are subject to assets freeze measures. The Ceding Company shall therefore apply any appropriate measure to fight against money laundering and terrorist financing, as defined by the FATF recommendations.

 

  2)

Pursuant to Article 30, Section 1 above and to the extent permitted by the applicable law, the Reinsurer may at any time request evidence from the Ceding Company as to its policyholders, the Policies, or any other matters connected thereto in the context of anti-money laundering and counter-terrorism financing.

ARTICLE 31

DATA PRIVACY

 

  1)

The Parties acknowledge and agree that they:

 

  i.

are committed to protect Personal Data in accordance with applicable law and regulation; and

 

  ii.

have implemented and will maintain within their organization policies and technical security measures preventing any such privacy breaches (e.g., of confidentiality) by their officers, representatives, employees or any other third party acting on their behalf.

 

  2)

Personal Data received by either the Reinsurer or the Ceding Company from the other shall not be:

 

25


  i.

used by the receiving party other than in connection with performing its obligations under this Agreement; or for the purpose of any retrocession arrangements; or

 

  ii.

commercially exploited by the receiving party; or

 

  iii.

transferred abroad without the Ceding Company having implemented appropriate safeguards in accordance with the applicable law and regulation;

 

  3)

In particular, without prejudice to the generality of the foregoing, the Ceding Company confirms that it has obtained and undertakes that it will obtain on a continuing basis all requisite consents from its policyholders both for its own compliance purposes, for the purposes of this Agreement and for the purposes of any facultative business and retrocession arrangements to be entered into by the Reinsurer.

 

  4)

To the extent permitted by the applicable law, each Party shall notify the other Party immediately upon becoming aware of privacy breaches related to Personal Data.

 

  5)

The Parties shall establish a Technical Committee consisting of an equal number of one (1) or more representative(s) of each of the Reinsurer and the Ceding Company, which shall meet on a quarterly basis to monitor the assessment and evolution of the ceded liabilities and risks.

 

  6)

This Article 31, Sections 1-4 shall survive termination of this Agreement.

ARTICLE 32

CORPORATE RESPONSIBILITY

 

  1)

The Parties acknowledges that the AXA Group adheres to certain principles designed to ensure that the AXA Group does business in a socially responsible manner by promoting sustainable development in its business through commitments towards its principal stakeholders (customers, suppliers, employees, environment, shareholders and community) as more fully set forth in the AXA Compliance and Ethics Guide located at http://www.axa.com/en/governance/disclosure/ethics. The AXA Group encourages its suppliers to be socially and environmentally responsible. The AXA Compliance and Ethics Guide may be supplemented or amended at any time at the sole discretion of the Reinsurer. In the event of any change to the AXA Compliance and Ethics Guide, the Reinsurer shall promptly send the newly revised version to the Ceding Company.

 

  2)

In addition, as part of AXA Group’s principles and practices of sustainable development, the AXA Group requires its consultants to observe the following three main specific International Labour Organization (ILO) principles: (i) refrain from using, or accepting that their own suppliers and sub-contractors make use of child labour (under 15 years of age) or forced labour; (ii) ensure staff safe and healthy working conditions and environment, respecting individual and collective liberties; and (iii) promote non-discrimination (sex, race, religion or political conviction) as regards staff recruitment and management. For more information, see the ILO website: http://www.ilo.org/public/english/standards/index.htm

 

26


  3)

The Ceding Company agrees to use commercially reasonable efforts to comply with these standards. The Parties agree to negotiate in utmost good faith to resolve any dispute that may arise regarding the adequacy of such efforts. In the event such negotiations are not successful, such dispute shall be resolved in accordance with the terms of Articles 20 and 21.

 

  4)

In the event that either Party becomes aware that any of its business practices are contrary to the foregoing ILO principles, such Party agrees to use its commercially reasonable efforts to remedy the practice in question and notify the other Party of the correction it made. In the event the Party does not appropriately address the issue in question or if it commits subsequent violations, the other Party may as of right and without any prior formality to terminate this Agreement on a run-off basis for breach of this Article 32 without liability of any kind (other than payment of amounts due and owing pursuant to this Agreement in connection with a run-off termination).

ARTICLE 33

INSOLVENCY

 

  1)

Reinsurance Claims shall be payable by the Reinsurer on the basis of the liability of the Ceding Company under the Policies reinsured without diminution because of insolvency of the Ceding Company. In the event of insolvency of the Ceding Company, payments by the Reinsurer shall be made directly to the Ceding Company or its liquidator, receiver or statutory successor except (i) where this Agreement specifically provides another payee for such reinsurance in the event of the insolvency of the Ceding Company, or (ii) the Reinsurer, with the consent of the direct insureds, has assumed such policy obligations of the Ceding Company as its direct obligations to the payees under such policies, in substitution for the obligations of the Ceding Company to such payees. The implementation of any novation shall be subject to the prior approval of the certificate of assumption on New York risks by the Superintendent of Financial Services of New York.

 

  2)

The rehabilitator, conservator, liquidator, receiver or statutory successor of the insolvent Ceding Company shall give written notice to the Reinsurer of the pendency of the claim against the Ceding Company on any policy reinsured hereunder within a reasonable time after such claim is filed in the insolvency proceeding, and during the pendency of such claim, the Reinsurer may investigate such claim and interpose, at its own expense, in the proceeding where such claim is to be adjudicated any defense or defenses which it may deem available to the Ceding Company or its rehabilitator, conservator, liquidator, receiver or statutory successor. Such expense shall be chargeable, subject to court approval, against the insolvent Ceding Company as part of the expense of the conservation or liquidation to the extent of a proportionate share of the benefit, which may accrue to the Ceding Company solely as a result of the defense undertaken by the Reinsurer.

 

27


ARTICLE 34

NOTICES, CONSTRUCTION, DEFINITIONS

 

  1)

All notices, requests and other communications to any party hereunder shall be in writing (including registered letter, facsimile transmission, electronic mail or any other means of communication that leaves a record of such communication) and shall be given:

 

  i.

if to the Ceding Company, to:

Oscar Insurance Corporation

295 Lafayette St.

6th Floor

New York, NY 10012

Attention: Legal

####

 

  ii.

if to the Reinsurer, to:

International Employee Benefits

AXA France

313, Terrasses de l’Arche, 92727 Nanterre Cedex, France

####

####

or such other address or facsimile number as such Party may hereafter specify for the purpose by notice to the other Parties hereto. All such notices, requests and other communications shall be deemed received on the date of receipt by the recipient thereof if received prior to 5:00 p.m. on a Business Day in the place of receipt. Otherwise, any such notice, request or communication shall be deemed to have been received on the next succeeding Business Day in the place of receipt.

 

  2)

Interpretation of this Agreement shall be governed by the following rules of construction: (a) words in the singular shall be held to include the plural and vice versa, and words of one gender shall be held to include the other gender as the context requires; (b) references to the terms Preamble, Recitals, Article, Section, paragraph, Annex, Schedule and Exhibit are references to the Preamble, Recitals, Articles, Sections, paragraphs, Annexes, Schedules and Exhibits to this Agreement unless otherwise specified; (c) references to “$” shall mean U.S. dollars; (d) the word “including” and words of similar import shall mean “including without limitation,” unless otherwise specified; (e) the word “or” shall not be exclusive; (f) the words “herein,” “hereof,” “hereunder” or “hereby” and similar terms are to be deemed to refer to this Agreement as a whole and not to any specific Section; (g) the headings are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement; (h) this Agreement shall be construed without regard to any presumption or rule requiring construction or interpretation against the party drafting or causing any instrument to be drafted; (i) if a word or phrase is defined, the other grammatical forms of such word or phrase have a corresponding meaning; (j) references to any statute, listing rule, rule, standard, regulation or other law include a reference to (A) the corresponding rules and regulations and (B) each of them as amended, modified, supplemented, consolidated, replaced or rewritten

 

28


  from time to time; (k) references to any section of any statute, listing rule, rule, standard, regulation or other law include any successor to such section; (l) references to any person or entity include such person’s or entity’s predecessors or successors, whether by merger, consolidation, amalgamation, reorganization or otherwise; and (m) references to any contract (including this Agreement) or organizational document are to the contract or organizational document as amended, modified, supplemented or replaced from time to time, unless otherwise stated.

 

  3)

For purposes of this Agreement, in addition to other terms operationally defined herein, the following terms have the respective meanings set forth below:

 

  i.

ACA Fees” means any “health insurer provider” or similar fee imposed by any governmental authority in connection with the Patient Protection and Affordable Care Act (“ACA”), including under Section 9010 thereof and including any assessments or fees imposed by any governmental authority of any state or other jurisdiction in connection with the existence or operation of, or participation in, any health insurance exchange or marketplace of such state or jurisdiction, or any other similar fee imposed under any other applicable law.

 

  ii.

Agreement” has the definition set forth in the Preamble.

 

  iii.

Annual Business Update” has the definition set forth in Article 1, Section 4.

 

  iv.

ARIAS-U.S.” means the AIDA Reinsurance and Insurance Arbitration Society.

 

  v.

AXA Group” means the group of companies to which the Reinsurer is affiliated.

 

  vi.

Business Day” means any day other than a Saturday, a Sunday or any other day on which banking institutions in New York City or in France are required or authorized by applicable law to be closed. Any reference herein to a day that is not a Business Day shall be deemed to be a calendar day.

 

  vii.

Ceding Company” has the definition set forth in the Preamble.

 

  viii.

Ceding Company Manager” has the definition set forth in Article 18, Section 4.

 

  ix.

Companion Agreements” has the definition set forth in Article 5, Section 3.

 

  x.

Confidential Information” means the information, data, analyses, studies, statements, representations and any other materials provided by the Ceding Company or the Reinsurer to the other in connection with the placement of and the course of performance under this Agreement.

 

  xi.

Consolidated MLR” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

29


  xii.

Cut-off” means that the Ceding Company shall relieve the Reinsurer of all liability hereunder for claims incurred after the date of termination of the Agreement. In case of cut-off termination, the Reinsurer shall refund to the Ceding Company the part of the Premium paid to the Reinsurer applicable to the unexpired liability on Policies in force.

 

  xiii.

Effective Time” has the definition set forth in Article 2, Section 1.

 

  xiv.

Extra-Contractual Obligations” has the definition set forth in Article 9, Section 8.

 

  xv.

FATF” means the Financial Action Task Force (on Money Laundering).

 

  xvi.

IBNR” means reserves for claims incurred but not reported.

 

  xvii.

Initial Term” has the definition set forth in Article 2, Section 1.

 

  xviii.

Insurance Companies” means collectively, the Ceding Company and each party to a Companion Agreement, excluding the Reinsurer.

 

  xix.

Medical Loss Ratio” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xx.

Net Reinsurance Premium” has the definition set forth in Article 7, Section 2.

 

  xxi.

Party” or “Parties” has the definition set forth in the Preamble.

 

  xxii.

Partial Reimbursement Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxiii.

Partial Reimbursement Formula” has the definition set forth in Article 12, Section 2.

 

  xxiv.

Personal Data” means and includes any of the following information that is acquired by, provided to, created by or maintained by a Party or any third party acting on behalf of a Party in connection with this Agreement: (i) any information that identifies or can reasonably be used to identify an individual, such as first and last name, social security number or other government issued number or identifier, date of birth, home or other physical address, e-mail address or other online contact information, financial account number, credit or debit card number, biometric data, mother’s maiden name, or other personally identifiable information; and (ii) personally identifiable financial or insurance information, including but not limited to “non-public personal information” as that term is defined in the Gramm-Leach-Bliley Act, as amended, and implementing regulations, 15 U.S.C. § 6809(4).

 

  xxv.

Policies” has the definition set forth in Article 1, Section 1.

 

  xxvi.

Policies Documentation” has the definition set forth in Article 1, Section 3.

 

30


  xxvii.

Privacy and Security Laws” has the definition set forth in Article 24, Section 2.

 

  xxviii.

Profit Sharing Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxix.

Profit Sharing Formula” has the definition set forth in Article 12, Section 2(ii).

 

  xxx.

Provisional Partial Reimbursement Amount” has the definition set forth in Article 12, Section 3.

 

  xxxi.

Provisional Profit Share Amount” has the definition set forth in Article 12, Section 3.

 

  xxxii.

Qualifying Assets” has the definition set forth in Article 10, Section 4(ii).

 

  xxxiii.

Reinsurance Claim” has the definition set forth in Article 9, Section 1.

 

  xxxiv.

Reinsurer” has the definition set forth in the Preamble.

 

  xxxv.

Reinsurer Manager” has the definition set forth in Article 18, Section 4.

 

  xxxvi.

Reinsurer Premium” has the definition set forth in Article 7, Section 1.

 

  xxxvii.

Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017 and [***]% for any Subscription Year subsequent to Subscription Year 2017.

 

  xxxviii.

Statutory Reserves” means, as of the date of determination, the aggregate amount of reserves of the Ceding Company in respect of the Policies calculated in accordance with statutory accounting practices prescribed or permitted by the insurance regulator in the Ceding Company’s state of domicile and determined in accordance with the methodology set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  xxxix.

Subscription Year” means a calendar year during which Policies are issued.

 

  xl.

third party” has the definition set forth in Article 24, Section 2.

 

  xli.

Trust Account” has the definition set forth in Article 10, Section 3(i).

 

  xlii.

Trust Agreement” has the definition set forth in Article 10, Section 3(i).

 

  xliii.

Trust Funds Withheld Account” has the definition set forth in Article 10, Section 5(iii).

 

  xliv.

Trustee” has the definition set forth in Article 10, Section 3(i).

 

  xlv.

Umpire” has the definition set forth in Article 20, Section 2(ii).

 

  xlvi.

XOL” has the definition set forth in Article 7, Section 2.

 

31


  4)

This Article 34 shall survive termination of this Agreement.

[Reminder of page intentionally left blank. Signature page to follow.]

 

32


In witness whereof, the Parties hereto by their respective duly authorized representatives have executed this Agreement in duplicate for and on behalf of:

 

The Ceding Company
Date and place:
December 21, 2017 New York, NY
Signature:
By:  

/s/ Mario Schlosser

Title:   CEO
The Reinsurer
Date and place:
December 21, 2017 Nanterre , France
Signature:
By:  

/s/ Jacques de Peretti

Title:   CEO

[Signature Page to Reinsurance Treaty- Oscar Insurance Corporation]


ANNEX 1 – SCOPE

Policies Covered

This Agreement applies to all individual health insurance policies corresponding to the Policy Documentation and issued or renewed by the Ceding Company in the State of New York providing coverage commencing on January 1, 2017 or thereafter, and with a period of insurance expiring on 31 December. The Policies ceded under this Agreement are only those in effect as of October 1, 2017 or issued or renewed between October 1, 2017 and the date of termination of this Agreement. The Parties acknowledge and agree that the Policies included on this Annex 1 will be subject to modification by the Ceding Company, per and in accordance with the provisions of this Agreement, each Subscription Year to reflect the product offerings and other modifications for the applicable Subscription Year.

2017 Policies:

 

   

Oscar Simple Bronze

 

   

Oscar Simple Silver

 

   

Oscar Simple Silver CSR 250

 

   

Oscar Simple Silver CSR 200

 

   

Oscar Simple Silver CSR 150

 

   

Oscar Simple Gold

 

   

Oscar Simple Platinum

 

   

Oscar Market Bronze

 

   

Oscar Market Silver

 

   

Oscar Market Silver CSR 250

 

   

Oscar Market Silver CSR 200

 

   

Oscar Market Silver CSR 150

 

   

Oscar Market Gold

 

   

Oscar Market Platinum

 

   

Oscar Simple Secure

 

   

Oscar AIAN

Policy Documentation:

Copies of current and accurate Policy Documentation shall be copied on a CD ROM that will be agreed as final by both Parties.


ANNEX 2 – TERRITORIAL SCOPE

This Agreement shall only apply to Policies issued by the Ceding Company in [***] rating regions [***] or any successor regions to [***] rating regions [***] to insureds having their principal residence in those territories.


ANNEX 3 - REINSURANCE COMMISSIONS & PROFIT SHARE INFORMATION

[***]


ANNEX 4 – DATA REPORTING

Monthly reporting dashboards:

 

   

Portfolio : number of policies/persons by month covered by global/ metal /state

 

   

Portfolio distribution (per gender/age) by global/metal/state

 

   

Premiums by month global / per metal / per state

 

   

Claims (split by % of reserves and paid by global/ metal/ state) (IBNR global / metal / state) (by month of occurrence)

 

   

Claims by benefits category split by global/ metal / state o Inpatient hospital

 

   

Outpatient hospital

 

   

Professional

 

   

Other medical

 

   

Capitation

 

   

Prescription drug

 

   

MLR by global / state / metal (current year, and n-1 year)

Risk adjustment estimate

Quarterly Basis

 

   

Cash flows (quarterly basis)

On a bi-yearly basis (according to regulatory possibilities)

Anonymized dataset

 

   

Information about the insureds (biometrical & contract related data): age (birthdate), gender, state & address, subscription date, premium paid.

Information about claims: customer paths, medical facilities used, hospitalization (length/costs), details about professional, other medical, prescription drug, fraud


ANNEX 5 – STATUTORY RESERVES & IBNR CALCULATION METHODOLOGY

Statutory reserves include:

 

   

Incurred but not reported claims (IBNR)

 

   

Claims in course of settlement

 

   

Claims due and unpaid

 

   

Reserve margin

Actuarial Process Narrative

The Ceding Company’s current reserves processes include monthly valuations for all actuarial liabilities based on models developed in-house incorporating the most current views of the claim data available from our data warehouse.

Reserves:

The In-house reserve model incorporates different methodologies based on the amount and recency of the claim. The completion factor development method is utilized for claims under $[***] and is supplemented by the incurred claim methodology for the most recent incurral months. A seriatim methodology is utilized for claims over $[***], supplemented by case management data supplied by our medical and claims operations areas. Claims reserve triangle analytical cohorts are segmented by metallic level within a given state and region, and all reserves are determined separately incorporating the current inventory of claims in course of settlement. The reserve model incorporates historical reserve testing and detail on prior period development down to the incurral month. Reserves accrued are best-estimates with an explicit margin for adverse deviation as well as an accrual for unpaid claim adjustment expenses. All margins are reviewed at least annually for appropriateness based on historical run-out. Claims reserve triangles are inclusive of medical and behavioral health claims only. Pharmacy claims are analyzed separately and assumed to not have any run-out.


ANNEX 6 – CURRENT YEAR AND CONSOLIDATED MEDICAL LOSS RATIO FORMULAS

Medical Loss Ratio Definition

All claims and premiums refer to the current Subscription Year

Numerator: [***]

Denominator: [***]

Consolidated MLR Definition

Numerator: [***]

Denominator: [***]


ANNEX 7 – REINSURANCE BALANCE CALCULATION

(1) Income: quota share of:

[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

(2) Outgo: quota share of:

[***]

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) + (4) - (3) + (6) - (5)


ANNEX 8 – LIMITATION OF LIABILITY CALCULATION

State A – [***]

 

     State A      State B      State C      Ceding Company      Total  

Gross Premiums

     [***]        [***]        [***]        [***]        [***]  

Gross Claims

     [***]        [***]        [***]        [***]        [***]  

MLR

     [***]        [***]        [***]        [***]        [***]  

Ceded Premiums

     [***]        [***]        [***]        [***]        [***]  

Ceded Claims

     [***]        [***]        [***]        [***]        [***]  

AXA Ceded MLR

     [***]        [***]        [***]        [***]        [***]  

Retained Premiums

     [***]        [***]        [***]        [***]        [***]  

Retained Claims

     [***]        [***]        [***]        [***]        [***]  
     Ceded      Claims Calculation         

Claims Ceded (up to local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Claims Ceded (above local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Allocation of Claims Retained

     [***]        [***]        [***]        [***]        [***]  

Total Claims

     [***]        [***]        [***]        [***]        [***]  

Exhibit 10.31

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [[***]] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(B)(10). SUCH EXCLUDED INFORMATION IS NOT

MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF

PUBLICLY DISCLOSED.

AMENDMENT TO QUOTA SHARE REINSURANCE AGREEMENT BETWEEN

OSCAR HEALTH PLAN OF CALIFORNIA

AND

AXA FRANCE VIE

This Amendment to the Quota Share Reinsurance Agreement between OSCAR Health Plan of California (the “Ceding Company”) and AXA France Vie (“AXA”), (this “Amendment”) is made as of January 1, 2020.

WHEREAS, the Ceding Company, on the one hand, and AXA, on the other hand, have entered into a quota share reinsurance agreement, dated as of December 21, 2017 (the “Reinsurance Agreement”), pursuant to which AXA has agreed to provide quota share reinsurance to the Ceding Company on the terms set forth in the Reinsurance Agreement;

WHEREAS, the Ceding Company and AXA desire to enter into this Amendment to clarify the terms of their mutual understanding relating to certain provisions of the Reinsurance Agreement and correct typographical errors therein;

WHEREAS, the Ceding Company and AXA wish to indicate their understanding of their respective rights and obligations with respect to the scope of any “excess of loss recoveries” referenced in Article 5.2 and Annex 7 of the Reinsurance Agreement; and

WHEREAS, the Ceding Company and AXA wish to clarify their respective rights and obligations with respect to the calculation of their liability limitation referenced in Article 5.3.

WHEREAS, the Ceding Company and AXA wish to clarify the definition of the Reinsurer’s Quota Share referenced in Article 34.3.

NOW THEREFORE, in consideration of the foregoing, and the representations, warranties, covenants and conditions set forth below, the parties hereto hereby agree as set forth herein.

 

  I.

Definitions. Capitalized terms used but not otherwise defined in this Amendment shall have the meanings ascribed to such terms in the Reinsurance Agreement, as may be amended from time to time.

 

  II.

Clarification of Article 5.2 and Annex 7. The parties hereto agree and confirm that the term “excess of loss recoveries” where it appears in Article 5.2 and Annex 7 of the Reinsurance Agreement includes, but is not limited to, any profit-share that may be received by the Ceding Company from any excess of loss reinsurance arrangement applicable to the Policies.

 

  III.

Modification of Article 5.3. Article 5.3 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:

“Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For


the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***].

An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01D-1002, between the Reinsurer and Oscar Insurance Corporation;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation;

 

  iii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01X-1002, between the Reinsurer and Oscar Insurance Company;

 

  iv.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Insurance Company of Florida;

 

  v.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Buckeye State Insurance Corporation

 

  vi.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan, Inc.;

 

  vii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Georgia; and

 

  viii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Pennsylvania

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Contracts in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year; provided, that the Reinsurer shall not be liable for any losses incurred under such Contracts prior to the Effective Time.”


  IV.

Modification of Article 7.2. Article 7.2 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:

“As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

= Net Reinsurance Premium

[***]

[***]

 

  V.

Original Earned Net Premium In Article 5.2 of the Reinsurance Agreement, the term “Original Earned Net Premium” is hereby deleted and replaced by “Gross Premiums Earned, as defined in Article 7.2”.

 

  VI.

Clarification of Article 12.2.

 

  a.

The table in Article 12.2 i is hereby deleted and replaced by the following:

 

         2020 and
each year
thereafter
 

C

 

OSCAR commissions (% of total Reinsurer Premium)

     [ ***] 
 

Broker Commission

     [ ***] 

F (Reinsurer fee (% of total Reinsurer Premium))

     [ ***] 

r (distribution rate)

     [ ***] 

 

  b.

The Profit Sharing Formula in Article 12.2 ii is hereby deleted and replaced by the following:


   The “Profit Sharing Formula” is as set forth below:

2017 to

2019

   [***]
2020 and    R [***]
each year thereafter   

 

  c.

The Partial Reimbursement Formula in Article 12.2 iii is hereby deleted and replaced by the following:

 

   The “Partial Reimbursement Formula” is as set forth below:
2017 to    [***]
2019   
2020 and each year thereafter    R [***]

 

  VII.

Modification of Article 34.3 xxxvii:

 

  a.

Article 34.3 xxxvii is hereby deleted and replaced by the following

“Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017, [***]% for Subscription Years 2018 and 2019, [***]% for Subscription Year 2020 and any Subscription Year subsequent to Subscription Year 2020.

 

  VIII.

Modification of Annex 7. Annex 7 of the Reinsurance Agreement is hereby deleted and replaced in its entirety with Exhibit A attached hereto.

 

  IX.

Excess of Loss Agreements. The Ceding Company hereby agree to submit for approval to AXA any amendment to the Excess of Loss Agreements.

 

  X.

Miscellaneous.

 

  a.

Entire agreement; Third Parties. This Amendment and the other agreements referred to herein set forth the entire understanding among the parties with respect


The Parties have executed this Amendment as of April 30, 2020.

Oscar Insurance Corporation

 

By:  

/s/ Siddhartha Sankaran

 
 

Siddhartha Sankaran

  Printed Name
 

Chief Financial Officer

  Title

 

AXA FRANCE VIE
By:  

/s/ Jacques de Peretti

 
 

Jacques de Peretti

  Printed Name


Appendix

Exhibit A :

(1) Income: quota share of:

[***]

(2) Outgo: quota share of:

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) – ((4) - (3)) – ((6) - (5))


CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF PUBLICLY DISCLOSED.

Execution Version

QUOTA SHARE REINSURANCE AGREEMENT

BETWEEN

OSCAR HEALTH PLAN OF CALIFORNIA

AND

AXA FRANCE VIE

Dated December 21, 2017


TABLE OF CONTENTS

 

ARTICLE 1 OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

     1  

ARTICLE 2 EFFECTIVE TIME – DURATION

     2  

ARTICLE 3 TERRITORIAL SCOPE

     2  

ARTICLE 4 RETENTION OF THE CEDING COMPANY

     2  

ARTICLE 5 LIABILITY AND SHARE OF THE REINSURER

     2  

ARTICLE 6 CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

     4  

ARTICLE 7 REINSURER PREMIUMS

     4  

ARTICLE 8 REINSURANCE COMMISSIONS

     5  

ARTICLE 9 CLAIMS

     5  

ARTICLE 10 RESERVES, REINSURANCE CREDIT

     7  

ARTICLE 11 SUNSET CLAUSE

     10  

ARTICLE 12 PROFIT SHARING AND PARTIAL REIMBURSEMENT

     11  

ARTICLE 13 FOLLOW THE FORTUNES

     15  

ARTICLE 14 INFORMATION

     15  

ARTICLE 15 ACCOUNTS

     15  

ARTICLE 16 CURRENCY

     16  

ARTICLE 17 SET OFF

     16  

ARTICLE 18 RIGHT OF INSPECTION, COORDINATION

     16  

ARTICLE 19 ERRORS AND OMISSIONS

     17  

ARTICLE 20 ARBITRATION

     18  

ARTICLE 21 JURISDICTION—APPLICABLE LAW

     20  

ARTICLE 22 NORMAL TERMINATION

     20  

ARTICLE 23 SPECIAL TERMINATION

     21  

ARTICLE 24 CONFIDENTIALITY

     23  


ARTICLE 25 SEVERABILITY, LAPSE

     24  

ARTICLE 26 ENTIRE AGREEMENT, ASSIGNMENT

     24  

ARTICLE 27 UTMOST GOOD FAITH

     25  

ARTICLE 28 SANCTION CLAUSE

     25  

ARTICLE 29 ANTI BRIBERY

     25  

ARTICLE 30 ANTI- MONEY LAUNDERING

     26  

ARTICLE 31 DATA PRIVACY

     26  

ARTICLE 32 CORPORATE RESPONSIBILITY

     27  

ARTICLE 33 INSOLVENCY

     28  

ARTICLE 34 NOTICES, CONSTRUCTION, DEFINITIONS

     29  

 


QUOTA SHARE REINSURANCE AGREEMENT

This QUOTA SHARE REINSURANCE AGREEMENT (this “Agreement”) is made and entered into on December 21, 2017 and effective as of the Effective Time by and between OSCAR HEALTH PLAN OF CALIFORNIA, a California health care service plan, (the “Ceding Company”) and AXA FRANCE VIE, a limited company registered in the Commercial Register of Nanterre under company number 310 499 959 00891, governed by the French Insurance Code (the “Reinsurer”). For purposes of this Agreement, the Ceding Company and the Reinsurer will each be deemed a “Party”, and collectively, the “Parties”.

ARTICLE 1

OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

 

1)

This Agreement refers to all contracts properly underwritten and issued by the Ceding Company as set out in the attached Annex 1 – Scope (the “Contracts”). This Agreement does not apply to any other business underwritten by the Ceding Company.

 

2)

This Agreement consists of this agreement, the Annexes hereto and any future amendments. The attached Annexes form and any future amendments will form integral parts of this Agreement and shall be equally binding. In the event of any discrepancy between this Agreement, an Annex or a future amendment, the terms of the respective Annex or future amendment will prevail.

 

3)

Copies of current and accurate specimen contract forms, contract premium information, application forms and rate tables with respect to the Contracts (“Contract Documentation”) shall be furnished to the Reinsurer. The Ceding Company shall provide the Reinsurer with the updated version of the Contract Documentation for each year beginning with calendar year 2019 as part of the governance process described in

Article 1, Section 4 below. The Contracts shall be issued in accordance with the requirements of the applicable Contract Documentation.

 

4)

In the second calendar quarter of each calendar year beginning in 2018, the Ceding Company will provide to the Reinsurer the proposed rating plans, pricing and related targeted Medical Loss Ratio with respect to each individual health contract product to be written within the territorial scope for the subsequent calendar year (“Annual Business Update”). Within thirty (30) days following delivery of the Annual Business Update, the Parties will meet to discuss the Reinsurer’s views with respect thereto and the economic impact to the Reinsurer under this Agreement. The Ceding Company will take into account the Reinsurer’s reasonable views with respect to the finalization of the plans and rates to be submitted to the state insurance department for review and approval. Following the approval of the plan and rates by the state insurance department, which generally occurs in the third calendar quarter, the Ceding Company shall provide without any delay the Reinsurer with the final Annual Business update for the subsequent calendar year. The Parties agree that, if, in good faith, the Reinsurer is not satisfied with the final Annual Business Update for Subscription Year 2019, the Reinsurer shall have the right to terminate this Agreement on 31 December 2018 in accordance with Article 23.

 

1


5)

This Agreement applies only to those Contracts properly underwritten and issued directly by the Ceding Company. Insurance contracts assumed by the Ceding Company through reinsurance, acquisitions, mergers or portfolio transfers will not be reinsured automatically under this Agreement. The inclusion, for purposes of this Agreement, of any such other insurance contracts, requires prior approval by the Reinsurer and appropriate terms and conditions will be mutually agreed upon between the Parties.

ARTICLE 2

EFFECTIVE TIME – DURATION

 

1)

This Agreement will take effect as of 12:01 a.m. Eastern Standard Time on October 1, 2017 (the “Effective Time”) and will remain in force for a duration of two (2) years and three (3) months from the Effective Time (the “Initial Term”).

 

2)

This Agreement shall renew automatically each year for one (1) year after expiry of the Initial Term.

ARTICLE 3

TERRITORIAL SCOPE

 

1)

This Agreement only covers Contracts issued in the territories listed in Annex 2 – Territorial Scope.

ARTICLE 4

RETENTION OF THE CEDING COMPANY

 

1)

Except as permitted by this Section, the Ceding Company is obligated to retain for its own account the share of the Contracts not reinsured by the Reinsurer and is not entitled to adjust, sell, reinsure, assign, charge, or alienate its retention under this Agreement in any way without the Reinsurer’s prior written consent, which consent may be withheld in the Reinsurer’s sole discretion. If the Ceding Company seeks any such reinsurance, the Ceding Company shall inform and seek the Reinsurer’s prior written consent accordingly. The foregoing shall in no way apply to any excess of loss coverage covering the Contracts in the excess of the limit of liability of USD [***] at [***]% per person per year including the Medical Per Person Excess of Loss Reinsurance Agreement and any replacement thereof.

 

2)

If the Ceding Company is in breach of Article 4, Section 1, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty (30) days’ prior written notice to the Ceding Company.

ARTICLE 5

LIABILITY AND SHARE OF THE REINSURER

 

1)

Pursuant to the terms and conditions of this Agreement, the Ceding Company shall cede to the Reinsurer and the Reinsurer shall accept and reinsure, automatically, the Reinsurer’s Quota Share of liabilities in respect of the Contracts set forth in Annex 1 – Scope and in compliance with the Contract Documentation.

 

2


2)

The Reinsurer’s Quota Share of liabilities ceded hereunder shall be protected by an excess of loss per person and per year underwritten by the Ceding Company with a priority of USD [***] at [***]% and unlimited capacity. The Reinsurer’s Quota Share of this Excess of Loss premium paid by the Ceding Company shall be deducted by the Ceding Company from the Original Earned Net Premium in accordance with Article 7, Section 2 below. The Reinsurer shall benefit from the Reinsurer’s Quota Share of the Excess of Loss recoveries.

 

3)

Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***]. An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01D-1002, between the Reinsurer and Oscar Insurance Corporation;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation; and

 

  iii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01X-1002, between the Reinsurer and Oscar Insurance Company of Texas.

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

 

3


This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Contracts in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year; provided, that the Reinsurer shall not be liable for any losses incurred under such Contracts prior to the Effective Time

 

4)

The maximum period of insurance of any one Contract shall not exceed [***]. Except as required by applicable law, no Contract may be issued for a period of insurance of less than [***] without the prior written approval of the Reinsurer, which approval may be withheld in the Reinsurer’s sole discretion. All Contracts covered under this Agreement [***].

 

5)

The Reinsurer shall not be liable under this Agreement for risks which are excluded under the Contract Documentation unless otherwise agreed in writing between the Reinsurer and the Ceding Company.

 

6)

This Agreement is solely between the Ceding Company and the Reinsurer, and, subject to Articles 10, 26, 33, and 34, nothing in this Agreement is intended or shall be construed to give any person or entity, other than the Parties, any legal or equitable right, remedy or claim under or in respect of this Agreement or any provision contained herein. Such persons and entities include, but are not limited to, the intermediary (if any), contract holders of Contracts, beneficiaries of Contracts and other reinsurers of the Ceding Company or its affiliates.

ARTICLE 6

CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

ln the event of any change in the law, regulation or administrative practice applicable to this Agreement, the Contract Documentation or the Parties, whether arising from legislation, administrative acts, decisions of the courts or otherwise, at any time after commencement of this Agreement that materially increases or extends the Reinsurer’s liability during the then current calendar year, the Ceding Company shall so inform the Reinsurer immediately following the Ceding Company’s awareness of such change and the Ceding Company shall have thirty (30) days to cure the impact of such change on the Reinsurer. If the Ceding Company is unable to cure the impact of such change to the satisfaction of the Reinsurer within the thirty (30) day period, it is agreed that the Reinsurer shall have the right to terminate this Agreement with immediate effect on a cut-off basis in accordance with Article 23.

ARTICLE 7

REINSURER PREMIUMS

 

1)

Corresponding to the ceded liability, the Reinsurer Premiums due by the Ceding Company to the Reinsurer shall be entered into the account for the relevant calendar quarter. The “Reinsurer Premium” shall mean the Reinsurer’s Quota Share of the Net Reinsurance Premiums.

 

4


2)

As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

ARTICLE 8

REINSURANCE COMMISSIONS

 

1)

The Reinsurer shall pay the Ceding Company reinsurance commissions, based on the Reinsurer Premium, as set out for each applicable Subscription Year on Annex 3 – Reinsurance Commissions & Profit Share Information.

 

2)

If any Reinsurer Premium or installments of Reinsurer Premium are returned to the Ceding Company, any corresponding reinsurance commissions previously credited to the Ceding Company shall be reimbursed to the Reinsurer.

ARTICLE 9

CLAIMS

 

1)

A condition precedent to any settlement of a claim due by the Reinsurer hereunder (a “Reinsurance Claim”) is that the respective Reinsurer Premium has been paid to or entered into the relevant account of the Reinsurer in accordance with the terms of this Agreement.

 

2)

Subject to Article 9, Section 1, the Reinsurer will reimburse the Ceding Company for the Reinsurer’s Quota Share of claims paid by the Ceding Company during the applicable calendar quarter in accordance with the settlement procedures set out in Article 15.

 

3)

The Ceding Company is responsible for the assessment of claims in a prudent and professional way and in accordance with the underlying Contract Documentation. The Ceding Company is furthermore responsible for the fulfillment of the claims information requirements agreed upon and as set out in the Annex 4 – Data Reporting. Any claims payment made is binding on the Reinsurer to the extent of its liability for claims hereunder.

 

4)

The Ceding Company shall provide the Reinsurer with claims data for the Contracts in accordance with the template set forth at Annex 4 – Data Reporting and shall provide the Reinsurer with any further claims information upon request.

 

5)

The Reinsurer shall follow the fortunes of the Ceding Company for the Reinsurer’s Quota Share of any Contract claim including interest and any legal costs and expenses incurred in investigating and assessing such claim (both medical and non- medical). Any salaries and travel expenses of the Ceding Company’s employees or employees of any third party administrator designated by the Ceding Company as well as any internal Contract claims assessment costs are excluded.

 

5


6)

Subject to the above provisions of this Article, the decisions of the Ceding Company on claims payments are binding on the Reinsurer with the exception of any payments made by the Ceding Company on an ex-gratia basis (i.e., those payments which the Ceding Company is not required to make according to the underlying Contract Documentation). Such payments will not be binding on the Reinsurer without its expressly stated prior written consent, which may be withheld in its sole discretion. Notwithstanding the foregoing, it is also acknowledged by the Reinsurer that due to the nature of the individual health insurance business, regulatory authorities may require the Ceding Company, from time to time, to pay claims for medically necessary services where coverage may otherwise have been denied. If the Ceding Company is formally required by a regulatory authority to make such a claims payment, such payment shall not be deemed as an “ex-gratia” payment and shall be reinsured hereunder. The Ceding Company shall provide the Reinsurer with a copy of the formal requirement by the regulatory authority.

 

7)

Relief and recoveries, whether recovered or received prior or subsequent to loss settlement under this Agreement shall be shared proportionately with the Reinsurer based on the Reinsurer’s Quota Share.

 

8)

The Reinsurer will not be liable for Extra-Contractual Obligations. For purposes of this Agreement, “Extra-Contractual Obligations” means all liabilities to any person or entity arising out of or relating to the Contracts (other than liabilities arising under the express terms and conditions and within the contract limits of the Contracts), including, without limitation, any loss in excess of the limits arising under or covered by any Contract, any liability for fines, penalties, taxes, fees, forfeitures, compensatory, consequential, punitive, exemplary, special, treble, bad faith, tort, statutory or any other form of extra-contractual damages, as well as all legal fees and expenses relating thereto, which liabilities arise out of, result from or relate to, any act, error or omission, whether or not intentional, negligent, fraudulent, in bad faith or otherwise (actual or alleged), arising out of or relating to the Contracts, including, without limitation, (i) the form, sale, marketing, distribution, underwriting, production, issuance, cancellation or administration of the Contracts, (ii) the investigation, defense, prosecution, trial, settlement (including the failure to settle) or handling of claims, benefits, or payments under the Contracts, (iii) the failure to pay or the delay in payment or errors in calculating or administering the payment of benefits, claims or any other amounts due or alleged to be due under or in connection with the Contracts or (iv) fines or other penalties associated with escheat and unclaimed property liabilities, including any interest thereon, arising under or relating to the Contracts.

 

9)

Except with respect to any third party administration arrangements in place as of the date hereof, the Ceding Company shall not delegate any administration with respect to the Contracts to a third party without the Reinsurer’s prior written consent, such consent not to be unreasonably withheld. In the case of any such permitted delegation, the Ceding Company remains liable for the compliance with all the conditions stated in this Article 9.

 

6


10)

If the Ceding Company is in breach of Article 9, Section 9, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty days’ prior written notice to the Ceding Company.

ARTICLE 10

RESERVES, REINSURANCE CREDIT

 

1)

The Reinsurer shall provide to the Ceding Company acceptable forms of security to secure the Statutory Reserves corresponding to the Reinsurer’s Quota Share of the Contracts reinsured pursuant to this Agreement and to provide full reinsurance reserve credit to the Ceding Company for the reinsurance hereunder. The Reinsurer’s obligation to provide acceptable forms of security shall be satisfied by holding assets in one or more credit for reinsurance trust accounts (pursuant to this Article 10). The Statutory Reserves shall be calculated on the basis set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

2)

MAINTENANCE OF THE RESERVE AND TRUST ACCOUNT.

 

  i.

The Ceding Company will provide to the Reinsurer a good faith written estimate of the Statutory Reserves (calculated in accordance with Annex 5 – Statutory Reserves & IBNR Calculation Methodology) by no later than the twentieth (20th) day of the last month of each calendar quarter for increase or decrease to the assets in the Trust Account and/or the Trusts Funds Withheld Account. If the Reinsurer disagrees with the estimated Statutory Reserves, it will within five (5) Business Days notify the Ceding Company. The Parties shall be expeditious and reasonable in resolving any such dispute; provided, that despite any continuing dispute between the Parties with respect to the estimated statutory reserve amount, the Reinsurer shall provide for the increase/decrease of assets in the Trust Account and/or the Trusts Funds Withheld Account as of the relevant calendar quarter end to ensure sufficient reserve credit to the Ceding Company; provided, further, that any such provision of assets shall not be deemed a waiver or release of any rights of the Reinsurer with respect to any continuing dispute hereunder.

 

  ii.

The Ceding Company will provide to the Reinsurer a written notice of the actual Statutory Reserves as of each calendar quarter end no later than the twentieth (20th) Business Days following the end of such calendar quarter. The amount of security provided by the Reinsurer through Qualifying Assets held in the Trust Account and the Trust Funds Withheld Account shall be adjusted appropriately to reflect the actual Statutory Reserves as of such calendar quarter end. If any such adjustment necessitates a decrease in the amount of Qualifying Assets held in the Trust Account, then the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute Qualifying Assets equaling the amount of any such decrease to the Reinsurer, as the designee of the Ceding Company.

 

7


  3)

STATUTORY TRUST AGREEMENT.

 

  i.

The Ceding Company and the Reinsurer will enter into a statutory trust agreement in compliance with the credit for reinsurance laws and regulations of the state of domicile of the Ceding Company in connection with reinsurance ceded to an unauthorized reinsurer (the “Trust Agreement”) with a trustee (the “Trustee”) establishing a trust account for the sole benefit of the Ceding Company (the “Trust Account”). The Trustee shall be a qualified United States financial institution authorized to act as a fiduciary of a trust. The institution shall not be a parent, subsidiary or affiliate of the Ceding Company or the Reinsurer. The Reinsurer and the Ceding Company may enter into more than one such Trust Agreement for purposes of providing reinsurance reserve credit to the Ceding Company.

 

  4)

QUALIFYING ASSETS.

 

  i.

The Reinsurer shall arrange for assets to be deposited into the Trust Account. Prior to depositing non-cash assets with the Trustee, the Reinsurer shall execute assignments, endorsements in blank or transfer legal title to the Trustee or the Trustee’s nominee of all shares, obligations or any other assets requiring assignment in order that the Ceding Company or the Trustee, upon direction of the Ceding Company, may, whenever necessary, negotiate any such assets without consent or signature from the Reinsurer or any other person or entity in accordance with the terms of the Trust Agreement.

 

  ii.

Assets deposited in the Trust Account shall be valued according to their current fair market value. The Trust Account shall consist only of the following (“Qualifying Assets”): cash (United States legal tender), certificates of deposit (issued by a United States bank and payable in United States legal tender), and investments of the types specified in accordance with the requirements of the Ceding Company’s state of domicile insurance law and investments; provided that such investments are issued by an institution that is not the parent, subsidiary or affiliate of either the Ceding Company or the Reinsurer.

 

  5)

DRAWING ON THE TRUST ACCOUNT.

 

  i.

Qualifying Assets in the Trust Account established hereunder may be withdrawn by the Ceding Company at any time, notwithstanding any other provision of this Agreement, and shall be utilized and applied by the Ceding Company or any successor by operation of law of the Ceding Company including, without limitation, any liquidator, rehabilitator, receiver or conservator of the Ceding Company, without diminution because of insolvency on the part of the Ceding Company or the Reinsurer, only for the following purposes:

 

  A.

To pay or reimburse the Ceding Company for the Reinsurer’s Quota Share of premiums returned, but not yet recovered from the Reinsurer, to the owners of Contracts reinsured under this Agreement on account of cancellations of such Contracts;

 

8


  B.

To pay or reimburse the Ceding Company for the Reinsurer’s Quota Share of surrenders and benefits or losses paid by the Ceding Company, but not yet recovered from the Reinsurer, pursuant to the provisions of the Contracts reinsured under this Agreement;

 

  C.

In the event of notice of termination of the trust, to fund an account with the Ceding Company in an amount at least equal to the deduction, for reinsurance ceded, from the Ceding Company’s liabilities for the Contracts reinsured hereunder. Such account shall include, but not be limited to, amounts for contract reserves, reserves for claims and losses incurred (including losses incurred but not reported), loss adjustment expenses and unearned premiums reserves; and

 

  D.

To pay or reimburse the Ceding Company for the Reinsurer’s Quota Share of any other amounts that the Ceding Company claims are due under this Agreement.

 

  ii.

The Ceding Company shall return to the Trust Account or to the Reinsurer assets withdrawn in excess of the actual amounts required in Article 10, Section 5(i)(A)-(C), or, in the case of Article 10, Section 5(D), assets that are subsequently determined not to be due.

 

  iii.

Any assets withdrawn by the Ceding Company pursuant to Article 10, Section 5(i)(C) and any assets withdrawn from any Trust Account in excess of the actual amounts required for Article 10, Section 5(i)(A) and (B) or, in the case of

Article 10, Section 5(i)(D), any amounts that are subsequently determined not to be due shall be held by the Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) in trust for the benefit of the Reinsurer, subject to the Ceding Company’s right to apply such assets to amounts due and payable by the Reinsurer to the Ceding Company under this Agreement, and shall at all times be maintained separate and apart from any assets of the Ceding Company in one or more designated funds withheld accounts (collectively the “Trust Funds Withheld Account”) for the sole purpose of funding the payments and reimbursements described in subsections (i), (ii) and (iv). The Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) shall ensure that any assets held in the Trust Funds Withheld Account pursuant to this Article 10, Section 5 consist of Qualifying Assets in accordance with its fiduciary obligations as trustee with respect to such amounts.

 

  iv.

For withdrawals by the Ceding Company pursuant to Article 10, Section 5(i)(C) and, with respect to Article 10, Section 5(i)(A), (B) and (D), in excess of the actual amounts applied to payment or reimbursement under such subsections, the Ceding Company shall pay interest in cash to the Reinsurer on the amount withdrawn at the then current prime rate as reported in the Federal Reserve Bulletin. Notwithstanding the foregoing, this Agreement permits the award, by any arbitration panel or court of competent jurisdiction, of:

 

  A.

Interest at a rate different from that provided in this paragraph,

 

9


  B.

Court or arbitration costs,

 

  C.

Attorney’s fees, and

 

  D.

Any other reasonable expenses.

 

  v.

At the Reinsurer’s request, and the approval of the Ceding Company, which shall not be unreasonably or arbitrarily withheld, the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute to the Reinsurer, as the designee of the Ceding Company, all or any part of the assets contained in the Trust Account, provided:

 

  A.

The Reinsurer shall, at the time of such withdrawal, replace the withdrawn assets with other Qualifying Assets having a market value equal to the market value of the assets withdrawn, so as to maintain at all times the Reinsurer’s Quota Share of the Statutory Reserves; or

 

  B.

After such withdrawals and transfers, the aggregate market value of the Qualifying Assets in the Trust Account shall be no less than [***]% of the Reinsurer’s Quota Share of the Statutory Reserves less the aggregate amount of assets held pursuant Article 10, Section 5 in the Trust Funds Withheld Account.

 

  vi.

After all payments have been discharged in full by the Reinsurer under the terms of this Agreement, the Ceding Company shall not unreasonably or arbitrarily withhold its approval to remit any remaining balance of funds in the Trust Account and Trust Funds Withheld Account to the Reinsurer.

 

  6)

This Article 10 shall survive termination of this Agreement.

ARTICLE 11

SUNSET CLAUSE

Notwithstanding Article 19 – Errors and Omissions of this Agreement, the Reinsurer shall not be liable for any claim which the Ceding Company has not reported within 24 months from the date upon which the Ceding Company knew or should reasonably have known of circumstances likely to give rise to a claim covered under this Agreement.

 

10


ARTICLE 12

PROFIT SHARING AND PARTIAL REIMBURSEMENT

 

  1)

This Article 12 sets forth the methodology for calculating the following potential annual payments: (i) a profit share payment from the Reinsurer to the Ceding Company, if the result of the Profit Sharing Formula equals a positive number, and (ii) a payment representing partial reimbursement of Reinsurance Claims, from the Ceding Company to the Reinsurer, if the result of the Partial Reimbursement Formula equals a positive number.

 

  2)

Formulas.

 

  i.

The following abbreviations, as used in the Profit Sharing Formula and the Partial Reimbursement Formula, have the respective meanings set forth below:

[***]

[***]

[***]

[***]

[***]

 

11


The values of C", F", and r, for any given Subscription Year, are as below, and as reflected in Annex 3 – Reinsurance Commissions & Profit Share Information:

 

     2017   2018   2019 and each
year thereafter

C (commissions (% of total Reinsurer Premium))

   [***]   [***]   [***]

Broker Commission

   [***]   [***]   [***]

F (Reinsurer fee (% of total Reinsurer Premium))

   [***]   [***]   [***]

r (distribution rate)

   [***]   [***]   [***]

 

  ii.

The “Profit Sharing Formula” is as set forth below:

[***]

[***]

[***]

[***]

[***]

[***]

For the purposes of this Article 12, Section 2, “PR” means partial reimbursement and “PS” means profit sharing.

 

  3)

Within fifteen (15) Business Days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for the prior Subscription Year for this Agreement, using the available amounts of premiums, claims, risk adjustment, XOL premiums and claims and IBNR and in accordance with Annex 3 – Reinsurance Commissions & Profit Share Information, with each of the resulting amounts reduced by [***]% to arrive at the “Provisional Profit Share Amount” and the “Provisional Partial Reimbursement Amount”.

 

12


  4)

If such Provisional Profit Share Amount is a positive number, the Reinsurer shall pay to the Ceding Company the Provisional Profit Share Amount promptly following the calculation of the Provisional Profit Share Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

13


  5)

If such Provisional Partial Reimbursement Amount is a positive number, the Ceding Company shall remit to the Reinsurer the Provisional Partial Reimbursement Amount promptly following the Ceding Company’s receipt of the calculation of the Provisional Partial Reimbursement Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  6)

Within fifteen (15) Business Days after the confirmation of the accounts for the fourth quarter of the year following the Subscription Year, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year for this Agreement, using the then-current amounts of premiums, claims, risk adjustment, XOL premiums, claims and IBNR and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. The Provisional Profit Share Amount shall be deducted from the Profit Sharing Formula result for such Subscription Year to arrive at the “Profit Sharing Adjustment”. The Provisional Partial Reimbursement Amount shall be deducted from the Partial Reimbursement Formula result to arrive at the “Partial Reimbursement Adjustment”.

 

  7)

If such Profit Share Adjustment is a positive number, the Reinsurer shall pay to the Ceding Company the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  8)

If such Profit Share Adjustment is a negative number, the Ceding Company shall pay to the Reinsurer the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  9)

If such Partial Reimbursement Adjustment is a positive number, the Ceding Company shall remit to the Reinsurer the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  10)

If such Partial Reimbursement Adjustment is a negative number, the Reinsurer shall remit to the Ceding Company the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  11)

The Ceding Company shall continue to provide the Reinsurer with quarterly accounts with respect to a given Subscription Year in accordance with Article 15 until the time of the first quarterly report that does not show any positive IBNR for such Subscription Year under this Agreement or any of the Companion Agreements. At such time, the Reinsurer shall deliver final calculations of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. For purposes of this Section, such terms shall be applied mutatis mutandis, except that references in Article 12, Section 6 to “Provisional Profit Share Amount” shall be understood to mean “Provisional Profit Share Amount plus any previously paid Profit Share Adjustment” and in Article 12, Section 6 “Provisional Partial Reimbursement Amount” shall be understood to mean “Provisional Partial Reimbursement Amount plus any previously paid Partial Reimbursement Adjustment”.

 

14


ARTICLE 13

FOLLOW THE FORTUNES

 

  1)

In proportion to the Reinsurer’s Quota Share the Reinsurer shall, subject to the terms and conditions of this Agreement, follow the fortunes of the Ceding Company in respect of risks which the Ceding Company has accepted under Contracts covered under this Agreement.

ARTICLE 14

INFORMATION

 

  1)

The Ceding Company shall report to the Reinsurer all information in respect of the Contracts as set out in Annex 4 – Data Reporting.

ARTICLE 15

ACCOUNTS

 

  1)

Within thirty (30) days after 31st March, 30th June, 30th September and 31st December of each year, the Ceding Company shall prepare and submit to the Reinsurer quarterly accounts showing the accounting items as specified in Annex 7 – Reinsurance Balance Calculation. For the avoidance of doubt, the quarterly account for any given Subscription Year shall continue to be submitted by the Ceding Company following the end of such Subscription Year for so long as there is still a positive amount of IBNR for such Subscription Year.

 

  2)

Accounts shall be confirmed by the Reinsurer within thirty (30) days upon receipt. This also applies if the confirmation can only be given for part of the accounts. Such partial confirmation shall also specify the objections to that part of the accounts on which confirmation cannot be given.

 

  3)

Any net balance of account, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Reinsurer shall be remitted by the Ceding Company promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts. Any balance, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Ceding Company shall be remitted by the Reinsurer promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts.

 

  4)

In case that confirmation can only be given for part of the accounts, the balance shall nevertheless be settled in full without delay. Should there be any items incorrect in or missing from a statement of account, such errors or omissions shall be corrected in the next statement of account, unless the discrepancy is material.

 

15


In such a case, correction and settlement of the discrepancy shall be completed as promptly as possible.

 

  5)

If the balance is not paid in due time such outstanding balance shall accrue interest on late payment, calculated from the confirmation date due to the date of actual payment, at the interest rate equal to the greater of (i) [***] and (ii) [***] plus [***]. If for any reason such rate is no longer published in the Wall Street Journal, the Parties shall agree on a replacement index that most closely approximates such rate.

The Parties acknowledge and agree that settlement of all amounts due from one Party to another hereunder for the period covering the Effective Time to the date hereof shall be settled as part of the first quarterly settlement following the date hereof.

ARTICLE 16

CURRENCY

All payments made, all amounts advised and all accounts prepared by either Party in accordance with the terms of this Agreement shall be in U.S. Dollars, with all payments paid in cash via wire transfer to an account designated by the receiving Party.

ARTICLE 17

SET OFF

Any debits or credits incurred on and after the Effective Time in favor of or against either the Ceding Company or the Reinsurer with respect to this Agreement are deemed mutual debits or credits, as the case may be, and shall be set off and recouped, and only the net balance shall be allowed or paid. To the extent permitted by applicable law, this Article 17 shall apply notwithstanding the initiation or commencement of a liquidation, insolvency, rehabilitation, conservation, supervision or similar proceeding by or against the Ceding Company or the Reinsurer.

ARTICLE 18

RIGHT OF INSPECTION, COORDINATION

 

  1)

The Reinsurer shall have the right, at any time, to inspect, through any duly authorized person or entity named in advance, all papers, books, accounts, documents and other records referring to the business reinsured under this Agreement at the head office of the Ceding Company or at any other place mutually agreed upon during the Ceding Company’s normal business hours. Notification of such visits shall be given two (2) weeks in advance but in urgent cases at least forty- eight (48) hours in advance.

 

16


  2)

Upon request, the Ceding Company shall supply or cause to be supplied to the Reinsurer, at the Reinsurer’s expense, copies of the whole or any part of such papers, books, accounts, documents and ether records relating to the business covered under this Agreement. Notwithstanding a termination of this Agreement, the Reinsurer’s right of inspection under this Article 18 will continue until all of the Reinsurer’s obligations under this Agreement have been terminated or fully discharged.

 

  3)

For the avoidance of doubt, all rights of inspection and any records requested or disclosed under this Article 18 will be subject to Article 24.

 

  4)

The Reinsurer shall have full access to, and open lines of communications with, the senior management of the Ceding Company in connection with this Agreement. Each Party shall appoint an individual as its primary point of operational contact for the administration and operation of this Agreement. The Reinsurer hereby appoints #### to act as its primary point of operational contact (the “Reinsurer Manager”), who shall have overall responsibility for coordinating, on behalf of the Reinsurer, the performance of the Reinsurer’s obligations hereunder and acting as a day-to-day contact with the Ceding Company Manager (as defined below). The Ceding Company hereby appoints Bruce Gottlieb to act as its primary point of operational contact (the “Ceding Company Manager”), who shall have overall responsibility for coordinating, on behalf of the Ceding Company, the performance of the Ceding Company’s obligations hereunder and acting as a day- to-day contact with the Reinsurer Manager. Either Party may change its respective Manager hereunder by providing five (5) days advance written notice to the other Party, provided that at all times the Ceding Company Manager shall be a senior officer of the Ceding Company.

ARTICLE 19

ERRORS AND OMISSIONS

 

  1)

ln the event that any error, omission or delay should occur in connection with the performance of this Agreement, including any error or omission being reflected in the accounts, such error, omission or delay will not invalidate the rights and obligations of the Parties arising from this Agreement, even when this error or omission has been discovered after the settlement of the respective balance. Any errors and omissions shall be corrected by the Parties promptly upon discovery.

 

  2)

An error or omission is defined as an unintentional failure and the result of an innocent oversight or misunderstanding which needs to be demonstrated to the satisfaction of the Party not in default. Any unintentional failure and the result of an innocent oversight or misunderstanding which results from a faulty business organization or structure of a party is not considered to be an error or an omission for the purposes of this Article 19.

 

  3)

Any liability of the Reinsurer shall be subject to the Ceding Company neither having committed gross negligence and/or willful misconduct with respect to underwriting or claims assessment, but having complied with the usual business, insurance and reinsurance practices. Otherwise, the Reinsurer shall have the right to refuse its liability.

 

17


ARTICLE 20

ARBITRATION

 

  1)

If a dispute controversy or claim arises between the Parties in connection with or in relation to this Agreement, the Parties undertake in good faith to use all reasonable best efforts to settle such dispute by oral or written consent directly with each other.

 

  2)

Where the Parties are unable to reach agreement in accordance with Article 20, Section 1 above, any dispute, controversy or claim arising between the Parties in connection with or in relation to this Agreement, including formation and validity, and whether arising before or after termination of this Agreement, shall be referred to an arbitration tribunal in the manner set out below.

 

  i.

To initiate arbitration, either Party shall notify the other Party in writing of its desire to arbitrate. The notice shall identify the claimant, the contract at issue, and the nature of the claims and/or issues. The arbitration will be deemed to have been commenced on the date the notice of arbitration is received

 

  ii.

There will be three arbitrators who will each have no less than ten (10) years of insurance or industry experience, who are knowledgeable regarding reinsurance and who are active or retired executive officers of insurance or reinsurance companies. The arbitrators shall not be under the control of any Party, shall not have ever worked for or performed substantial services for either Party, nor shall any member of the panel have a financial interest in the outcome of the dispute. Within thirty (30) days following the commencement of the arbitration proceedings, each Party will provide the other with the identification of their appointed arbitrator, and provide a copy of the arbitrator’s curriculum vitae. If either Party refuses or neglects to appoint an arbitrator within thirty (30) days, the other Party may appoint the second arbitrator to act as the appointed arbitrator for the defaulting Party by providing notice and a copy of the arbitrator’s curriculum vitae. Each Party’s appointed arbitrator shall propose a candidate to serve as a third arbitrator (the “Umpire”), which shall be subject to the other Party’s agreement. In the event the two Party-appointed arbitrators fail to reach an agreement on an Umpire within sixty (60) days of their appointment, then either Party may petition ARIAS-U.S. to appoint the Umpire and each Party shall cooperate and take whatever action is required to give effect to the ARIAS-U.S. umpire appointment procedures. Notwithstanding the previous sentence, the Parties may agree on an alternative Umpire appointment procedure. In the event any arbitrator fails, refuses, or becomes unable to act as such before an award has been rendered, a successor shall be selected in the same manner as the original arbitrator.

 

  iii.

The three (3) arbitrators shall decide by majority. If no majority can be reached the opinion of the Umpire shall prevail. He shall also act as chairman of the tribunal and conduct the arbitration proceedings.

 

  iv.

In the event of the death of an arbitrator or if an arbitrator is unable to continue, another shall in such case be appointed in such arbitrator’s stead by the Party who made the original appointment. In the event of the death of the Umpire, or if the Umpire is unable to continue, the arbitrators shall agree upon the appointment of a new chairman within thirty (30) days in accordance with the procedures set forth above.

 

18


  3)

The arbitration tribunal shall have power to fix all procedural rules for the holding of the arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, investigation of facts, the disclosure and inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the arbitration and may receive and act upon such evidence, whether oral or written, strictly admissible or not, as it shall in its discretion think fit.

 

  4)

The cost of the arbitration shall be borne by the non-prevailing Party. If a Party prevails in part, then the other Party shall bear the cost to that extent. Each Party shall, however, bear the costs of its own legal representation and assistance. The amount of the cost of the arbitration shall be determined as agreed between the Parties and the arbitrators prior to the arbitration. The arbitration tribunal shall, as a part of its award, specifically state the cost of the arbitration and the manner of its payment.

 

  5)

The arbitration shall take place in New York, New York (USA) and the arbitration tribunal shall apply the law of the State of New York as the proper law of this Agreement. In addition, the arbitration tribunal shall observe the customs and practices of the reinsurance business.

 

  6)

The award of the arbitration tribunal shall be in writing and state the reasons upon which it is based. Judgment upon the award may be entered in any court having jurisdiction thereof. The award shall be final and binding and not subject to appeal. The Parties undertake to carry out the same without delay. If either of the Parties should fail to carry out any award, the other may apply for its enforcement to a court of relevant jurisdiction in any territory in which the Party in default is domiciled or has assets or carries on business.

 

  7)

The arbitrators may consolidate an arbitration under this Agreement with any arbitration arising under or relating to any of the Companion Agreements or any other agreement between the Parties entered into pursuant hereto, as the case may be, provided that the subject of the disputes thereunder arise out of or relate to the same or substantially similar set of facts or transactions. Such consolidated arbitration shall be determined by the arbitrator appointed for the arbitration proceeding that was commenced first in time.

 

  8)

Notwithstanding the foregoing, a matter regarding the failure of a Party to settle a confirmed and undisputed balance may be brought before a court of relevant jurisdiction.

 

  9)

This Article 20 shall survive termination of this Agreement.

 

19


ARTICLE 21

JURISDICTION - APPLICABLE LAW

 

  1)

EXCEPT AS OTHERWISE SET FORTH HEREIN, THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS, INCLUDING AS TO VALIDITY, INTERPRETATION AND EFFECT, BY THE LAWS OF THE STATE OF NEW YORK WITHOUT GIVING EFFECT TO ITS PRINCIPLES OR RULES OF CONFLICT OF LAWS, TO THE EXTENT SUCH PRINCIPLES OR RULES ARE NOT MANDATORILY APPLICABLE BY STATUTE AND WOULD PERMIT OR REQUIRE THE APPLICATION OF THE LAWS OF ANOTHER JURISDICTION.

 

  2)

The Reinsurer shall (i) submit itself to the jurisdiction of any arbitration panel or court of competent jurisdiction within California in accordance with Article 20, and (ii) comply with all the requirements necessary to give such court or arbitration panel jurisdiction over the Reinsurer. Furthermore, the Reinsurer shall designate the Director of the Department of Managed Health Care in the State of California or a designated attorney as its true and lawful attorney upon whom service of process may be effected within California. The Reinsurer agrees to abide by the final decision of the arbitration panel in accordance with Article 20.

 

  3)

This Article 21 shall survive termination of this Agreement.

ARTICLE 22

NORMAL TERMINATION

 

  1)

This Agreement may be terminated [***].

 

  2)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

  3)

Termination of this Agreement at the end of the Initial Term or any renewal term shall not affect the Parties obligations with respect to the Contracts ceded hereunder prior to date of termination, but no additional Contracts shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after the Agreement termination date because all Contracts terminate on 31 December of the Subscription Year and any renewal of a ceded Contract after the Agreement termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Contract on or prior to 31 December of the Agreement termination year but reported after such 31 December.

 

20


  4)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

ARTICLE 23

SPECIAL TERMINATION

 

  1)

Either Party affected by one of the events mentioned in Article 23, Section 3 below shall notify the other Party in writing within thirty (30) days after its occurrence. The termination to be effective at the end of such thirty (30) days period.

 

  2)

Except in respect of termination by the Reinsurer pursuant to Article 23, Section 3(viii) or for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv), termination of this Agreement in accordance with this Article 23 shall not affect the Parties obligations with respect to the Contracts ceded hereunder prior to date of termination, but no additional new Contracts shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after 31 December of the Subscription Year and any renewal of a ceded Contract after the termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Contract on or prior to 31 December of the Agreement termination year but reported after such 31 December).

 

  3)

This Agreement may be terminated at any time (including during the Initial Term) on a run-off basis (except as otherwise stated in paragraphs (iv) and (viii) below which shall be terminated on a cut-off basis) with respect to Contracts issued prior to the applicable termination date by giving written notice to the other Party:

 

  i.

If the Ceding Company has become insolvent or is unable to pay its debts or has a Risk-Based Capital ratio of less than [***]% of its Authorized Control Level Risk Based Capital (each term as defined in the insurance laws and regulations in the Ceding Company’s state of domicile) or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  ii.

If the Reinsurer has become insolvent or is unable to pay its debts or has lost [***] of its paid up capital or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  iii.

If the other Party ceases writing insurance and/or reinsurance and elects to run-off its existing business or if the performance of the whole or any part of this Agreement that materially affects the interests of either of the Parties is prohibited or rendered impossible de jure or de facto for a period exceeding ninety (90) days.

 

21


  iv.

If the other Party fails to fulfill its material obligations under this Agreement within two (2) months after being requested in writing to do so; provided, that this Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company if the Ceding Company fails to pay any Reinsurer Premium in accordance with Article 7, the Reinsurer notifies the Ceding Company in writing of such failure and such failure remains uncured five (5) days after such notice.

 

  v.

If the other Party merges with or becomes acquired or controlled by any company, corporation or individual(s) who did not control it directly or indirectly at the inception of this Agreement and if (i) such company’s, corporation’s, or individual(s)’ financial strength rating is below A- Standard & Poor’s or A- A.M. Best and/or (ii) if such company, corporation, or individual(s) is not rated.

 

  vi.

If the Reinsurer’s financial strength rating is downgraded below A- Standard & Poor’s or A- A.M. Best and/or the Reinsurer loses its rating.

 

  vii.

If the Party giving notice or the other Party is definitively prevented from performing its obligations under this Agreement because of a “force majeure” i.e. an event beyond the control of a Party, which could not reasonably have been foreseen at the time of the conclusion of this Agreement and whose effects cannot be avoided by appropriate measures. If the prevention is temporary, this Agreement may be terminated by either Party by notification to the other Party after ninety (90) days of non- performance due to a “force majeure”.

 

  viii.

This Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company pursuant to Article 6.

 

  ix.

If the Reinsurer terminates this Agreement pursuant to Article 9, Section 10 (with 30-day notice).

 

  x.

If the Reinsurer terminates this Agreement pursuant to Article 4, Section 2 (with 30-day notice).

 

  xi.

If the Reinsurer terminates this Agreement pursuant to Article 1, Section 4.

 

  xii.

If the Reinsurer terminates this Agreement pursuant to Article 29, Section 3.

 

  4)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

  5)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

 

22


  6)

If this Agreement is terminated in accordance with the terms of this Article 23, the Reinsurer Premium due to the Reinsurer to the termination date will be calculated pro rata temporis to the Reinsurer Premium payable in respect of the annual period during which the termination date falls. In the event this Agreement is terminated pursuant to Article 23, Section 3(iv) or Section 3(viii), all figures relating to the Ceding Company used in the calculations set forth in Article 12 shall be based only on the period in which the Agreement is in effect

 

  7)

For the avoidance of doubt if this Agreement is terminated by the Reinsurer for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv) and Section 3(viii), the Reinsurer shall remain liable for covered losses incurred up to and including the date of the Ceding Company’s failure to pay such Reinsurer Premium under this Agreement, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement.

 

  8)

Additionally, if any Companion Agreement is terminated, the Reinsurer shall have the right to terminate this Agreement on 31 December of the termination year of the Companion Agreement (including during the Initial Term) in accordance with Article 23, Section 2 above.

 

  9)

If this Agreement is terminated by the Reinsurer pursuant to Article 23, Section 3(viii) and/or (iv), the Reinsurer shall remain liable for covered losses incurred up to and including the termination date thereunder, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement and this Agreement shall be terminated on a cut-off basis.

ARTICLE 24

CONFIDENTIALITY

 

  1)

The Parties agree that the Confidential Information constitutes confidential or proprietary information of the disclosing party unless expressly indicated otherwise by the disclosing party and the Parties agree that they shall only use the Confidential Information for the purposes of this Agreement.

 

  2)

Neither Party, except with the express prior written consent of the other, shall directly or indirectly, communicate, disclose or divulge to any third party any Confidential Information, subject always to compliance with all applicable Privacy and Security Laws. A “third party” is anyone other than the Parties or their subsidiaries, affiliates, parent company, employees, retrocessionaire, agents, subcontractors, representatives, auditors or other professional advisers. For purposes of this Agreement, “Privacy and Security Laws” means any applicable data privacy, data security, or data protection law or regulation in the United States of America, including, without limitation, Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations, including, without limitation, the amendments and associated regulations enacted and implemented pursuant to the Health Information Technology for Economic and Clinical Health Act (HIPAA).

 

23


  3)

Each Party shall use their best efforts to ensure that its respective employees, retrocessionaires, agents, subcontractors, representatives and auditors and other professional advisors, are fully informed of the provisions of this Article 27 and that they will be bound by the provisions of this Article 27 as if a signatory hereto.

 

  4)

Where disclosure is required by a court order or by an arbitrator or by a regulatory, legal or regulatory authority, such disclosures will not constitute a breach of confidentiality, provided always that the Party from whom such disclosure is requested shall immediately advise the other Party in order to allow each Party the opportunity to take such protective steps as may be appropriate.

 

  5)

Notwithstanding the foregoing, the Parties are not required to keep confidential Confidential Information which:

 

  i.

was publicly known prior to the time of disclosure by one Party to the other Party;

 

  ii.

has become publicly known and made generally available after disclosure to one Party through no fault of such Party;

 

  iii.

was already in the lawful possession of one Party at the time of the disclosure by the other Party;

 

  iv.

has been obtained by a Party from a third party lawfully in possession of such information and without a breach of such Party’s obligations of confidentiality; or

 

  v.

has been independently developed by one Party without use of or reference to other Party’s Confidential Information.

 

  6)

The foregoing exceptions shall not apply to Personal Data.

 

  7)

Each of the Parties agrees that the other shall be fully informed of any breach in these confidentiality provisions of which either Party becomes aware.

 

  8)

This Article 24 shall survive termination of this Agreement.

ARTICLE 25

SEVERABILITY, LAPSE

If any provision of this Agreement is determined to be invalid or unenforceable, such determination shall not affect or impair the validity or the enforceability of the remaining provisions of the Agreement. The invalid or unenforceable provision shall be construed by the Parties hereto in such manner that the economic aim originally pursued with this provision without being invalid or unenforceable can be reached as far as it is possible. This Article 25 shall survive termination of this Agreement.

ARTICLE 26

ENTIRE AGREEMENT, ASSIGNMENT

 

  1)

This Agreement sets forth the entire agreement between the Parties with respect to its subject matter. This Agreement replaces and supersedes all other prior written, oral or electronic communications and treaties of any kind relating to the subject matter of this Agreement.

 

24


  2)

Any amendment to this Agreement shall be made by addendum attached to this Agreement, embodying such amendments as may be agreed upon, and will be regarded as part of this Agreement and be equally binding. Notwithstanding the above, any amendment may also be made by issuing a revised and restated version of this Agreement. Any amendment shall be null and void unless made in writing and signed by both Parties hereto.

 

  3)

This Agreement shall be binding upon and inure to the benefit of the Parties and their respective successors, permitted assigns and legal representatives. Except as otherwise provided herein, neither this Agreement nor any right or obligation hereunder may be assigned or delegated by any Party (in whole or in part) to a third party without the prior written consent of the other Party hereto. Any purported assignment or delegation not in compliance with the provisions of this Agreement will be void ab initio and of no force or effect.

ARTICLE 27

UTMOST GOOD FAITH

This Agreement is governed by the principle of utmost good faith and was concluded on mutual trust leading the relationship between the Parties hereto as well as of usual insurance and reinsurance practice in terms of prudent and reasonable underwriting, claims assessment and administration.

ARTICLE 28

SANCTION CLAUSE

Neither the Reinsurer nor the Ceding Company shall be deemed to provide cover and neither the Reinsurer nor the Ceding Company shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose either the Reinsurer or the Ceding Company to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ARTICLE 29

ANTI BRIBERY

 

  1)

The parties acknowledge and agree that:

 

  i.

They are committed to prevent bribery; and

 

  ii.

They have implemented and will maintain within their organization policies to prevent any such actions by their officers, representatives, employees or any other third party acting on their behalf.

 

25


  2)

To the extent permitted by applicable law, each Party shall notify the other Party immediately upon becoming aware that an activity carried out in connection with this Agreement has or may have contravened this obligation or any applicable anti- bribery law or regulation.

 

  3)

Each party may terminate this Agreement on a run-off basis upon written notice - as of right and without any judicial authorization - if during the term of the Agreement the other Party is convicted of an act of bribery or fails to comply with any anti-bribery law or regulation even if not connected to this Agreement. To the extent permitted by applicable law, such Party shall indemnify the other Party, its officers, employees, affiliates, agents, subcontractors, or any other third party acting on its behalf, against any losses, liabilities, damages, costs (including legal fees) and expenses incurred related thereto.

ARTICLE 30

ANTI-MONEY LAUNDERING

 

  1)

The Reinsurer is not subject to anti-money laundering and counter-terrorist financing provisions. The Reinsurer will not however provide services to individuals or entities that are subject to assets freeze measures. The Ceding Company shall therefore apply any appropriate measure to fight against money laundering and terrorist financing, as defined by the FATF recommendations.

 

  2)

Pursuant to Article 30, Section 1 above and to the extent permitted by the applicable law, the Reinsurer may at any time request evidence from the Ceding Company as to its contract holders, the Contracts, or any other matters connected thereto in the context of anti-money laundering and counter-terrorism financing.

ARTICLE 31

DATA PRIVACY

 

  1)

The Parties acknowledge and agree that they:

 

  i.

are committed to protect Personal Data in accordance with applicable law and regulation; and

 

  ii.

have implemented and will maintain within their organization policies and technical security measures preventing any such privacy breaches (e.g., of confidentiality) by their officers, representatives, employees or any other third party acting on their behalf.

 

  2)

Personal Data received by either the Reinsurer or the Ceding Company from the other shall not be:

 

  i.

used by the receiving party other than in connection with performing its obligations under this Agreement; or for the purpose of any retrocession arrangements; or

 

  ii.

commercially exploited by the receiving party; or

 

26


  iii.

transferred abroad without the Ceding Company having implemented appropriate safeguards in accordance with the applicable law and regulation;

 

  3)

In particular, without prejudice to the generality of the foregoing, the Ceding Company confirms that it has obtained and undertakes that it will obtain on a continuing basis all requisite consents from its contract holders both for its own compliance purposes, for the purposes of this Agreement and for the purposes of any facultative business and retrocession arrangements to be entered into by the Reinsurer.

 

  4)

To the extent permitted by the applicable law, each Party shall notify the other Party immediately upon becoming aware of privacy breaches related to Personal Data.

 

  5)

The Parties shall establish a Technical Committee consisting of an equal number of one (1) or more representative(s) of each of the Reinsurer and the Ceding Company, which shall meet on a quarterly basis to monitor the assessment and evolution of the ceded liabilities and risks.

 

  6)

This Article 31, Sections 1-4 shall survive termination of this Agreement.

ARTICLE 32

CORPORATE RESPONSIBILITY

 

  1)

The Parties acknowledges that the AXA Group    adheres    to    certain principles designed to ensure that the AXA Group does business in a socially responsible manner by promoting sustainable development in its business through commitments towards its principal stakeholders (customers, suppliers, employees, environment, shareholders and community) as more fully set forth    in    the    AXA                Compliance                 and                Ethics                 Guide                located                at http://www.axa.com/en/governance/disclosure/ethics. The AXA Group encourages its suppliers to be socially and environmentally responsible. The AXA Compliance and Ethics Guide may be supplemented or amended at any time at the sole discretion of the Reinsurer. In the event of any change to the AXA Compliance and Ethics Guide, the Reinsurer shall promptly send the newly revised version to the Ceding Company.

 

  2)

In addition, as part of AXA Group’s principles and practices of sustainable development, the AXA Group requires its consultants to observe the following three main specific International Labour Organization (ILO) principles: (i) refrain from using, or accepting that their own suppliers and sub-contractors make use of child labour (under 15 years of age) or forced labour; (ii) ensure staff safe and healthy working conditions and environment, respecting individual and collective liberties; and (iii) promote non-discrimination (sex, race, religion or political conviction) as regards staff recruitment and management. For more information, see the ILO website: http://www.ilo.org/public/english/standards/index.htm

 

  3)

The Ceding Company agrees to use commercially reasonable efforts to comply with these standards. The Parties agree to negotiate in utmost good faith to resolve any dispute that may arise regarding the adequacy of such efforts. In the event such negotiations are not successful, such dispute shall be resolved in accordance with the terms of Articles 20 and 21.

 

27


  4)

In the event that either Party becomes aware that any of its business practices are contrary to the foregoing ILO principles, such Party agrees to use its commercially reasonable efforts to remedy the practice in question and notify the other Party of the correction it made. In the event the Party does not appropriately address the issue in question or if it commits subsequent violations, the other Party may as of right and without any prior formality to terminate this Agreement on a run-off basis for breach of this Article 32 without liability of any kind (other than payment of amounts due and owing pursuant to this Agreement in connection with a run-off termination).

ARTICLE 33

INSOLVENCY

 

  1)

In the event of an insolvency, or a change in status of the Ceding Company as defined under California Insurance Code §922.2(d), and the appointment of a conservator, liquidator, or statutory successor, any amounts due to the Ceding Company under this Agreement shall be payable by the Reinsurer directly to the conservator, liquidator, or statutory successor, after reasonable provision for verification, on the basis of claims allowed against the insolvent Ceding Company by any court of competent jurisdiction having authority to allow such claims or allowed by the conservator, liquidator, or statutory successor of the Ceding Company having authority to allow those claims, as a result of the conclusion of the claim filing, approval and appeal process before the conservator, liquidator, or statutory successor. Regardless of any provision in this Agreement or other agreement to the contrary, payment shall be made without diminution because of such insolvency or because the conservator, liquidator, or statutory successor has failed to pay all or a portion of any claims.

 

  2)

The conservator, liquidator, or statutory successor of the Ceding Company shall give or arrange to give to the Reinsurer, written notice of the pendency of a claim against the Ceding Company, within a reasonable period of time after the initiation of such claim. Failure to give such notice shall not excuse the obligation of the Reinsurer unless it is substantially prejudiced thereby. The Reinsurer may interpose, at its own expense, in the proceeding where such claim is to be adjudicated, any defense or defenses which it may deem available to the Ceding Company or its conservator, liquidator, or statutory successor. The reasonable expense thus incurred by the Reinsurer shall be payable, subject to court approval, out of the estate of the insolvent Ceding Company as part of the expense of the conservation or liquidation to the extent of a proportionate share of the benefit which may accrue to the Ceding Company in receivership, solely as a result of the defense undertaken by the Reinsurer.

 

  3)

Payments by the Reinsurer shall be made directly to the conservator, liquidator, or statutory successor of the Ceding Company except where this Agreement specifically provides another payee for such reinsurance in the event of the insolvency of the Ceding Company.

 

28


ARTICLE 34

NOTICES, CONSTRUCTION, DEFINITIONS

 

  1)

All notices, requests and other communications to any party hereunder shall be in writing (including registered letter, facsimile transmission, electronic mail or any other means of communication that leaves a record of such communication) and shall be given:

 

  i.

if to the Ceding Company, to:

Oscar Insurance Corporation

295 Lafayette St.

6th Floor

New York, NY 10012

Attention: Legal

####

 

  ii.

if to the Reinsurer, to:

International Employee Benefits

AXA France

313, Terrasses de l’Arche, 92727 Nanterre Cedex, France

####

####

or such other address or facsimile number as such Party may hereafter specify for the purpose by notice to the other Parties hereto. All such notices, requests and other communications shall be deemed received on the date of receipt by the recipient thereof if received prior to 5:00 p.m. on a Business Day in the place of receipt. Otherwise, any such notice, request or communication shall be deemed to have been received on the next succeeding Business Day in the place of receipt.

 

  2)

Interpretation of this Agreement shall be governed by the following rules of construction: (a) words in the singular shall be held to include the plural and vice versa, and words of one gender shall be held to include the other gender as the context requires; (b) references to the terms Preamble, Recitals, Article, Section, paragraph, Annex, Schedule and Exhibit are references to the Preamble, Recitals, Articles, Sections, paragraphs, Annexes, Schedules and Exhibits to this Agreement unless otherwise specified; (c) references to “$” shall mean U.S. dollars; (d) the word “including” and words of similar import shall mean “including without limitation,” unless otherwise specified; (e) the word “or” shall not be exclusive; (f) the words “herein,” “hereof,” “hereunder” or “hereby” and similar terms are to be deemed to refer to this Agreement as a whole and not to any specific Section; (g) the headings are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement; (h) this Agreement shall be construed without regard to any presumption or rule requiring construction or interpretation against the party drafting or causing any instrument to be drafted; (i) if a word or phrase is defined, the other grammatical forms of such word or phrase have a corresponding meaning; (j) references to any statute, listing rule, rule, standard, regulation or other law include a reference to (A) the corresponding rules and regulations and (B) each of them as amended, modified, supplemented, consolidated, replaced or rewritten

 

29


  from time to time; (k) references to any section of any statute, listing rule, rule, standard, regulation or other law include any successor to such section; (l) references to any person or entity include such person’s or entity’s predecessors or successors, whether by merger, consolidation, amalgamation, reorganization or otherwise; and (m) references to any contract (including this Agreement) or organizational document are to the contract or organizational document as amended, modified, supplemented or replaced from time to time, unless otherwise stated.

 

  3)

For purposes of this Agreement, in addition to other terms operationally defined herein, the following terms have the respective meanings set forth below:

 

  i.

ACA Fees” means any “health insurer provider” or similar fee imposed by any governmental authority in connection with the Patient Protection and Affordable Care Act (“ACA”), including under Section 9010 thereof and including any assessments or fees imposed by any governmental authority of any state or other jurisdiction in connection with the existence or operation of, or participation in, any health insurance exchange or marketplace of such state or jurisdiction, or any other similar fee imposed under any other applicable law.

 

  ii.

Agreement” has the definition set forth in the Preamble.

 

  iii.

Annual Business Update” has the definition set forth in Article 1, Section 4.

 

  iv.

ARIAS-U.S.” means the AIDA Reinsurance and Insurance Arbitration Society.

 

  v.

AXA Group” means the group of companies to which the Reinsurer is affiliated.

 

  vi.

Business Day” means any day other than a Saturday, a Sunday or any other day on which banking institutions in New York City or in France are required or authorized by applicable law to be closed. Any reference herein to a day that is not a Business Day shall be deemed to be a calendar day.

 

  vii.

Ceding Company” has the definition set forth in the Preamble.

 

  viii.

Ceding Company Manager” has the definition set forth in Article 18, Section 4.

 

  ix.

Companion Agreements” has the definition set forth in Article 5, Section 3.

 

  x.

Confidential Information” means the information, data, analyses, studies, statements, representations and any other materials provided by the Ceding Company or the Reinsurer to the other in connection with the placement of and the course of performance under this Agreement.

 

  xi.

Consolidated MLR” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

30


  xii.

Contract Documentation” has the definition set forth in Article 11, Section 3.

 

  xiii.

Contracts” has the definition set forth in Article 1, Section 1.

 

  xiv.

Cut-off” means that the Ceding Company shall relieve the Reinsurer of all liability hereunder for claims incurred after the date of termination of the Agreement. In case of cut-off termination, the Reinsurer shall refund to the Ceding Company the part of the Premium paid to the Reinsurer applicable to the unexpired liability on Contracts in force.

 

  xv.

Effective Time” has the definition set forth in Article 2, Section 1.

 

  xvi.

Extra-Contractual Obligations” has the definition set forth in Article 9, Section 8.

 

  xvii.

FATF” means the Financial Action Task Force (on Money Laundering).

 

  xviii.

IBNR” means reserves for claims incurred but not reported.

 

  xix.

Initial Term” has the definition set forth in Article 2, Section 1.

 

  xx.

Insurance Companies” means collectively, the Ceding Company and each party to a Companion Agreement, excluding the Reinsurer.

 

  xxi.

Medical Loss Ratio” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xxii.

Net Reinsurance Premium” has the definition set forth in Article 7, Section 2.

 

  xxiii.

Party” or “Parties” has the definition set forth in the Preamble

 

  xxiv.

Partial Reimbursement Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxv.

Partial Reimbursement Formula” has the definition set forth in Article 12, Section 2(iii).

 

  xxvi.

Personal Data” means and includes any of the following information that is acquired by, provided to, created by or maintained by a Party or any third party acting on behalf of a Party in connection with this Agreement: (i) any information that identifies or can reasonably be used to identify an individual, such as first and last name, social security number or other government issued number or identifier, date of birth, home or other physical address, e-mail address or other online contact information, financial account number, credit or debit card number, biometric data, mother’s maiden name, or other personally identifiable information; and (ii) personally identifiable financial or insurance information, including but not limited to “non-public personal information” as that term is defined in the Gramm-Leach-Bliley Act, as amended, and implementing regulations, 15 U.S.C. § 6809(4).

 

31


  xxvii.

Privacy and Security Laws” has the definition set forth in Article 24, Section 2.

 

  xxviii.

Profit Sharing Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxix.

Profit Sharing Formula” has the definition set forth in Article 12, Section 2(ii).

 

  xxx.

Provisional Partial Reimbursement Amount” has the definition set forth in Article 12, Section 3.

 

  xxxi.

Provisional Profit Share Amount” has the definition set forth in Article 12, Section 3.

 

  xxxii.

Qualifying Assets” has the definition set forth in Article 10, Section 4(ii).

 

  xxxiii.

Reinsurance Claim” has the definition set forth in Article 9, Section 1.

 

  xxxiv.

Reinsurer” has the definition set forth in the Preamble.

 

  xxxv.

Reinsurer Manager” has the definition set forth in Article 18, Section 4.

 

  xxxvi.

Reinsurer Premium” has the definition set forth in Article 7, Section 1.

 

  xxxvii.

Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017 and [***]% for any Subscription Year subsequent to Subscription Year 2017.

 

  xxxviii.

Statutory Reserves” means, as of the date of determination, the aggregate amount of reserves of the Ceding Company in respect of the Contracts calculated in accordance with statutory accounting practices prescribed or permitted by the insurance regulator in the Ceding Company’s state of domicile and determined in accordance with the methodology set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  xxxix.

Subscription Year” means a calendar year during which Contracts are issued.

 

  xl.

third party” has the definition set forth in Article 24, Section 2.

 

  xli.

Trust Account” has the definition set forth in Article 10, Section 3(i).

 

  xlii.

Trust Agreement” has the definition set forth in Article 10, Section 3(i).

 

  xliii.

Trust Funds Withheld Account” has the definition set forth in Article 10, Section 5(iii).

 

  xliv.

Trustee” has the definition set forth in Article 10, Section 3(i).

 

32


  xlv.

Umpire” has the definition set forth in Article 20, Section 2(ii).

 

  xlvi.

XOL” has the definition set forth in Article 7, Section 2.

 

  4)

This Article 34 shall survive termination of this Agreement.

[Reminder of page intentionally left blank. Signature page to follow.]

 

33


In witness whereof, the Parties hereto by their respective duly authorized representatives have executed this Agreement in duplicate for and on behalf of:

The Ceding Company

Date and place:

December 21, 2017 New York, NY

 

Signature:   /s/ Mario Schlosser
By:   Mario Schlosser
Title:   CEO

The Reinsurer

Date and place:

December 21, 2017

 

Signature:   /s/ Jacques de Peretti
By:   Jacques de Peretti
Title:   CEO

[Signature Page to Reinsurance Treaty- Oscar Health Plan of California]


ANNEX 1 – SCOPE

Contracts Covered

This Agreement applies to all individual health insurance Contracts corresponding to the Contract Documentation and issued or renewed by the Ceding Company in the State of California providing coverage commencing on January 1, 2017 or thereafter, and with a period of insurance expiring on 31 December. The Contracts ceded under this Agreement are only those in effect as of October 1, 2017 or issued or renewed between October 1, 2017 and the date of termination of this Agreement. The Parties acknowledge and agree that the Contracts included on this Annex 1 will be subject to modification by the Ceding Company, per and in accordance with the provisions of this Agreement, each Subscription Year to reflect the product offerings and other modifications for the applicable Subscription Year.

2017 Contracts:

 

 

Classic Secure

 

 

Classic Bronze

 

 

Classic Silver

 

 

Classic Gold

 

 

Classic Platinum

 

 

Simple Bronze

 

 

Simple Silver

 

 

Simple Gold

Contract Documentation:

Copies of current and accurate Contract Documentation shall be copied on a CD ROM that will be agreed as final by both Parties.


ANNEX 2 – TERRITORIAL SCOPE

This Agreement shall only apply to Contracts issued by the Ceding Company in [***] rating regions [***] or any successor regions to [***] rating regions [***] to insureds having their principal residence in those territories.


ANNEX 3 - REINSURANCE COMMISSIONS & PROFIT SHARE INFORMATION

[***]


ANNEX 4 – DATA REPORTING

Monthly reporting dashboards:

 

   

Portfolio : number of policies/persons by month covered by global/ metal /state

 

   

Portfolio distribution (per gender/age) by global/metal/state

 

   

Premiums by month global / per metal / per state

 

   

Claims (split by % of reserves and paid by global/ metal/ state) (IBNR global / metal / state) (by month of occurrence)

 

   

Claims by benefits category split by global/ metal / state

 

   

Inpatient hospital

 

   

Outpatient hospital

 

   

Professional

 

   

Other medical

 

   

Capitation

 

   

Prescription drug

 

   

MLR by global / state / metal (current year, and n-1 year)

Risk adjustment estimate

Quarterly Basis

 

   

Cash flows (quarterly basis)

On a bi-yearly basis (according to regulatory possibilities)

Anonymized dataset

 

   

Information about the insureds (biometrical & contract related data): age (birthdate), gender, state & address, subscription date, premium paid.

Information about claims : customer paths, medical facilities used, hospitalization (length/costs), details about professional, other medical, prescription drug, fraud


ANNEX 5 – STATUTORY RESERVES & IBNR CALCULATION METHODOLOGY

Statutory reserves include:

 

 

Incurred but not reported claims (IBNR)

 

 

Claims in course of settlement

 

 

Claims due and unpaid

 

 

Reserve margin

Actuarial Process Narrative

The Ceding Company’s current reserves processes include monthly valuations for all actuarial liabilities based on models developed in-house incorporating the most current views of the claim data available from our data warehouse.

Reserves:

The In-house reserve model incorporates different methodologies based on the amount and recency of the claim. The completion factor development method is utilized for claims under [***] and is supplemented by the incurred claim methodology for the most recent incurral months. A seriatim methodology is utilized for claims over [***], supplemented by case management data supplied by our medical and claims operations areas. Claims reserve triangle analytical cohorts are segmented by metallic level within a given state and region, and all reserves are determined separately incorporating the current inventory of claims in course of settlement. The reserve model incorporates historical reserve testing and detail on prior period development down to the incurral month. Reserves accrued are best-estimates with an explicit margin for adverse deviation as well as an accrual for unpaid claim adjustment expenses. All margins are reviewed at least annually for appropriateness based on historical run-out. Claims reserve triangles are inclusive of medical and behavioral health claims only. Pharmacy claims are analyzed separately and assumed to not have any run-out.


ANNEX 6 – CURRENT YEAR AND CONSOLIDATED MEDICAL LOSS RATIO FORMULAS

Medical Loss Ratio Definition

All claims and premiums refer to the current Subscription Year

Numerator: [***]

Denominator: [***]

Consolidated MLR Definition

Numerator: [***]

Denominator: [***]


ANNEX 7 – REINSURANCE BALANCE CALCULATION

(1) Income: quota share of:

[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

(2) Outgo: quota share of:

[***]

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) + (4) - (3) + (6) - (5)


ANNEX 8 – LIMITATION OF LIABILITY CALCULATION

State A – [***]

 

State A

   State B      State C      Ceding Company      Total  

Gross Premiums

     [***]        [***]        [***]        [***]        [***]  

Gross Claims

     [***]        [***]        [***]        [***]        [***]  

MLR

     [***]        [***]        [***]        [***]        [***]  

Ceded Premiums

     [***]        [***]        [***]        [***]        [***]  

Ceded Claims

     [***]        [***]        [***]        [***]        [***]  

AXA Ceded MLR

     [***]        [***]        [***]        [***]        [***]  

Retained Premiums

     [***]        [***]        [***]        [***]        [***]  

Retained Claims

     [***]        [***]        [***]        [***]        [***]  

Ceded Claims Calculation

 

Claims Ceded (up to local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Claims Ceded (above local attachment point)

     [***]        [***]        [***]        [***]        [***]  

Allocation of Claims Retained

     [***]        [***]        [***]        [***]        [***]  

Total Claims

     [***]        [***]        [***]        [***]        [***]  

Exhibit 10.32

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT

MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF

PUBLICLY DISCLOSED.

AMENDMENT TO QUOTA SHARE REINSURANCE AGREEMENT BETWEEN

OSCAR INSURANCE COMPANY

AND

AXA FRANCE VIE

This Amendment to the Quota Share Reinsurance Agreement between Oscar Insurance Company (formerly known as Oscar Insurance Company of Texas) (the “Ceding Company”) and AXA France Vie (“AXA”), (this “Amendment”) is made as of January 1, 2019.

WHEREAS, the Ceding Company, on the one hand, and AXA, on the other hand, have entered into a quota share reinsurance agreement, dated as of December 21, 2017 (the “Reinsurance Agreement”), pursuant to which AXA has agreed to provide quota share reinsurance to the Ceding Company on the terms set forth in the Reinsurance Agreement;

WHEREAS, the Ceding Company and AXA desire to enter into this Amendment to clarify the terms of their mutual understanding relating to certain provisions of the Reinsurance Agreement and correct typographical errors therein;

WHEREAS, the Ceding Company and AXA wish to indicate their understanding of their respective rights and obligations with respect to the scope of any “excess of loss recoveries” referenced in Article 5.2 and Annex 7 of the Reinsurance Agreement;

WHEREAS, the Ceding Company and AXA wish to clarify their respective rights and obligations with respect to the calculation of their liability limitation referenced in Article 5.3; and

WHEREAS, the Ceding Company and AXA wish to clarify the definition of the Reinsurer’s Quota Share referenced in Article 34.3.

WHEREAS, the Ceding Company and AXA wish to extend the territorial scope of the Quota Share Reinsurance Agreement referenced in Annex 2 of the Reinsurance Agreement

NOW THEREFORE, in consideration of the foregoing, and the representations, warranties, covenants and conditions set forth below, the parties hereto hereby agree as set forth herein.

 

  I.

Definitions. Capitalized terms used but not otherwise defined in this Amendment shall have the meanings ascribed to such terms in the Reinsurance Agreement, as may be amended from time to time.

 

  II.

Clarification of Article 5.2 and Annex 7. The parties hereto agree and confirm that the term “excess of loss recoveries” where it appears in Article 5.2 and Annex 7 of the Reinsurance Agreement includes, but is not limited to, any profit-share that may be received by the Ceding Company from any excess of loss reinsurance arrangement applicable to the Policies.

 

  III.

Modification of Article 5.3. Article 5.3 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:


“Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to the Stop Loss Percentage of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed the Stop Loss Percentage for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds the Stop Loss Limit Percentage and the Medical Loss Ratio for such Subscription Year exceeds the Stop Loss Percentage, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***].

The Stop Loss Percentage is defined as set forth:

 

For Subscription Years 2017 - 2019

     [***

For Subscription Year 2020 and each year thereafter

     [***

An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01D-1002, between the Reinsurer and Oscar Insurance Corporation;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation;

 

  iii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O020 -1002, between the Reinsurer and Oscar Health Plan of California;

 

  iv.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Insurance Company of Florida;

 

  v.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Buckeye State Insurance Corporation;

 

  vi.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan, Inc.;


  vii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Georgia; and

 

  viii.

Quota Share Reinsurance Agreement, effective January 1, 2020, between the Reinsurer and Oscar Health Plan of Pennsylvania

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Contracts in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year; provided, that the Reinsurer shall not be liable for any losses incurred under such Contracts prior to the Effective Time.”

 

  IV.

Modification of Article 7.2. Article 7.2 of Reinsurance Agreement is hereby deleted and replaced in its entirety by the following:

“As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

[***]

[***]

= Net Reinsurance Premium

[***]

[***]

 

  V.

Original Earned Net Premium In Article 5.2 of the Reinsurance Agreement, the term “Original Earned Net Premium” is hereby deleted and replaced by “Gross Premiums Earned, as defined in Article 7.2”.

 


  VI.

Clarification of Article 12.2.

 

  a.

The table in Article 12.2 i is hereby deleted and replaced by the following:

 

For policies issued by the Ceding Company in Texas rating regions [***], the ceding commission, brokerage fee and reinsurer fee are defined as below:

     2019       
2020 and each
year thereafter
 
 

C OSCAR commissions (% of total Reinsurer Premium)

     [***      [***

Broker Commission

     [***      [***

F (Reinsurer fee (% of total Reinsurer Premium))

     [***      [***

r (distribution rate)

     [***      [***

 

For policies issued by the Ceding Company in Texas rating regions [***], and in Tennessee rating regions [***], the ceding commission, brokerage fee and reinsurer fee are defined as below:

     2019       
2020 and each
year thereafter
 
 

C OSCAR commissions (% of total Reinsurer Premium)

     [***      [***

Broker Commission

     [***      [***

F (Reinsurer fee (% of total Reinsurer Premium))

     [***      [***

r (distribution rate)

     [***      [***

 

  b.

The Profit Sharing Formula in Article 12.2 ii is hereby deleted and replaced by the following:

 

   The “Profit Sharing Formula” is as set forth below:
2017 to 2019    [***]
   [***]
   R [***]
2020 and each year thereafter    [***]
   [***]
   [***]
   R [***]

 


  c.

The Partial Reimbursement Formula in Article 12.2 iii is hereby deleted and replaced by the following:

 

   The “Partial Reimbursement Formula” is as set forth below:
2017 to 2019    [***]
   [***]
2020 and each year thereafter    [***]
   [***]
   [***]

 

  VII.

Modification of Annex 2. Annex 2 of the Reinsurance Agreement is hereby deleted and replaced in its entirety by the following table:

“This Agreement shall only apply to Policies issued by the Ceding Company as set forth below:

 

In 2018    [***]
In 2019    [***]
In 2020 and each year thereafter    [***]
  VIII.

Modification of Article 34.3 xxxvii:

a. Article 34.3 xxxvii is hereby deleted and replaced by the following

“Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017, [***]% for Subscription Years 2018 and 2019, [***]% for Subscription Year 2020 and any Subscription Year subsequent to Subscription Year 2020.

 

  IX.

Modification of Annex 7. Annex 7 of the Reinsurance Agreement is hereby deleted and replaced in its entirety with Exhibit A attached hereto.

 

  X.

Excess of Loss Agreements. The Ceding Company hereby agree to submit for approval to AXA any amendment to the Excess of Loss Agreements.

 

  XI.

Miscellaneous.

 

  a.

Entire agreement; Third Parties. This Amendment and the other agreements referred to herein set forth the entire understanding among the parties with respect to the subject matter hereof. Except as expressly provided in this Amendment, nothing in this agreement is intended to confer upon any party, other than the parties hereto and their respective successors and permitted assigns, any rights under this Amendment.


  b.

Counterparts. This Amendment may be executed in any number of counterparts, each of which shall be deemed an original but all of which shall together constitute one and the same instrument.

The Parties have executed this Amendment as of March 16 2020.

 

Oscar Insurance Company
By:  

/s/ Sid Sankaran

Sid Sankaran
Printed Name
Chief Financial Officer
Title

 

AXA FRANCE VIE
By:  

/s/ Jacques de Peretti

Jacques de Peretti
Printed Name


Appendix

Exhibit A :

(1) Income: quota share of:

[***]

(2) Outgo: quota share of:

[***]

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) – ((4) - (3)) – ((6) - (5))


CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED PURSUANT

TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS NOT MATERIAL AND

WOULD LIKELY CAUSE COMPETITIVE HARM TO THE REGISTRANT IF PUBLICLY DISCLOSED.

Execution Version

QUOTA SHARE REINSURANCE AGREEMENT

BETWEEN

OSCAR INSURANCE COMPANY OF TEXAS

AND

AXA FRANCE VIE

Dated December 21, 2017


TABLE OF CONTENTS

 

ARTICLE 1 OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

     1  

ARTICLE 2 EFFECTIVE TIME – DURATION

     2  

ARTICLE 3 TERRITORIAL SCOPE

     2  

ARTICLE 4 RETENTION OF THE CEDING COMPANY

     2  

ARTICLE 5 LIABILITY AND SHARE OF THE REINSURER

     2  

ARTICLE 6 CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

     4  

ARTICLE 7 REINSURER PREMIUMS

     4  

ARTICLE 8 REINSURANCE COMMISSIONS

     5  

ARTICLE 9 CLAIMS

     5  

ARTICLE 10 RESERVES, REINSURANCE CREDIT

     7  

ARTICLE 11 SUNSET CLAUSE

     10  

ARTICLE 12 PROFIT SHARING AND PARTIAL REIMBURSEMENT

     10  

ARTICLE 13 FOLLOW THE FORTUNES

     13  

ARTICLE 14 INFORMATION

     13  

ARTICLE 15 ACCOUNTS

     14  

ARTICLE 16 CURRENCY

     15  

ARTICLE 17 SET OFF

     15  

ARTICLE 18 RIGHT OF INSPECTION, COORDINATION

     15  

ARTICLE 19 ERRORS AND OMISSIONS

     16  

ARTICLE 20 ARBITRATION

     16  

ARTICLE 21 JURISDICTION - APPLICABLE LAW

     18  

ARTICLE 22 NORMAL TERMINATION

     19  

ARTICLE 23 SPECIAL TERMINATION

     19  

ARTICLE 24 CONFIDENTIALITY

     22  


ARTICLE 25 SEVERABILITY, LAPSE

     23  

ARTICLE 26 ENTIRE AGREEMENT, ASSIGNMENT

     23  

ARTICLE 27 UTMOST GOOD FAITH

     23  

ARTICLE 28 SANCTION CLAUSE

     24  

ARTICLE 29 ANTI BRIBERY

     24  

ARTICLE 30 ANTI-MONEY LAUNDERING

     24  

ARTICLE 31 DATA PRIVACY

     25  

ARTICLE 32 CORPORATE RESPONSIBILITY

     25  

ARTICLE 33 INSOLVENCY

     26  

ARTICLE 34 NOTICES, CONSTRUCTION, DEFINITIONS

     27  


QUOTA SHARE REINSURANCE AGREEMENT

This QUOTA SHARE REINSURANCE AGREEMENT (this “Agreement”) is made and entered into on December 21, 2017 and effective as of the Effective Time by and between OSCAR INSURANCE COMPANY OF TEXAS, a Texas life, accident and health insurance company, (the “Ceding Company”) and AXA FRANCE VIE, a limited company registered in the Commercial Register of Nanterre under company number 310 499 959 00891, governed by the French Insurance Code (the “Reinsurer”). For purposes of this Agreement, the Ceding Company and the Reinsurer will each be deemed a “Party”, and collectively, the “Parties”.

ARTICLE 1

OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

 

  1)

This Agreement refers to all policies properly underwritten and issued by the Ceding Company as set out in the attached Annex 1 – Scope (the “Policies”). This Agreement does not apply to any other business underwritten by the Ceding Company.

 

  2)

This Agreement consists of this agreement, the Annexes hereto and any future amendments. The attached Annexes form and any future amendments will form integral parts of this Agreement and shall be equally binding. In the event of any discrepancy between this Agreement, an Annex or a future amendment, the terms of the respective Annex or future amendment will prevail.

 

  3)

Copies of current and accurate specimen policy forms, policy premium information, application forms and rate tables with respect to the Policies (“Policy Documentation”) shall be furnished to the Reinsurer. The Ceding Company shall provide the Reinsurer with the updated version of the Policy Documentation for each year beginning with calendar year 2019 as part of the governance process described in Article 1, Section 4 below. The Policies shall be issued in accordance with the requirements of the applicable Policy Documentation.

 

  4)

In the second calendar quarter of each calendar year beginning in 2018, the Ceding Company will provide to the Reinsurer the proposed rating plans, pricing and related targeted Medical Loss Ratio with respect to each individual health policy product to be written within the territorial scope for the subsequent calendar year (“Annual Business Update”). Within thirty (30) days following delivery of the Annual Business Update, the Parties will meet to discuss the Reinsurer’s views with respect thereto and the economic impact to the Reinsurer under this Agreement. The Ceding Company will take into account the Reinsurer’s reasonable views with respect to the finalization of the plans and rates to be submitted to the state insurance department for review and approval. Following the approval of the plan and rates by the state insurance department, which generally occurs in the third calendar quarter, the Ceding Company shall provide without any delay the Reinsurer with the final Annual Business update for the subsequent calendar year. The Parties agree that, if, in good faith, the Reinsurer is not satisfied with the final Annual Business Update for Subscription Year 2019, the Reinsurer shall have the right to terminate this Agreement on 31 December 2018 in accordance with Article 23.

 

1


  5)

This Agreement applies only to those Policies properly underwritten and issued directly by the Ceding Company. Insurance policies assumed by the Ceding Company through reinsurance, acquisitions, mergers or portfolio transfers will not be reinsured automatically under this Agreement. The inclusion, for purposes of this Agreement, of any such other insurance policies, requires prior approval by the Reinsurer and appropriate terms and conditions will be mutually agreed upon between the Parties.

ARTICLE 2

EFFECTIVE TIME – DURATION

 

  1)

This Agreement will take effect as of 12:01 a.m. Eastern Standard Time on October 1, 2017 (the “Effective Time”) and will remain in force for a duration of two (2) years and three (3) months from the Effective Time (the “Initial Term”).

 

  2)

This Agreement shall renew automatically each year for one (1) year after expiry of the Initial Term.

ARTICLE 3

TERRITORIAL SCOPE

This Agreement only covers Policies issued in the territories listed in Annex 2 – Territorial Scope.

ARTICLE 4

RETENTION OF THE CEDING COMPANY

 

  1)

Except as permitted by this Section, the Ceding Company is obligated to retain for its own account the share of the Policies not reinsured by the Reinsurer and is not entitled to adjust, sell, reinsure, assign, charge, or alienate its retention under this Agreement in any way without the Reinsurer’s prior written consent, which consent may be withheld in the Reinsurer’s sole discretion. If the Ceding Company seeks any such reinsurance, the Ceding Company shall inform and seek the Reinsurer’s prior written consent accordingly. The foregoing shall in no way apply to any excess of loss coverage covering the Policies in the excess of the limit of liability of USD [***] at [***]% per person per year including the Medical Per Person Excess of Loss Reinsurance Agreement and any replacement thereof.

 

  2)

If the Ceding Company is in breach of Article 4, Section 1, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty (30) days’ prior written notice to the Ceding Company.

ARTICLE 5

LIABILITY AND SHARE OF THE REINSURER

 

  1)

Pursuant to the terms and conditions of this Agreement, the Ceding Company shall cede to the Reinsurer and the Reinsurer shall accept and reinsure, automatically, the Reinsurer’s Quota Share of liabilities in respect of the Policies set forth in Annex 1 – Scope and in compliance with the Policy Documentation.

 

2


  2)

The Reinsurer’s Quota Share of liabilities ceded hereunder shall be protected by an excess of loss per person and per year underwritten by the Ceding Company with a priority of USD [***] at [***]% and unlimited capacity. The Reinsurer’s Quota Share of this Excess of Loss premium paid by the Ceding Company shall be deducted by the Ceding Company from the Original Earned Net Premium in accordance with Article 7, Section 2 below. The Reinsurer shall benefit from the Reinsurer’s Quota Share of the Excess of Loss recoveries.

 

  3)

Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***]. An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O01D-1002, between the Reinsurer and Oscar Insurance Corporation;

 

  ii.

Quota Share Reinsurance Agreement, effective January 1, 2018, Aon Benfield reference O02M-1002, between the Reinsurer and Oscar Garden State Insurance Corporation; and

 

  ii.

Quota Share Reinsurance Agreement, effective October 1, 2017, Aon Benfield reference O020-1002, between the Reinsurer and Oscar Health Plan of California.

To the extent the Parties (or their Affiliates) agree to enter into additional reinsurance agreements between the Parties (or their Affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

 

3


This limit will be implemented through the provisions of Article 12.    For the avoidance of doubt, the first Subscription Year will last for a period of three (3) months, beginning on October 1, 2017 and concluding on December 31, 2017. Policies in force as of October 1, 2017 that were issued by the Ceding Company for calendar year 2017 in accordance with Annex 1 – Scope and Annex 2 – Territorial Scope shall be ceded for this first Subscription Year; provided, that the Reinsurer shall not be liable for any losses incurred under such Policies prior to the Effective Time.

 

  4)

The maximum period of insurance of any one Policy shall not exceed [***]. Except as required by applicable law, no Policy may be issued for a period of insurance of less than [***] without the prior written approval of the Reinsurer, which approval may be withheld in the Reinsurer’s sole discretion. All Policies covered under this Agreement [***].

 

  5)

The Reinsurer shall not be liable under this Agreement for risks which are excluded under the Policy Documentation unless otherwise agreed in writing between the Reinsurer and the Ceding Company.

 

  6)

This Agreement is solely between the Ceding Company and the Reinsurer, and, subject to Articles 10, 26, 33 and 34, nothing in this Agreement is intended or shall be construed to give any person or entity, other than the Parties, any legal or equitable right, remedy or claim under or in respect of this Agreement or any provision contained herein. Such persons and entities include, but are not limited to, the intermediary (if any), policyholders of Policies, beneficiaries of Policies and other reinsurers of the Ceding Company or its affiliates.

ARTICLE 6

CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

ln the event of any change in the law, regulation or administrative practice applicable to this Agreement, the Policy Documentation or the Parties, whether arising from legislation, administrative acts, decisions of the courts or otherwise, at any time after commencement of this Agreement that materially increases or extends the Reinsurer’s liability during the then current calendar year, the Ceding Company shall so inform the Reinsurer immediately following the Ceding Company’s awareness of such change and the Ceding Company shall have thirty (30) days to cure the impact of such change on the Reinsurer. If the Ceding Company is unable to cure the impact of such change to the satisfaction of the Reinsurer within the thirty (30) day period, it is agreed that the Reinsurer shall have the right to terminate this Agreement with immediate effect on a cut-off basis in accordance with Article 23.

ARTICLE 7

REINSURER PREMIUMS

 

  1)

Corresponding to the ceded liability, the Reinsurer Premiums due by the Ceding Company to the Reinsurer shall be entered into the account for the relevant calendar quarter. The “Reinsurer Premium” shall mean the Reinsurer’s Quota Share of the Net Reinsurance Premiums.

 

4


  2)

As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

ARTICLE 8

REINSURANCE COMMISSIONS

 

  1)

The Reinsurer shall pay the Ceding Company reinsurance commissions, based on the Reinsurer Premium, as set out for each applicable Subscription Year on Annex 3 – Reinsurance Commissions & Profit Share Information.

 

  2)

If any Reinsurer Premium or installments of Reinsurer Premium are returned to the Ceding Company, any corresponding reinsurance commissions previously credited to the Ceding Company shall be reimbursed to the Reinsurer.

ARTICLE 9

CLAIMS

 

  1)

A condition precedent to any settlement of a claim due by the Reinsurer hereunder (a “Reinsurance Claim”) is that the respective Reinsurer Premium has been paid to or entered into the relevant account of the Reinsurer in accordance with the terms of this Agreement.

 

  2)

Subject to Article 9, Section 1, the Reinsurer will reimburse the Ceding Company for the Reinsurer’s Quota Share of claims paid by the Ceding Company during the applicable calendar quarter in accordance with the settlement procedures set out in Article 15.

 

  3)

The Ceding Company is responsible for the assessment of claims in a prudent and professional way and in accordance with the underlying Policy Documentation. The Ceding Company is furthermore responsible for the fulfillment of the claims information requirements agreed upon and as set out in the Annex 4 – Data Reporting. Any claims payment made is binding on the Reinsurer to the extent of its liability for claims hereunder.

 

  4)

The Ceding Company shall provide the Reinsurer with claims data for the Policies in accordance with the template set forth at Annex 4 – Data Reporting and shall provide the Reinsurer with any further claims information upon request.

 

5


  5)

The Reinsurer shall follow the fortunes of the Ceding Company for the Reinsurer’s Quota Share of any Policy claim including interest and any legal costs and expenses incurred in investigating and assessing such claim (both medical and non-medical). Any salaries and travel expenses of the Ceding Company’s employees or employees of any third party administrator designated by the Ceding Company as well as any internal Policy claims assessment costs are excluded.

 

  6)

Subject to the above provisions of this Article, the decisions of the Ceding Company on claims payments are binding on the Reinsurer with the exception of any payments made by the Ceding Company on an ex-gratia basis (i.e., those payments which the Ceding Company is not required to make according to the underlying Policy Documentation). Such payments will not be binding on the Reinsurer without its expressly stated prior written consent, which may be withheld in its sole discretion. Notwithstanding the foregoing, it is also acknowledged by the Reinsurer that due to the nature of the individual health insurance business, regulatory authorities may require the Ceding Company, from time to time, to pay claims for medically necessary services where coverage may otherwise have been denied. If the Ceding Company is formally required by a regulatory authority to make such a claims payment, such payment shall not be deemed as an “ex-gratia” payment and shall be reinsured hereunder. The Ceding Company shall provide the Reinsurer with a copy of the formal requirement by the regulatory authority.

 

  7)

Relief and recoveries, whether recovered or received prior or subsequent to loss settlement under this Agreement shall be shared proportionately with the Reinsurer based on the Reinsurer’s Quota Share.

 

  8)

The Reinsurer will not be liable for Extra-Contractual Obligations. For purposes of this Agreement, “Extra-Contractual Obligations” means all liabilities to any person or entity arising out of or relating to the Policies (other than liabilities arising under the express terms and conditions and within the policy limits of the Policies), including, without limitation, any loss in excess of the limits arising under or covered by any Policy, any liability for fines, penalties, taxes, fees, forfeitures, compensatory, consequential, punitive, exemplary, special, treble, bad faith, tort, statutory or any other form of extra-contractual damages, as well as all legal fees and expenses relating thereto, which liabilities arise out of, result from or relate to, any act, error or omission, whether or not intentional, negligent, fraudulent, in bad faith or otherwise (actual or alleged), arising out of or relating to the Policies, including, without limitation, (i) the form, sale, marketing, distribution, underwriting, production, issuance, cancellation or administration of the Policies, (ii) the investigation, defense, prosecution, trial, settlement (including the failure to settle) or handling of claims, benefits, or payments under the Policies, (iii) the failure to pay or the delay in payment or errors in calculating or administering the payment of benefits, claims or any other amounts due or alleged to be due under or in connection with the Policies or (iv) fines or other penalties associated with escheat and unclaimed property liabilities, including any interest thereon, arising under or relating to the Policies.

 

  9)

Except with respect to any third party administration arrangements in place as of the date hereof, the Ceding Company shall not delegate any administration with respect to the Policies to a third party without the Reinsurer’s prior written consent, such consent not to be unreasonably withheld. In the case of any such permitted delegation, the Ceding Company remains liable for the compliance with all the conditions stated in this Article 9.

 

6


  10)

If the Ceding Company is in breach of Article 9, Section 9, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty days’ prior written notice to the Ceding Company.

ARTICLE 10

RESERVES, REINSURANCE CREDIT

 

  1)

The Reinsurer shall provide to the Ceding Company acceptable forms of security to secure the Statutory Reserves corresponding to the Reinsurer’s Quota Share of the Policies reinsured pursuant to this Agreement and to provide full reinsurance reserve credit to the Ceding Company for the reinsurance hereunder. The Reinsurer’s obligation to provide acceptable forms of security shall be satisfied by holding assets in one or more credit for reinsurance trust accounts (pursuant to this Article 10). The Statutory Reserves shall be calculated on the basis set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  2)

MAINTENANCE OF THE RESERVE AND TRUST ACCOUNT.

 

  i.

The Ceding Company will provide to the Reinsurer a good faith written estimate of the Statutory Reserves (calculated in accordance with Annex 5 – Statutory Reserves & IBNR Calculation Methodology) by no later than the twentieth (20th) day of the last month of each calendar quarter for increase or decrease to the assets in the Trust Account and/or the Trusts Funds Withheld Account. If the Reinsurer disagrees with the estimated Statutory Reserves, it will within five (5) Business Days notify the Ceding Company. The Parties shall be expeditious and reasonable in resolving any such dispute; provided that despite any continuing dispute between the Parties with respect to the estimated statutory reserve amount, the Reinsurer shall provide for the increase/decrease of assets in the Trust Account and/or the Trusts Funds Withheld Account as of the relevant calendar quarter end to ensure sufficient reserve credit to the Ceding Company; provided, further, that any such provision of assets shall not be deemed a waiver or release of any rights of the Reinsurer with respect to any continuing dispute hereunder.

 

  ii.

The Ceding Company will provide to the Reinsurer a written notice of the actual Statutory Reserves as of each calendar quarter end no later than the twentieth (20th) Business Days following the end of such calendar quarter. The amount of security provided by the Reinsurer through Qualifying Assets held in the Trust Account and the Trust Funds Withheld Account shall be adjusted appropriately to reflect the actual Statutory Reserves as of such calendar quarter end. If any such adjustment necessitates a decrease in the amount of Qualifying Assets held in the Trust Account, then the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute Qualifying Assets equaling the amount of any such decrease to the Reinsurer, as the designee of the Ceding Company.

 

7


  3)

STATUTORY TRUST AGREEMENT.

 

  i.

The Ceding Company and the Reinsurer will enter into a statutory trust agreement in compliance with the credit for reinsurance laws and regulations of the State of Texas in connection with reinsurance ceded to an unauthorized reinsurer (the “Trust Agreement”) with a trustee (the “Trustee”) establishing a trust account for the sole benefit of the Ceding Company (the “Trust Account”). The Trustee shall be a qualified United States financial institution authorized to act as a fiduciary of a trust. The institution shall not be a parent, subsidiary or affiliate of the Ceding Company or the Reinsurer. The Reinsurer and the Ceding Company may enter into more than one such Trust Agreement for purposes of providing reinsurance reserve credit to the Ceding Company.

 

  4)

QUALIFYING ASSETS.

 

  i.

The Reinsurer shall arrange for assets to be deposited into the Trust Account. Prior to depositing non-cash assets with the Trustee, the Reinsurer shall execute assignments, endorsements in blank or transfer legal title to the Trustee or the Trustee’s nominee of all shares, obligations or any other assets requiring assignment in order that the Ceding Company or the Trustee, upon direction of the Ceding Company, may, whenever necessary, negotiate any such assets without consent or signature from the Reinsurer or any other person or entity in accordance with the terms of the Trust Agreement.

 

  ii.

Assets deposited in the Trust Account shall be valued according to their current fair market value. The Trust Account shall consist only of the following (“Qualifying Assets”): cash (United States legal tender), certificates of deposit (issued by a United States bank and payable in United States legal tender), and/or investments of the types permitted by the Texas Insurance Code; provided that such investments are issued by an institution that is not the parent, subsidiary or affiliate of either the Ceding Company or the Reinsurer.

 

  5)

DRAWING ON THE TRUST ACCOUNT.

 

  i.

Qualifying Assets in the Trust Account established hereunder may be withdrawn by the Ceding Company at any time, notwithstanding any other provision of this Agreement, and shall be utilized and applied by the Ceding Company or any successor in interest by operation of law, including, without limitation, any liquidator, rehabilitator, receiver or conservator of the Ceding Company, without diminution because of insolvency on the part of the Ceding Company or the Reinsurer, only for the following purposes:

 

  A.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of premiums returned, but not yet recovered from the Reinsurer, to the owners of Policies reinsured under this Agreement on account of cancellations of such Policies;

 

  B.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of surrenders and benefits or losses paid by the Ceding Company, but not yet recovered from the Reinsurer, pursuant to the provisions of the Policies reinsured under this Agreement;

 

8


  C.

In the event of notice of termination of the trust, to fund an account with the Ceding Company in an amount at least equal to the deduction, for reinsurance ceded, from the Ceding Company’s liabilities for the Policies reinsured hereunder. Such account shall include, but not be limited to, amounts for policy reserves, reserves for claims and losses incurred (including losses incurred but not reported), loss adjustment expenses and unearned premiums reserves; and

 

  D.

To pay the Ceding Company for the Reinsurer’s Quota Share of any other amounts that the Ceding Company claims are due under this Agreement.

 

  ii.

The Ceding Company shall return to the Trust Account or to the Reinsurer assets withdrawn in excess of the actual amounts required in Article 10, Section 5(i)(A)-(C), or, in the case of Article 10, Section 5(D), assets that are subsequently determined not to be due.

 

  iii.

Any assets withdrawn by the Ceding Company pursuant to Article 10, Section 5(i)(C) and any assets withdrawn from any Trust Account in excess of the actual amounts required for Article 10, Section 5(i)(A) and (B) or, in the case of Article 10, Section 5(i)(D), any amounts that are subsequently determined not to be due shall be held by the Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) in trust for the benefit of the Reinsurer, subject to the Ceding Company’s right to apply such assets to amounts due and payable by the Reinsurer to the Ceding Company under this Agreement, and shall at all times be maintained separate and apart from any assets of the Ceding Company in one or more designated funds withheld accounts (collectively the “Trust Funds Withheld Account”) for the sole purpose of funding the payments and reimbursements described in subsections (i), (ii) and (iv). The Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) shall ensure that any assets held in the Trust Funds Withheld Account pursuant to this Article 10, Section 5 consist of Qualifying Assets in accordance with its fiduciary obligations as trustee with respect to such amounts.

 

  iv.

For withdrawals by the Ceding Company pursuant to Article 10, Section 5(i)(C) and, with respect to Article 10, Section 5(i)(A), (B) and (D), in excess of the actual amounts applied to payment or reimbursement under such subsections, the Ceding Company shall pay interest in cash to the Reinsurer on the amount withdrawn at the then current prime rate as reported in the Federal Reserve Bulletin. Notwithstanding the foregoing, this Agreement permits the award, by any arbitration panel or court of competent jurisdiction, of:

 

9


  A.

Interest at a rate different from that provided in this paragraph,

 

  B.

Court or arbitration costs,

 

  C.

Attorney’s fees, and

 

  D.

Any other reasonable expenses.

 

  v.

At the Reinsurer’s request, and the approval of the Ceding Company, which shall not be unreasonably or arbitrarily withheld, the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute to the Reinsurer, as the designee of the Ceding Company, all or any part of the assets contained in the Trust Account, provided:

 

  A.

The Reinsurer shall, at the time of such withdrawal, replace the withdrawn assets with other Qualifying Assets having a market value equal to the market value of the assets withdrawn, so as to maintain at all times the Reinsurer’s Quota Share of the Statutory Reserves; or

 

  B.

After such withdrawals and transfers, the aggregate market value of the Qualifying Assets in the Trust Account shall be no less than [***]% of the Reinsurer’s Quota Share of the Statutory Reserves less the aggregate amount of assets held pursuant Article 10, Section 5 in the Trust Funds Withheld Account.

 

  vi.

After all payments have been discharged in full by the Reinsurer under the terms of this Agreement, the Ceding Company shall not unreasonably or arbitrarily withhold its approval to remit any remaining balance of funds in the Trust Account and Trust Funds Withheld Account to the Reinsurer.

 

  6)

This Article 10 shall survive termination of this Agreement.

ARTICLE 11

SUNSET CLAUSE

Notwithstanding Article 19 – Errors and Omissions of this Agreement, the Reinsurer shall not be liable for any claim which the Ceding Company has not reported within 24 months from the date upon which the Ceding Company knew or should reasonably have known of circumstances likely to give rise to a claim covered under this Agreement.

ARTICLE 12

PROFIT SHARING AND PARTIAL REIMBURSEMENT

 

  1)

This Article 12 sets forth the methodology for calculating the following potential annual payments: (i) a profit share payment from the Reinsurer to the Ceding Company, if the result of the Profit Sharing Formula equals a positive number, and (ii) a payment representing partial reimbursement of Reinsurance Claims, from the Ceding Company to the Reinsurer, if the result of the Partial Reimbursement Formula equals a positive number.

 

10


  2)

Formulas.

 

  i.

The following abbreviations, as used in the Profit Sharing Formula and the Partial Reimbursement Formula, have the respective meanings set forth below:

[***]

[***]

[***]

[***]

[***]

The values of C", F", and r, for any given Subscription Year, are as below, and as reflected in Annex 3 – Reinsurance Commissions & Profit Share Information:

 

     2017      2018      2019 and each
year thereafter
 

C (commissions (% of total Reinsurer Premium))

     [***      [***      [***

Broker Commission

     [***      [***      [***

F (Reinsurer fee (% of total Reinsurer Premium))

     [***      [***      [***

r (distribution rate)

     [***      [***      [***

 

11


  ii.

The “Profit Sharing Formula” is as set forth below:

[***]

[***]

[***]

 

  iii.

The “Partial Reimbursement Formula” is as set forth below:

 

[***]   [***]                    
  [***]

[***]

For the purposes of this Article 12, Section 2, “PR” means partial reimbursement and “PS” means profit sharing.

 

  3)

Within fifteen (15) Business Days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for the prior Subscription Year for this Agreement, using the available amounts of premiums, claims, risk adjustment, XOL premiums and claims and IBNR and in accordance with Annex 3 – Reinsurance Commissions & Profit Share Information, with each of the resulting amounts reduced by [***]% to arrive at the “Provisional Profit Share Amount” and the “Provisional Partial Reimbursement Amount”.

 

  4)

If such Provisional Profit Share Amount is a positive number, the Reinsurer shall pay to the Ceding Company the Provisional Profit Share Amount promptly following the calculation of the Provisional Profit Share Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  5)

If such Provisional Partial Reimbursement Amount is a positive number, the Ceding Company shall remit to the Reinsurer the Provisional Partial Reimbursement Amount promptly following the Ceding Company’s receipt of the calculation of the Provisional Partial Reimbursement Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  6)

Within fifteen (15) Business Days after the confirmation of the accounts for the fourth quarter of the year following the Subscription Year, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year for this Agreement, using the then-current amounts of premiums, claims, risk adjustment, XOL premiums, claims and IBNR and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. The Provisional Profit Share Amount shall be deducted from the Profit Sharing Formula result for such Subscription Year to arrive at the “Profit Sharing Adjustment”. The Provisional Partial Reimbursement Amount shall be deducted from the Partial Reimbursement Formula result to arrive at the “Partial Reimbursement Adjustment”.

 

12


  7)

If such Profit Share Adjustment is a positive number, the Reinsurer shall pay to the Ceding Company the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  8)

If such Profit Share Adjustment is a negative number, the Ceding Company shall pay to the Reinsurer the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  9)

If such Partial Reimbursement Adjustment is a positive number, the Ceding Company shall remit to the Reinsurer the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  10)

If such Partial Reimbursement Adjustment is a negative number, the Reinsurer shall remit to the Ceding Company the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  11)

The Ceding Company shall continue to provide the Reinsurer with quarterly accounts with respect to a given Subscription Year in accordance with Article 15 until the time of the first quarterly report that does not show any positive IBNR for such Subscription Year under this Agreement or any of the Companion Agreements. At such time, the Reinsurer shall deliver final calculations of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. For purposes of this Section, such terms shall be applied mutatis mutandis, except that references in Article 12, Section 6 to “Provisional Profit Share Amount” shall be understood to mean “Provisional Profit Share Amount plus any previously paid Profit Share Adjustment” and in Article 12, Section 6 “Provisional Partial Reimbursement Amount” shall be understood to mean “Provisional Partial Reimbursement Amount plus any previously paid Partial Reimbursement Adjustment”.

ARTICLE 13

FOLLOW THE FORTUNES

In proportion to the Reinsurer’s Quota Share the Reinsurer shall, subject to the terms and conditions of this Agreement, follow the fortunes of the Ceding Company in respect of risks which the Ceding Company has accepted under Policies covered under this Agreement.

ARTICLE 14

INFORMATION

The Ceding Company shall report to the Reinsurer all information in respect of the Policies as set out in Annex 4 – Data Reporting.

 

13


ARTICLE 15 ACCOUNTS

 

  1)

Within thirty (30) days after 31st March, 30th June, 30th September and 31st December of each year, the Ceding Company shall prepare and submit to the Reinsurer quarterly accounts showing the accounting items as specified in Annex 7 – Reinsurance Balance Calculation. For the avoidance of doubt, the quarterly account for any given Subscription Year shall continue to be submitted by the Ceding Company following the end of such Subscription Year for so long as there is still a positive amount of IBNR for such Subscription Year.

 

  2)

Accounts shall be confirmed by the Reinsurer within thirty (30) days upon receipt. This also applies if the confirmation can only be given for part of the accounts. Such partial confirmation shall also specify the objections to that part of the accounts on which confirmation cannot be given.

 

  3)

Any net balance of account, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Reinsurer shall be remitted by the Ceding Company promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts. Any balance, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Ceding Company shall be remitted by the Reinsurer promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts.

 

  4)

In case that confirmation can only be given for part of the accounts, the balance shall nevertheless be settled in full without delay. Should there be any items incorrect in or missing from a statement of account, such errors or omissions shall be corrected in the next statement of account, unless the discrepancy is material. In such a case, correction and settlement of the discrepancy shall be completed as promptly as possible.

 

  5)

If the balance is not paid in due time such outstanding balance shall accrue interest on late payment, calculated from the confirmation date due to the date of actual payment, at the interest rate equal to the greater of (i) [***] and (ii) [***] plus [***]. If for any reason such rate is no longer published in the Wall Street Journal, the Parties shall agree on a replacement index that most closely approximates such rate.

The Parties acknowledge and agree that settlement of all amounts due from one Party to another hereunder for the period covering the Effective Time to the date hereof shall be settled as part of the first quarterly settlement following the date hereof.

 

14


ARTICLE 16

CURRENCY

All payments made, all amounts advised and all accounts prepared by either Party in accordance with the terms of this Agreement shall be in U.S. Dollars, with all payments paid in cash via wire transfer to an account designated by the receiving Party.

ARTICLE 17

SET OFF

Any debits or credits incurred on and after the Effective Time in favor of or against either the Ceding Company or the Reinsurer with respect to this Agreement are deemed mutual debits or credits, as the case may be, and shall be set off and recouped, and only the net balance shall be allowed or paid. To the extent permitted by applicable law, this Article 17 shall apply notwithstanding the initiation or commencement of a liquidation, insolvency, rehabilitation, conservation, supervision or similar proceeding by or against the Ceding Company or the Reinsurer.

ARTICLE 18

RIGHT OF INSPECTION, COORDINATION

 

  1)

The Reinsurer shall have the right, at any time, to inspect, through any duly authorized person or entity named in advance, all papers, books, accounts, documents and other records referring to the business reinsured under this Agreement at the head office of the Ceding Company or at any other place mutually agreed upon during the Ceding Company’s normal business hours. Notification of such visits shall be given two (2) weeks in advance but in urgent cases at least forty- eight (48) hours in advance.

 

  2)

Upon request, the Ceding Company shall supply or cause to be supplied to the Reinsurer, at the Reinsurer’s expense, copies of the whole or any part of such papers, books, accounts, documents and ether records relating to the business covered under this Agreement. Notwithstanding a termination of this Agreement, the Reinsurer’s right of inspection under this Article 18 will continue until all of the Reinsurer’s obligations under this Agreement have been terminated or fully discharged.

 

  3)

For the avoidance of doubt, all rights of inspection and any records requested or disclosed under this Article 18 will be subject to Article 24.

 

  4)

The Reinsurer shall have full access to, and open lines of communications with, the senior management of the Ceding Company in connection with this Agreement. Each Party shall appoint an individual as its primary point of operational contact for the administration and operation of this Agreement. The Reinsurer hereby appoints #### to act as its primary point of operational contact (the “Reinsurer Manager”), who shall have overall responsibility for coordinating, on behalf of the Reinsurer, the performance of the Reinsurer’s obligations hereunder and acting as a day-to-day contact with the Ceding Company Manager (as defined below). The Ceding Company hereby appoints Bruce Gottlieb to act as its primary

 

15


  point of operational contact (the “Ceding Company Manager”), who shall have overall responsibility for coordinating, on behalf of the Ceding Company, the performance of the Ceding Company’s obligations hereunder and acting as a day- to-day contact with the Reinsurer Manager. Either Party may change its respective Manager hereunder by providing five (5) days advance written notice to the other Party, provided that at all times the Ceding Company Manager shall be a senior officer of the Ceding Company.

ARTICLE 19

ERRORS AND OMISSIONS

 

  1)

ln the event that any error, omission or delay should occur in connection with the performance of this Agreement, including any error or omission being reflected in the accounts, such error, omission or delay will not invalidate the rights and obligations of the Parties arising from this Agreement, even when this error or omission has been discovered after the settlement of the respective balance. Any errors and omissions shall be corrected by the Parties promptly upon discovery.

 

  2)

An error or omission is defined as an unintentional failure and the result of an innocent oversight or misunderstanding which needs to be demonstrated to the satisfaction of the Party not in default. Any unintentional failure and the result of an innocent oversight or misunderstanding which results from a faulty business organization or structure of a party is not considered to be an error or an omission for the purposes of this Article 19.

 

  3)

Any liability of the Reinsurer shall be subject to the Ceding Company neither having committed gross negligence and/or willful misconduct with respect to underwriting or claims assessment, but having complied with the usual business, insurance and reinsurance practices. Otherwise, the Reinsurer shall have the right to refuse its liability.

ARTICLE 20

ARBITRATION

 

  1)

If a dispute controversy or claim arises between the Parties in connection with or in relation to this Agreement, the Parties undertake in good faith to use all reasonable best efforts to settle such dispute by oral or written consent directly with each other.

 

  2)

Where the Parties are unable to reach agreement in accordance with Article 20, Section 1 above, any dispute, controversy or claim arising between the Parties in connection with or in relation to this Agreement, including formation and validity, and whether arising before or after termination of this Agreement, shall be referred to an arbitration tribunal in the manner set out below.

 

  i.

To initiate arbitration, either Party shall notify the other Party in writing of its desire to arbitrate. The notice shall identify the claimant, the contract at issue, and the nature of the claims and/or issues. The arbitration will be deemed to have been commenced on the date the notice of arbitration is received

 

16


  ii.

There will be three arbitrators who will each have no less than ten (10) years of insurance or industry experience, who are knowledgeable regarding reinsurance and who are active or retired executive officers of insurance or reinsurance companies. The arbitrators shall not be under the control of any Party, shall not have ever worked for or performed substantial services for either Party, nor shall any member of the panel have a financial interest in the outcome of the dispute. Within thirty (30) days following the commencement of the arbitration proceedings, each Party will provide the other with the identification of their appointed arbitrator, and provide a copy of the arbitrator’s curriculum vitae. If either Party refuses or neglects to appoint an arbitrator within thirty (30) days, the other Party may appoint the second arbitrator to act as the appointed arbitrator for the defaulting Party by providing notice and a copy of the arbitrator’s curriculum vitae. Each Party’s appointed arbitrator shall propose a candidate to serve as a third arbitrator (the “Umpire”), which shall be subject to the other Party’s agreement. In the event the two Party-appointed arbitrators fail to reach an agreement on an Umpire within sixty (60) days of their appointment, then either Party may petition ARIAS-U.S. to appoint the Umpire and each Party shall cooperate and take whatever action is required to give effect to the ARIAS-U.S. umpire appointment procedures. Notwithstanding the previous sentence, the Parties may agree on an alternative Umpire appointment procedure. In the event any arbitrator fails, refuses, or becomes unable to act as such before an award has been rendered, a successor shall be selected in the same manner as the original arbitrator.

 

  iii.

The three (3) arbitrators shall decide by majority. If no majority can be reached the opinion of the Umpire shall prevail. He shall also act as chairman of the tribunal and conduct the arbitration proceedings.

 

  iv.

In the event of the death of an arbitrator or if an arbitrator is unable to continue, another shall in such case be appointed in such arbitrator’s stead by the Party who made the original appointment. In the event of the death of the Umpire, or if the Umpire is unable to continue, the arbitrators shall agree upon the appointment of a new chairman within thirty (30) days in accordance with the procedures set forth above.

 

  3)

The arbitration tribunal shall have power to fix all procedural rules for the holding of the arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, investigation of facts, the disclosure and inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the arbitration and may receive and act upon such evidence, whether oral or written, strictly admissible or not, as it shall in its discretion think fit.

 

  4)

The cost of the arbitration shall be borne by the non-prevailing Party. If a Party prevails in part, then the other Party shall bear the cost to that extent. Each Party shall, however, bear the costs of its own legal representation and assistance. The amount of the cost of the arbitration shall be determined as agreed between the Parties and the arbitrators prior to the arbitration. The arbitration tribunal shall, as a part of its award, specifically state the cost of the arbitration and the manner of its payment.

 

17


  5)

The arbitration shall take place in New York, New York (USA) and the arbitration tribunal shall apply the law of the State of New York as the proper law of this Agreement. In addition, the arbitration tribunal shall observe the customs and practices of the reinsurance business.

 

  6)

The award of the arbitration tribunal shall be in writing and state the reasons upon which it is based. Judgment upon the award may be entered in any court having jurisdiction thereof. The award shall be final and binding and not subject to appeal. The Parties undertake to carry out the same without delay. If either of the Parties should fail to carry out any award, the other may apply for its enforcement to a court of relevant jurisdiction in any territory in which the Party in default is domiciled or has assets or carries on business.

 

  7)

The arbitrators may consolidate an arbitration under this Agreement with any arbitration arising under or relating to any of the Companion Agreements or any other agreement between the Parties entered into pursuant hereto, as the case may be, provided that the subject of the disputes thereunder arise out of or relate to the same or substantially similar set of facts or transactions. Such consolidated arbitration shall be determined by the arbitrator appointed for the arbitration proceeding that was commenced first in time.

 

  8)

Notwithstanding the foregoing, a matter regarding the failure of a Party to settle a confirmed and undisputed balance may be brought before a court of relevant jurisdiction.

 

  9)

This Article 20 shall survive termination of this Agreement.

ARTICLE 21

JURISDICTION - APPLICABLE LAW

 

  1)

EXCEPT AS OTHERWISE SET FORTH HEREIN, THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS, INCLUDING AS TO VALIDITY, INTERPRETATION AND EFFECT, BY THE LAWS OF THE STATE OF NEW YORK WITHOUT GIVING EFFECT TO ITS PRINCIPLES OR RULES OF CONFLICT OF LAWS, TO THE EXTENT SUCH PRINCIPLES OR RULES ARE NOT MANDATORILY APPLICABLE BY STATUTE AND WOULD PERMIT OR REQUIRE THE APPLICATION OF THE LAWS OF ANOTHER JURISDICTION.

 

  2)

The Reinsurer shall (i) submit itself to the jurisdiction of any arbitration panel or court of competent jurisdiction within New York in accordance with Article 20, and (ii) comply with all the requirements necessary to give such court or arbitration panel jurisdiction over the Reinsurer. Furthermore, the Reinsurer shall designate the Superintendent of Financial Services in the State of New York as its true and lawful attorney upon whom service of process may be effected within New York and simultaneous notification may, at the Reinsurer’s election, be provided to a designated attorney in the event any such service of process is effected. The Reinsurer agrees to abide by the final decision of the arbitration panel in accordance with Article 20.

 

  3)

This Article 21 shall survive termination of this Agreement.

 

18


ARTICLE 22

NORMAL TERMINATION

 

  1)

This Agreement may be terminated [***].

 

  2)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

  3)

Termination of this Agreement at the end of the Initial Term or any renewal term shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after the Agreement termination date because all Policies terminate on 31 December of the Subscription Year and any renewal of a ceded Policy after the Agreement termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December.

 

  4)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

ARTICLE 23

SPECIAL TERMINATION

 

  1)

Either Party affected by one of the events mentioned in Article 23, Section 3 below shall notify the other Party in writing within thirty (30) days after its occurrence. The termination to be effective at the end of such thirty (30) days period.

 

  2)

Except in respect of termination by the Reinsurer pursuant to Article 23, Section 3(viii) or for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv), termination of this Agreement in accordance with this Article 23 shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional new Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after 31 December of the Subscription Year and any renewal of a ceded Policy after the termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December).

 

19


  3)

This Agreement may be terminated at any time (including during the Initial Term) on a run-off basis (except as otherwise stated in paragraphs (iv) and (viii) below which shall be terminated on a cut-off basis) with respect to Policies issued prior to the applicable termination date by giving written notice to the other Party:

 

  i.

If the Ceding Company has become insolvent or is unable to pay its debts or has a Risk-Based Capital ratio of [***] of its Authorized Control Level Risk Based Capital (each term as defined in the insurance laws and regulations in the Ceding Company’s state of domicile) or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  ii.

If the Reinsurer has become insolvent or is unable to pay its debts or has lost [***] of its paid up capital or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  iii.

If the other Party ceases writing insurance and/or reinsurance and elects to run-off its existing business or if the performance of the whole or any part of this Agreement that materially affects the interests of either of the Parties is prohibited or rendered impossible de jure or de facto for a period exceeding ninety (90) days.

 

  iv.

If the other Party fails to fulfill its material obligations under this Agreement within two (2) months after being requested in writing to do so; provided, that this Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company if the Ceding Company fails to pay any Reinsurer Premium in accordance with Article 7, the Reinsurer notifies the Ceding Company in writing of such failure and such failure remains uncured five (5) days after such notice.

 

  v.

If the other Party merges with or becomes acquired or controlled by any company, corporation or individual(s) who did not control it directly or indirectly at the inception of this Agreement and if (i) such company’s, corporation’s, or individual(s)’ financial strength rating is below A- Standard & Poor’s or A- A.M. Best and/or (ii) if such company, corporation, or individual(s) is not rated.

 

  vi.

If the Reinsurer’s financial strength rating is downgraded below A- Standard & Poor’s or A- A.M. Best and/or the Reinsurer loses its rating.

 

  vii.

If the Party giving notice or the other Party is definitively prevented from performing its obligations under this Agreement because of a “force majeure” i.e. an event beyond the control of a Party, which could not reasonably have been foreseen at the time of the conclusion of this Agreement and whose effects cannot be avoided by appropriate measures. If the prevention is temporary, this Agreement may be terminated by either Party by notification to the other Party after ninety (90) days of non- performance due to a “force majeure”.

 

20


  viii.

This Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company pursuant to Article 6.

 

  ix.

If the Reinsurer terminates this Agreement pursuant to Article 9, Section 10 (with 30-day notice).

 

  x.

If the Reinsurer terminates this Agreement pursuant to Article 4, Section 2 (with 30-day notice).

 

  xi.

If the Reinsurer terminates this Agreement pursuant to Article 1, Section 4.

 

  xii.

If the Reinsurer terminates this Agreement pursuant to Article 29, Section 3.

 

  4)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

  5)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

 

  6)

If this Agreement is terminated in accordance with the terms of this Article 23, the Reinsurer Premium due to the Reinsurer to the termination date will be calculated pro rata temporis to the Reinsurer Premium payable in respect of the annual period during which the termination date falls. In the event this Agreement is terminated pursuant to Article 23, Section 3(iv) or Section 3(viii), all figures relating to the Ceding Company used in the calculations set forth in Article 12 shall be based only on the period in which the Agreement is in effect.

 

  7)

For the avoidance of doubt if this Agreement is terminated by the Reinsurer for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv) and Section 3(viii), the Reinsurer shall remain liable for covered losses incurred up to and including the date of the Ceding Company’s failure to pay such Reinsurer Premium under this Agreement, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement.

 

  8)

Additionally, if any Companion Agreement is terminated, the Reinsurer shall have the right to terminate this Agreement on 31 December of the termination year of the Companion Agreement (including during the Initial Term) in accordance with Article 23, Section 2 above.

 

  9)

If this Agreement is terminated by the Reinsurer pursuant to Article 23, Section 3(viii) and/or (iv), the Reinsurer shall remain liable for covered losses incurred up to and including the termination date thereunder, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement and this Agreement shall be terminated on a cut-off basis.

 

21


ARTICLE 24

CONFIDENTIALITY

 

  1)

The Parties agree that the Confidential Information constitutes confidential or proprietary information of the disclosing party unless expressly indicated otherwise by the disclosing party and the Parties agree that they shall only use the Confidential Information for the purposes of this Agreement.

 

  2)

Neither Party, except with the express prior written consent of the other, shall directly or indirectly, communicate, disclose or divulge to any third party any Confidential Information, subject always to compliance with all applicable Privacy and Security Laws. A “third party” is anyone other than the Parties or their subsidiaries, affiliates, parent company, employees, retrocessionaire, agents, subcontractors, representatives, auditors or other professional advisers. For purposes of this Agreement, “Privacy and Security Laws” means any applicable data privacy, data security, or data protection law or regulation in the United States of America, including, without limitation, Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations, including, without limitation, the amendments and associated regulations enacted and implemented pursuant to the Health Information Technology for Economic and Clinical Health Act (HIPAA).

 

  3)

Each Party shall use their best efforts to ensure that its respective employees, retrocessionaires, agents, subcontractors, representatives and auditors and other professional advisors, are fully informed of the provisions of this Article 27 and that they will be bound by the provisions of this Article 27 as if a signatory hereto.

 

  4)

Where disclosure is required by a court order or by an arbitrator or by a regulatory, legal or regulatory authority, such disclosures will not constitute a breach of confidentiality, provided always that the Party from whom such disclosure is requested shall immediately advise the other Party in order to allow each Party the opportunity to take such protective steps as may be appropriate.

 

  5)

Notwithstanding the foregoing, the Parties are not required to keep confidential Confidential Information which:

 

  i.

was publicly known prior to the time of disclosure by one Party to the other Party;

 

  ii.

has become publicly known and made generally available after disclosure to one Party through no fault of such Party;

 

  iii.

was already in the lawful possession of one Party at the time of the disclosure by the other Party;

 

  iv.

has been obtained by a Party from a third party lawfully in possession of such information and without a breach of such Party’s obligations of confidentiality; or

 

  v.

has been independently developed by one Party without use of or reference to other Party’s Confidential Information.

 

22


  6)

The foregoing exceptions shall not apply to Personal Data.

 

  7)

Each of the Parties agrees that the other shall be fully informed of any breach in these confidentiality provisions of which either Party becomes aware.

 

  8)

This Article 24 shall survive termination of this Agreement.

ARTICLE 25

SEVERABILITY, LAPSE

If any provision of this Agreement is determined to be invalid or unenforceable, such determination shall not affect or impair the validity or the enforceability of the remaining provisions of the Agreement. The invalid or unenforceable provision shall be construed by the Parties hereto in such manner that the economic aim originally pursued with this provision without being invalid or unenforceable can be reached as far as it is possible. This Article 25 shall survive termination of this Agreement.

ARTICLE 26

ENTIRE AGREEMENT, ASSIGNMENT

 

  1)

This Agreement sets forth the entire agreement between the Parties with respect to its subject matter. This Agreement replaces and supersedes all other prior written, oral or electronic communications and treaties of any kind relating to the subject matter of this Agreement.

 

  2)

Any amendment to this Agreement shall be made by addendum attached to this Agreement, embodying such amendments as may be agreed upon, and will be regarded as part of this Agreement and be equally binding. Notwithstanding the above, any amendment may also be made by issuing a revised and restated version of this Agreement. Any amendment shall be null and void unless made in writing and signed by both Parties hereto.

 

  3)

This Agreement shall be binding upon and inure to the benefit of the Parties and their respective successors, permitted assigns and legal representatives. Except as otherwise provided herein, neither this Agreement nor any right or obligation hereunder may be assigned or delegated by any Party (in whole or in part) to a third party without the prior written consent of the other Party hereto. Any purported assignment or delegation not in compliance with the provisions of this Agreement will be void ab initio and of no force or effect.

ARTICLE 27

UTMOST GOOD FAITH

This Agreement is governed by the principle of utmost good faith and was concluded on mutual trust leading the relationship between the Parties hereto as well as of usual insurance and reinsurance practice in terms of prudent and reasonable underwriting, claims assessment and administration.

 

23


ARTICLE 28

SANCTION CLAUSE

Neither the Reinsurer nor the Ceding Company shall be deemed to provide cover and neither the Reinsurer nor the Ceding Company shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose either the Reinsurer or the Ceding Company to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ARTICLE 29

ANTI BRIBERY

 

  1)

The parties acknowledge and agree that:

 

  i.

They are committed to prevent bribery; and

 

  ii.

They have implemented and will maintain within their organization policies to prevent any such actions by their officers, representatives, employees or any other third party acting on their behalf.

 

  2)

To the extent permitted by applicable law, each Party shall notify the other Party immediately upon becoming aware that an activity carried out in connection with this Agreement has or may have contravened this obligation or any applicable anti- bribery law or regulation.

 

  3)

Each party may terminate this Agreement on a run-off basis upon written notice—as of right and without any judicial authorization—if during the term of the Agreement the other Party is convicted of an act of bribery or fails to comply with any anti-bribery law or regulation even if not connected to this Agreement. To the extent permitted by applicable law, such Party shall indemnify the other Party, its officers, employees, affiliates, agents, subcontractors, or any other third party acting on its behalf, against any losses, liabilities, damages, costs (including legal fees) and expenses incurred related thereto.

ARTICLE 30

ANTI-MONEY LAUNDERING

 

  1)

The Reinsurer is not subject to anti-money laundering and counter-terrorist financing provisions. The Reinsurer will not however provide services to individuals or entities that are subject to assets freeze measures. The Ceding Company shall therefore apply any appropriate measure to fight against money laundering and terrorist financing, as defined by the FATF recommendations.

 

  2)

Pursuant to Article 30, Section 1 above and to the extent permitted by the applicable law, the Reinsurer may at any time request evidence from the Ceding Company as to its policyholders, the Policies, or any other matters connected thereto in the context of anti-money laundering and counter-terrorism financing.

 

24


ARTICLE 31

DATA PRIVACY

 

  1)

The Parties acknowledge and agree that they:

 

  i.

are committed to protect Personal Data in accordance with applicable law and regulation; and

 

  ii.

have implemented and will maintain within their organization policies and technical security measures preventing any such privacy breaches (e.g., of confidentiality) by their officers, representatives, employees or any other third party acting on their behalf.

 

  2)

Personal Data received by either the Reinsurer or the Ceding Company from the other shall not be:

 

  i.

used by the receiving party other than in connection with performing its obligations under this Agreement; or for the purpose of any retrocession arrangements; or

 

  ii.

commercially exploited by the receiving party; or

 

  iii.

transferred abroad without the Ceding Company having implemented appropriate safeguards in accordance with the applicable law and regulation;

 

  3)

In particular, without prejudice to the generality of the foregoing, the Ceding Company confirms that it has obtained and undertakes that it will obtain on a continuing basis all requisite consents from its policyholders both for its own compliance purposes, for the purposes of this Agreement and for the purposes of any facultative business and retrocession arrangements to be entered into by the Reinsurer.

 

  4)

To the extent permitted by the applicable law, each Party shall notify the other Party immediately upon becoming aware of privacy breaches related to Personal Data.

 

  5)

The Parties shall establish a Technical Committee consisting of an equal number of one (1) or more representative(s) of each of the Reinsurer and the Ceding Company, which shall meet on a quarterly basis to monitor the assessment and evolution of the ceded liabilities and risks.

 

  6)

This Article 31, Sections 1-4 shall survive termination of this Agreement.

ARTICLE 32

CORPORATE RESPONSIBILITY

 

  1)

The Parties acknowledges that the AXA Group adheres to certain principles designed to ensure that the AXA Group does business in a socially responsible manner by promoting sustainable development in its business through commitments towards its principal stakeholders (customers,

 

25


suppliers, employees, environment, shareholders and community) as more fully set forth in the AXA Compliance and Ethics Guide located at http://www.axa.com/en/governance/disclosure/ethics. The AXA Group encourages its suppliers to be socially and environmentally responsible. The AXA Compliance and Ethics Guide may be supplemented or amended at any time at the sole discretion of the Reinsurer. In the event of any change to the AXA Compliance and Ethics Guide, the Reinsurer shall promptly send the newly revised version to the Ceding Company.

 

  2)

In addition, as part of AXA Group’s principles and practices of sustainable development, the AXA Group requires its consultants to observe the following three main specific International Labour Organization (ILO) principles: (i) refrain from using, or accepting that their own suppliers and sub-contractors make use of child labour (under 15 years of age) or forced labour; (ii) ensure staff safe and healthy working conditions and environment, respecting individual and collective liberties; and (iii) promote non-discrimination (sex, race, religion or political conviction) as regards staff recruitment and management. For more information, see the ILO website: http://www.ilo.org/public/english/standards/index.htm

 

  3)

The Ceding Company agrees to use commercially reasonable efforts to comply with these standards. The Parties agree to negotiate in utmost good faith to resolve any dispute that may arise regarding the adequacy of such efforts. In the event such negotiations are not successful, such dispute shall be resolved in accordance with the terms of Articles 20 and 21.

 

  4)

In the event that either Party becomes aware that any of its business practices are contrary to the foregoing ILO principles, such Party agrees to use its commercially reasonable efforts to remedy the practice in question and notify the other Party of the correction it made. In the event the Party does not appropriately address the issue in question or if it commits subsequent violations, the other Party may as of right and without any prior formality to terminate this Agreement on a run-off basis for breach of this Article 32 without liability of any kind (other than payment of amounts due and owing pursuant to this Agreement in connection with a run-off termination).

ARTICLE 33

INSOLVENCY

 

  1)

In the event of a receivership, any amounts due to the Ceding Company under this Agreement shall be payable by the Reinsurer directly to the receiver, after reasonable provision for verification, on the basis of claims allowed against the insolvent Ceding Company by any court of competent jurisdiction having authority to allow such claims or allowed by the receiver as a result of the conclusion of the claim filing, approval and appeal process before the receiver. Regardless of any provision in this Agreement or other agreement to the contrary, payment shall be made without diminution because of such insolvency or because the receiver has failed to pay all or a portion of any claims.

 

26


  2)

The receiver of the Ceding Company shall give or arrange to give to the Reinsurer, written notice of the pendency of a claim against the Ceding Company, within a reasonable period of time after the initiation of the receivership. Failure to give such notice shall not excuse the obligation of the Reinsurer unless it is substantially prejudiced thereby. The Reinsurer may interpose, at its own expense, in the proceeding where such claim is to be adjudicated, any defense or defenses which it may deem available to the Ceding Company or its receiver. The reasonable expense thus incurred by the Reinsurer shall be payable, subject to court approval, out of the estate of the insolvent Ceding Company as part of the expense of the receivership to the extent of a proportionate share of the benefit which may accrue to the Ceding Company in receivership, solely as a result of the defense undertaken by the Reinsurer.

 

  3)

Payments by the Reinsurer shall be made directly to the receiver of the Ceding Company except where this Agreement specifically provides another payee for such reinsurance in the event of the insolvency of the Ceding Company.

ARTICLE 34

NOTICES, CONSTRUCTION, DEFINITIONS

 

  1)

All notices, requests and other communications to any party hereunder shall be in writing (including registered letter, facsimile transmission, electronic mail or any other means of communication that leaves a record of such communication) and shall be given:

 

  i.

if to the Ceding Company, to:

Oscar Insurance Corporation

295 Lafayette St.

6th Floor

New York, NY 10012

Attention: Legal

####

 

  ii.

if to the Reinsurer, to:

International Employee Benefits

AXA France

313, Terrasses de l’Arche, 92727 Nanterre Cedex, France

####

####

or such other address or facsimile number as such Party may hereafter specify for the purpose by notice to the other Parties hereto. All such notices, requests and other communications shall be deemed received on the date of receipt by the recipient thereof if received prior to 5:00 p.m. on a Business Day in the place of receipt. Otherwise, any such notice, request or communication shall be deemed to have been received on the next succeeding Business Day in the place of receipt.

 

27


  2)

Interpretation of this Agreement shall be governed by the following rules of construction: (a) words in the singular shall be held to include the plural and vice versa, and words of one gender shall be held to include the other gender as the context requires; (b) references to the terms Preamble, Recitals, Article, Section, paragraph, Annex, Schedule and Exhibit are references to the Preamble, Recitals, Articles, Sections, paragraphs, Annexes, Schedules and Exhibits to this Agreement unless otherwise specified; (c) references to “$” shall mean U.S. dollars; (d) the word “including” and words of similar import shall mean “including without limitation,” unless otherwise specified; (e) the word “or” shall not be exclusive; (f) the words “herein,” “hereof,” “hereunder” or “hereby” and similar terms are to be deemed to refer to this Agreement as a whole and not to any specific Section; (g) the headings are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement; (h) this Agreement shall be construed without regard to any presumption or rule requiring construction or interpretation against the party drafting or causing any instrument to be drafted; (i) if a word or phrase is defined, the other grammatical forms of such word or phrase have a corresponding meaning; (j) references to any statute, listing rule, rule, standard, regulation or other law include a reference to (A) the corresponding rules and regulations and (B) each of them as amended, modified, supplemented, consolidated, replaced or rewritten from time to time; (k) references to any section of any statute, listing rule, rule, standard, regulation or other law include any successor to such section; (l) references to any person or entity include such person’s or entity’s predecessors or successors, whether by merger, consolidation, amalgamation, reorganization or otherwise; and (m) references to any contract (including this Agreement) or organizational document are to the contract or organizational document as amended, modified, supplemented or replaced from time to time, unless otherwise stated.

 

  3)

For purposes of this Agreement, in addition to other terms operationally defined herein, the following terms have the respective meanings set forth below:

 

  i.

ACA Fees” means any “health insurer provider” or similar fee imposed by any governmental authority in connection with the Patient Protection and Affordable Care Act (“ACA”), including under Section 9010 thereof and including any assessments or fees imposed by any governmental authority of any state or other jurisdiction in connection with the existence or operation of, or participation in, any health insurance exchange or marketplace of such state or jurisdiction, or any other similar fee imposed under any other applicable law.

 

  ii.

Agreement” has the definition set forth in the Preamble.

 

  iii.

Annual Business Update” has the definition set forth in Article 1, Section 4.

 

  iv.

ARIAS-U.S.” means the AIDA Reinsurance and Insurance Arbitration Society.

 

  v.

AXA Group” means the group of companies to which the Reinsurer is affiliated.

 

  vi.

Business Day” means any day other than a Saturday, a Sunday or any other day on which banking institutions in New York City or in France are required or authorized by applicable law to be closed. Any reference herein to a day that is not a Business Day shall be deemed to be a calendar day.

 

28


  vii.

Ceding Company” has the definition set forth in the Preamble.

 

  viii.

Ceding Company Manager” has the definition set forth in Article 18, Section 4.

 

  ix.

Companion Agreements” has the definition set forth in Article 5, Section 3.

 

  x.

Confidential Information” means the information, data, analyses, studies, statements, representations and any other materials provided by the Ceding Company or the Reinsurer to the other in connection with the placement of and the course of performance under this Agreement.

 

  xi.

Consolidated MLR” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xii.

Cut-off” means that the Ceding Company shall relieve the Reinsurer of all liability hereunder for claims incurred after the date of termination of the Agreement. In case of cut-off termination, the Reinsurer shall refund to the Ceding Company the part of the Premium paid to the Reinsurer applicable to the unexpired liability on Policies in force.

 

  xiii.

Effective Time” has the definition set forth in Article 2, Section 1.

 

  xiv.

Extra-Contractual Obligations” has the definition set forth in Article 9, Section 8.

 

  xv.

FATF” means the Financial Action Task Force (on Money Laundering).

 

  xvi.

IBNR” means reserves for claims incurred but not reported.

 

  xvii.

Initial Term” has the definition set forth in Article 2, Section 1.

 

  xviii.

Insurance Companies” means collectively, the Ceding Company and each party to a Companion Agreement, excluding the Reinsurer.

 

  xix.

Medical Loss Ratio” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xx.

Net Reinsurance Premium” has the definition set forth in Article 7, Section 2.

 

  xxi.

“Party” or “Parties” has the definition set forth in the Preamble.

 

  xxii.

Partial Reimbursement Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxiii.

Partial Reimbursement Formula” has the definition set forth in Article 12, Section 2(iii).

 

29


  xxiv.

Personal Data” means and includes any of the following information that is acquired by, provided to, created by or maintained by a Party or any third party acting on behalf of a Party in connection with this Agreement: (i) any information that identifies or can reasonably be used to identify an individual, such as first and last name, social security number or other government issued number or identifier, date of birth, home or other physical address, e-mail address or other online contact information, financial account number, credit or debit card number, biometric data, mother’s maiden name, or other personally identifiable information; and (ii) personally identifiable financial or insurance information, including but not limited to “non-public personal information” as that term is defined in the Gramm-Leach-Bliley Act, as amended, and implementing regulations, 15 U.S.C. § 6809(4).

 

  xxv.

Policies” has the definition set forth in Article 1, Section 1.

 

  xxvi.

Policies Documentation” has the definition set forth in Article 1, Section 3.

 

  xxvii.

Privacy and Security Laws” has the definition set forth in Article 24, Section 2.

 

  xxviii.

“Profit Sharing Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxix.

“Profit Sharing Formula” has the definition set forth in Article 12, Section 2(ii).

 

  xxx.

Provisional Partial Reimbursement Amount” has the definition set forth in Article 12, Section 3.

 

  xxxi.

Provisional Profit Share Amount” has the definition set forth in Article 12, Section 3.

 

  xxxii.

Qualifying Assets” has the definition set forth in Article 10, Section 4(ii).

 

  xxxiii.

Reinsurance Claim” has the definition set forth in Article 9, Section 1.

 

  xxxiv.

Reinsurer” has the definition set forth in the Preamble.

 

  xxxv.

Reinsurer Manager” has the definition set forth in Article 18, Section 4.

 

  xxxvi.

Reinsurer Premium” has the definition set forth in Article 7, Section 1.

 

  xxxvii.

Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2017 and [***]% for any Subscription Year subsequent to Subscription Year 2017.

 

  xxxviii.

Statutory Reserves” means, as of the date of determination, the aggregate amount of reserves of the Ceding Company in respect of the Policies calculated in accordance with statutory accounting practices prescribed or permitted by the insurance regulator in the Ceding Company’s state of domicile and determined in accordance with the methodology set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

30


  xxxix.

Subscription Year” means a calendar year during which Policies are issued.

 

  xl.

third party” has the definition set forth in Article 24, Section 2.

 

  xli.

Trust Account” has the definition set forth in Article 10, Section 3(i).

 

  xlii.

Trust Agreement” has the definition set forth in Article 10, Section 3(i).

 

  xliii.

Trust Funds Withheld Account” has the definition set forth in Article 10, Section 5(iii).

 

  xliv.

Trustee” has the definition set forth in Article 10, Section 3(i).

 

  xlv.

Umpire” has the definition set forth in Article 20, Section 2(ii).

 

  xlvi.

XOL” has the definition set forth in Article 7, Section 2.

 

  4)

This Article 34 shall survive termination of this Agreement.

[Reminder of page intentionally left blank. Signature page to follow.]

 

31


In witness whereof, the Parties hereto by their respective duly authorized representatives have executed this Agreement in duplicate for and on behalf of:

The Ceding Company

Date and place:

December 21, 2017 New York, NY

Signature: /s/ Mario Schlosser

By: Mario Schlosser                                             

Title: CEO

The Reinsurer

Date and place:

December 21, 2017 Nanterre, France

Signature: /s/ Jacques de Peretti

By: Jacques de Peretti                                         

Title: CEO

[Signature Page to Reinsurance Treaty- Oscar Insurance Company of Texas]


ANNEX 1 – SCOPE

Policies Covered

This Agreement applies to all individual health insurance policies corresponding to the Policy Documentation and issued or renewed by the Ceding Company in the State of Texas providing coverage commencing on January 1, 2017 or thereafter, and with a period of insurance expiring on 31 December. The Policies ceded under this Agreement are only those in effect as of October 1, 2017 or issued or renewed between October 1, 2017 and the date of termination of this Agreement. The Parties acknowledge and agree that the Policies included on this Annex 1 will be subject to modification by the Ceding Company, per and in accordance with the provisions of this Agreement, each Subscription Year to reflect the product offerings and other modifications for the applicable Subscription Year.

2017 Policies:

 

   

Oscar Simple Secure

 

   

Oscar Saver Bronze

 

   

Oscar Classic Bronze

 

   

Oscar Simple Silver

 

   

Oscar Classic Silver

 

   

Oscar Saver Silver

 

   

Oscar Simple Gold

 

   

Oscar Classic Gold

Policy Documentation:

Copies of current and accurate Policy Documentation shall be copied on a CD ROM that will be agreed as final by both Parties.


ANNEX 2 – TERRITORIAL SCOPE

This Agreement shall only apply to Policies issued by the Ceding Company in [***] rating regions [***] or any successor regions to [***] rating regions [***] to insureds having their principal residence in those territories.


ANNEX 3 - REINSURANCE COMMISSIONS & PROFIT SHARE INFORMATION

[***]


ANNEX 4 – DATA REPORTING

Monthly reporting dashboards:

 

  -

Portfolio : number of policies/persons by month covered by global/ metal/state

 

  -

Portfolio distribution (per gender/age) by global/metal/state

 

  -

Premiums by month global / per metal / per state

 

  -

Claims (split by % of reserves and paid by global/ metal/ state) (IBNR global / metal / state) (by month of occurrence)

 

  -

Claims by benefits category split by global/ metal / state

 

  o

Inpatient hospital

 

  o

Outpatient hospital

 

  o

Professional

 

  o

Other medical

 

  o

Capitation

 

  o

Prescriptiondrug

 

  -

MLR by global / state / metal (current year, and n-1 year)

Risk adjustment estimate

Quarterly Basis

 

  -

Cash flows (quarterly basis)

On a bi-yearly basis (according to regulatory possibilities)

Anonymized data set

 

  -

Information about the insureds (biometrical & contract related data): age (birthdate), gender, state & address, subscription date, premium paid.

Information about claims: customer paths, medical facilities used, hospitalization (length/costs), details about professional, other medical, prescription drug, fraud


ANNEX 5 – STATUTORY RESERVES & IBNR CALCULATION METHODOLOGY

Statutory reserves include:

 

   

Incurred but not reported claims (IBNR)

 

   

Claims in course of settlement

 

   

Claims due and unpaid

 

   

Reserve margin

Actuarial Process Narrative

The Ceding Company’s current reserves processes include monthly valuations for all actuarial liabilities based on models developed in-house incorporating the most current views of the claim data available from our data warehouse.

Reserves:

The In-house reserve model incorporates different methodologies based on the amount and recency of the claim. The completion factor development method is utilized for claims under $[***] and is supplemented by the incurred claim methodology for the most recent incurral months. A seriatim methodology is utilized for claims over $[***], supplemented by case management data supplied by our medical and claims operations areas. Claims reserve triangle analytical cohorts are segmented by metallic level within a given state and region, and all reserves are determined separately incorporating the current inventory of claims in course of settlement. The reserve model incorporates historical reserve testing and detail on prior period development down to the incurral month. Reserves accrued are best-estimates with an explicit margin for adverse deviation as well as an accrual for unpaid claim adjustment expenses. All margins are reviewed at least annually for appropriateness based on historical run-out. Claims reserve triangles are inclusive of medical and behavioral health claims only. Pharmacy claims are analyzed separately and assumed to not have any run-out.


ANNEX 6 – CURRENT YEAR AND CONSOLIDATED MEDICAL LOSS RATIO FORMULAS

Medical Loss Ratio Definition

All claims and premiums refer to the current Subscription Year

Numerator: [***]

Denominator: [***]

Consolidated MLR Definition

Numerator: [***]

Denominator: [***]


ANNEX 7 – REINSURANCE BALANCE CALCULATION

 

(1)

Income: quota share of:

[***]

[***]

[***]

[***]

[***]

[***]

= Net Reinsurance Premium

 

(2)

Outgo: quota share of:

[***]

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

 

(3)

[***]

 

(4)

[***]

 

(5)

[***]

 

(6)

[***]

Technical result (for information) = (1) - (2) + (4) - (3) + (6) - (5)


ANNEX 8 – LIMITATION OF LIABILITY CALCULATION

State A – [***]

 

State A

   State B     State C     Ceding Company     Total  

Gross Premiums

     [***     [***     [***     [***     [***

Gross Claims

     [***     [***     [***     [***     [***

MLR

     [***     [***     [***     [***     [***

Ceded Premiums

     [***     [***     [***     [***     [***

Ceded Claims

     [***     [***     [***     [***     [***

AXA Ceded MLR

     [***     [***     [***     [***     [***

Retained Premiums

     [***     [***     [***     [***     [***

Retained Claims

     [***     [***     [***     [***     [***
     Ceded Claims Calculation              

Claims Ceded (up to local attachment point)

     [***     [***     [***     [***     [***

Claims Ceded (above local attachment point)

     [***     [***     [***     [***     [***

Allocation of Claims Retained

     [***     [***     [***     [***     [***

Total Claims

     [***     [***     [***     [***     [***

Exhibit 10.33

ENDORSEMENT NO. 1 TO QUOTA SHARE REINSURANCE AGREEMENT

The parties to this Quota Share Reinsurance Agreement (“Agreement”) hereby mutually agree this Endorsement No. 1, effective January 1, 2020:

WHEREAS, the parties mutually agreed the terms of the Agreement effective                 , 2019; and

WHEREAS, with effect from January 1 of 2020, the second underwriting year under the Agreement, the parties have agreed that Reinsurer’s affiliate, Berkshire Hathaway Specialty Insurance Company, shall be the reinsurer under this Agreement;

NOW, THEREFORE, the parties mutually agree as follows:

 

  1.

With effect from January 1, 2020, National Indemnity Company shall be replaced as reinsurer by its affiliate, Berkshire Hathaway Specialty Insurance Company;

 

  2.

The results of the 2020 and prior and subsequent underwriting years, if any, shall be combined for purposes of evaluating and applying any margin sensitive or similar Agreement provisions under all underwriting years’;

 

  3.

All other terms and conditions remain unchanged.

WHEREFOR, the parties have executed this Endorsement by their duly authorized representatives.

Oscar Insurance Company of Florida

 

By:   /s/ Cornelia Miller
Title:   Director of Strategic Finance

 

NATIONAL INDEMNITY COMPANY
By:   /s/ Brian Snover
Title:   VP

 

BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY
By:   /s/ Brian Snover
Title:   VP


CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE

REGISTRANT IF PUBLICLY DISCLOSED.

QUOTA SHARE REINSURANCE AGREEMENT

This Quota Share Reinsurance Agreement (the “Agreement”), effective as of the Coinsurance Effective Date, is made and entered into by and between Oscar Insurance Company of Florida, a Florida domiciled insurance company (the “Reinsured”), and National Indemnity Company, a Nebraska domiciled insurance company (the “Reinsurer”) (the Reinsured and the Reinsurer each individually, a “Party”, and collectively, the “Parties”).

RECITALS

WHEREAS, the Reinsured is, among other things, engaged in the business of underwriting, marketing, selling, issuing, renewing and servicing commercial health insurance products for individuals and small employers;

WHEREAS, the Reinsurer, among other things, is authorized under Applicable Law to assume reinsurance of such commercial health insurance products;

WHEREAS, the Reinsured desires to cede on a [***] indemnity quota share reinsurance basis to the Reinsurer, as of the Coinsurance Effective Date (as defined below), all of the commercial health insurance products for individuals and small employers that it writes in the United States (the “Subject Business”), subject to the terms and conditions stated herein;

WHEREAS, the Reinsurer desires to reinsure on such basis the Subject Business; and

WHEREAS, this Agreement is an agreement solely between the Reinsured and the Reinsurer and performance of the obligations of each Party under this Agreement will be rendered solely to the other Party.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the Parties hereby agree as follows:

ARTICLE I [***] QUOTA SHARE REINSURANCE OF SUBJECT BUSINESS

The reinsurance provided by the Reinsurer under this Agreement is in respect of all policies of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or after the Coinsurance Effective Date, through the Agreement Period, and on or prior to the Termination Date (as such terms are defined below) on the following basis:

 

  (i)

For calendar year 2019:

 

  (a)

In respect of all policies of the Subject Business written by the Reinsured that is not subject to the AXA quota share reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring AXA Ceded Reinsurance”) and the Odyssey Re excess of loss reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring Ceded Odyssey Re XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis; and


  (b)

In respect of all policies of the Subject Business written by the Reinsured that is subject to the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable, in each case, for calendar year 2019, the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable.

 

  (ii)

For calendar year 2020 and, if applicable, the remainder of the Agreement Period:

In respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020 and, if applicable, the remainder of the Agreement Period 1 that may be entered into from time to time with the Reinsured, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Other Inuring Ceded XOL Reinsurance.

For the avoidance of doubt, the Inuring Ceded Odyssey Re XOL Reinsurance for calendar year 2019, and the Other Inuring Ceded XOL Reinsurance for calendar year 2020 and, if applicable, the remainder of the Agreement Period, shall each be maintained by the Reinsured during its applicable calendar year period, as specified immediately above in this ARTICLE I, and shall be deemed, for purposes of this Agreement, as inuring to this Agreement and the reinsurance being provided hereunder by the Reinsurer during its applicable calendar year period specified above.

ARTICLE II AGREEMENT PERIOD

The reinsurance provided by the Reinsurer under this Agreement covers the Subject Business during the time period commencing at 12:01 AM Eastern Time on January 1, 2019 (the “Coinsurance Effective Date”) and terminating at 12:00 AM (midnight) Eastern Time on December 31, 2020 (such period, the “Initial Agreement Period”). The Initial Agreement Period, together with any extensions thereof, if any, by the Reinsurer as provided in this ARTICLE II, shall be referred to hereafter as the “Agreement Period”. Except as provided in ARTICLE XXX, this Agreement cannot be terminated during the Agreement Period by either Party. The Initial Agreement Period shall be subject to the following unilateral right of the Reinsurer to extend it: the Reinsurer has the right, but not the obligation, to choose, by providing the Reinsured with prior

 

 

1 

Note to Draft: This is to pick up any extension period of the Agreement Period by the Reinsurer.

 

2


written notice no later than ten (10) days prior to the expiration of the then current Agreement Period, to extend the Agreement Period for an additional one (1) year period should the Reinsurer not have realized a [***]% margin on its quota share participation in this Agreement at any time prior to the expiration of the then current Agreement Period, as set forth in ARTICLE VII hereof.

ARTICLE III TERRITORIAL SCOPE

The territorial scope of this Agreement shall be wherever in the United States the Reinsured issues the Subject Business.

ARTICLE IV REINSURANCE PREMIUM AND CEDING COMMISSION

In consideration of the reinsurance provided by the Reinsurer under this Agreement, the Reinsured shall pay to the Reinsurer its quota share participation in all Premiums received by the Reinsured in connection with the Subject Business which shall be payable to the Reinsurer in cash in accordance with ARTICLE XIII. The only deduction allowable from the Reinsurer’s quota share participation in the Premiums shall be a [***]% ceding commission payable by the Reinsurer to the Reinsured (the “Ceding Commission”).

ARTICLE V PREMIUM ADJUSTMENTS

The Reinsurer’s quota share participation in all Premiums, which Premiums were received by the Reinsurer, that are required to be refunded, rebated or otherwise repaid by the Reinsured to a Policyholder or Governmental Authority due to, (i) changes in or cancellations of any policy of the Subject Business, (ii) contractual requirements under the terms of the policies of the Subject Business, or (iii) Applicable Law including the ACA Risk Adjustment Program, and any such refunds, rebates or payments resulting from (x) a finding in a commercial risk adjustment audit by any federal Governmental Authority or a self-audit performed by the Reinsured that the Premiums were incorrect, and (y) any ACA Rebates (to the extent such rebates are related to the policies of the Subject Business, as solely determined by the Reinsured) (paragraphs (i), (ii), and (iii) of this ARTICLE V, collectively, the “Premium Adjustments”), shall be refunded by the Reinsurer to the Reinsured in accordance with ARTICLE XIII. The Parties shall promptly make all necessary financial adjustments between them with respect to the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin necessitated by any such Premium Adjustments in a manner consistent with the terms herein.

This ARTICLE V will survive the termination or expiration of this Agreement.

ARTICLE VI MAXIMUM COMBINED RATIO

Under no circumstances whatsoever, howsoever arising, will the Reinsurer be liable for any sums in excess of a combined ratio of Ultimate Net Loss to the Reinsurer’s quota share participation in the Premiums actually received by the Reinsurer (i.e., after deducting the Ceding Commission from such Premiums) of [***]% in the aggregate during any calendar year period (the “Maximum Combined Ratio”), For the avoidance of doubt, any Ceding Commission paid to the Reinsured or other deductions from the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder shall be first deducted from such ceded Premiums in calculating the Maximum Combined Ratio, [***].

 

3


ARTICLE VII PROFIT COMMISSION

Reinsured shall be paid a profit commission by the Reinsurer in an amount equal to any profit resulting from this Agreement from a [***]% or better combined ratio during any calendar year period (the “Profit Commission”) (i.e., the Reinsurer shall retain a margin of [***]% (the “Reinsurer’s Margin”)). Payment to the Reinsured of the Profit Commission shall be made in accordance with ARTICLE XIII.

ARTICLE VIII DEFINITIONS

In this Agreement, (i) the singular includes the plural, and the plural the singular; (ii) words importing any gender include the other gender; (iii) the words “including”, “includes” and “include” will be deemed to be followed by the words “without limitation” (where “including”, “includes”, and “include” are not followed by “without limitation”); and (iv) when a reference is made in this Agreement to an article or a section, exhibit, or schedule, such reference will be to an article or a section of, or an exhibit or schedule to, this Agreement, unless otherwise indicated. Any agreement, instrument, statute or regulation defined or referenced to herein or in any agreement or instrument that is referred to herein means such agreement, instrument, statute or regulation as from time to time amended, modified or supplemented, including (in the case of agreements or instruments) by waiver or consent and (in the case of statutes or regulations) by succession of comparable successor statutes. References to any Person include the successors and permitted assigns of such Person. References from or through any date mean, unless otherwise specified, from and including or through and including, respectively. The following terms will have the respective meanings set forth below throughout this Agreement.

(A) The term “ACA” shall mean the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 and its implementing regulations and any written and published or released sub-regulatory guidance.

(B) The term “ACA Rebate” shall mean any rebate required by Section 2718 of ACA.

(C) The term “ACA Risk Adjustment Program” shall mean any mandatory state or federal risk adjustment program created pursuant to Section 1343 of ACA.

(D) The term “Allocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest accrued prior to judgment where such interest is not added to the judgment, and interest accrued after judgment, which are actually paid by the Reinsured (excluding salaries of officers and permanent employees of the Reinsured) in connection with any investigation, adjustment, defense, resistance to, compromise, settlement, or negotiations that are allocated to a specific loss occurrence with respect to a policy of the Subject Business for which reimbursement is due the Reinsured under this Agreement. Allocated Loss Adjustment Expenses shall be apportioned in proportion to the respective Parties’ quota share participation under this Agreement, as finally determined by the Parties. All costs and expenses that are not Allocated Loss Adjustment Expenses shall be Unallocated Loss Adjustment Expenses.

 

4


The Allocated Loss Adjustment Expenses shall be a part of, and included in, the Ultimate Net Loss.

(E) The term “Applicable Interest Rate” shall mean as of any date of determination, a rate of interest equal to the three (3) month U.S. Treasury Note, as published in the Wall Street Journal on such date, [***].

(F) The term “Applicable Law” shall mean any domestic or foreign federal, state or local statute, law, ordinance or code, or any rules, regulations, administrative interpretations or orders issued by any Governmental Authority pursuant to any of the foregoing, and any order, writ, injunction, directive, judgment or decree of a court of competent jurisdiction, in each case solely to the extent applicable to the Parties hereto or the performance of their respective obligations under this Agreement.

(G) The term “Business Day” shall mean any day other than a Saturday, Sunday or other day on which commercial banks in the then current state of domicile of either Party are required or authorized by law to be closed.

(H) The term “Change in Control” shall mean a transaction or series of related transactions for the acquisition by one or more Persons that are not affiliates of the Reinsured of more than 50% of the outstanding common stock of the Reinsured.

(I) The term “Claim” shall mean with respect to each individual policy of the Subject Business, any and all claims, requests, demands or notices made by or on behalf of any Policyholder or any other Person for the payment of benefits under the policy including return of Premiums or any other payments or benefits due or alleged to be due under or in connection with any policy of the Subject Business including interest payable thereon in accordance with Applicable Law.

(J) The term “Governmental Authority” shall mean any domestic government, any national, state or other political subdivision thereof or any self-regulatory authority, and any entity exercising executive, legislative, judicial, regulatory or administrative functions of or pertaining to government.

(K) The term “Person” shall mean any natural person, corporation, partnership, joint venture, limited liability company, association, trust, unincorporated organization or other legal entity.

(L) The term “Policyholders” shall mean policyholders, insureds, beneficiaries, subscribers, members, certificate holders and assignees, and eligible dependents of each of the foregoing, under policies of the Subject Business.

(M) The terms “Premiums” shall mean all premiums, fees and contributions received by the Reinsured in connection with the issuance of the policies of the Subject Business, net of such amounts paid or payable by the Reinsured under the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, as applicable, and subject, in each case, to Premium Adjustments.

 

5


(N) The term “Ultimate Net Loss” shall mean the sum which is payable or has in fact been paid in cash by the Reinsurer to the Reinsured for Claims under the policies of the Subject Business after making deductions for all recoveries, all salvages, and all claims upon the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, in each case, to the extent applicable, whether collected or not from the reinsurers thereunder. Ultimate Net Loss shall include Allocated Loss Adjustment Expenses. Ultimate Net Loss shall not include any Unallocated Loss Adjustment Expenses. All salvages, recoveries and payments recovered or received subsequent to reimbursement to the Reinsured of Ultimate Net Loss by the Reinsurer under this Agreement shall be regarded as if recovered or received prior to said reimbursement and all necessary adjustments shall be undertaken by the Parties hereto. Nothing, however, in this paragraph (N) of this ARTICLE VIII shall be construed to mean that Ultimate Net Losses are not reimbursable from the Reinsurer until the Ultimate Net Loss has been determined.

(0) The term “Unallocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest that are not allocated to a specific loss occurrence with respect to a policy of the Subject Business. Unallocated Loss Adjustment Expenses shall also include salaries of officers and permanent employees of the Reinsured.

(P) The term “United States” shall mean the United States of America, including all of its states, the District of Columbia, its territories, possessions and commonwealths.

ARTICLE IX INTERLOCKING

It is understood and mutually agreed as between the Reinsurer, on the one hand, and the Reinsured and its insurance-issuing affiliates on the other hand, the list of all such entities being, as of the Coinsurance Effective Date: Oscar Insurance Corporation, Oscar Garden State Insurance Corporation, Oscar Insurance Company, Oscar Health Plan of California, Oscar Buckeye State Insurance Corporation, Oscar Insurance Company of Florida, and Oscar Health Plan, Inc. (each, an “Oscar Reinsured”), that: (i) each and every one of the Oscar Reinsureds is a reinsured under a separate quota share reinsurance agreement issued by the Reinsurer that is identical to this Agreement with respect to all of the economic terms and conditions included herein; (ii) all such quota share reinsurance agreements shall be interlocked and applied in the aggregate as between the Reinsurer and the Oscar Reinsureds for all economic purposes hereunder and thereunder, including with respect to the determination by the Parties of the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin, such that the economic results of all such quota share reinsurance agreements for such purposes shall be aggregated and applied as though all Oscar Reinsureds were subject to one and the same quota share reinsurance agreement; and (iii) all Oscar Reinsureds jointly appoint each other as agent and representative of the others so that communications, negotiations, accommodations and agreements as between the Reinsurer and any Oscar Reinsured shall bind all Oscar Reinsureds to the extent and for so long as they remain affiliates, unless expressly stated otherwise.

 

6


ARTICLE X SUBROGATION AND SALVAGE

(A) The Reinsurer shall be subrogated, as respects any Ultimate Net Loss for which the Reinsurer shall actually pay or become liable to pay, but only to the extent of the amount of payment by, or the amount of liability of, the Reinsurer, to all rights of the Reinsured against any Person who may be legally responsible in damages for said Ultimate Net Loss. The Reinsured hereby agrees to use commercially reasonable efforts to enforce such rights. In the event the Reinsured shall fail or neglect to do so, the Reinsurer is hereby authorized and empowered to bring any commercially reasonable appropriate action in the name of the Reinsured or in the name of a Policyholder under an insurance policy of the Subject Business reinsured hereunder to enforce such rights.

(B) Any rights of subrogation, recoveries, salvages or reimbursements applying to loss occurrences reinsured under this Agreement shall always be used to reimburse the reinsurers excess of the Reinsurer (from the last to the first, beginning with the reinsurer of the last excess) according to their participation, before being used in any way to reimburse the Reinsurer. The Reinsured shall recover for the retention from recoveries, salvages or reimbursements only after the Reinsurer has been reimbursed in full for its Ultimate Net Loss reimbursement payment. In determining the amount of recoveries, salvages or reimbursements, there shall first be deducted from any amount recovered the expenses incurred in effecting the recovery (excluding salaries and expenses of officers and employees of the Reinsured).

(C) All salvages, recoveries or reimbursements, after deduction of all expenses allowed under paragraph (B) of this ARTICLE X applicable thereto, recovered or received subsequent to an Ultimate Net Loss reimbursement to the Reinsured by the Reinsurer under this Agreement shall be applied as if recovered or received prior to the aforesaid settlement and all necessary adjustments shall be made by the Parties hereto; provided that nothing in this ARTICLE X shall be construed to mean that Ultimate Net Losses under this Agreement are not recoverable until all salvage, recovery and reimbursement has been determined.

ARTICLE XI INURING THIRD PARTY CEDED REINSURANCE

The amount of the Reinsurer’s liability in respect of any Ultimate Net Loss shall not be increased by the inability of the Reinsured to collect from any other reinsurer(s), whether specific or general, any amounts which may have become due from them regardless of whether such inability arises from the insolvency of such other reinsurers or for any other reason whatsoever.

ARTICLE XII CURRENCY

Wherever the word “Dollars” of the symbol “.$.” appears in this Agreement, it shall mean United States dollars. All payments under this Agreement shall be made in Dollars.

 

7


ARTICLE XIII REPORTS AND REIMBURSEMENTS

Accounts shall be submitted by the Reinsured to the Reinsurer on a quarterly basis, in arrears. Within 30 days of the end of each calendar quarter, the Reinsured shall submit to the Reinsurer a statement setting forth the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder, Premium Adjustments, Ultimate Net Loss activity, reserves (including IBNR reserves), etc., in each case, for the prior calendar quarter, and within thirty (30) days of the end of each calendar year, the Reinsured shall submit to the Reinsurer a statement setting forth the Profit Commission due the Reinsured, if any, under ARTICLE VII for the prior calendar year. Any net balance payable to or from either Party shall be paid by the debtor Party within 15 days of the receipt of such statement. The form of the quarterly and calendar year statements and the information set out therein shall be mutually agreed as between the Parties, and subject to the Parties’ mutual amendments, as the Parties may agree from time to time. This ARTICLE XIII will survive the termination or expiration of this Agreement.

ARTICLE XIV LIABILITY AND PAYMENT

The Reinsured’s good faith determinations regarding its liabilities under the policies of the Subject Business, including the Reinsured’s decisions to adjust, settle, and compromise all Claims will bind the Reinsurer. Notwithstanding anything contained in this Agreement to the contrary, the liability of the Reinsurer with respect to Claims will follow the liability of the Reinsured in all respects and will be subject to all good faith interpretations of contract provisions in the policies of the Subject Business by the Reinsured including interpretations resulting in the payment of Claims. Notwithstanding anything contained in this Agreement to the contrary, all such adjustments, settlements and compromises will be unconditionally binding upon the Reinsurer in proportion to the Reinsurer’s quota share participation, the true intent of this Agreement being that the Reinsurer will, in every case to which this Agreement applies, follow the fortunes, and follow the settlements of the Reinsured.

ARTICLE XV AUDIT AND INSPECTION

The Parties will maintain complete and correct books and records relating to the policies of the Subject Business, Claims and their respective obligations under this Agreement (the “Books and Records”). The Books and Records will be open to audit and reproduction by the Reinsured and Reinsurer and their respective designated representatives (collectively, the “Auditing Parties,” and individually, the “Auditing Party”) at the expense of the Auditing Party at the office of the Audited Party (as defined below) during the Agreement Period, the Run-Off Period and until one (1) year following the expiration of the Run-Off Period, upon reasonable advance written notice and for the sole purpose of confirming the compliance of the Party being audited (the “Audited Party”) with Applicable Law and/or its obligations, in each case, with respect to or under this Agreement; provided, that such audits shall be limited to not more than two (2) audits during any twelve (12) calendar month period; provided, further, that such temporal limitation will not apply to any such audit that is required by Applicable Law. Such audits will occur only during normal business hours using reasonable care not to cause damage and not to interrupt the normal business operations of the Audited Party and will be subject to, (i) such security procedures as the Audited Party may reasonably impose, and (ii) such limitations as may be required under Applicable Law governing the conduct of the Audited Party’s business, or as may be otherwise reasonably required in order to protect from disclosure information of the Audited Party that does not relate to the policies of the Subject Business, Claims and the Audited Party’s obligations under this Agreement.

 

8


ARTICLE XVI ERRORS AND OMISSIONS

Any inadvertent error or omission on the part of either Party hereto shall not relieve the other Party from any liability which would have attached hereunder, provided that such error or omission is rectified promptly upon discovery, and shall not impose any greater liability on the Reinsurer than would have attached hereunder if the error or omission had not occurred.

ARTICLE XVII ADJUSTMENTS

Notwithstanding anything contained herein to the contrary, if the Reinsured’s liability under any policy of the Subject Business is changed because of a misstatement of age, sex, marital status, smoking status, amount or nature of coverage, or any other material fact by any Policyholder or its representative (including any employer, sponsor, group policyholder, broker, agent or other Person acting on behalf of the Policyholder), or in good faith by the Reinsured or by a Governmental Authority, the Reinsurer will, (i) assume that portion of any increase in reinsured liabilities resulting from the change, and (ii) receive credit for that portion of any decrease in reinsured liabilities resulting from the change, and the Reinsured and the Reinsurer will make all appropriate adjustments to amounts due each other under this Agreement.

ARTICLE XVIII CHANGES IN THE AGREEMENT

The terms of this Agreement shall not be waived or changed except by written amendment executed by a duly authorized officer of the Reinsurer and by a duly authorized officer or representative of the Reinsured.

ARTICLE XIX OFFSET CLAUSE

The Reinsured or the Reinsurer may offset any balance(s) which may become due between them under this Agreement or any reinsurance agreement with an Oscar Reinsured that is subject to the Interlocking provision herein. This offset right shall apply regardless of whether the balances arose on account of Premiums, commission, claims, losses, Allocated Loss Adjustment Expense, salvage or any other amount(s) due from one Party to the other.

ARTICLE XX NO THIRD PARTY RIGHTS

Except with respect to the Oscar Reinsureds, in no event shall anyone other than the Reinsurer or the Reinsured have any rights under this Agreement.

ARTICLE XXI PRACTICES CHANGES IN OWNERSHIP AND ADMINISTRATIVE

The Reinsured undertakes not to voluntarily make any material change in its established acceptance and underwriting policy in respect of the Subject Business, nor to undergo any Change in Control, without, in each case, the prior consent of the Reinsurer, such consent not to be unreasonably withheld, denied or conditioned; provided, however, that such consent shall not be required if such change is required by Applicable Law. It is furthermore understood and agreed that should a new affiliate to the Oscar Reinsureds be established for purposes of writing business similar to the Subject Business, the Parties hereto shall, subject to Applicable Law and regulatory approval, mutually agree on a quota share reinsurance agreement in respect of such new affiliate and such business that shall be consistent with the terms and conditions hereof and subject to the same Interlocking provision and principles set forth here.

 

9


ARTICLE XXII NON-WAIVER CLAUSE

The failure of the Reinsured or the Reinsurer to insist on compliance with this Agreement or to exercise any right or remedy hereunder shall not constitute a waiver of any rights or remedies contained herein nor estop either Party from thereafter demanding full and complete compliance nor prevent either Party from exercising such rights or remedy in the future.

ARTICLE XXIII INSOLVENCY

In the event of the Reinsured’s insolvency, any payments due the Reinsured from the Reinsurer pursuant to the terms of this Agreement will be made directly to the statutory successor of the Reinsured or its conservator, liquidator, or receiver without diminution because of the insolvency of the Reinsured for those claims reported and allowed against the Reinsured by any court of competent jurisdiction or by the liquidator, rehabilitator, receiver or statutory successor having authority over such claims. The conservator, liquidator, receiver or statutory successor of the Reinsured will give the Reinsurer written notice of the pendency of a claim against the Reinsured on any policy of the Subject Business within a reasonable time after such claim is filed in the insolvency proceeding. During the pendency of any such claim, the Reinsurer may investigate such claim and interpose in the Reinsured’s name (or in the name of the Reinsured’s conservator, liquidator, receiver or statutory successor), in the proceeding where such claim is to be adjudicated, any defense or defenses which the Reinsurer may deem available to the Reinsured or its conservator, liquidator, receiver or statutory successor. The expense thus incurred by the Reinsurer will be chargeable, subject to court approval, against the Reinsured as a part of the expense of liquidation to the extent of a proportionate share of the benefit which may accrue to the Reinsured solely as a result of the defense undertaken by the Reinsurer.

ARTICLE XXIV NO INTERMEDIARY

This Reinsurance has been negotiated and agreed solely between the Parties hereto and no broker or intermediary has represented either Party or is entitled to any remuneration.

ARTICLE XXV PAYMENTS

All ceded Premiums and Ultimate Net Loss reimbursement settlements shall be made directly between the Reinsurer and the Reinsured; provided that the Reinsured may appoint as Reinsured’s agent for the payment of ceded Premiums and acceptance of Ultimate Net Loss settlements any one Oscar Reinsured it so chooses, from time to time, by providing written notice thereof to the Reinsurer.

 

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ARTICLE XXVI DELAYED PAYMENTS

For purposes of any payments due hereunder, if there is a delayed settlement of a payment due, interest will accrue on such payment at the Applicable Interest Rate. Interest will be calculated on the basis of actual days for a 365-day year based on the actual number of days elapsed. For purposes of this Agreement, a payment will be considered overdue, and such interest will begin to accrue, on the date which is thirty (30) days after the date such payment is due.

ARTICLE XXVII CREDIT FOR REINSURANCE

The Parties intend that the Reinsured will receive, from and after the Coinsurance Effective Date, full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile. If the Reinsured nevertheless loses statutory reserve financial statement credit in the Reinsured’s state of domicile due to any reason attributable to the Reinsurer, the Reinsurer’s business, operations, condition, licenses and/or authorizations (including any losses thereof or restrictions thereon) or to a change in Applicable Law (collectively, a “Coinsurance Credit Event”), or if the Reinsured is notified in writing by a Governmental Authority that it will not receive statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsurer will promptly, and in any event will no later than thirty (30) calendar days following receipt of written notice from the Reinsured that a Coinsurance Credit Event has occurred, (i) cure such Coinsurance Credit Event to the Parties’ mutual satisfaction and at the Reinsurer’s sole cost and expense, and/or (ii) establish for the benefit of the Reinsured, at the Reinsurer’s sole cost and expense, such trust accounts, letters of credit, funds withheld, or other security permitted by Applicable Law to allow the Reinsured to obtain full statutory reserve financial statement credit for reinsurance provided under this Agreement in the Reinsured’s state of domicile. Subject to the preceding two sentences, in the event of a Coinsurance Credit Event, the Reinsurer will have the option of determining the method of security to be utilized for such purpose. If such method elected by the Reinsurer requires any change to this Agreement in order for the Reinsured to obtain such statutory reserve financial statement credit, the Parties will cooperate in good faith to promptly amend this Agreement to incorporate such change. Any trust accounts, letters of credit, funds withheld, or other security established by the Reinsurer under this ARTICLE XXVII to address a Coinsurance Credit Event as set forth herein shall only be required to be maintained for so long a period as the Reinsured cannot receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile, and the Reinsured shall reasonably cooperate in the release of any such security should the Reinsured’s ability to receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile without such security be fully restored. This ARTICLE XXVII will survive the termination or expiration of this Agreement.

ARTICLE XXVIII ARBITRATION CLAUSE

This Clause shall form a separate agreement between the Reinsured and the Reinsurer from the main Agreement.

 

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All matters in difference between the Reinsured and the Reinsurer (hereinafter referred to as the “Disputing Parties”) in relation to this reinsurance, including its formation and validity, and whether arising during or after the period of this reinsurance, shall be referred to an Arbitration Tribunal in the manner hereinafter set out.

Unless the Disputing Parties agree upon a single Arbitrator within thirty days of one receiving a written request from the other for Arbitration, the Claimant (the Disputing Party requesting Arbitration) shall appoint its Arbitrator and give written notice thereof to the Respondent. Within thirty days of receiving such notice the Respondent shall appoint its Arbitrator and give written notice thereof to the Claimant, failing which the Claimant may nominate an Arbitrator on behalf of the Respondent.

Should the Arbitrators fail to agree, they shall appoint, by mutual agreement or by a mutually agreed selection process, an Umpire to whom the matter in difference shall be referred.

Unless the Disputing Parties otherwise agree, the Arbitration Tribunal shall consist of persons employed or engaged in a senior position in insurance or reinsurance underwriting or claims.

The Arbitration Tribunal shall have the power to fix all procedural rules for the holding of the Arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, discovery, inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the Arbitration and may receive and act upon such evidence whether oral or written strictly admissible or not as it shall in its discretion think fit.

All costs and expenses including attorneys’ fees, arbitrator fees, and expert fees of the Arbitration shall be in the discretion of the Arbitration Tribunal who may direct to and by whom and in what manner they shall be paid.

The seat of the Arbitration shall be in New York, NY and the Arbitration Tribunal shall apply the laws of the state of domicile of the Reinsured, without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction, as the proper law of this reinsurance.

The Arbitration Tribunal may not award exemplary, punitive, multiple or other damages of a similar nature.

The award of the Arbitration Tribunal shall be in writing and binding upon the Disputing Parties who covenant to carry out the same. If either of the Disputing Parties should fail to carry out any award the other may apply for its enforcement to a court of competent jurisdiction in any territory in which the Disputing Party in default is domiciled or has assets or carries on business.

ARTICLE XXIX TERM

This Agreement will commence on the Coinsurance Effective Date and run indefinitely unless earlier terminated as provided in ARTICLE XXX (the “Term”).

 

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ARTICLE XXX TERMINATION

Notwithstanding anything contained to the contrary in this Agreement, this Agreement may only be terminated as follows:

 

  (b)

If either Party to this Agreement fails to pay (the “Non-paying Party”) the other Party an amount due within thirty (30) days after the due date provided in this Agreement, the other Party (the “Terminating Party”) may terminate this Agreement, subject to thirty (30) days prior written notice to the Non-paying Party of the Terminating Party’s intention to terminate; provided, however, that the Non-paying Party may avoid termination of this Agreement pursuant to this paragraph by paying all undisputed amounts that are delinquent and then due, including any interest owing thereon pursuant to ARTICLE XXVI, on or before the termination date specified in the written notice;

 

  (c)

In the event that a Governmental Authority with jurisdiction over the Reinsured denies or revokes the ability of the Reinsured to take full statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsured may terminate this Agreement, subject to thirty (30) days prior written notice to the Reinsurer of the Reinsured’s intention to terminate; provided, however, that the Reinsurer may avoid termination of this Agreement pursuant to this paragraph by fully complying with ARTICLE XXVII prior to the end of such thirty (30) day notice period;

 

  (d)

This Agreement may be terminated by either Party by giving written notice of termination to the other Party if such termination is required by any Governmental Authority under Applicable Law;

 

  (e)

This Agreement may be terminated by either Party at any time after the third (3rd) year anniversary of the Coinsurance Effective Date by giving written notice of termination to the other Party; and

 

  (f)

If one or more of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein is terminated for reasons other than that such termination was required by a Governmental Authority under Applicable Law, either Party may terminate this Agreement within thirty (30) days following the termination of such reinsurance agreement that is subject to the Interlocking provision herein by giving the other Party written notice of termination of this Agreement.

 

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The effective date of termination of this Agreement (the “Termination Date”) for any notice of termination properly delivered in accordance with this ARTICLE XXX, will be the date specified in such notice.

Upon the Termination Date of this Agreement, subject to all other terms and conditions hereof including the Maximum Combined Ratio, the Reinsurer will remain liable for all reinsured liabilities under this Agreement with respect to each policy of the Subject Business that was effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement and the Reinsurer will remain liable for all such reinsurance until the end of the “Run-Off Period,” which will mean the period beginning on the Termination Date of this Agreement and continuing until the date on which the Reinsured has no further liabilities or obligations under any policy of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement. For the avoidance of doubt, the Reinsured’s and the Reinsurer’s respective obligation to pay the other all amounts due hereunder, as applicable, in accordance with the terms of this Agreement, with respect to the policies of the Subject Business that were effected, bound, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement, will extend during the Run-Off Period, as provided herein. The Parties hereto expressly agree that they will reasonably cooperate with each other in the handling of all run-off obligations with respect to the policies of the Subject Business reinsured hereunder.

Upon the Termination Date of this Agreement, no policies of the Subject Business effected, bound, sold, issued, renewed or reinstated, as applicable, by the Reinsured after the Termination Date of this Agreement will be reinsured under this Agreement.

This ARTICLE XXX will survive the termination or expiration of this Agreement.

ARTICLE XXXI NOTICES

All notices, demands and other communications hereunder will be in writing and will be sent by certified mail return receipt requested, by hand or by nationally recognized overnight courier service addressed to the Party to whom such notice or other communication is to be given or made at such Party’s address as set forth below, or to such other address as such Party may designate in writing to the other Parties from time to time in accordance with the provisions hereof and will be deemed given five (5) calendar days after being sent by certified mail and one (1) Business Day after being sent by any other method described above, as follows:

(i) If to Reinsurer:

National Indemnity Company

100 First Stamford Place

Stamford, CT 06902

Attn: General Counsel

####

 

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(ii) If to Reinsured:

Oscar Insurance Company of Florida

75 Varick Street, 5th Floor

New York, NY 10013

Attn: Legal

####

(iii) provided, however, if any of the above Parties will have designated a different address by notice to the other Parties, then to the last address so designated.

ARTICLE XXXII GOVERNING LAW

This Agreement will be governed by and construed in accordance with the laws of the state of domicile of the Reinsured without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction.

ARTICLE XXXIII ENTIRE AGREEMENT

This Agreement, and each of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein, and the schedules and exhibits hereto and thereto, which are expressly incorporated by reference herein and made a part hereof, constitute the entire agreement of the Parties with respect to the subject matter hereof and supersedes all other prior understandings and agreements between the Parties with respect to the subject matter hereof, whether written or oral.

ARTICLE XXXIV ASSIGNMENT AND DELEGATION

This Agreement will be binding upon and inure solely to the benefit of the Parties and their respective successors and permitted assigns. This Agreement, and the rights and obligations hereunder, cannot be assigned or delegated, in whole or in part, by the Reinsurer or the Reinsured without, except as otherwise expressly permitted under this Agreement, the prior written consent of the other; provided, however, that no such assignment or delegation will relieve either the Reinsurer or the Reinsured from any liability or obligation hereunder. Any assignment or delegation in violation of this ARTICLE XXXIV will be null and void ab initio.

ARTICLE XXXV EXPENSES

Unless otherwise specifically provided herein, all costs and expenses incurred in connection with this Agreement and the transactions and obligations contemplated herein will be paid by the Party incurring such cost or expense.

 

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IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed in duplicate by their duly authorized representatives

 

This 13 day of August 2019     by Oscar Insurance Company of Florida
   

/s/ Siddhartha Sankaran

    Title: Chief Financial Officer
This 13 day of August 2019     by National Indemnity Company
   

/s/ Brian Snover

    Title: Senior Vice President

 

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Exhibit 10.34

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE

REGISTRANT IF PUBLICLY DISCLOSED.

QUOTA SHARE REINSURANCE AGREEMENT

This Quota Share Reinsurance Agreement (the “Agreement”), effective as of the Coinsurance Effective Date, is made and entered into by and between Oscar Insurance Company, a Texas domiciled insurance company (the “Reinsured”), and National Indemnity Company, a Nebraska domiciled insurance company (the “Reinsurer”) (the Reinsured and the Reinsurer each individually, a “Party”, and collectively, the “Parties”).

RECITALS

WHEREAS, the Reinsured is, among other things, engaged in the business of underwriting, marketing, selling, issuing, renewing and servicing commercial health insurance products for individuals and small employers;

WHEREAS, the Reinsurer, among other things, is authorized under Applicable Law to assume reinsurance of such commercial health insurance products;

WHEREAS, the Reinsured desires to cede on a [***] indemnity quota share reinsurance basis to the Reinsurer, as of the Coinsurance Effective Date (as defined below), all of the commercial health insurance products for individuals and small employers that it writes in the United States (the “Subject Business”), subject to the terms and conditions stated herein;

WHEREAS, the Reinsurer desires to reinsure on such basis the Subject Business; and

WHEREAS, this Agreement is an agreement solely between the Reinsured and the Reinsurer and performance of the obligations of each Party under this Agreement will be rendered solely to the other Party.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the Parties hereby agree as follows:

ARTICLE I [***] QUOTA SHARE REINSURANCE OF SUBJECT BUSINESS

The reinsurance provided by the Reinsurer under this Agreement is in respect of all policies of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or after the Coinsurance Effective Date, through the Agreement Period, and on or prior to the Termination Date (as such terms are defined below) on the following basis:

 

  (i)

For calendar year 2019:

 

  (a)

In respect of all policies of the Subject Business written by the Reinsured that is not subject to the AXA quota share reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring AXA Ceded Reinsurance”) and the Odyssey Re excess of loss reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring Ceded Odyssey Re XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis; and


  (b)

In respect of all policies of the Subject Business written by the Reinsured that is subject to the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable, in each case, for calendar year 2019, the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable.

 

  (ii)

For calendar year 2020 and, if applicable, the remainder of the Agreement Period:

In respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020 and, if applicable, the remainder of the Agreement Period1 that may be entered into from time to time with the Reinsured, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Other Inuring Ceded XOL Reinsurance.

For the avoidance of doubt, the Inuring Ceded Odyssey Re XOL Reinsurance for calendar year 2019, and the Other Inuring Ceded XOL Reinsurance for calendar year 2020 and, if applicable, the remainder of the Agreement Period, shall each be maintained by the Reinsured during its applicable calendar year period, as specified immediately above in this ARTICLE I, and shall be deemed, for purposes of this Agreement, as inuring to this Agreement and the reinsurance being provided hereunder by the Reinsurer during its applicable calendar year period specified above.

ARTICLE II AGREEMENT PERIOD

The reinsurance provided by the Reinsurer under this Agreement covers the Subject Business during the time period commencing at 12:01 AM Eastern Time on January 1, 2019 (the “Coinsurance Effective Date”) and terminating at 12:00 AM (midnight) Eastern Time on December 31, 2020 (such period, the “Initial Agreement Period”). The Initial Agreement Period, together with any extensions thereof, if any, by the Reinsurer as provided in this ARTICLE II, shall be referred to hereafter as the “Agreement Period”. Except as provided in ARTICLE XXX, this Agreement cannot be terminated during the Agreement Period by either Party. The Initial Agreement Period shall be subject to the following unilateral right of the Reinsurer to extend it: the Reinsurer has the right, but not the obligation, to choose, by providing the Reinsured with prior

 

 

1 

Note to Draft: This is to pick up any extension period of the Agreement Period by the Reinsurer.

 

2


written notice no later than ten (10) days prior to the expiration of the then current Agreement Period, to extend the Agreement Period for an additional one (1) year period should the Reinsurer not have realized a [***]% margin on its quota share participation in this Agreement at any time prior to the expiration of the then current Agreement Period, as set forth in ARTICLE VII hereof.

ARTICLE III TERRITORIAL SCOPE

The territorial scope of this Agreement shall be wherever in the United States the Reinsured issues the Subject Business.

ARTICLE IV REINSURANCE PREMIUM AND CEDING COMMISSION

In consideration of the reinsurance provided by the Reinsurer under this Agreement, the Reinsured shall pay to the Reinsurer its quota share participation in all Premiums received by the Reinsured in connection with the Subject Business which shall be payable to the Reinsurer in cash in accordance with ARTICLE XIII. The only deduction allowable from the Reinsurer’s quota share participation in the Premiums shall be a [***]% ceding commission payable by the Reinsurer to the Reinsured (the “Ceding Commission”).

ARTICLE V PREMIUM ADJUSTMENTS

The Reinsurer’s quota share participation in all Premiums, which Premiums were received by the Reinsurer, that are required to be refunded, rebated or otherwise repaid by the Reinsured to a Policyholder or Governmental Authority due to, (i) changes in or cancellations of any policy of the Subject Business, (ii) contractual requirements under the terms of the policies of the Subject Business, or (iii) Applicable Law including the ACA Risk Adjustment Program, and any such refunds, rebates or payments resulting from (x) a finding in a commercial risk adjustment audit by any federal Governmental Authority or a self-audit performed by the Reinsured that the Premiums were incorrect, and (y) any ACA Rebates (to the extent such rebates are related to the policies of the Subject Business, as solely determined by the Reinsured) (paragraphs (i), (ii), and (iii) of this ARTICLE V, collectively, the “Premium Adjustments”), shall be refunded by the Reinsurer to the Reinsured in accordance with ARTICLE XIII. The Parties shall promptly make all necessary financial adjustments between them with respect to the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin necessitated by any such Premium Adjustments in a manner consistent with the terms herein.

This ARTICLE V will survive the termination or expiration of this Agreement.

ARTICLE VI MAXIMUM COMBINED RATIO

Under no circumstances whatsoever, howsoever arising, will the Reinsurer be liable for any sums in excess of a combined ratio of Ultimate Net Loss to the Reinsurer’s quota share participation in the Premiums actually received by the Reinsurer (i.e., after deducting the Ceding Commission from such Premiums) of [***]% in the aggregate during any calendar year period (the “Maximum Combined Ratio”). For the avoidance of doubt, any Ceding Commission paid to the Reinsured or other deductions from the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder shall be first deducted from such ceded Premiums in calculating the Maximum Combined Ratio, [***].

 

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ARTICLE VII PROFIT COMMISSION

Reinsured shall be paid a profit commission by the Reinsurer in an amount equal to any profit resulting from this Agreement from a [***]% or better combined ratio during any calendar year period (the “Profit Commission”) (i.e., the Reinsurer shall retain a margin of [***]% (the “Reinsurer’s Margin”)). Payment to the Reinsured of the Profit Commission shall be made in accordance with ARTICLE XIII.

ARTICLE VIII DEFINITIONS

In this Agreement, (i) the singular includes the plural, and the plural the singular; (ii) words importing any gender include the other gender; (iii) the words “including”, “includes” and “include” will be deemed to be followed by the words “without limitation” (where “including”, “includes”, and “include” are not followed by “without limitation”); and (iv) when a reference is made in this Agreement to an article or a section, exhibit, or schedule, such reference will be to an article or a section of, or an exhibit or schedule to, this Agreement, unless otherwise indicated. Any agreement, instrument, statute or regulation defined or referenced to herein or in any agreement or instrument that is referred to herein means such agreement, instrument, statute or regulation as from time to time amended, modified or supplemented, including (in the case of agreements or instruments) by waiver or consent and (in the case of statutes or regulations) by succession of comparable successor statutes. References to any Person include the successors and permitted assigns of such Person. References from or through any date mean, unless otherwise specified, from and including or through and including, respectively. The following terms will have the respective meanings set forth below throughout this Agreement.

(A) The term “ACA” shall mean the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 and its implementing regulations and any written and published or released sub-regulatory guidance.

(B) The term “ACA Rebate” shall mean any rebate required by Section 2718 of ACA.

(C) The term “ACA Risk Adjustment Program” shall mean any mandatory state or federal risk adjustment program created pursuant to Section 1343 of ACA.

(D) The term “Allocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest accrued prior to judgment where such interest is not added to the judgment, and interest accrued after judgment, which are actually paid by the Reinsured (excluding salaries of officers and permanent employees of the Reinsured) in connection with any investigation, adjustment, defense, resistance to, compromise, settlement, or negotiations that are allocated to a specific loss occurrence with respect to a policy of the Subject Business for which reimbursement is due the Reinsured under this Agreement. Allocated Loss Adjustment Expenses shall be apportioned in proportion to the respective Parties’ quota share participation under this Agreement, as finally determined by the Parties. All costs and expenses that are not Allocated Loss Adjustment Expenses shall be Unallocated Loss Adjustment Expenses.

 

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The Allocated Loss Adjustment Expenses shall be a part of, and included in, the Ultimate Net Loss.

(E) The term “Applicable Interest Rate” shall mean as of any date of determination, a rate of interest equal to the three (3) month U.S. Treasury Note, as published in the Wall Street Journal on such date [***].

(F) The term “Applicable Law” shall mean any domestic or foreign federal, state or local statute, law, ordinance or code, or any rules, regulations, administrative interpretations or orders issued by any Governmental Authority pursuant to any of the foregoing, and any order, writ, injunction, directive, judgment or decree of a court of competent jurisdiction, in each case solely to the extent applicable to the Parties hereto or the performance of their respective obligations under this Agreement.

(G) The term “Business Day” shall mean any day other than a Saturday, Sunday or other day on which commercial banks in the then current state of domicile of either Party are required or authorized by law to be closed.

(H) The term “Change in Control” shall mean a transaction or series of related transactions for the acquisition by one or more Persons that are not affiliates of the Reinsured of more than 50% of the outstanding common stock of the Reinsured.

(I) The term “Claim” shall mean with respect to each individual policy of the Subject Business, any and all claims, requests, demands or notices made by or on behalf of any Policyholder or any other Person for the payment of benefits under the policy including return of Premiums or any other payments or benefits due or alleged to be due under or in connection with any policy of the Subject Business including interest payable thereon in accordance with Applicable Law.

(J) The term “Governmental Authority” shall mean any domestic government, any national, state or other political subdivision thereof or any self-regulatory authority, and any entity exercising executive, legislative, judicial, regulatory or administrative functions of or pertaining to government.

(K) The term “Person” shall mean any natural person, corporation, partnership, joint venture, limited liability company, association, trust, unincorporated organization or other legal entity.

(L) The term “Policyholders” shall mean policyholders, insureds, beneficiaries, subscribers, members, certificate holders and assignees, and eligible dependents of each of the foregoing, under policies of the Subject Business.

(M) The terms “Premiums” shall mean all premiums, fees and contributions received by the Reinsured in connection with the issuance of the policies of the Subject Business, net of such amounts paid or payable by the Reinsured under the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, as applicable, and subject, in each case, to Premium Adjustments.

 

5


(N) The term “Ultimate Net Loss” shall mean the sum which is payable or has in fact been paid in cash by the Reinsurer to the Reinsured for Claims under the policies of the Subject Business after making deductions for all recoveries, all salvages, and all claims upon the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, in each case, to the extent applicable, whether collected or not from the reinsurers thereunder. Ultimate Net Loss shall include Allocated Loss Adjustment Expenses. Ultimate Net Loss shall not include any Unallocated Loss Adjustment Expenses. All salvages, recoveries and payments recovered or received subsequent to reimbursement to the Reinsured of Ultimate Net Loss by the Reinsurer under this Agreement shall be regarded as if recovered or received prior to said reimbursement and all necessary adjustments shall be undertaken by the Parties hereto. Nothing, however, in this paragraph (N) of this ARTICLE VIII shall be construed to mean that Ultimate Net Losses are not reimbursable from the Reinsurer until the Ultimate Net Loss has been determined.

(O) The term “Unallocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest that are not allocated to a specific loss occurrence with respect to a policy of the Subject Business. Unallocated Loss Adjustment Expenses shall also include salaries of officers and permanent employees of the Reinsured.

(P) The term “United States” shall mean the United States of America, including all of its states, the District of Columbia, its territories, possessions and commonwealths.

ARTICLE IX INTERLOCKING

It is understood and mutually agreed as between the Reinsurer, on the one hand, and the Reinsured and its insurance-issuing affiliates on the other hand, the list of all such entities being, as of the Coinsurance Effective Date: Oscar Insurance Corporation, Oscar Garden State Insurance Corporation, Oscar Insurance Company, Oscar Health Plan of California, Oscar Buckeye State Insurance Corporation, Oscar Insurance Company of Florida, and Oscar Health Plan, Inc. (each, an “Oscar Reinsured”), that: (i) each and every one of the Oscar Reinsureds is a reinsured under a separate quota share reinsurance agreement issued by the Reinsurer that is identical to this Agreement with respect to all of the economic terms and conditions included herein; (ii) all such quota share reinsurance agreements shall be interlocked and applied in the aggregate as between the Reinsurer and the Oscar Reinsureds for all economic purposes hereunder and thereunder, including with respect to the determination by the Parties of the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin, such that the economic results of all such quota share reinsurance agreements for such purposes shall be aggregated and applied as though all Oscar Reinsureds were subject to one and the same quota share reinsurance agreement; and (iii) all Oscar Reinsureds jointly appoint each other as agent and representative of the others so that communications, negotiations, accommodations and agreements as between the Reinsurer and any Oscar Reinsured shall bind all Oscar Reinsureds to the extent and for so long as they remain affiliates, unless expressly stated otherwise.

 

6


ARTICLE X SUBROGATION AND SALVAGE

(A) The Reinsurer shall be subrogated, as respects any Ultimate Net Loss for which the Reinsurer shall actually pay or become liable to pay, but only to the extent of the amount of payment by, or the amount of liability of, the Reinsurer, to all rights of the Reinsured against any Person who may be legally responsible in damages for said Ultimate Net Loss. The Reinsured hereby agrees to use commercially reasonable efforts to enforce such rights. In the event the Reinsured shall fail or neglect to do so, the Reinsurer is hereby authorized and empowered to bring any commercially reasonable appropriate action in the name of the Reinsured or in the name of a Policyholder under an insurance policy of the Subject Business reinsured hereunder to enforce such rights.

(B) Any rights of subrogation, recoveries, salvages or reimbursements applying to loss occurrences reinsured under this Agreement shall always be used to reimburse the reinsurers excess of the Reinsurer (from the last to the first, beginning with the reinsurer of the last excess) according to their participation, before being used in any way to reimburse the Reinsurer. The Reinsured shall recover for the retention from recoveries, salvages or reimbursements only after the Reinsurer has been reimbursed in full for its Ultimate Net Loss reimbursement payment. In determining the amount of recoveries, salvages or reimbursements, there shall first be deducted from any amount recovered the expenses incurred in effecting the recovery (excluding salaries and expenses of officers and employees of the Reinsured).

(C) All salvages, recoveries or reimbursements, after deduction of all expenses allowed under paragraph (B) of this ARTICLE X applicable thereto, recovered or received subsequent to an Ultimate Net Loss reimbursement to the Reinsured by the Reinsurer under this Agreement shall be applied as if recovered or received prior to the aforesaid settlement and all necessary adjustments shall be made by the Parties hereto; provided that nothing in this ARTICLE X shall be construed to mean that Ultimate Net Losses under this Agreement are not recoverable until all salvage, recovery and reimbursement has been determined.

ARTICLE XI INURING THIRD PARTY CEDED REINSURANCE

The amount of the Reinsurer’s liability in respect of any Ultimate Net Loss shall not be increased by the inability of the Reinsured to collect from any other reinsurer(s), whether specific or general, any amounts which may have become due from them regardless of whether such inability arises from the insolvency of such other reinsurers or for any other reason whatsoever.

ARTICLE XII CURRENCY

Wherever the word “Dollars” of the symbol “$” appears in this Agreement, it shall mean United States dollars. All payments under this Agreement shall be made in Dollars.

ARTICLE XIII REPORTS AND REIMBURSEMENTS

Accounts shall be submitted by the Reinsured to the Reinsurer on a quarterly basis, in arrears. Within 30 days of the end of each calendar quarter, the Reinsured shall submit to the Reinsurer a statement setting forth the Reinsurer’s quota share participation in the Premiums payable to the

 

7


Reinsurer hereunder, Premium Adjustments, Ultimate Net Loss activity, reserves (including IBNR reserves), etc., in each case, for the prior calendar quarter, and within thirty (30) days of the end of each calendar year, the Reinsured shall submit to the Reinsurer a statement setting forth the Profit Commission due the Reinsured, if any, under ARTICLE VII for the prior calendar year. Any net balance payable to or from either Party shall be paid by the debtor Party within 15 days of the receipt of such statement. The form of the quarterly and calendar year statements and the information set out therein shall be mutually agreed as between the Parties, and subject to the Parties’ mutual amendments, as the Parties may agree from time to time. This ARTICLE XIII will survive the termination or expiration of this Agreement.

ARTICLE XIV LIABILITY AND PAYMENT

The Reinsured’s good faith determinations regarding its liabilities under the policies of the Subject Business, including the Reinsured’s decisions to adjust, settle, and compromise all Claims will bind the Reinsurer. Notwithstanding anything contained in this Agreement to the contrary, the liability of the Reinsurer with respect to Claims will follow the liability of the Reinsured in all respects and will be subject to all good faith interpretations of contract provisions in the policies of the Subject Business by the Reinsured including interpretations resulting in the payment of Claims. Notwithstanding anything contained in this Agreement to the contrary, all such adjustments, settlements and compromises will be unconditionally binding upon the Reinsurer in proportion to the Reinsurer’s quota share participation, the true intent of this Agreement being that the Reinsurer will, in every case to which this Agreement applies, follow the fortunes, and follow the settlements of the Reinsured.

ARTICLE XV AUDIT AND INSPECTION

The Parties will maintain complete and correct books and records relating to the policies of the Subject Business, Claims and their respective obligations under this Agreement (the “Books and Records”). The Books and Records will be open to audit and reproduction by the Reinsured and Reinsurer and their respective designated representatives (collectively, the “Auditing Parties,” and individually, the “Auditing Party”) at the expense of the Auditing Party at the office of the Audited Party (as defined below) during the Agreement Period, the Run-Off Period and until one (1) year following the expiration of the Run-Off Period, upon reasonable advance written notice and for the sole purpose of confirming the compliance of the Party being audited (the “Audited Party”) with Applicable Law and/or its obligations, in each case, with respect to or under this Agreement; provided, that such audits shall be limited to not more than two (2) audits during any twelve (12) calendar month period; provided, further, that such temporal limitation will not apply to any such audit that is required by Applicable Law. Such audits will occur only during normal business hours using reasonable care not to cause damage and not to interrupt the normal business operations of the Audited Party and will be subject to, (i) such security procedures as the Audited Party may reasonably impose, and (ii) such limitations as may be required under Applicable Law governing the conduct of the Audited Party’s business, or as may be otherwise reasonably required in order to protect from disclosure information of the Audited Party that does not relate to the policies of the Subject Business, Claims and the Audited Party’s obligations under this Agreement.

 

8


ARTICLE XVI ERRORS AND OMISSIONS

Any inadvertent error or omission on the part of either Party hereto shall not relieve the other Party from any liability which would have attached hereunder, provided that such error or omission is rectified promptly upon discovery, and shall not impose any greater liability on the Reinsurer than would have attached hereunder if the error or omission had not occurred.

ARTICLE XVII ADJUSTMENTS

Notwithstanding anything contained herein to the contrary, if the Reinsured’s liability under any policy of the Subject Business is changed because of a misstatement of age, sex, marital status, smoking status, amount or nature of coverage, or any other material fact by any Policyholder or its representative (including any employer, sponsor, group policyholder, broker, agent or other Person acting on behalf of the Policyholder), or in good faith by the Reinsured or by a Governmental Authority, the Reinsurer will, (i) assume that portion of any increase in reinsured liabilities resulting from the change, and (ii) receive credit for that portion of any decrease in reinsured liabilities resulting from the change, and the Reinsured and the Reinsurer will make all appropriate adjustments to amounts due each other under this Agreement.

ARTICLE XVIII CHANGES IN THE AGREEMENT

The terms of this Agreement shall not be waived or changed except by written amendment executed by a duly authorized officer of the Reinsurer and by a duly authorized officer or representative of the Reinsured.

ARTICLE XIX OFFSET CLAUSE

The Reinsured or the Reinsurer may offset any balance(s) which may become due between them under this Agreement or any reinsurance agreement with an Oscar Reinsured that is subject to the Interlocking provision herein. This offset right shall apply regardless of whether the balances arose on account of Premiums, commission, claims, losses, Allocated Loss Adjustment Expense, salvage or any other amount(s) due from one Party to the other.

ARTICLE XX NO THIRD PARTY RIGHTS

Except with respect to the Oscar Reinsureds, in no event shall anyone other than the Reinsurer or the Reinsured have any rights under this Agreement.

ARTICLE XXI CHANGES IN OWNERSHIP AND ADMINISTRATIVE PRACTICES

The Reinsured undertakes not to voluntarily make any material change in its established acceptance and underwriting policy in respect of the Subject Business, nor to undergo any Change in Control, without, in each case, the prior consent of the Reinsurer, such consent not to be unreasonably withheld, denied or conditioned; provided, however, that such consent shall not be required if such change is required by Applicable Law. It is furthermore understood and agreed that should a new affiliate to the Oscar Reinsureds be established for purposes of writing business similar to the Subject Business, the Parties hereto shall, subject to Applicable Law and regulatory approval, mutually agree on a quota share reinsurance agreement in respect of such new affiliate and such business that shall be consistent with the terms and conditions hereof and subject to the same Interlocking provision and principles set forth here.

 

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ARTICLE XXII NON-WAIVER CLAUSE

The failure of the Reinsured or the Reinsurer to insist on compliance with this Agreement or to exercise any right or remedy hereunder shall not constitute a waiver of any rights or remedies contained herein nor estop either Party from thereafter demanding full and complete compliance nor prevent either Party from exercising such rights or remedy in the future.

ARTICLE XXIII INSOLVENCY

In the event of the Reinsured’s insolvency, any payments due the Reinsured from the Reinsurer pursuant to the terms of this Agreement will be made directly to the statutory successor of the Reinsured or its conservator, liquidator, or receiver without diminution because of the insolvency of the Reinsured for those claims reported and allowed against the Reinsured by any court of competent jurisdiction or by the liquidator, rehabilitator, receiver or statutory successor having authority over such claims. The conservator, liquidator, receiver or statutory successor of the Reinsured will give the Reinsurer written notice of the pendency of a claim against the Reinsured on any policy of the Subject Business within a reasonable time after such claim is filed in the insolvency proceeding. During the pendency of any such claim, the Reinsurer may investigate such claim and interpose in the Reinsured’s name (or in the name of the Reinsured’s conservator, liquidator, receiver or statutory successor), in the proceeding where such claim is to be adjudicated, any defense or defenses which the Reinsurer may deem available to the Reinsured or its conservator, liquidator, receiver or statutory successor. The expense thus incurred by the Reinsurer will be chargeable, subject to court approval, against the Reinsured as a part of the expense of liquidation to the extent of a proportionate share of the benefit which may accrue to the Reinsured solely as a result of the defense undertaken by the Reinsurer.

ARTICLE XXIV NO INTERMEDIARY

This Reinsurance has been negotiated and agreed solely between the Parties hereto and no broker or intermediary has represented either Party or is entitled to any remuneration.

ARTICLE XXV PAYMENTS

All ceded Premiums and Ultimate Net Loss reimbursement settlements shall be made directly between the Reinsurer and the Reinsured; provided that the Reinsured may appoint as Reinsured’s agent for the payment of ceded Premiums and acceptance of Ultimate Net Loss settlements any one Oscar Reinsured it so chooses, from time to time, by providing written notice thereof to the Reinsurer.

 

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ARTICLE XXVI DELAYED PAYMENTS

For purposes of any payments due hereunder, if there is a delayed settlement of a payment due, interest will accrue on such payment at the Applicable Interest Rate. Interest will be calculated on the basis of actual days for a 365-day year based on the actual number of days elapsed. For purposes of this Agreement, a payment will be considered overdue, and such interest will begin to accrue, on the date which is thirty (30) days after the date such payment is due.

ARTICLE XXVII CREDIT FOR REINSURANCE

The Parties intend that the Reinsured will receive, from and after the Coinsurance Effective Date, full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile. If the Reinsured nevertheless loses statutory reserve financial statement credit in the Reinsured’s state of domicile due to any reason attributable to the Reinsurer, the Reinsurer’s business, operations, condition, licenses and/or authorizations (including any losses thereof or restrictions thereon) or to a change in Applicable Law (collectively, a “Coinsurance Credit Event”), or if the Reinsured is notified in writing by a Governmental Authority that it will not receive statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsurer will promptly, and in any event will no later than thirty (30) calendar days following receipt of written notice from the Reinsured that a Coinsurance Credit Event has occurred, (i) cure such Coinsurance Credit Event to the Parties’ mutual satisfaction and at the Reinsurer’s sole cost and expense, and/or (ii) establish for the benefit of the Reinsured, at the Reinsurer’s sole cost and expense, such trust accounts, letters of credit, funds withheld, or other security permitted by Applicable Law to allow the Reinsured to obtain full statutory reserve financial statement credit for reinsurance provided under this Agreement in the Reinsured’s state of domicile. Subject to the preceding two sentences, in the event of a Coinsurance Credit Event, the Reinsurer will have the option of determining the method of security to be utilized for such purpose. If such method elected by the Reinsurer requires any change to this Agreement in order for the Reinsured to obtain such statutory reserve financial statement credit, the Parties will cooperate in good faith to promptly amend this Agreement to incorporate such change. Any trust accounts, letters of credit, funds withheld, or other security established by the Reinsurer under this ARTICLE XXVII to address a Coinsurance Credit Event as set forth herein shall only be required to be maintained for so long a period as the Reinsured cannot receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile, and the Reinsured shall reasonably cooperate in the release of any such security should the Reinsured’s ability to receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile without such security be fully restored. This ARTICLE XXVII will survive the termination or expiration of this Agreement.

ARTICLE XXVIII ARBITRATION CLAUSE

This Clause shall form a separate agreement between the Reinsured and the Reinsurer from the main Agreement.

 

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All matters in difference between the Reinsured and the Reinsurer (hereinafter referred to as the “Disputing Parties”) in relation to this reinsurance, including its formation and validity, and whether arising during or after the period of this reinsurance, shall be referred to an Arbitration Tribunal in the manner hereinafter set out.

Unless the Disputing Parties agree upon a single Arbitrator within thirty days of one receiving a written request from the other for Arbitration, the Claimant (the Disputing Party requesting Arbitration) shall appoint its Arbitrator and give written notice thereof to the Respondent. Within thirty days of receiving such notice the Respondent shall appoint its Arbitrator and give written notice thereof to the Claimant, failing which the Claimant may nominate an Arbitrator on behalf of the Respondent.

Should the Arbitrators fail to agree, they shall appoint, by mutual agreement or by a mutually agreed selection process, an Umpire to whom the matter in difference shall be referred.

Unless the Disputing Parties otherwise agree, the Arbitration Tribunal shall consist of persons employed or engaged in a senior position in insurance or reinsurance underwriting or claims.

The Arbitration Tribunal shall have the power to fix all procedural rules for the holding of the Arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, discovery, inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the Arbitration and may receive and act upon such evidence whether oral or written strictly admissible or not as it shall in its discretion think fit.

All costs and expenses including attorneys’ fees, arbitrator fees, and expert fees of the Arbitration shall be in the discretion of the Arbitration Tribunal who may direct to and by whom and in what manner they shall be paid.

The seat of the Arbitration shall be in New York, NY and the Arbitration Tribunal shall apply the laws of the state of domicile of the Reinsured, without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction, as the proper law of this reinsurance.

The Arbitration Tribunal may not award exemplary, punitive, multiple or other damages of a similar nature.

The award of the Arbitration Tribunal shall be in writing and binding upon the Disputing Parties who covenant to carry out the same. If either of the Disputing Parties should fail to carry out any award the other may apply for its enforcement to a court of competent jurisdiction in any territory in which the Disputing Party in default is domiciled or has assets or carries on business.

ARTICLE XXIX TERM

This Agreement will commence on the Coinsurance Effective Date and run indefinitely unless earlier terminated as provided in ARTICLE XXX (the “Term”).

 

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ARTICLE XXX TERMINATION

Notwithstanding anything contained to the contrary in this Agreement, this Agreement may only be terminated as follows:

 

  (b)

If either Party to this Agreement fails to pay (the “Non-paying Party”) the other Party an amount due within thirty (30) days after the due date provided in this Agreement, the other Party (the “Terminating Party”) may terminate this Agreement, subject to thirty (30) days prior written notice to the Non-paying Party of the Terminating Party’s intention to terminate; provided, however, that the Non-paying Party may avoid termination of this Agreement pursuant to this paragraph by paying all undisputed amounts that are delinquent and then due, including any interest owing thereon pursuant to ARTICLE XXVI, on or before the termination date specified in the written notice;

 

  (c)

In the event that a Governmental Authority with jurisdiction over the Reinsured denies or revokes the ability of the Reinsured to take full statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsured may terminate this Agreement, subject to thirty (30) days prior written notice to the Reinsurer of the Reinsured’s intention to terminate; provided, however, that the Reinsurer may avoid termination of this Agreement pursuant to this paragraph by fully complying with ARTICLE XXVII prior to the end of such thirty (30) day notice period;

 

  (d)

This Agreement may be terminated by either Party by giving written notice of termination to the other Party if such termination is required by any Governmental Authority under Applicable Law;

 

  (e)

This Agreement may be terminated by either Party at any time after the third (3rd) year anniversary of the Coinsurance Effective Date by giving written notice of termination to the other Party; and

 

  (f)

If one or more of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein is terminated for reasons other than that such termination was required by a Governmental Authority under Applicable Law, either Party may terminate this Agreement within thirty (30) days following the termination of such reinsurance agreement that is subject to the Interlocking provision herein by giving the other Party written notice of termination of this Agreement.

 

13


The effective date of termination of this Agreement (the “Termination Date”) for any notice of termination properly delivered in accordance with this ARTICLE XXX, will be the date specified in such notice.

Upon the Termination Date of this Agreement, subject to all other terms and conditions hereof including the Maximum Combined Ratio, the Reinsurer will remain liable for all reinsured liabilities under this Agreement with respect to each policy of the Subject Business that was effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement and the Reinsurer will remain liable for all such reinsurance until the end of the “Run-Off Period,” which will mean the period beginning on the Termination Date of this Agreement and continuing until the date on which the Reinsured has no further liabilities or obligations under any policy of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement. For the avoidance of doubt, the Reinsured’s and the Reinsurer’s respective obligation to pay the other all amounts due hereunder, as applicable, in accordance with the terms of this Agreement, with respect to the policies of the Subject Business that were effected, bound, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement, will extend during the Run-Off Period, as provided herein. The Parties hereto expressly agree that they will reasonably cooperate with each other in the handling of all run-off obligations with respect to the policies of the Subject Business reinsured hereunder.

Upon the Termination Date of this Agreement, no policies of the Subject Business effected, bound, sold, issued, renewed or reinstated, as applicable, by the Reinsured after the Termination Date of this Agreement will be reinsured under this Agreement.

This ARTICLE XXX will survive the termination or expiration of this Agreement.

ARTICLE XXXI NOTICES

All notices, demands and other communications hereunder will be in writing and will be sent by certified mail return receipt requested, by hand or by nationally recognized overnight courier service addressed to the Party to whom such notice or other communication is to be given or made at such Party’s address as set forth below, or to such other address as such Party may designate in writing to the other Parties from time to time in accordance with the provisions hereof and will be deemed given five (5) calendar days after being sent by certified mail and one (1) Business Day after being sent by any other method described above, as follows:

(i) If to Reinsurer:

National Indemnity Company

100 First Stamford Place

Stamford, CT 06902

Attn: General Counsel

####

 

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(ii) If to Reinsured:

Oscar Insurance Company

75 Varick Street, 5th Floor

New York, NY 10013

Attn: Legal

####

(iii) provided, however, if any of the above Parties will have designated a different address by notice to the other Parties, then to the last address so designated.

ARTICLE XXXII GOVERNING LAW

This Agreement will be governed by and construed in accordance with the laws of the state of domicile of the Reinsured without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction.

ARTICLE XXXIII ENTIRE AGREEMENT

This Agreement, and each of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein, and the schedules and exhibits hereto and thereto, which are expressly incorporated by reference herein and made a part hereof, constitute the entire agreement of the Parties with respect to the subject matter hereof and supersedes all other prior understandings and agreements between the Parties with respect to the subject matter hereof, whether written or oral.

ARTICLE XXXIV ASSIGNMENT AND DELEGATION

This Agreement will be binding upon and inure solely to the benefit of the Parties and their respective successors and permitted assigns. This Agreement, and the rights and obligations hereunder, cannot be assigned or delegated, in whole or in part, by the Reinsurer or the Reinsured without, except as otherwise expressly permitted under this Agreement, the prior written consent of the other; provided, however, that no such assignment or delegation will relieve either the Reinsurer or the Reinsured from any liability or obligation hereunder. Any assignment or delegation in violation of this ARTICLE XXXIV will be null and void ab initio.

ARTICLE XXXV EXPENSES

Unless otherwise specifically provided herein, all costs and expenses incurred in connection with this Agreement and the transactions and obligations contemplated herein will be paid by the Party incurring such cost or expense.

 

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IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed in duplicate by their duly authorized representatives

This 30 day of September, 2019

 

by Oscar Insurance Company
/s/ Sid Sankaran
Title: Chief Financial Officer

This 30 day of September, 2019

 

by National Indemnity Company
/s/ Brian Snover
Title: Sr VP

 

16

Exhibit 10.35

ENDORSEMENT NO. 1 TO QUOTA SHARE REINSURANCE AGREEMENT

The parties to this Quota Share Reinsurance Agreement (“Agreement “) hereby mutually agree this Endorsement No. 1, effective January 1, 2020:

WHEREAS, the parties mutually agreed the terms of the Agreement effective January 1, 2019 ; and

WHEREAS, with effect from January 1 of 2020, the second underwriting year under the Agreement, the parties have agreed that Reinsurer’s affiliate , Berkshire Hathaway Specialty Insurance Company, shall be the reinsurer under this Agreement;

NOW, THEREFORE , the parties mutually agree as follows:

 

  1.

With effect from January 1, 2020, National Indemnity Company shall be replaced as reinsurer by its affiliate , Berkshire Hathaway Specialty Insurance Company ;

 

  2.

The results of the 2020 and prior and subsequent underwriting years, if any, shall be combined for purposes of evaluating and applying any margin sensitive or similar Agreement provisions under all underwriting years’;

 

  3.

All other terms and conditions remain unchanged.

WHEREFOR, the parties have executed this Endorsement by their duly authorized representatives.

 

Oscar Health Plan of California
By:  

/s/ Cornelia Miller

Title:   Head of Strategic Finance
NATIONAL INDEMNITY COMPANY
By:  

/s/ Brian Snover

Title:   SR VP
BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY
By:  

/s/ Brian Snover

Title:   Director


CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO

THE REGISTRANT IF PUBLICLY DISCLOSED.

QUOTA SHARE REINSURANCE AGREEMENT

This Quota Share Reinsurance Agreement (the “Agreement”), effective as of the Coinsurance Effective Date, is made and entered into by and between Oscar Health Plan of California, a California Health Care Service Plan (the “Reinsured”), and National Indemnity Company, a Nebraska domiciled insurance company (the “Reinsurer”) (the Reinsured and the Reinsurer each individually, a “Party”, and collectively, the “Parties”).

RECITALS

WHEREAS, the Reinsured is, among other things, engaged in the business of underwriting, marketing, selling, issuing, renewing and servicing health care service plan products for individuals and small employers in California;

WHEREAS, the Reinsurer, among other things, is authorized under Applicable Law to assume reinsurance of such health care service plan products;

WHEREAS, the Reinsured desires to cede on a [***] indemnity quota share reinsurance basis to the Reinsurer, as of the Coinsurance Effective Date (as defined below), all of the commercial health care service plan products for individuals and small employers that it writes in the State of California (the “Subject Business”), subject to the terms and conditions stated herein;

WHEREAS, the Reinsurer desires to reinsure on such basis the Subject Business; and

WHEREAS, this Agreement is an agreement solely between the Reinsured and the Reinsurer and performance of the obligations of each Party under this Agreement will be rendered solely to the other Party.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the Parties hereby agree as follows:

ARTICLE I [***] QUOTA SHARE REINSURANCE OF SUBJECT BUSINESS

The reinsurance provided by the Reinsurer under this Agreement is in respect of all health plan products (referred to in this Agreement as “ policies”) of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or after the Coinsurance Effective Date, through the Agreement Period, and on or prior to the Termination Date (as such terms are defined below) on the following basis:

 

  (i)

For calendar year 2019:

 

  (a)

In respect of all policies of the Subject Business written by the Reinsured that is not subject to the AXA quota share reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring AXA Ceded Reinsurance”) and the Odyssey Re excess of loss reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring Ceded Odyssey Re XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis; and


  (b)

In respect of all policies of the Subject Business written by the Reinsured that is subject to the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable, in each case, for calendar year 2019, the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable.

 

  (ii)

For calendar year 2020 and, if applicable, the remainder of the Agreement Period:

In respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020 and, if applicable, the remainder of the Agreement Period that may be entered into from time to time with the Reinsured, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Other Inuring Ceded XOL Reinsurance.

For the avoidance of doubt, the Inuring Ceded Odyssey Re XOL Reinsurance for calendar year 2019, and the Other Inuring Ceded XOL Reinsurance for calendar year 2020 and, if applicable, the remainder of the Agreement Period, shall each be maintained by the Reinsured during its applicable calendar year period, as specified immediately above in this ARTICLE I, and shall be deemed, for purposes of this Agreement, as inuring to this Agreement and the reinsurance being provided hereunder by the Reinsurer during its applicable calendar year period specified above.

ARTICLE II AGREEMENT PERIOD

The reinsurance provided by the Reinsurer under this Agreement covers the Subject Business during the time period commencing at 12:01 AM Eastern Time on January 1, 2019 (the “Coinsurance Effective Date”) and terminating at 12:00 AM (midnight) Eastern Time on December 31, 2020 (such period, the “Initial Agreement Period”). The Initial Agreement Period, together with any extensions thereof, if any, by the Reinsurer as provided in this ARTICLE II, shall be referred to hereafter as the “Agreement Period”. Except as provided in ARTICLE XXX,

 

2


this Agreement cannot be terminated during the Agreement Period by either Party. The Initial Agreement Period shall be subject to the following unilateral right of the Reinsurer to extend it: the Reinsurer has the right, but not the obligation, to choose, by providing the Reinsured with prior written notice no later than ten (10) days prior to the expiration of the then current Agreement Period, to extend the Agreement Period for an additional one (1) year period should the Reinsurer not have realized a [***]% margin on its quota share participation in this Agreement at any time prior to the expiration of the then current Agreement Period, as set forth in ARTICLE VII hereof.

ARTICLE III TERRITORIAL SCOPE

The territorial scope of this Agreement shall be wherever in the United States the Reinsured issues the Subject Business.

ARTICLE IV REINSURANCE PREMIUM AND CEDING COMMISSION

In consideration of the reinsurance provided by the Reinsurer under this Agreement, the Reinsured shall pay to the Reinsurer its quota share participation in all Premiums received by the Reinsured in connection with the Subject Business which shall be payable to the Reinsurer in cash in accordance with ARTICLE XIII. The only deduction allowable from the Reinsurer’s quota share participation in the Premiums shall be a [***]% ceding commission payable by the Reinsurer to the Reinsured (the “Ceding Commission”).

ARTICLE V PREMIUM ADJUSTMENTS

The Reinsurer’s quota share participation in all Premiums, which Premiums were received by the Reinsurer, that are required to be refunded, rebated or otherwise repaid by the Reinsured to a Policyholder or Governmental Authority due to, (i) changes in or cancellations of any policy of the Subject Business, (ii) contractual requirements under the terms of the policies of the Subject Business, or (iii) Applicable Law including the ACA Risk Adjustment Program, and any such refunds, rebates or payments resulting from (x) a finding in a commercial risk adjustment audit by any federal Governmental Authority or a self-audit performed by the Reinsured that the Premiums were incorrect, and (y) any ACA Rebates (to the extent such rebates are related to the policies of the Subject Business, as solely determined by the Reinsured) (paragraphs (i), (ii), and (iii) of this ARTICLE V, collectively, the “Premium Adjustments”), shall be refunded by the Reinsurer to the Reinsured in accordance with ARTICLE XIII. The Parties shall promptly make all necessary financial adjustments between them with respect to the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin necessitated by any such Premium Adjustments in a manner consistent with the terms herein.

This ARTICLE V will survive the termination or expiration of this Agreement.

ARTICLE VI MAXIMUM COMBINED RATIO

Under no circumstances whatsoever, howsoever arising, will the Reinsurer be liable for any sums in excess of a combined ratio of Ultimate Net Loss to the Reinsurer’s quota share participation in the Premiums actually received by the Reinsurer (i.e., after deducting the Ceding Commission from such Premiums) of [***]% in the aggregate during any calendar year period (the “Maximum Combined Ratio”). For the avoidance of doubt, any Ceding Commission paid to the Reinsured or other deductions from the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder shall be first deducted from such ceded Premiums in calculating the Maximum Combined Ratio, [***].

 

3


ARTICLE VII PROFIT COMMISSION

Reinsured shall be paid a profit commission by the Reinsurer in an amount equal to any profit resulting from this Agreement from a [***] combined ratio during any calendar year period (the “Profit Commission”) (i.e., the Reinsurer shall retain a margin of [***]% (the “Reinsurer’s Margin”)). Payment to the Reinsured of the Profit Commission shall be made in accordance with ARTICLE XIII.

ARTICLE VIII DEFINITIONS

In this Agreement, (i) the singular includes the plural, and the plural the singular; (ii) words importing any gender include the other gender; (iii) the words “including”, “includes” and “include” will be deemed to be followed by the words “without limitation” (where “including”, “includes”, and “include” are not followed by “without limitation”); and (iv) when a reference is made in this Agreement to an article or a section, exhibit, or schedule, such reference will be to an article or a section of, or an exhibit or schedule to, this Agreement, unless otherwise indicated. Any agreement, instrument, statute or regulation defined or referenced to herein or in any agreement or instrument that is referred to herein means such agreement, instrument, statute or regulation as from time to time amended, modified or supplemented, including (in the case of agreements or instruments) by waiver or consent and (in the case of statutes or regulations) by succession of comparable successor statutes. References to any Person include the successors and permitted assigns of such Person. References from or through any date mean, unless otherwise specified, from and including or through and including, respectively. The following terms will have the respective meanings set forth below throughout this Agreement.

(A) The term “ACA” shall mean the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 and its implementing regulations and any written and published or released sub-regulatory guidance.

(B) The term “ACA Rebate” shall mean any rebate required by Section 2718 of ACA.

(C) The term “ACA Risk Adjustment Program” shall mean any mandatory state or federal risk adjustment program created pursuant to Section 1343 of ACA.

(D) The term “Allocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest accrued prior to judgment where such interest is not added to the judgment, and interest accrued after judgment, which are actually paid by the Reinsured (excluding salaries of officers and permanent employees of the Reinsured) in connection with any investigation, adjustment, defense, resistance to, compromise, settlement, or negotiations that are allocated to a specific loss occurrence with respect to a policy of the Subject Business for which reimbursement is due the Reinsured under this Agreement. Allocated Loss

 

4


Adjustment Expenses shall be apportioned in proportion to the respective Parties’ quota share participation under this Agreement, as finally determined by the Parties. All costs and expenses that are not Allocated Loss Adjustment Expenses shall be Unallocated Loss Adjustment Expenses. The Allocated Loss Adjustment Expenses shall be a part of, and included in, the Ultimate Net Loss.

(E) The term “Applicable Interest Rate” shall mean as of any date of determination, a rate of interest equal to the three (3) month U.S. Treasury Note, as published in the Wall Street Journal on such date, [***].

(F) The term “Applicable Law” shall mean any domestic or foreign federal, state or local statute, law, ordinance or code, or any rules, regulations, administrative interpretations or orders issued by any Governmental Authority pursuant to any of the foregoing, and any order, writ, injunction, directive, judgment or decree of a court of competent jurisdiction, in each case solely to the extent applicable to the Parties hereto or the performance of their respective obligations under this Agreement.

(G) The term “Business Day” shall mean any day other than a Saturday, Sunday or other day on which commercial banks in the then current state of domicile of either Party are required or authorized by law to be closed.

(H) The term “Change in Control” shall mean a transaction or series of related transactions for the acquisition by one or more Persons that are not affiliates of the Reinsured of more than 50% of the outstanding common stock of the Reinsured.

(I) The term “Claim” shall mean with respect to each individual policy of the Subject Business, any and all claims, requests, demands or notices made by or on behalf of any Policyholder or any other Person for the payment of benefits under the policy including return of Premiums or any other payments or benefits due or alleged to be due under or in connection with any policy of the Subject Business including interest payable thereon in accordance with Applicable Law.

(J) The term “Governmental Authority” shall mean any domestic government, any national, state or other political subdivision thereof or any self-regulatory authority, and any entity exercising executive, legislative, judicial, regulatory or administrative functions of or pertaining to government.

(K) The term “Person” shall mean any natural person, corporation, partnership, joint venture, limited liability company, association, trust, unincorporated organization or other legal entity.

(L) The term “Policyholders” shall mean policyholders, insureds, beneficiaries, subscribers, members, certificate holders and assignees, and eligible dependents of each of the foregoing, under policies of the Subject Business.

 

5


(M) The terms “Premiums” shall mean all premiums, fees and contributions received by the Reinsured in connection with the issuance of the policies of the Subject Business, net of such amounts paid or payable by the Reinsured under the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, as applicable, and subject, in each case, to Premium Adjustments.

(N) The term “Ultimate Net Loss” shall mean the sum which is payable or has in fact been paid in cash by the Reinsurer to the Reinsured for Claims under the policies of the Subject Business after making deductions for all recoveries, all salvages, and all claims upon the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, in each case, to the extent applicable, whether collected or not from the reinsurers thereunder. Ultimate Net Loss shall include Allocated Loss Adjustment Expenses. Ultimate Net Loss shall not include any Unallocated Loss Adjustment Expenses. All salvages, recoveries and payments recovered or received subsequent to reimbursement to the Reinsured of Ultimate Net Loss by the Reinsurer under this Agreement shall be regarded as if recovered or received prior to said reimbursement and all necessary adjustments shall be undertaken by the Parties hereto. Nothing, however, in this paragraph (N) of this ARTICLE VIII shall be construed to mean that Ultimate Net Losses are not reimbursable from the Reinsurer until the Ultimate Net Loss has been determined.

(O) The term “Unallocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest that are not allocated to a specific loss occurrence with respect to a policy of the Subject Business. Unallocated Loss Adjustment Expenses shall also include salaries of officers and permanent employees of the Reinsured.

(P) The term “United States” shall mean the United States of America, including all of its states, the District of Columbia, its territories, possessions and commonwealths.

ARTICLE IX INTERLOCKING

It is understood and mutually agreed as between the Reinsurer, on the one hand, and the Reinsured and its insurance-issuing affiliates on the other hand, the list of all such entities being, as of the Coinsurance Effective Date: Oscar Insurance Corporation, Oscar Garden State Insurance Corporation, Oscar Insurance Company, Oscar Health Plan of California, Oscar Buckeye State Insurance Corporation, Oscar Insurance Company of Florida, and Oscar Health Plan, Inc. (each, an “Oscar Reinsured”), that: (i) each and every one of the Oscar Reinsureds is a reinsured under a separate quota share reinsurance agreement issued by the Reinsurer that is identical to this Agreement with respect to all of the economic terms and conditions included herein; (ii) all such quota share reinsurance agreements shall be interlocked and applied in the aggregate as between the Reinsurer and the Oscar Reinsureds for all economic purposes hereunder and thereunder, including with respect to the determination by the Parties of the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin, such that the economic results of all such quota share reinsurance agreements for such purposes shall be aggregated and applied as though all Oscar Reinsureds were subject to one and the same quota share reinsurance agreement; and (iii) all Oscar Reinsureds jointly appoint each other as agent and representative of the others so that communications, negotiations, accommodations and agreements as between the Reinsurer and any Oscar Reinsured shall bind all Oscar Reinsureds to the extent and for so long as they remain affiliates, unless expressly stated otherwise.

 

6


ARTICLE X SUBROGATION AND SALVAGE

(A) The Reinsurer shall be subrogated, as respects any Ultimate Net Loss for which the Reinsurer shall actually pay or become liable to pay, but only to the extent of the amount of payment by, or the amount of liability of, the Reinsurer, to all rights of the Reinsured against any Person who may be legally responsible in damages for said Ultimate Net Loss. The Reinsured hereby agrees to use commercially reasonable efforts to enforce such rights. In the event the Reinsured shall fail or neglect to do so, the Reinsurer is hereby authorized and empowered to bring any commercially reasonable appropriate action in the name of the Reinsured or in the name of a Policyholder under an insurance policy of the Subject Business reinsured hereunder to enforce such rights.

(B) Any rights of subrogation, recoveries, salvages or reimbursements applying to loss occurrences reinsured under this Agreement shall always be used to reimburse the reinsurers excess of the Reinsurer (from the last to the first, beginning with the reinsurer of the last excess) according to their participation, before being used in any way to reimburse the Reinsurer. The Reinsured shall recover for the retention from recoveries, salvages or reimbursements only after the Reinsurer has been reimbursed in full for its Ultimate Net Loss reimbursement payment. In determining the amount of recoveries, salvages or reimbursements, there shall first be deducted from any amount recovered the expenses incurred in effecting the recovery (excluding salaries and expenses of officers and employees of the Reinsured).

(C) All salvages, recoveries or reimbursements, after deduction of all expenses allowed under paragraph (B) of this ARTICLE X applicable thereto, recovered or received subsequent to an Ultimate Net Loss reimbursement to the Reinsured by the Reinsurer under this Agreement shall be applied as if recovered or received prior to the aforesaid settlement and all necessary adjustments shall be made by the Parties hereto; provided that nothing in this ARTICLE X shall be construed to mean that Ultimate Net Losses under this Agreement are not recoverable until all salvage, recovery and reimbursement has been determined.

ARTICLE XI INURING THIRD PARTY CEDED REINSURANCE

The amount of the Reinsurer’s liability in respect of any Ultimate Net Loss shall not be increased by the inability of the Reinsured to collect from any other reinsurer(s), whether specific or general, any amounts which may have become due from them regardless of whether such inability arises from the insolvency of such other reinsurers or for any other reason whatsoever.

ARTICLE XII CURRENCY

Wherever the word “Dollars” of the symbol “$” appears in this Agreement, it shall mean United States dollars. All payments under this Agreement shall be made in Dollars.

 

7


ARTICLE XIII REPORTS AND REIMBURSEMENTS

Accounts shall be submitted by the Reinsured to the Reinsurer on a quarterly basis, in arrears. Within 30 days of the end of each calendar quarter, the Reinsured shall submit to the Reinsurer a statement setting forth the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder, Premium Adjustments, Ultimate Net Loss activity, reserves (including IBNR reserves), etc., in each case, for the prior calendar quarter, and within thirty (30) days of the end of each calendar year, the Reinsured shall submit to the Reinsurer a statement setting forth the Profit Commission due the Reinsured, if any, under ARTICLE VII for the prior calendar year. Any net balance payable to or from either Party shall be paid by the debtor Party within 15 days of the receipt of such statement. The form of the quarterly and calendar year statements and the information set out therein shall be mutually agreed as between the Parties, and subject to the Parties’ mutual amendments, as the Parties may agree from time to time. This ARTICLE XIII will survive the termination or expiration of this Agreement.

ARTICLE XIV LIABILITY AND PAYMENT

The Reinsured’s good faith determinations regarding its liabilities under the policies of the Subject Business, including the Reinsured’s decisions to adjust, settle, and compromise all Claims will bind the Reinsurer. Notwithstanding anything contained in this Agreement to the contrary, the liability of the Reinsurer with respect to Claims will follow the liability of the Reinsured in all respects and will be subject to all good faith interpretations of contract provisions in the policies of the Subject Business by the Reinsured including interpretations resulting in the payment of Claims. Notwithstanding anything contained in this Agreement to the contrary, all such adjustments, settlements and compromises will be unconditionally binding upon the Reinsurer in proportion to the Reinsurer’s quota share participation, the true intent of this Agreement being that the Reinsurer will, in every case to which this Agreement applies, follow the fortunes, and follow the settlements of the Reinsured.

ARTICLE XV AUDIT AND INSPECTION

The Parties will maintain complete and correct books and records relating to the policies of the Subject Business, Claims and their respective obligations under this Agreement (the “Books and Records”). The Books and Records will be open to audit and reproduction by the Reinsured and Reinsurer and their respective designated representatives (collectively, the “Auditing Parties,” and individually, the “Auditing Party”) at the expense of the Auditing Party at the office of the Audited Party (as defined below) during the Agreement Period, the Run-Off Period and until one (1) year following the expiration of the Run-Off Period, upon reasonable advance written notice and for the sole purpose of confirming the compliance of the Party being audited (the “Audited Party”) with Applicable Law and/or its obligations, in each case, with respect to or under this Agreement; provided, that such audits shall be limited to not more than two (2) audits during any twelve (12) calendar month period; provided, further, that such temporal limitation will not apply to any such audit that is required by Applicable Law. Such audits will occur only during normal business hours using reasonable care not to cause damage and not to interrupt the normal business operations of the Audited Party and will be subject to, (i) such security procedures as the Audited Party may reasonably impose, and (ii) such limitations as may be required under Applicable Law governing the conduct of the Audited Party’s business, or as may be otherwise reasonably required in order to protect from disclosure information of the Audited Party that does not relate to the policies of the Subject Business, Claims and the Audited Party’s obligations under this Agreement.

 

8


ARTICLE XVI ERRORS AND OMISSIONS

Any inadvertent error or omission on the part of either Party hereto shall not relieve the other Party from any liability which would have attached hereunder, provided that such error or omission is rectified promptly upon discovery, and shall not impose any greater liability on the Reinsurer than would have attached hereunder if the error or omission had not occurred.

ARTICLE XVII ADJUSTMENTS

Notwithstanding anything contained herein to the contrary, if the Reinsured’s liability under any policy of the Subject Business is changed because of a misstatement of age, sex, marital status, smoking status, amount or nature of coverage, or any other material fact by any Policyholder or its representative (including any employer, sponsor, group policyholder, broker, agent or other Person acting on behalf of the Policyholder), or in good faith by the Reinsured or by a Governmental Authority, the Reinsurer will, (i) assume that portion of any increase in reinsured liabilities resulting from the change, and (ii) receive credit for that portion of any decrease in reinsured liabilities resulting from the change, and the Reinsured and the Reinsurer will make all appropriate adjustments to amounts due each other under this Agreement.

ARTICLE XVIII CHANGES IN THE AGREEMENT

The terms of this Agreement shall not be waived or changed except by written amendment executed by a duly authorized officer of the Reinsurer and by a duly authorized officer or representative of the Reinsured.

ARTICLE XIX OFFSET CLAUSE

The Reinsured or the Reinsurer may offset any balance(s) which may become due between them under this Agreement or any reinsurance agreement with an Oscar Reinsured that is subject to the Interlocking provision herein. This offset right shall apply regardless of whether the balances arose on account of Premiums, commission, claims, losses, Allocated Loss Adjustment Expense, salvage or any other amount(s) due from one Party to the other.

ARTICLE XX NO THIRD PARTY RIGHTS

Except with respect to the Oscar Reinsureds, in no event shall anyone other than the Reinsurer or the Reinsured have any rights under this Agreement.

ARTICLE XXI CHANGES IN OWNERSHIP AND ADMINISTRATIVE PRACTICES

The Reinsured undertakes not to voluntarily make any material change in its established acceptance and underwriting policy in respect of the Subject Business, nor to undergo any Change in Control, without, in each case, the prior consent of the Reinsurer, such consent not to be unreasonably withheld, denied or conditioned; provided, however, that such consent shall not be required if such change is required by Applicable Law. It is furthermore understood and agreed that should a new affiliate to the Oscar Reinsureds be established for purposes of writing business similar to the Subject Business, the Parties hereto shall, subject to Applicable Law and regulatory approval, mutually agree on a quota share reinsurance agreement in respect of such new affiliate and such business that shall be consistent with the terms and conditions hereof and subject to the same Interlocking provision and principles set forth here.

 

9


ARTICLE XXII NON-WAIVER CLAUSE

The failure of the Reinsured or the Reinsurer to insist on compliance with this Agreement or to exercise any right or remedy hereunder shall not constitute a waiver of any rights or remedies contained herein nor estop either Party from thereafter demanding full and complete compliance nor prevent either Party from exercising such rights or remedy in the future.

ARTICLE XXIII INSOLVENCY

In the event of the Reinsured’s insolvency, any payments due the Reinsured from the Reinsurer pursuant to the terms of this Agreement will be made directly to the statutory successor of the Reinsured or its conservator, liquidator, or receiver without diminution because of the insolvency of the Reinsured for those claims reported and allowed against the Reinsured by any court of competent jurisdiction or by the liquidator, rehabilitator, receiver or statutory successor having authority over such claims. The conservator, liquidator, receiver or statutory successor of the Reinsured will give the Reinsurer written notice of the pendency of a claim against the Reinsured on any policy of the Subject Business within a reasonable time after such claim is filed in the insolvency proceeding. During the pendency of any such claim, the Reinsurer may investigate such claim and interpose in the Reinsured’s name (or in the name of the Reinsured’s conservator, liquidator, receiver or statutory successor), in the proceeding where such claim is to be adjudicated, any defense or defenses which the Reinsurer may deem available to the Reinsured or its conservator, liquidator, receiver or statutory successor. The expense thus incurred by the Reinsurer will be chargeable, subject to court approval, against the Reinsured as a part of the expense of liquidation to the extent of a proportionate share of the benefit which may accrue to the Reinsured solely as a result of the defense undertaken by the Reinsurer.

ARTICLE XXIV NO INTERMEDIARY

This Reinsurance has been negotiated and agreed solely between the Parties hereto and no broker or intermediary has represented either Party or is entitled to any remuneration.

ARTICLE XXV PAYMENTS

All ceded Premiums and Ultimate Net Loss reimbursement settlements shall be made directly between the Reinsurer and the Reinsured; provided that the Reinsured may appoint as Reinsured’s agent for the payment of ceded Premiums and acceptance of Ultimate Net Loss settlements any one Oscar Reinsured it so chooses, from time to time, by providing written notice thereof to the Reinsurer.

 

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ARTICLE XXVI DELAYED PAYMENTS

For purposes of any payments due hereunder, if there is a delayed settlement of a payment due, interest will accrue on such payment at the Applicable Interest Rate. Interest will be calculated on the basis of actual days for a 365-day year based on the actual number of days elapsed. For purposes of this Agreement, a payment will be considered overdue, and such interest will begin to accrue, on the date which is thirty (30) days after the date such payment is due.

ARTICLE XXVII CREDIT FOR REINSURANCE

The Parties intend that the Reinsured will receive, from and after the Coinsurance Effective Date, full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile. If the Reinsured nevertheless loses statutory reserve financial statement credit in the Reinsured’s state of domicile due to any reason attributable to the Reinsurer, the Reinsurer’s business, operations, condition, licenses and/or authorizations (including any losses thereof or restrictions thereon) or to a change in Applicable Law (collectively, a “Coinsurance Credit Event”), or if the Reinsured is notified in writing by a Governmental Authority that it will not receive statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsurer will promptly, and in any event will no later than thirty (30) calendar days following receipt of written notice from the Reinsured that a Coinsurance Credit Event has occurred, (i) cure such Coinsurance Credit Event to the Parties’ mutual satisfaction and at the Reinsurer’s sole cost and expense, and/or (ii) establish for the benefit of the Reinsured, at the Reinsurer’s sole cost and expense, such trust accounts, letters of credit, funds withheld, or other security permitted by Applicable Law to allow the Reinsured to obtain full statutory reserve financial statement credit for reinsurance provided under this Agreement in the Reinsured’s state of domicile. Subject to the preceding two sentences, in the event of a Coinsurance Credit Event, the Reinsurer will have the option of determining the method of security to be utilized for such purpose. If such method elected by the Reinsurer requires any change to this Agreement in order for the Reinsured to obtain such statutory reserve financial statement credit, the Parties will cooperate in good faith to promptly amend this Agreement to incorporate such change. Any trust accounts, letters of credit, funds withheld, or other security established by the Reinsurer under this ARTICLE XXVII to address a Coinsurance Credit Event as set forth herein shall only be required to be maintained for so long a period as the Reinsured cannot receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile, and the Reinsured shall reasonably cooperate in the release of any such security should the Reinsured’s ability to receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile without such security be fully restored. This ARTICLE XXVII will survive the termination or expiration of this Agreement.

ARTICLE XXVIII ARBITRATION CLAUSE

This Clause shall form a separate agreement between the Reinsured and the Reinsurer from the main Agreement.

 

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All matters in difference between the Reinsured and the Reinsurer (hereinafter referred to as the “Disputing Parties”) in relation to this reinsurance, including its formation and validity, and whether arising during or after the period of this reinsurance, shall be referred to an Arbitration Tribunal in the manner hereinafter set out.

Unless the Disputing Parties agree upon a single Arbitrator within thirty days of one receiving a written request from the other for Arbitration, the Claimant (the Disputing Party requesting Arbitration) shall appoint its Arbitrator and give written notice thereof to the Respondent. Within thirty days of receiving such notice the Respondent shall appoint its Arbitrator and give written notice thereof to the Claimant, failing which the Claimant may nominate an Arbitrator on behalf of the Respondent.

Should the Arbitrators fail to agree, they shall appoint, by mutual agreement or by a mutually agreed selection process, an Umpire to whom the matter in difference shall be referred.

Unless the Disputing Parties otherwise agree, the Arbitration Tribunal shall consist of persons employed or engaged in a senior position in insurance or reinsurance underwriting or claims.

The Arbitration Tribunal shall have the power to fix all procedural rules for the holding of the Arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, discovery, inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the Arbitration and may receive and act upon such evidence, whether oral or written strictly admissible or not as it shall in its discretion think fit.

All costs and expenses including attorneys’ fees, arbitrator fees, and expert fees of the Arbitration shall be in the discretion of the Arbitration Tribunal who may direct to and by whom and in what manner they shall be paid.

The seat of the Arbitration shall be in New York, NY and the Arbitration Tribunal shall apply the laws of the state of domicile of the Reinsured, without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction, as the proper law of this reinsurance.

The Arbitration Tribunal may not award exemplary, punitive, multiple or other damages of a similar nature.

The award of the Arbitration Tribunal shall be in writing and binding upon the Disputing Parties who covenant to carry out the same. If either of the Disputing Parties should fail to carry out any award the other may apply for its enforcement to a court of competent jurisdiction in any territory in which the Disputing Party in default is domiciled or has assets or carries on business.

ARTICLE XXIX TERM

This Agreement will commence on the Coinsurance Effective Date and run indefinitely unless earlier terminated as provided in ARTICLE XXX (the “Term”).

 

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ARTICLE XXX TERMINATION

Notwithstanding anything contained to the contrary in this Agreement, this Agreement may only be terminated as follows:

 

  (b)

If either Party to this Agreement fails to pay (the “Non-paying Party”) the other Party an amount due within thirty (30) days after the due date provided in this Agreement, the other Party (the “Terminating Party”) may terminate this Agreement, subject to thirty (30) days prior written notice to the Non-paying Party of the Terminating Party’s intention to terminate; provided, however, that the Non-paying Party may avoid termination of this Agreement pursuant to this paragraph by paying all undisputed amounts that are delinquent and then due, including any interest owing thereon pursuant to ARTICLE XXVI, on or before the termination date specified in the written notice;

 

  (c)

In the event that a Governmental Authority with jurisdiction over the Reinsured denies or revokes the ability of the Reinsured to take full statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsured may terminate this Agreement, subject to thirty (30) days prior written notice to the Reinsurer of the Reinsured’s intention to terminate; provided, however, that the Reinsurer may avoid termination of this Agreement pursuant to this paragraph by fully complying with ARTICLE XXVII prior to the end of such thirty (30) day notice period;

 

  (d)

This Agreement may be terminated by either Party by giving written notice of termination to the other Party if such termination is required by any Governmental Authority under Applicable Law;

 

  (e)

This Agreement may be terminated by either Party at any time after the third (3rd) year anniversary of the Coinsurance Effective Date by giving written notice of termination to the other Party; and

 

  (f)

If one or more of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein is terminated for reasons other than that such termination was required by a Governmental Authority under Applicable Law, either Party may terminate this Agreement within thirty (30) days following the termination of such reinsurance agreement that is subject to the Interlocking provision herein by giving the other Party written notice of termination of this Agreement.

 

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The effective date of termination of this Agreement (the “Termination Date”) for any notice of termination properly delivered in accordance with this ARTICLE XXX, will be the date specified in such notice.

Upon the Termination Date of this Agreement, subject to all other terms and conditions hereof including the Maximum Combined Ratio, the Reinsurer will remain liable for all reinsured liabilities under this Agreement with respect to each policy of the Subject Business that was effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement and the Reinsurer will remain liable for all such reinsurance until the end of the “Run-Off Period,” which will mean the period beginning on the Termination Date of this Agreement and continuing until the date on which the Reinsured has no further liabilities or obligations under any policy of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement. For the avoidance of doubt, the Reinsured’s and the Reinsurer’s respective obligation to pay the other all amounts due hereunder, as applicable, in accordance with the terms of this Agreement, with respect to the policies of the Subject Business that were effected, bound, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement, will extend during the Run-Off Period, as provided herein. The Parties hereto expressly agree that they will reasonably cooperate with each other in the handling of all run-off obligations with respect to the policies of the Subject Business reinsured hereunder.

Upon the Termination Date of this Agreement, no policies of the Subject Business effected, bound, sold, issued, renewed or reinstated, as applicable, by the Reinsured after the Termination Date of this Agreement will be reinsured under this Agreement.

This ARTICLE XXX will survive the termination or expiration of this Agreement.

ARTICLE XXXI NOTICES

All notices, demands and other communications hereunder will be in writing and will be sent by certified mail return receipt requested, by hand or by nationally recognized overnight courier service addressed to the Party to whom such notice or other communication is to be given or made at such Party’s address as set forth below, or to such other address as such Party may designate in writing to the other Parties from time to time in accordance with the provisions hereof and will be deemed given five (5) calendar days after being sent by certified mail and one (1) Business Day after being sent by any other method described above, as follows:

(i) If to Reinsurer:

National Indemnity Company

100 First Stamford Place

Stamford, CT 06902

Attn: General Counsel

####


(ii) If to Reinsured:

Oscar Health Plan of California

3535 Hayden Ave.

Culver City, CA

90232

Attn: Legal

####

(iii) provided, however, if any of the above Parties will have designated a different address by notice to the other Parties, then to the last address so designated.

ARTICLE XXXII GOVERNING LAW

This Agreement will be governed by and construed in accordance with the laws of the state of domicile of the Reinsured without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction.

ARTICLE XXXIII ENTIRE AGREEMENT

This Agreement, and each of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein, and the schedules and exhibits hereto and thereto, which are expressly incorporated by reference herein and made a part hereof, constitute the entire agreement of the Parties with respect to the subject matter hereof and supersedes all other prior understandings and agreements between the Parties with respect to the subject matter hereof, whether written or oral.

ARTICLE XXXIV ASSIGNMENT AND DELEGATION

This Agreement will be binding upon and inure solely to the benefit of the Parties and their respective successors and permitted assigns. This Agreement, and the rights and obligations hereunder, cannot be assigned or delegated, in whole or in part, by the Reinsurer or the Reinsured without, except as otherwise expressly permitted under this Agreement, the prior written consent of the other; provided, however, that no such assignment or delegation will relieve either the Reinsurer or the Reinsured from any liability or obligation hereunder. Any assignment or delegation in violation of this ARTICLE XXXIV will be null and void ab initio.

ARTICLE XXXV EXPENSES

Unless otherwise specifically provided herein, all costs and expenses incurred in connection with this Agreement and the transactions and obligations contemplated herein will be paid by the Party incurring such cost or expense.

 

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IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed in duplicate by their duly authorized representatives

This 30 day of September, 2019 by Oscar Health Plan of California

 

/s/ Sid Sankaran

Title: Chief Financial Officer

This 30 day of September, 2019 by National Indemnity Company

 

/s/ Brian Snover

Title: Sr VP

 

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Exhibit 10.36

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE

ENDORSEMENT NO. 1 TO QUOTA SHARE REINSURANCE AGREEMENT

The parties to the Quota Share Reinsurance Agreement between Oscar Insurance Corporation, a New York domiciled insurance company, and National Indemnity Company, a Nebraska domiciled insurance company (the “Agreement”) , effective during the time period commencing at 12:01 AM Eastern Time on October 1, 2019 (the “Coinsurance Effective Date”) and terminating at 12:00 AM (midnight) Eastern Time on December 31, 2020 hereby mutually agree to this Endorsement No. 1, effective, October 1, 2020:

WHEREAS, the parties mutually agreed the terms of the Agreement effective December 31, 2019; and

WHEREAS, with effect from October 1 of 2020, the second underwriting year under the Agreement, the parties have agreed that Reinsurer’s affiliate, Berkshire Hathaway Specialty Insurance Company, shall be the reinsurer under this Agreement;

NOW, THEREFORE, the parties mutually agree as follows:

 

  1.

With effect from October 1, 2020, Berkshire Hathaway Specialty Insurance Company is (the “Reinsurer”) and Oscar Insurance Corporation (the “Reinsured”). The Reinsured and the Reinsurer each individually, a “Party”, and collectively, the “Parties”). Paragraph 1 of the Quota Share Reinsurance Agreement now reflects Berkshire Hathaway Specialty Insurance Company as the reinsurer.

 

  2.

Article I (ii) shall be replaced with the following: For calendar year 2020 and, if applicable, the remainder of the Agreement Period:

Effective January 1,2020 through June 30, 2020, in respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”) , the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Other Inuring Ceded XOL Reinsurance.

Effective July 1, 2020 and, if applicable, the remainder of the Agreement Period, in respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020 and, if applicable, the remainder of the Agreement Period that may be entered into from time to time with the Reinsured, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business after such cession under the Other Inuring Ceded XOL Reinsurance.


  3.

Modification of Article IX to add: “The results of the 2020 and prior and subsequent underwriting years, if any, shall be combined for purposes of evaluating and applying any margin sensitive or similar Agreement provisions under all underwriting years.”

 

  4.

Modification of Article IX: Oscar Health Plan of Georgia , and Oscar Health Plan of Pennsylvania have been added.

 

  5.

Modification of Article XXX: “Article XXX” in the second line has been replaced with “Article XXXI”.

 

  6.

Modification of Article XXXI: “Article XXX” in the fourth and seventh paragraphs has been replaced with “Article XXXI”.

 

  7.

Modification Article XXXII - Notices:

If to Reinsurer:

Berkshire Hathaway Specialty Insurance Company

100 First Stamford Place

Stamford, CT 06902

Attn: General Counsel

E-mail: ####

 

  8.

Except the provisions above, all other terms and conditions remain unchanged.

WHERE FOR, the parties have executed this Endorsement by their duly authorized representatives.

 

Oscar Insurance Corporation
By:   /s/ Sid Sankaran
Title:   CFO
Date:   1/15/2021
NATIONAL INDEMNITY COMPANY
By:   /s/ Brian Snover
Title:   SR VP
Date:   1/15/2021
BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY
By:   /s/ Brian Snover
Title:   SR VP
Date:   1/15/2021

 

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CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE

REGISTRANT IF PUBLICLY DISCLOSED.

QUOTA SHARE REINSURANCE AGREEMENT

This Quota Share Reinsurance Agreement (the “Agreement”), effective as of the Coinsurance Effective Date, is made and entered into by and between Oscar Insurance Corporation, a New York domiciled insurance company (the “Reinsured”), and National Indemnity Company, a Nebraska domiciled insurance company (the “Reinsurer”) (the Reinsured and the Reinsurer each individually, a “Party”, and collectively, the “Parties”).

RECITALS

WHEREAS, the Reinsured is, among other things, engaged in the business of underwriting, marketing, selling, issuing, renewing and servicing commercial health insurance products for individuals and small employers;

WHEREAS, the Reinsurer, among other things, is authorized under Applicable Law to assume reinsurance of such commercial health insurance products;

WHEREAS, the Reinsured desires to cede on a [***] indemnity quota share reinsurance basis to the Reinsurer, as of the Coinsurance Effective Date (as defined below), all of the commercial health insurance products for individuals and small employers that it writes in the United States (the “Subject Business”), subject to the terms and conditions stated herein;

WHEREAS, the Reinsurer desires to reinsure on such basis the Subject Business; and

WHEREAS, except as set forth in ARTICLE IX, this Agreement is an agreement solely between the Reinsured and the Reinsurer and performance of the obligations of each Party under this Agreement will be rendered solely to the other Party.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the Parties hereby agree as follows:

ARTICLE I [***]% QUOTA SHARE REINSURANCE OF SUBJECT BUSINESS

The reinsurance provided by the Reinsurer under this Agreement is in respect of all policies of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or after the Coinsurance Effective Date, through the Agreement Period, and on or prior to the Termination Date (as such terms are defined below) on the following basis:

 

  (i)

For calendar year 2019:

 

  (a)

In respect of all policies of the Subject Business written by the Reinsured that is not subject to the AXA quota share reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring AXA Ceded Reinsurance”) and the Odyssey Re excess of loss reinsurance agreement entered into with the Reinsured for calendar year 2019 (the “Inuring Ceded Odyssey Re XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis; and


  (b)

In respect of all policies of the Subject Business written by the Reinsured that is subject to the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable, in each case, for calendar year 2019, the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Inuring AXA Ceded Reinsurance and/or the Inuring Ceded Odyssey Re XOL Reinsurance, as applicable.

 

  (ii)

For calendar year 2020 and, if applicable, the remainder of the Agreement Period:

In respect of all policies of the Subject Business written by the Reinsured that is subject to any excess of loss reinsurance agreement for calendar year 2020 and, if applicable, the remainder of the Agreement Period1 that may be entered into from time to time with the Reinsured, such excess of loss reinsurance to be substantially similar to, in coverage and amount, as the Inuring Ceded Odyssey Re XOL Reinsurance that was in place for calendar year 2019 (such excess of loss reinsurance, the “Other Inuring Ceded XOL Reinsurance”), the reinsurance provided by the Reinsurer under this Agreement shall apply on a [***]% quota share basis to all such policies of the Subject Business retained net and un-reinsured by the Reinsured after such cession under the Other Inuring Ceded XOL Reinsurance.

For the avoidance of doubt, the Inuring Ceded Odyssey Re XOL Reinsurance for calendar year 2019, and the Other Inuring Ceded XOL Reinsurance for calendar year 2020 and, if applicable, the remainder of the Agreement Period, shall each be maintained by the Reinsured during its applicable calendar year period, as specified immediately above in this ARTICLE I, and shall be deemed, for purposes of this Agreement, as inuring to this Agreement and the reinsurance being provided hereunder by the Reinsurer during its applicable calendar year period specified above.

ARTICLE II AGREEMENT PERIOD

The reinsurance provided by the Reinsurer under this Agreement covers the Subject Business during the time period commencing at 12:01 AM Eastern Time on October 1, 2019 (the “Coinsurance Effective Date”) and terminating at 12:00 AM (midnight) Eastern Time on December 31, 2020 (such period, the “Initial Agreement Period”). The Initial Agreement Period, together with any extensions thereof, if any, by the Reinsurer as provided in this ARTICLE II, shall be referred to hereafter as the “Agreement Period”. Except as provided in ARTICLE XXX,

 

1 Note to Draft: This is to pick up any extension period of the Agreement Period by the Reinsurer.

 

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this Agreement cannot be terminated during the Agreement Period by either Party. Should the Reinsurer not have realized a [***]% margin on its quota share participation in this Agreement 6 months prior to the expiration of the then current Agreement Period, as set forth in ARTICLE VII hereof, the Parties agree to negotiate in good faith the terms for renewal.

ARTICLE III TERRITORIAL SCOPE

The territorial scope of this Agreement shall be wherever in the United States the Reinsured issues the Subject Business.

ARTICLE IV REINSURANCE PREMIUM AND CEDING COMMISSION

In consideration of the reinsurance provided by the Reinsurer under this Agreement, the Reinsured shall pay to the Reinsurer its quota share participation in all Premiums received by the Reinsured in connection with the Subject Business which shall be payable to the Reinsurer in cash in accordance with ARTICLE XIII. The only deduction allowable from the Reinsurer’s quota share participation in the Premiums shall be a [***]% ceding commission payable by the Reinsurer to the Reinsured (the “Ceding Commission”).

ARTICLE V PREMIUM ADJUSTMENTS

The Reinsurer’s quota share participation in all Premiums, which Premiums were received by the Reinsurer, that are required to be refunded, rebated or otherwise repaid by the Reinsured to a Policyholder or Governmental Authority due to, (i) changes in or cancellations of any policy of the Subject Business, (ii) contractual requirements under the terms of the policies of the Subject Business, or (iii) Applicable Law including the ACA Risk Adjustment Program, and any such refunds, rebates or payments resulting from (x) a finding in a commercial risk adjustment audit by any federal Governmental Authority or a self-audit performed by the Reinsured that the Premiums were incorrect, and (y) any ACA Rebates (to the extent such rebates are related to the policies of the Subject Business, as solely determined by the Reinsured) (paragraphs (i), (ii), and (iii) of this ARTICLE V, collectively, the “Premium Adjustments”), shall be refunded by the Reinsurer to the Reinsured in accordance with ARTICLE XIII. The Parties shall promptly make all necessary financial adjustments between them with respect to the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin necessitated by any such Premium Adjustments in a manner consistent with the terms herein.

This ARTICLE V will survive the termination or expiration of this Agreement.

ARTICLE VI MAXIMUM COMBINED RATIO

Under no circumstances whatsoever, howsoever arising, will the Reinsurer be liable for any sums in excess of a combined ratio of Ultimate Net Loss to the Reinsurer’s quota share participation in the Premiums actually received by the Reinsurer (i.e., after deducting the Ceding Commission from such Premiums) of [***]% in the aggregate during any calendar year period (the “Maximum Combined Ratio”). For the avoidance of doubt, any Ceding Commission paid to the Reinsured or other deductions from the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder shall be first deducted from such ceded Premiums in calculating the Maximum Combined Ratio, [***].

 

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ARTICLE VII PROFIT COMMISSION

Reinsured shall be paid a profit commission by the Reinsurer in an amount equal to any profit resulting from this Agreement from a [***] combined ratio during any calendar year period (the “Profit Commission”) (i.e., the Reinsurer shall retain a margin of [***]% (the “ Reinsurer’s Margin”)). Payment to the Reinsured of the Profit Commission shall be made in accordance with ARTICLE XIII.

ARTICLE VIII DEFINITIONS

In this Agreement, (i) the singular includes the plural, and the plural the singular; (ii) words importing any gender include the other gender; (iii) the words “including”, “includes” and “include” will be deemed to be followed by the words “without limitation” (where “including”, “includes”, and “include” are not followed by “without limitation”); and (iv) when a reference is made in this Agreement to an article or a section, such reference will be to an article or a section of this Agreement, unless otherwise indicated. Any agreement, instrument, statute or regulation defined or referenced to herein or in any agreement or instrument that is referred to herein means such agreement, instrument, statute or regulation as from time to time amended, modified or supplemented, including (in the case of agreements or instruments) by waiver or consent and (in the case of statutes or regulations) by succession of comparable successor statutes. References to any Person include the successors and permitted assigns of such Person. References from or through any date mean, unless otherwise specified, from and including or through and including, respectively. The following terms will have the respective meanings set forth below throughout this Agreement.

(A) The term “ACA” shall mean the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 and its implementing regulations and any written and published or released sub-regulatory guidance.

(B) The term “ACA Rebate” shall mean any rebate required by Section 2718 of ACA.

(C) The term “ACA Risk Adjustment Program” shall mean any mandatory state or federal risk adjustment program created pursuant to Section 1343 of ACA.

(D) The term “Allocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest accrued prior to judgment where such interest is not added to the judgment, and interest accrued after judgment, which are actually paid by the Reinsured (excluding salaries of officers and permanent employees of the Reinsured) in connection with any investigation, adjustment, defense, resistance to, compromise, settlement, or negotiations that are allocated to a specific loss occurrence with respect to a policy of the Subject Business for which reimbursement is due the Reinsured under this Agreement. Allocated Loss Adjustment Expenses shall be apportioned in proportion to the respective Parties’ quota share participation under this Agreement, as finally determined by the Parties. All costs and expenses that are not Allocated Loss Adjustment Expenses shall be Unallocated Loss Adjustment Expenses.

 

6


The Allocated Loss Adjustment Expenses shall be a part of, and included in, the Ultimate Net Loss.

(E) The term “Applicable Interest Rate” shall mean as of any date of determination, a rate of interest equal to the three (3) month U.S. Treasury Note, as published in the Wall Street Journal on such date, plus [***] basis points.

(F) The term “Applicable Law” shall mean any domestic or foreign federal, state or local statute, law, ordinance or code, or any rules, regulations, administrative interpretations or orders issued by any Governmental Authority pursuant to any of the foregoing, and any order, writ, injunction, directive, judgment or decree of a court of competent jurisdiction, in each case solely to the extent applicable to the Parties hereto or the performance of their respective obligations under this Agreement.

(G) The term “Business Day” shall mean any day other than a Saturday, Sunday or other day on which commercial banks in the then current state of domicile of either Party are required or authorized by law to be closed.

(H) The term “Change in Control” shall mean a transaction or series of related transactions for the acquisition by one or more Persons that are not affiliates of the Reinsured of more than 50% of the outstanding common stock of the Reinsured.

(I) The term “Claim” shall mean with respect to each individual policy of the Subject Business, any and all claims, requests, demands or notices made by or on behalf of any Policyholder or any other Person for the payment of benefits under the policy including return of Premiums or any other payments or benefits due or alleged to be due under or in connection with any policy of the Subject Business including interest payable thereon in accordance with Applicable Law.

(J) The term “Governmental Authority” shall mean any domestic government, any national, state or other political subdivision thereof or any self-regulatory authority, and any entity exercising executive, legislative, judicial, regulatory or administrative functions of or pertaining to government.

(K) The term “IBNR” shall mean reserves for claims incurred but not reported.

(L) The term “Person” shall mean any natural person, corporation, partnership, joint venture, limited liability company, association, trust, unincorporated organization or other legal entity.

(M) The term “Personal Data” shall mean and include any of the following information that is acquired by, provided to, created by or maintained by a Party or any third party acting on behalf of a Party in connection with this Agreement: (i) any information that identifies or can reasonably be used to identify an individual, such as first and last name, social security number or other government issued number or identifier, date of birth, home or other physical address, e-mail address or other online contact information, financial account number, credit or debit card number, biometric data, mother’s maiden name, or other personally identifiable information; and (ii) personally identifiable financial or insurance information, including but not limited to “non-public personal information” as that term is defined in the Gramm-Leach-Bliley Act, as amended, and implementing regulations, 15 U.S.C. § 6809(4).

 

7


(N) The term “Policyholders” shall mean policyholders, insureds, beneficiaries, subscribers, members, certificate holders and assignees, and eligible dependents of each of the foregoing, under policies of the Subject Business.

(O) The terms “Premiums” shall mean all premiums, fees and contributions received by the Reinsured in connection with the issuance of the policies of the Subject Business, net of such amounts paid or payable by the Reinsured under the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, as applicable, and subject, in each case, to Premium Adjustments.

(P) The term “Ultimate Net Loss” shall mean the sum which is payable or has in fact been paid in cash by the Reinsurer to the Reinsured for Claims under the policies of the Subject Business after making deductions for all recoveries, all salvages, and all claims upon the Inuring AXA Ceded Reinsurance, the Inuring Ceded Odyssey Re XOL Reinsurance, and the Other Inuring Ceded XOL Reinsurance, in each case, to the extent applicable, whether collected or not from the reinsurers thereunder. Ultimate Net Loss shall include Allocated Loss Adjustment Expenses. Ultimate Net Loss shall not include any Unallocated Loss Adjustment Expenses. All salvages, recoveries and payments recovered or received subsequent to reimbursement to the Reinsured of Ultimate Net Loss by the Reinsurer under this Agreement shall be regarded as if recovered or received prior to said reimbursement and all necessary adjustments shall be undertaken by the Parties hereto. Nothing, however, in this paragraph (N) of this ARTICLE VIII shall be construed to mean that Ultimate Net Losses are not reimbursable from the Reinsurer until the Ultimate Net Loss has been determined.

(Q) The term “Unallocated Loss Adjustment Expenses” shall mean all expenses including court costs, attorneys’ fees, expenses, and interest that are not allocated to a specific loss occurrence with respect to a policy of the Subject Business. Unallocated Loss Adjustment Expenses shall also include salaries of officers and permanent employees of the Reinsured.

(R) The term “United States” shall mean the United States of America, including all of its states, the District of Columbia, its territories, possessions and commonwealths.

ARTICLE IX INTERLOCKING

It is understood and mutually agreed as between the Reinsurer, on the one hand, and the Reinsured and its insurance-issuing affiliates on the other hand, the list of all such entities being, as of the Coinsurance Effective Date: Oscar Insurance Corporation, Oscar Garden State Insurance Corporation, Oscar Insurance Company, Oscar Health Plan of California, Oscar Buckeye State Insurance Corporation, Oscar Insurance Company of Florida, and Oscar Health Plan, Inc. (each, an “Oscar Reinsured”), that: (i) each and every one of the Oscar Reinsureds is a reinsured under a separate quota share reinsurance agreement issued by the Reinsurer that is identical to this Agreement with respect to all of the economic terms and conditions included herein; and (ii) all

 

8


such quota share reinsurance agreements shall be interlocked and applied in the aggregate as between the Reinsurer and the Oscar Reinsureds for all economic purposes hereunder and thereunder, including with respect to the determination by the Parties of the Maximum Combined Ratio, Profit Commission, and the Reinsurer’s Margin, such that the economic results of all such quota share reinsurance agreements for such purposes shall be aggregated and applied as though all Oscar Reinsureds were subject to one and the same quota share reinsurance agreement.

ARTICLE X SUBROGATION AND SALVAGE

(a) The Reinsurer shall be subrogated, as respects any Ultimate Net Loss for which the Reinsurer shall actually pay or become liable to pay, but only to the extent of the amount of payment by, or the amount of liability of, the Reinsurer, to all rights of the Reinsured against any Person who may be legally responsible in damages for said Ultimate Net Loss. The Reinsured hereby agrees to use commercially reasonable efforts to enforce such rights. In the event the Reinsured shall fail or neglect to do so, the Reinsurer is hereby authorized and empowered to bring any commercially reasonable appropriate action in the name of the Reinsured or in the name of a Policyholder under an insurance policy of the Subject Business reinsured hereunder to enforce such rights.

(b) Any rights of subrogation, recoveries, salvages or reimbursements applying to loss occurrences reinsured under this Agreement shall always be used to reimburse the reinsurers excess of the Reinsurer (from the last to the first, beginning with the reinsurer of the last excess) according to their participation, before being used in any way to reimburse the Reinsurer. The Reinsured shall recover for the retention from recoveries, salvages or reimbursements only after the Reinsurer has been reimbursed in full for its Ultimate Net Loss reimbursement payment. In determining the amount of recoveries, salvages or reimbursements, there shall first be deducted from any amount recovered the expenses incurred in effecting the recovery (excluding salaries and expenses of officers and employees of the Reinsured).

(c) All salvages, recoveries or reimbursements, after deduction of all expenses allowed under paragraph (B) of this ARTICLE X applicable thereto, recovered or received subsequent to an Ultimate Net Loss reimbursement to the Reinsured by the Reinsurer under this Agreement shall be applied as if recovered or received prior to the aforesaid settlement and all necessary adjustments shall be made by the Parties hereto; provided that nothing in this ARTICLE X shall be construed to mean that Ultimate Net Losses under this Agreement are not recoverable until all salvage, recovery and reimbursement has been determined.

ARTICLE XI INURING THIRD PARTY CEDED REINSURANCE

The amount of the Reinsurer’s liability in respect of any Ultimate Net Loss shall not be increased by the inability of the Reinsured to collect from any other reinsurer(s), whether specific or general, any amounts which may have become due from them regardless of whether such inability arises from the insolvency of such other reinsurers or for any other reason whatsoever.

 

9


ARTICLE XII CURRENCY

Wherever the word “Dollars” of the symbol “$” appears in this Agreement, it shall mean United States dollars. All payments under this Agreement shall be made in Dollars.

ARTICLE XIII REPORTS AND REIMBURSEMENTS

Accounts shall be submitted by the Reinsured to the Reinsurer on a quarterly basis, in arrears. Within 30 days of the end of each calendar quarter, the Reinsured shall submit to the Reinsurer a statement setting forth the Reinsurer’s quota share participation in the Premiums payable to the Reinsurer hereunder, Premium Adjustments, Ultimate Net Loss activity, reserves (including IBNR reserves), etc., in each case, for the prior calendar quarter, and within thirty (30) days of the end of each calendar year, the Reinsured shall submit to the Reinsurer a statement setting forth the Profit Commission due the Reinsured, if any, under ARTICLE VII for the prior calendar year. Any net balance payable to or from either Party shall be paid by the debtor Party within 15 days of the receipt of such statement. The form of the quarterly and calendar year statements and the information set out therein shall be mutually agreed as between the Parties, and subject to the Parties’ mutual amendments, as the Parties may agree from time to time. This ARTICLE XIII will survive the termination or expiration of this Agreement.

ARTICLE XIV LIABILITY AND PAYMENT

The Reinsured’s good faith determinations regarding its liabilities under the policies of the Subject Business, including the Reinsured’s decisions to adjust, settle, and compromise all Claims will bind the Reinsurer. Notwithstanding anything contained in this Agreement to the contrary, the liability of the Reinsurer with respect to Claims will follow the liability of the Reinsured in all respects and will be subject to all good faith interpretations of contract provisions in the policies of the Subject Business by the Reinsured including interpretations resulting in the payment of Claims. Notwithstanding anything contained in this Agreement to the contrary, all such adjustments, settlements and compromises will be unconditionally binding upon the Reinsurer in proportion to the Reinsurer’s quota share participation, the true intent of this Agreement being that the Reinsurer will, in every case to which this Agreement applies, follow the fortunes, and follow the settlements of the Reinsured.

ARTICLE XV AUDIT AND INSPECTION

The Parties will maintain complete and correct books and records relating to the policies of the Subject Business, Claims and their respective obligations under this Agreement (the “Books and Records”). The Books and Records will be open to audit and reproduction by the Reinsured and Reinsurer and their respective designated representatives (collectively, the “Auditing Parties,” and individually, the “Auditing Party”) at the expense of the Auditing Party at the office of the Audited Party (as defined below) during the Agreement Period, the Run-Off Period and until one (1) year following the expiration of the Run-Off Period, upon reasonable advance written notice and for the sole purpose of confirming the compliance of the Party being audited (the “Audited Party”) with Applicable Law and/or its obligations, in each case, with respect to or under this Agreement; provided, that such audits shall be limited to not more than two (2) audits during any twelve (12)

 

10


calendar month period; provided, further, that such temporal limitation will not apply to any such audit that is required by Applicable Law. Such audits will occur only during normal business hours using reasonable care not to cause damage and not to interrupt the normal business operations of the Audited Party and will be subject to, (i) such security procedures as the Audited Party may reasonably impose, and (ii) such limitations as may be required under Applicable Law governing the conduct of the Audited Party’s business, or as may be otherwise reasonably required in order to protect from disclosure information of the Audited Party that does not relate to the policies of the Subject Business, Claims and the Audited Party’s obligations under this Agreement.

ARTICLE XVI ERRORS AND OMISSIONS

Any inadvertent error or omission on the part of either Party hereto shall not relieve the other Party from any liability which would have attached hereunder, provided that such error or omission is rectified promptly upon discovery, and shall not impose any greater liability on the Reinsurer than would have attached hereunder if the error or omission had not occurred.

ARTICLE XVII ADJUSTMENTS

Notwithstanding anything contained herein to the contrary, if the Reinsured’s liability under any policy of the Subject Business is changed because of a misstatement of age, sex, marital status, smoking status, amount or nature of coverage, or any other material fact by any Policyholder or its representative (including any employer, sponsor, group policyholder, broker, agent or other Person acting on behalf of the Policyholder), or in good faith by the Reinsured or by a Governmental Authority, the Reinsurer will, (i) assume that portion of any increase in reinsured liabilities resulting from the change, and (ii) receive credit for that portion of any decrease in reinsured liabilities resulting from the change, and the Reinsured and the Reinsurer will make all appropriate adjustments to amounts due each other under this Agreement.

ARTICLE XVIII CHANGES IN THE AGREEMENT

The terms of this Agreement shall not be waived or changed except by written amendment executed by a duly authorized officer of the Reinsurer and by a duly authorized officer or representative of the Reinsured. Any such amendment or addendum shall be a formal written addendum to the reinsurance contract. No amendment or addendum to this Agreement shall be effective without prior notification to and approval by the New York Department of Financial Services.

ARTICLE XIX OFFSET CLAUSE

The Reinsured or the Reinsurer may offset any balance(s) which may become due between them under this Agreement. This offset right shall apply regardless of whether the balances arose on account of Premiums, commission, claims, losses, Allocated Loss Adjustment Expense, salvage or any other amount(s) due from one Party to the other.

 

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ARTICLE XX NO THIRD PARTY RIGHTS

In no event shall anyone other than the Reinsurer or the Reinsured have any rights under this Agreement.

ARTICLE XXI CHANGES IN OWNERSHIP AND ADMINISTRATIVE PRACTICES

The Reinsured undertakes not to voluntarily make any material change in its established acceptance and underwriting policy in respect of the Subject Business, nor to undergo any Change in Control, without, in each case, the prior consent of the Reinsurer, such consent not to be unreasonably withheld, denied or conditioned; provided, however, that such consent shall not be required if such change is required by Applicable Law. It is furthermore understood and agreed that should a new affiliate to the Oscar Reinsureds be established for purposes of writing business similar to the Subject Business, the Parties hereto shall, subject to Applicable Law and regulatory approval, mutually agree on a quota share reinsurance agreement in respect of such new affiliate and such business that shall be consistent with the terms and conditions hereof and subject to the same Interlocking provision and principles set forth here.

ARTICLE XXII NON-WAIVER CLAUSE

The failure of the Reinsured or the Reinsurer to insist on compliance with this Agreement or to exercise any right or remedy hereunder shall not constitute a waiver of any rights or remedies contained herein nor estop either Party from thereafter demanding full and complete compliance nor prevent either Party from exercising such rights or remedy in the future.

ARTICLE XXIII INSOLVENCY

(a) Claims shall be payable by the Reinsurer on the basis of the liability of the Reinsured under the policies reinsured without diminution because of insolvency of the Reinsured. In the event of insolvency of the Reinsured, payments by the Reinsurer shall be made directly to the Reinsured or its liquidator, receiver or statutory successor except (i) where this Agreement specifically provides another payee for such reinsurance in the event of the insolvency of the Reinsured, or (ii) the Reinsurer, with the consent of the direct insureds, has assumed such policy obligations of the Reinsured as its direct obligations to the payees under such policies, in substitution for the obligations of the Reinsured to such payees. The implementation of any novation shall be subject to the prior approval of the certificate of assumption on New York risks by the Superintendent of Financial Services of New York.

(b) The rehabilitator, conservator, liquidator, receiver or statutory successor of the insolvent Reinsured shall give written notice to the Reinsurer of the pendency of the claim against the Reinsured on any policy reinsured hereunder within a reasonable time after such claim is filed in the insolvency proceeding, and during the pendency of such claim, the Reinsurer may investigate such claim and interpose, at its own expense, in the proceeding where such claim is to be adjudicated any defense or defenses which it may deem available to the Reinsured or its rehabilitator, conservator, liquidator, receiver or statutory successor. Such expense shall be chargeable, subject to court approval, against the insolvent Reinsured as part of the expense of the conservation or liquidation to the extent of a proportionate share of the benefit, which may accrue to the Reinsured solely as a result of the defense undertaken by the Reinsurer.

 

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ARTICLE XXIV NO INTERMEDIARY

This Reinsurance has been negotiated and agreed solely between the Parties hereto and no broker or intermediary has represented either Party or is entitled to any remuneration.

ARTICLE XXV PAYMENTS

All ceded Premiums and Ultimate Net Loss reimbursement settlements shall be made directly between the Reinsurer and the Reinsured.

ARTICLE XXVI DELAYED PAYMENTS

For purposes of any payments due hereunder, if there is a delayed settlement of a payment due, interest will accrue on such payment at the Applicable Interest Rate. Interest will be calculated on the basis of actual days for a 365-day year based on the actual number of days elapsed. For purposes of this Agreement, a payment will be considered overdue, and such interest will begin to accrue, on the date which is thirty (30) days after the date such payment is due.

ARTICLE XXVII CREDIT FOR REINSURANCE

The Parties intend that the Reinsured will receive, from and after the Coinsurance Effective Date, full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile. If the Reinsured nevertheless loses statutory reserve financial statement credit in the Reinsured’s state of domicile due to any reason attributable to the Reinsurer, the Reinsurer’s business, operations, condition, licenses and/or authorizations (including any losses thereof or restrictions thereon) or to a change in Applicable Law (collectively, a “Coinsurance Credit Event”), or if the Reinsured is notified in writing by a Governmental Authority that it will not receive statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsurer will promptly, and in any event will no later than thirty (30) calendar days following receipt of written notice from the Reinsured that a Coinsurance Credit Event has occurred, (i) cure such Coinsurance Credit Event to the Parties’ mutual satisfaction and at the Reinsurer’s sole cost and expense, and/or

(ii) establish for the benefit of the Reinsured, at the Reinsurer’s sole cost and expense, such trust accounts, letters of credit, funds withheld, or other security permitted by Applicable Law to allow the Reinsured to obtain full statutory reserve financial statement credit for reinsurance provided under this Agreement in the Reinsured’s state of domicile. Subject to the preceding two sentences, in the event of a Coinsurance Credit Event, the Reinsurer will have the option of determining the method of security to be utilized for such purpose. If such method elected by the Reinsurer requires any change to this Agreement in order for the Reinsured to obtain such statutory reserve financial statement credit, the Parties will cooperate in good faith to promptly amend this Agreement to incorporate such change. Any trust accounts, letters of credit, funds withheld, or other security established by the Reinsurer under this ARTICLE XXVII to address a Coinsurance Credit Event as set forth herein shall only be required to be maintained for so long a period as the Reinsured

 

13


cannot receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile, and the Reinsured shall reasonably cooperate in the release of any such security should the Reinsured’s ability to receive full statutory reserve financial statement credit for the reinsurance provided under this Agreement in the Reinsured’s state of domicile without such security be fully restored. This ARTICLE XXVII will survive the termination or expiration of this Agreement.

ARTICLE XXVIII DATA PROTECTION

Personal Data received by either the Reinsurer or the Reinsured from the other shall not be (i) used by the receiving party other than in connection with performing its obligations under this Agreement; (ii) commercially exploited by the receiving party; or (iii) transferred abroad without the Reinsured having implemented appropriate safeguards in accordance with the applicable law and regulation. To the extent permitted by the applicable law, each Party shall notify the other Party immediately upon becoming aware of privacy breaches related to Personal Data.

ARTICLE XXIX ARBITRATION CLAUSE

This clause shall remain in full force and effect notwithstanding any determination that the Agreement is void or rescinded for any reason.

All matters in difference between the Reinsured and the Reinsurer (hereinafter referred to as the “Disputing Parties”) in relation to this reinsurance, including its formation and validity, and whether arising during or after the period of this reinsurance, shall be referred to an Arbitration Tribunal in the manner hereinafter set out.

Unless the Disputing Parties agree upon a single Arbitrator within thirty days of one receiving a written request from the other for Arbitration, the Claimant (the Disputing Party requesting Arbitration) shall appoint its Arbitrator and give written notice thereof to the Respondent. Within thirty days of receiving such notice the Respondent shall appoint its Arbitrator and give written notice thereof to the Claimant, failing which the Claimant may nominate an Arbitrator on behalf of the Respondent. The Arbitrators shall not be under the control of either party.

Should the Arbitrators fail to agree, they shall appoint, by mutual agreement or by a mutually agreed selection process, an Umpire to whom the matter in difference shall be referred.

Unless the Disputing Parties otherwise agree, the Arbitration Tribunal shall consist of persons employed or engaged in a senior position in insurance or reinsurance underwriting or claims.

The Arbitration Tribunal shall have the power to fix all procedural rules for the holding of the Arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, discovery, inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the Arbitration and may receive and act upon such evidence whether oral or written strictly admissible or not as it shall in its discretion think fit.

 

14


All costs and expenses including attorneys’ fees, arbitrator fees, and expert fees of the Arbitration shall be in the discretion of the Arbitration Tribunal who may direct to and by whom and in what manner they shall be paid.

The seat of the Arbitration shall be in New York, NY and the Arbitration Tribunal shall apply the laws of the state of domicile of the Reinsured, without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction, as the proper law of this reinsurance.

The Arbitration Tribunal may not award exemplary, punitive, multiple or other damages of a similar nature.

The award of the Arbitration Tribunal shall be in writing and binding upon the Disputing Parties who covenant to carry out the same. If either of the Disputing Parties should fail to carry out any award the other may apply for its enforcement to a court of competent jurisdiction in any territory in which the Disputing Party in default is domiciled or has assets or carries on business.

ARTICLE XXX TERM

This Agreement will commence on the Coinsurance Effective Date and run indefinitely unless earlier terminated as provided in ARTICLE XXX (the “Term”).

ARTICLE XXXI TERMINATION

Notwithstanding anything contained to the contrary in this Agreement, this Agreement may only be terminated as follows:

(a) If either Party to this Agreement fails to pay (the “Non-paying Party”) the other Party an amount due within thirty (30) days after the due date provided in this Agreement, the other Party (the “Terminating Party”) may terminate this Agreement, subject to ninety (90) days’ prior written notice to the Non-paying Party of the Terminating Party’s intention to terminate; provided, however, that the Non-paying Party may avoid termination of this Agreement pursuant to this paragraph by paying all undisputed amounts that are delinquent and then due, including any interest owing thereon pursuant to ARTICLE XXVI, on or before the termination date specified in the written notice;

(b) In the event that a Governmental Authority with jurisdiction over the Reinsured denies or revokes the ability of the Reinsured to take full statutory reserve financial statement credit for the reinsurance provided under this Agreement due to a Coinsurance Credit Event, the Reinsured may terminate this Agreement, subject to thirty (30) days prior written notice to the Reinsurer of the Reinsured’s intention to terminate; provided, however, that the Reinsurer may avoid termination of this Agreement pursuant to this paragraph by fully complying with ARTICLE XXVII prior to the end of such thirty (30) day notice period;

(c) This Agreement may be terminated by either Party by giving ninety (90) days’ written notice of termination to the other Party if such termination is required, but not sooner required, by any Governmental Authority under Applicable Law;

 

15


(d) This Agreement may be terminated by either Party at any time after the third (3rd) year anniversary of the Coinsurance Effective Date by giving ninety (90) days’ written notice of termination to the other Party; and

(e) If one or more of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein is terminated for reasons other than that such termination was required by a Governmental Authority under Applicable Law, either Party may terminate this Agreement within ninety (90) days following the termination of such reinsurance agreement that is subject to the Interlocking provision herein by giving the other Party written notice of termination of this Agreement.

(f) This Agreement may be terminated immediately upon the mutual written consent of the Parties.

The effective date of termination of this Agreement (the “Termination Date”) for any notice of termination properly delivered in accordance with this ARTICLE XXX, will be the date specified in such notice. The Reinsured shall provide notice of termination of this Agreement to the New York Department of Financial Services upon Termination.

Upon the Termination Date of this Agreement, subject to all other terms and conditions hereof including the Maximum Combined Ratio, the Reinsurer will remain liable for all reinsured liabilities under this Agreement with respect to each policy of the Subject Business that was effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement and the Reinsurer will remain liable for all such reinsurance until the end of the “Run-Off Period,” which will mean the period beginning on the Termination Date of this Agreement and continuing until the date on which the Reinsured has no further liabilities or obligations under any policy of the Subject Business effected, bound, sold, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement. For the avoidance of doubt, the Reinsured’s and the Reinsurer’s respective obligation to pay the other all amounts due hereunder, as applicable, in accordance with the terms of this Agreement, with respect to the policies of the Subject Business that were effected, bound, issued, entered into, renewed or reinstated, as applicable, by the Reinsured on or prior to the Termination Date of this Agreement, will extend during the Run-Off Period, as provided herein. The Parties hereto expressly agree that they will reasonably cooperate with each other in the handling of all run-off obligations with respect to the policies of the Subject Business reinsured hereunder.

Upon the Termination Date of this Agreement, no policies of the Subject Business effected, bound, sold, issued, renewed or reinstated, as applicable, by the Reinsured after the Termination Date of this Agreement will be reinsured under this Agreement.

This ARTICLE XXX will survive the termination or expiration of this Agreement.

 

16


ARTICLE XXXII NOTICES

All notices, demands and other communications hereunder will be in writing and will be sent by certified mail return receipt requested, by hand or by nationally recognized overnight courier service addressed to the Party to whom such notice or other communication is to be given or made at such Party’s address as set forth below, or to such other address as such Party may designate in writing to the other Parties from time to time in accordance with the provisions hereof and will be deemed given five (5) calendar days after being sent by certified mail and one (1) Business Day after being sent by any other method described above, as follows:

(i) If to Reinsurer:

National Indemnity Company

100 First Stamford Place

Stamford, CT 06902

Attn: General Counsel

####

(ii) If to Reinsured:

Oscar Insurance Corporation 75 Varick Street, 5th Floor

New York, NY 10013

Attn: Legal

####

(iii) provided, however, if any of the above Parties will have designated a different address by notice to the other Parties, then to the last address so designated.

ARTICLE XXXIII GOVERNING LAW

This Agreement will be governed by and construed in accordance with the laws of the state of domicile of the Reinsured without regard to such state’s principles of conflict of laws that could compel the application of the laws of another jurisdiction.

ARTICLE XXXIV ENTIRE AGREEMENT

This Agreement, and each of the reinsurance agreements between the Reinsurer and the Oscar Reinsureds that are subject to the Interlocking provision herein, which are expressly incorporated by reference herein and made a part hereof, constitute the entire agreement of the Parties with respect to the subject matter hereof and supersedes all other prior understandings and agreements between the Parties with respect to the subject matter hereof, whether written or oral.

ARTICLE XXXV ASSIGNMENT AND DELEGATION

This Agreement will be binding upon and inure solely to the benefit of the Parties and their respective successors and permitted assigns. This Agreement, and the rights and obligations hereunder, cannot be assigned or delegated, in whole or in part, by the Reinsurer or the Reinsured without, except as otherwise expressly permitted under this Agreement, the prior written consent of the other; provided, however, that no such assignment or delegation will relieve either the Reinsurer or the Reinsured from any liability or obligation hereunder. Any assignment or delegation in violation of this ARTICLE XXXIV will be null and void ab initio.

 

17


ARTICLE XXXVI EXPENSES

Unless otherwise specifically provided herein, all costs and expenses incurred in connection with this Agreement and the transactions and obligations contemplated herein will be paid by the Party incurring such cost or expense.

ARTICLE XXXVII SEVERABILITY

If any provision of this Agreement is determined to be invalid or unenforceable, such determination shall not affect or impair the validity or the enforceability of the remaining provisions of the Agreement.

 

18


IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed in duplicate by their duly authorized representatives

This 31 day of December, 2019

 

by Oscar Insurance Corporation

/s/ Siddhartha Sankaran

Title: Chief Financial Officer

This 31 day of December, 2019

 

by National Indemnity Company

/s/ Brian Snover

Title: SR VP

 

19

Exhibit 10.37

CERTAIN INFORMATION IN THIS DOCUMENT, MARKED BY [***] HAS BEEN EXCLUDED

PURSUANT TO REGULATION S-K, ITEM 601(b)(10)(iv). SUCH EXCLUDED INFORMATION IS

NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO THE

REGISTRANT IF PUBLICLY DISCLOSED.

QUOTA SHARE REINSURANCE AGREEMENT

 

     
  

BETWEEN

 

OSCAR INSURANCE COMPANY OF FLORIDA

 

AND

 

AXA FRANCE VIE

 

EFFECTIVE: JANUARY 1, 2021

 

AGREEMENT NUMBER CR 4652

  
     

 

Page 1


TABLE OF CONTENTS

 

ARTICLE 1

  

OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

     4  

ARTICLE 2

  

EFFECTIVE TIME – DURATION

     5  

ARTICLE 3

  

TERRITORIAL SCOPE

     5  

ARTICLE 4

  

RETENTION OF THE CEDING COMPANY

     5  

ARTICLE 5

  

LIABILITY AND SHARE OF THE REINSURER

     6  

ARTICLE 6

  

CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

     8  

ARTICLE 7

  

REINSURER PREMIUMS

     8  

ARTICLE 8

  

REINSURANCE COMMISSIONS

     9  

ARTICLE 9

  

CLAIMS

     9  

ARTICLE 10

  

RESERVES, REINSURANCE CREDIT

     11  

ARTICLE 11

  

SUNSET CLAUSE

     15  

ARTICLE 12

  

PROFIT SHARING AND PARTIAL REIMBURSEMENT

     15  

ARTICLE 13

  

FOLLOW THE FORTUNES

     20  

ARTICLE 14

  

INFORMATION

     20  

ARTICLE 15

  

ACCOUNTS

     20  

ARTICLE 16

  

CURRENCY

     21  

ARTICLE 17

  

SET OFF

     21  

ARTICLE 18

  

RIGHT OF INSPECTION, COORDINATION

     21  

ARTICLE 19

  

ERRORS AND OMISSIONS

     22  

ARTICLE 20

  

ARBITRATION

     23  

ARTICLE 21

  

JURISDICTION - APPLICABLE LAW

     25  

ARTICLE 22

  

NORMAL TERMINATION

     25  

ARTICLE 23

  

SPECIAL TERMINATION

     26  

ARTICLE 24

  

CONFIDENTIALITY

     28  

 

Agreement CR 4652    Page 2


ARTICLE 25

  

SEVERABILITY, LAPSE

     29  

ARTICLE 26

  

ENTIRE AGREEMENT, ASSIGNMENT

     30  

ARTICLE 27

  

UTMOST GOOD FAITH

     30  

ARTICLE 28

  

SANCTION CLAUSE

     31  

ARTICLE 29

  

ANTI BRIBERY

     31  

ARTICLE 30

  

ANTI-MONEY LAUNDERING

     31  

ARTICLE 31

  

DATA PRIVACY

     32  

ARTICLE 32

  

CORPORATE RESPONSIBILITY

     32  

ARTICLE 33

  

INSOLVENCY

     33  

ARTICLE 34

  

NOTICES, CONSTRUCTION, DEFINITIONS

     34  

 

Agreement CR 4652    Page 3


QUOTA SHARE REINSURANCE AGREEMENT

PREAMBLE

This QUOTA SHARE REINSURANCE AGREEMENT (this “Agreement”) is made and entered into on January 29, 2021 and effective as of the Effective Time by and between OSCAR INSURANCE COMPANY OF FLORIDA, a Florida life and health insurance company incorporated under the laws of Florida and licensed and governed by the Florida Commissioner of Insurance Regulation, (the “Ceding Company”) and AXA FRANCE VIE, a limited company registered in the Commercial Register of Nanterre under company number 310 499 959 00891, governed by the French Insurance Code (the “Reinsurer”). For purposes of this Agreement, the Ceding Company and the Reinsurer will each be deemed a “Party”, and collectively, the “Parties”.

ARTICLE 1

OBJECT AND SCOPE OF THIS REINSURANCE AGREEMENT

 

  1)

This Agreement refers to all policies properly underwritten and issued by the Ceding Company as set out in the attached Annex 1 – Scope (the “Policies”). This Agreement does not apply to any other business underwritten by the Ceding Company.

 

  2)

This Agreement consists of this agreement, the Annexes hereto and any future amendments. The attached Annexes form and any future amendments will form integral parts of this Agreement and shall be equally binding. In the event of any discrepancy between this Agreement, an Annex or a future amendment, the terms of the respective Annex or future amendment will prevail as provided for in Article 26.

 

  3)

Copies of current and accurate specimen policy forms, policy premium information, application forms and rate tables with respect to the Policies (“Policy Documentation”) shall be furnished to the Reinsurer. The Ceding Company shall provide the Reinsurer with the updated version of the Policy Documentation for each year beginning with calendar year 2021 as part of the governance process described in Article 1, Section 4 below. The Policies shall be issued in accordance with the requirements of the applicable Policy Documentation.

 

  4)

In the second calendar quarter of each calendar year beginning in 2021, the Ceding Company will provide to the Reinsurer the proposed rating plans, pricing and related targeted Medical Loss Ratio with respect to each individual health policy product to be written within the territorial scope for the subsequent calendar year (“Annual Business Update”). Within thirty (30) days following delivery of the Annual Business Update, the Parties will meet to discuss the Reinsurer’s views with respect thereto and the economic impact to the Reinsurer under this Agreement. The Ceding Company will take into account the Reinsurer’s reasonable views with respect to the finalization of the plans and rates to be submitted to the state insurance department for review and approval. Following the approval of the plan and rates by the state insurance department, which generally occurs in the third calendar quarter, the Ceding Company shall provide without any delay the Reinsurer with the final Annual Business Update for the subsequent calendar year. Within thirty (30) days following the delivery of the final Annual Business Update, the Parties will meet to discuss

 

Agreement CR 4652    Page 4


  possible amendments, if any, to Article 8 – Reinsurance Commissions and/or Article 12 – Profit Sharing, Collective Experience Refund, and Partial Reimbursement as of January 1 of the subsequent Subscription Year. The Parties agree that, if, in good faith, the Reinsurer is not satisfied with the final Annual Business Update for the subsequent Subscription Year, the Reinsurer shall have the right to terminate this Agreement on 31 December of the ongoing Subscription Year in accordance with Article 23.

 

  5)

This Agreement applies only to those Policies properly underwritten and issued directly by the Ceding Company. Insurance policies assumed by the Ceding Company through reinsurance, acquisitions, mergers or portfolio transfers will not be reinsured automatically under this Agreement. The inclusion, for purposes of this Agreement, of any such other insurance policies, requires prior approval by the Reinsurer and appropriate terms and conditions will be mutually agreed upon between the Parties.

ARTICLE 2

EFFECTIVE TIME – DURATION

 

1)

This Agreement will take effect as of 12:01 a.m. Eastern Standard Time on January 1, 2021 (the “Effective Time”) and will remain in force for a duration of three (3) years from the Effective Time (the “Initial Term”) unless otherwise terminated as provided herein.

 

  2)

This Agreement shall renew automatically each year for one (1) year after expiry of the Initial Term (“Renewal Term”) unless otherwise terminated as provided herein.

ARTICLE 3

TERRITORIAL SCOPE

This Agreement only covers Policies issued in the territories listed in Annex 2 – Territorial Scope.    

ARTICLE 4

RETENTION OF THE CEDING COMPANY

 

  1)

Except as permitted by this Section, the Ceding Company is obligated to retain for its own account no less than [***]% of the share of liabilities in respect of the Policies set forth in Annex 1 – Scope and in compliance with the Policy Documentation, and is not entitled to adjust, sell, reinsure, assign, charge, or alienate its retention under this Agreement in any way that would reduce this retention to less than [***]% without the Reinsurer’s prior written consent, which consent may be withheld in the Reinsurer’s sole discretion. If the Ceding Company seeks any such reinsurance that reduces its retention to less than [***]%, the Ceding Company shall inform and seek the Reinsurer’s prior written consent accordingly. The foregoing shall in no way apply to any excess of loss coverage covering the Policies in the excess of the limit of liability of USD [***] at [***]% per person per year including the Medical Per Person Excess of Loss Reinsurance Agreement and any replacement thereof.

 

Agreement CR 4652    Page 5


  2)

If the Ceding Company is in breach of Article 4, Section 1, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty (30) days’ prior written notice to the Ceding Company.

ARTICLE 5

LIABILITY AND SHARE OF THE REINSURER

 

  1)

Pursuant to the terms and conditions of this Agreement, the Ceding Company shall cede to the Reinsurer and the Reinsurer shall accept and reinsure, automatically, the Reinsurer’s Quota Share of liabilities in respect of the Policies set forth in Annex 1 – Scope and in compliance with the Policy Documentation.

 

  2)

The Reinsurer’s Quota Share of liabilities ceded hereunder shall be protected by an excess of loss per person and per year underwritten by the Ceding Company with a priority of USD [***] at [***]% and unlimited capacity. The Reinsurer’s Quota Share of this Excess of Loss premium paid by the Ceding Company shall be deducted by the Ceding Company from the Gross Premium Earned in accordance with Article 7, Section 2 below. The Reinsurer shall benefit from the Reinsurer’s Quota Share of the Excess of Loss recoveries which includes but is not limited to any profit-share that may be received by the Ceding Company from any excess of loss reinsurance arrangement applicable to the Policies. Any amendment to the Excess of Loss Agreements shall be submitted by the Ceding Company to the Reinsurer for approval and in accordance with Article 26 herein.

 

  3)

Notwithstanding Article 5, Section 1, the total Reinsurance Claims paid hereunder and under the Companion Agreements by the Reinsurer for any given Subscription Year will be limited to [***]% of the Reinsurer Premium for such Subscription Year under this Agreement and under each of the Companion Agreements, on a consolidated basis. For the avoidance of doubt, in no event shall the Reinsurance Claims paid by the Reinsurer hereunder for any Subscription Year be less than the Reinsurer’s Quota Share of the total claims of the Ceding Company for such Subscription Year, provided that the Consolidated MLR for such Subscription Year does not exceed [***]% for such Subscription Year. If the Consolidated MLR for any Subscription Year exceeds [***]%, and the Medical Loss Ratio for such Subscription Year exceeds [***]%, the Ceding Company shall retain claims for such Subscription Year in an amount equal to [***]. An illustrative example of the preceding calculation is attached hereto as Annex 8 – Limitation of Liability Calculation. The “Companion Agreements” shall mean the following agreements:

 

  i.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4647, between the Reinsurer and Oscar Insurance Corporation;

 

Agreement CR 4652    Page 6


  ii.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4648, between the Reinsurer and OSCAR Health Plan of California;

 

  iii.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4649, between the Reinsurer and Oscar Garden State Insurance Corporation;

 

  iv.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4651, between the Reinsurer and Oscar Insurance Company;

 

  v.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4653, between the Reinsurer and Oscar Buckeye State Insurance Corporation;

 

  vi.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4654, between the Reinsurer and Oscar Health Plan, Inc.;

 

  vii.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4655, between the Reinsurer and Oscar Health Plan of Georgia;

 

  viii.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4656, between the Reinsurer and Oscar Health Plan of Pennsylvania; and

 

  ix.

Quota Share Reinsurance Agreement, effective January 1, 2021, AXA reference CR 4657, between the Reinsurer and Oscar Health Plan of North Carolina, Inc.

To the extent the Parties (or their affiliates) agree to enter into additional reinsurance agreements between the Parties (or their affiliates), the Parties shall amend this Agreement to include such additional agreements as Companion Agreements.

This limit will be implemented through the provisions of Article 12. For the avoidance of doubt, the first Subscription Year will last for a period of one (1) year, beginning on January 1, 2021 and concluding on December 31, 2021.

 

  4)

The maximum period of insurance of any one Policy shall not exceed [***]. Except as required by applicable law, no Policy may be issued for a period of insurance of less than [***] without the prior written approval of the Reinsurer, which approval may be withheld in the Reinsurer’s sole discretion. All Policies covered under this Agreement [***].

 

  5)

The Reinsurer shall not be liable under this Agreement for risks which are excluded under the Policy Documentation unless otherwise agreed in writing between the Reinsurer and the Ceding Company.

 

Agreement CR 4652    Page 7


  6)

This Agreement is entered into and agreed upon solely between the Ceding Company and the Reinsurer, and, subject to Articles 10, 26, 33 and 34, nothing, unless otherwise provided herein, in this Agreement is intended or shall be construed to give any person or entity, other than the Parties, any legal or equitable right, remedy or claim under or in respect of this Agreement or any provision contained herein. Such persons and entities include, but are not limited to, the intermediary (if any), policyholders of Policies, beneficiaries of Policies and other reinsurers of the Ceding Company or its affiliates.

ARTICLE 6

CHANGE IN LAW AND CHANGE OF CIRCUMSTANCES

In the event of any change in the law, regulation, fiscal and/or administrative practices applicable to this Agreement, the Policy Documentation, and/or the Parties hereto (including any request from regulatory authorities to waive or alter deductibles, co-payments or other type of limitations or exclusions which are otherwise applicable under the existing Policy Documentation and/or this Agreement, and more generally any request from regulatory authorities to pay claims which are not due to be made according to the underlying Policy Documentation), whether arising from legislation, administrative acts, decisions of the courts or otherwise, at any time after commencement of this Agreement that Materially increases or extends the Reinsurer’s liability, the Ceding Company shall inform the Reinsurer immediately following the Ceding Company’s awareness of such change and provide the details of the regulation change and information regarding its potential impact on the Policy Documentation and/or this Agreement. Within thirty (30) days following the notification by the Ceding Company to the Reinsurer of the change in law or, failing such notification, following the Reinsurer’s awareness of such change and upon the Reinsurer’s request, the Parties will meet to discuss the Reinsurer’s views with respect thereto, the economic impact to the Reinsurer under this Agreement and to discuss mitigation actions to cure the impact of such change on the Reinsurer. If, upon the expiry of the thirty (30) day period, the Reinsurer is still not satisfied with the general impact and/or specific impact on the liability and risk of the Reinsurer including but not limited to the evolution of the risk profile of the Policies reinsured and/or any significant modification to the Reinsurer’s Quota Share of liabilities and/or Reinsurer Premiums described herein, it is agreed that the Reinsurer shall have the right to terminate this Agreement with immediate effect on a cut-off basis in accordance with Article 23.

ARTICLE 7

REINSURER PREMIUMS

 

  1)

Corresponding to the ceded liability, the Reinsurer Premiums due by the Ceding Company to the Reinsurer shall be entered into the account for the relevant calendar quarter. The “Reinsurer Premium” shall mean the Reinsurer’s Quota Share of the Net Reinsurance Premiums.

 

Agreement CR 4652    Page 8


  2)

As used in this Agreement, “Net Reinsurance Premium” means an amount equal to:

[***]

[***]

[***]

= Net Reinsurance Premium

Where Gross Premiums Earned under the Policies are equal to the total of insurance premiums collected by the Ceding Company in relation with the Policies without any deduction of any tax, stamp fee or duty.

Any tax, stamp fee, or duty due to federal, state, or local authorities with respect to the Policies will be paid by the Ceding Company to the relevant authorities and will have no impact on the reinsurance accounts, either past, present or future, of this Agreement.

ARTICLE 8

REINSURANCE COMMISSIONS

 

  1)

The Reinsurer shall pay the Ceding Company reinsurance commissions, based on [***]% of the Reinsurer Premium, as set out for each applicable Subscription Year and illustrated in Annex 3 – Reinsurance Commission & Profit Share Information.

 

  2)

If any Reinsurer Premium or installments of Reinsurer Premium are returned to the Ceding Company, any corresponding reinsurance commissions previously credited to the Ceding Company shall be reimbursed to the Reinsurer.

ARTICLE 9

CLAIMS

 

  1)

A condition precedent to any settlement of a claim due by the Reinsurer hereunder (a “Reinsurance Claim”) is that the respective Reinsurer Premium has been paid to or entered into the relevant account of the Reinsurer in accordance with the terms of this Agreement.

 

  2)

Subject to Article 9, Section 1, the Reinsurer will reimburse the Ceding Company for the Reinsurer’s Quota Share of claims paid by the Ceding Company during the applicable calendar quarter in accordance with the settlement procedures set out in Article 15.

 

  3)

The Ceding Company is responsible for the assessment of claims in a prudent and professional way and in accordance with the underlying Policy Documentation. The Ceding Company is furthermore responsible for the fulfillment of the claims information requirements agreed upon and as set out in the Annex 4 – Data Reporting. Any claims payment made is binding on the Reinsurer to the extent of its liability for claims hereunder.    

 

Agreement CR 4652    Page 9


  4)

The Ceding Company shall provide the Reinsurer with claims data for the Policies in accordance with the template set forth at Annex 4 – Data Reporting and shall provide the Reinsurer with any further claims information upon request.

 

  5)

The Reinsurer shall follow the fortunes of the Ceding Company for the Reinsurer’s Quota Share of any Policy claim including interest and any legal costs and expenses incurred in investigating and assessing such claim (both medical and non-medical). Any salaries and travel expenses of the Ceding Company’s employees or employees of any third-party administrator designated by the Ceding Company as well as any internal Policy claims assessment costs are excluded.

 

  6)

Subject to the above provisions of this Article, the decisions of the Ceding Company on claims payments are binding on the Reinsurer with the exception of any payments made by the Ceding Company on an ex-gratia basis (i.e., those payments which the Ceding Company is not required to make according to the underlying Policy Documentation). Such payments will not be binding on the Reinsurer without its expressly stated prior written consent, which may be withheld in its sole discretion. Notwithstanding the foregoing, it is also acknowledged by the Reinsurer that due to the nature of the individual health insurance business, regulatory authorities may require the Ceding Company, from time to time, to pay claims for medically necessary services where coverage may otherwise have been denied. If the Ceding Company is formally required by a regulatory authority to make such a claims payment, such payment shall not be deemed as an “ex-gratia” payment and shall be reinsured hereunder. The Ceding Company shall provide the Reinsurer with a copy of the formal requirement by the regulatory authority.

 

  7)

Relief and recoveries, whether recovered or received prior or subsequent to loss settlement under this Agreement shall be shared proportionately with the Reinsurer based on the Reinsurer’s Quota Share.

 

  8)

The Reinsurer will not be liable for Extra-Contractual Obligations. For purposes of this Agreement, “Extra-Contractual Obligations” means all liabilities to any person or entity arising out of or relating to the Policies (other than liabilities arising under the express terms and conditions and within the policy limits of the Policies), including, without limitation, any loss in excess of the limits arising under or covered by any Policy, any liability for fines, penalties, taxes, fees, forfeitures, compensatory, consequential, punitive, exemplary, special, treble, bad faith, tort, statutory or any other form of extra-contractual damages, as well as all legal fees and expenses relating thereto, which liabilities arise out of, result from or relate to, any act, error or omission, whether or not intentional, negligent, fraudulent, in bad faith or otherwise (actual or alleged), arising out of or relating to the Policies, including, without limitation, (i) the form, sale, marketing, distribution, underwriting, production, issuance, cancellation or administration of the Policies, (ii) the investigation, defense, prosecution, trial, settlement (including the failure to settle) or handling of claims, benefits, or payments under the Policies, (iii) the failure to pay or the delay in payment or errors in calculating or administering the payment of benefits, claims or any other amounts due or alleged to be due under or in connection with the Policies or (iv) fines or other penalties associated with escheat and unclaimed property liabilities, including any interest thereon, arising under or relating to the Policies.

 

Agreement CR 4652    Page 10


  9)

Except with respect to any third-party administration arrangements in place as of the date hereof, the Ceding Company shall not delegate any administration with respect to the Policies to a third-party without the Reinsurer’s prior written consent, such consent not to be unreasonably withheld. In the case of any such permitted delegation, the Ceding Company remains liable for the compliance with all the conditions stated in this Article 9.

 

  10)

If the Ceding Company is in breach of Article 9, Section 9, the Reinsurer may terminate the Agreement on a run-off basis in accordance with Article 23 on thirty (30) days’ prior written notice to the Ceding Company.

ARTICLE 10

RESERVES, REINSURANCE CREDIT

 

  1)

The Reinsurer shall provide to the Ceding Company acceptable forms of security to secure the Statutory Reserves corresponding to the Reinsurer’s Quota Share of the Policies reinsured pursuant to this Agreement and to provide full reinsurance reserve credit to the Ceding Company for the reinsurance hereunder. The Reinsurer’s obligation to provide acceptable forms of security shall be satisfied by holding assets in one or more credit for reinsurance trust accounts (pursuant to this Article 10). The Statutory Reserves shall be calculated on the basis set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  2)

MAINTENANCE OF THE RESERVE AND TRUST ACCOUNT.

 

  i.

The Ceding Company will provide to the Reinsurer a good faith written estimate of the Statutory Reserves (calculated in accordance with Annex 5 – Statutory Reserves & IBNR Calculation Methodology) by no later than the thirtieth (30th) day of the last month of each calendar quarter for increase or decrease to the assets in the Trust Account and/or the Trusts Funds Withheld Account. If the Reinsurer disagrees with the estimated Statutory Reserves, it will within five (5) Business Days notify the Ceding Company. The Parties shall be expeditious and reasonable in resolving any such dispute; provided, that despite any continuing dispute between the Parties with respect to the estimated statutory reserve amount, the Reinsurer shall provide for the increase/decrease of assets in the Trust Account and/or the Trusts Funds Withheld Account as of the relevant calendar quarter end to ensure sufficient reserve credit to the Ceding Company; provided, further, that any such provision of assets shall not be deemed a waiver or release of any rights of the Reinsurer with respect to any continuing dispute hereunder.

 

  ii.

The Ceding Company will provide to the Reinsurer a written notice of the actual Statutory Reserves as of each calendar quarter end no later than the thirtieth (30th) Business Day following the end of such calendar quarter. The amount of security provided by the Reinsurer through Qualifying Assets held in the Trust Account and the Trust Funds Withheld Account shall be adjusted appropriately to reflect the actual Statutory Reserves as of such calendar quarter end. If any such adjustment necessitates a decrease in the amount of Qualifying Assets held in the

 

Agreement CR 4652    Page 11


  Trust Account, then the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute Qualifying Assets equaling the amount of any such decrease to the Reinsurer, as the designee of the Ceding Company.

 

  iii.

The Ceding Company will provide to the Reinsurer written notice of any anticipated unsecured recoverable from the Reinsurer that is greater than the amount calculated in Section 5(ii). Furthermore, the Ceding Company will provide documentation explaining the amount of unsecured recoverable and its calculation. The Reinsurer, within 45 days of the receipt of notification and documentation, will adjust the Qualifying Assets held in the Trust Account and the Trust Funds Withheld Account in an amount at least equal to the Ceding Company’s unsecured recoverable.

 

  iv.

The Ceding Company shall not unreasonably withhold their consent authorizing the Reinsurer to withdraw funds that are held in excess of the amount calculated in Section 5(ii).

 

  3)

STATUTORY TRUST AGREEMENT.

 

  i.

The Ceding Company and the Reinsurer will enter into a statutory trust agreement in compliance with the credit for reinsurance laws and regulations of the state of domicile of the Ceding Company in connection with reinsurance ceded to an unauthorized reinsurer (the “Trust Agreement”) with a trustee (the “Trustee”) establishing a trust account for the sole benefit of the Ceding Company (the “Trust Account”). The Trustee shall be a qualified United States financial institution authorized to act as a fiduciary of a trust. The institution shall not be a parent, subsidiary or affiliate of the Ceding Company or the Reinsurer. The Reinsurer and the Ceding Company may enter into more than one such Trust Agreement for purposes of providing reinsurance reserve credit to the Ceding Company.

 

  4)

QUALIFYING ASSETS.

 

  i.

The Reinsurer shall arrange for assets to be deposited into the Trust Account. Prior to depositing non-cash assets with the Trustee, the Reinsurer shall execute assignments, endorsements in blank or transfer legal title to the Trustee or the Trustee’s nominee of all shares, obligations or any other assets requiring assignment in order that the Ceding Company or the Trustee, upon direction of the Ceding Company, may, whenever necessary, negotiate any such assets without consent or signature from the Reinsurer or any other person or entity in accordance with the terms of the Trust Agreement.

 

  ii.

Assets deposited in the Trust Account shall be valued according to their current fair market value. The Trust Account shall consist only of the following (“Qualifying Assets”): cash (United States legal tender), certificates of deposit (issued by a United States bank and payable in United States legal tender), instruments that are acceptable to the

 

Agreement CR 4652    Page 12


  commissioner of the insurance department of the Ceding Company’s state of domicile, and investments of the types specified in accordance with the requirements of the Ceding Company’s state of domicile insurance law and investments; provided that such investments are issued by an institution that is not the parent, subsidiary or affiliate of either the Ceding Company or the Reinsurer.

 

  5)

DRAWING ON THE TRUST ACCOUNT.

 

  i.

Qualifying Assets in the Trust Account established hereunder may be withdrawn by the Ceding Company at any time, notwithstanding any other provision of this Agreement, and shall be utilized and applied by the Ceding Company or any successor by operation of law of the Ceding Company including, without limitation, any liquidator, rehabilitator, receiver or conservator of the Ceding Company, without diminution because of insolvency on the part of the Ceding Company or the Reinsurer, only for the following purposes:

 

  A.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of premiums returned, but not yet recovered from the Reinsurer, to the owners of Policies reinsured under this Agreement on account of cancellations of such Policies;

 

  B.

To reimburse the Ceding Company for the Reinsurer’s Quota Share of benefits or losses paid by the Ceding Company, but not yet recovered from the Reinsurer, pursuant to the provisions of the Policies reinsured under this Agreement;

 

  C.

To fund an account with the Ceding Company in an amount at least equal to the deduction, for reinsurance ceded, from the Ceding Company’s liabilities for the Policies reinsured hereunder. Such account shall include, but not be limited to, amounts for policy reserves, reserves for claims and losses incurred (including losses incurred but not reported), loss adjustment expenses and unearned premiums; and

 

  D.

To pay the Ceding Company for the Reinsurer’s Quota Share of any other amounts that the Ceding Company claims are due under this Agreement.

 

  ii.

The Ceding Company shall return to the Trust Account or to the Reinsurer assets withdrawn in excess of the actual amounts required in Article 10, Section 5(i)(A)-(C), or, in the case of Article 10, Section 5(D), assets that are subsequently determined not to be due.

 

  iii.

Any assets withdrawn by the Ceding Company pursuant to Article 10, Section 5(i)(C) and any assets withdrawn from any Trust Account in excess of the actual amounts required for Article 10, Section 5(i)(A) and (B) or, in the case of Article 10, Section 5(i)(D), any amounts that are subsequently determined not to be due shall be held by the Ceding Company (or any successor by operation of law of the Ceding Company, including, but not

 

Agreement CR 4652    Page 13


  limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) in trust for the benefit of the Reinsurer, subject to the Ceding Company’s right to apply such assets to amounts due and payable by the Reinsurer to the Ceding Company under this Agreement, and shall at all times be maintained separate and apart from any assets of the Ceding Company in one or more designated funds withheld accounts (collectively the “Trust Funds Withheld Account”) for the sole purpose of funding the payments and reimbursements described in subsections (i), (ii) and (iv). The Ceding Company (or any successor by operation of law of the Ceding Company, including, but not limited to, any liquidator, rehabilitator, receiver or conservator of the Ceding Company) shall ensure that any assets held in the Trust Funds Withheld Account pursuant to this Article 10, Section 5 consist of Qualifying Assets in accordance with its fiduciary obligations as trustee with respect to such amounts.

 

  iv.

For withdrawals by the Ceding Company pursuant to Article 10, Section 5(i)(C) and, with respect to Article 10, Section 5(i)(A), (B) and (D), in excess of the actual amounts applied to payment or reimbursement under such subsections, the Ceding Company shall pay interest in cash to the Reinsurer on the amount withdrawn at the then current prime rate as reported in the Federal Reserve Bulletin. Notwithstanding the foregoing, this Agreement permits the award, by any arbitration panel or court of competent jurisdiction, of:

 

  A.

Interest at a rate different from that provided in this paragraph,

 

  B.

Court or arbitration costs,

 

  C.

Attorney’s fees, and

 

  D.

Any other reasonable expenses.

 

  v.

At the Reinsurer’s request, and the approval of the Ceding Company, which shall not be unreasonably or arbitrarily withheld, the Ceding Company shall promptly direct the Trustee, in accordance with the terms of the Trust Agreement, to distribute to the Reinsurer, as the designee of the Ceding Company, all or any part of the assets contained in the Trust Account, provided:

 

  A.

The Reinsurer shall, at the time of such withdrawal, replace the withdrawn assets with other Qualifying Assets having a market value equal to the market value of the assets withdrawn, so as to maintain at all times the Reinsurer’s Quota Share of the Statutory Reserves; or

 

  B.

After such withdrawals and transfers, the aggregate market value of the Qualifying Assets in the Trust Account shall be no less than [***]% of the Reinsurer’s Quota Share of the Statutory Reserves less the aggregate amount of assets held pursuant Article 10, Section 5 in the Trust Funds Withheld Account.

 

Agreement CR 4652    Page 14


  vi.

After all payments have been discharged in full by the Reinsurer under the terms of this Agreement, the Ceding Company shall not unreasonably or arbitrarily withhold its approval to remit any remaining balance of funds in the Trust Account and Trust Funds Withheld Account to the Reinsurer.

 

  6)

This Article 10 shall survive termination of this Agreement.

ARTICLE 11

SUNSET CLAUSE

Notwithstanding Article 19 – Errors and Omissions of this Agreement, the Reinsurer shall not be liable for any claim which the Ceding Company has not reported within 24 months from the date upon which the Ceding Company knew or should reasonably have known of circumstances likely to give rise to a claim covered under this Agreement.

ARTICLE 12

PROFIT SHARING, COLLECTIVE EXPERIENCE REFUND, AND PARTIAL REIMBURSEMENT

 

  1)

This Article 12 sets forth the methodology for calculating the following potential payments: (i) annually, a profit share payment from the Reinsurer to the Ceding Company, if the result of the Profit Sharing Formula equals a positive number, (ii) at the end of the third Subscription Year, a collective experience refund payment from the Reinsurer to the Ceding Company, if the result of the Collective Experience Formula equals a positive number, and (iii) annually, a payment representing partial reimbursement of Reinsurance Claims, from the Ceding Company to the Reinsurer, if the result of the Partial Reimbursement Formula equals a positive number.

 

  2)

Formulas.

 

  i.

The following abbreviations, as used in the Profit-Sharing Formula and the Partial Reimbursement Formula, have the respective meanings set forth below:

[***]

[***]

[***]

 

Agreement CR 4652    Page 15


[***]

[***]

The values of Ci, Fi, and r, for any given Subscription Year, are as below, and as illustrated in Annex 3 – Reinsurance Commissions & Profit Share Information:

 

C (commissions (% of total Reinsurer Premium))

     [ ***] 

MLR as defined in Annex 6

  

F (Reinsurer fee (% of total Reinsurer Premium))

     [ ***] 

r (distribution rate)

     [ ***] 

 

  ii.

The “Profit Sharing Formula” is as set forth below:

 

  [***]    [***]                       
     [***]   

[***]

[***]

R [***]

 

  iii.

The “Collective Experience Refund Formula” is as set forth below:

 

  [***]    [***]                       
     [***]   

[***]

[***]

[***]

[***]

 

Agreement CR 4652    Page 16


[***]

[***]

[***]

 

  iv.

The “Partial Reimbursement Formula” is as set forth below:

 

[***]    [***]                       
   [***]   

[***]

[***]

For the purposes of this Article 12, Section 2, “PR” means partial reimbursement, “XR” means collective experience refund, and “PS” means profit sharing.

 

  3)

Within fifteen (15) Business Days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for the prior Subscription Year for this Agreement, using the available amounts of premiums, claims, risk adjustment, XOL premiums and claims and IBNR and in accordance with Annex 3 – Reinsurance Commissions & Profit Share Information, with each of the resulting amounts reduced by [***]% to arrive at the “Provisional Profit Share Amount” and the “Provisional Partial Reimbursement Amount”.

 

  4)

If such Provisional Profit Share Amount is a positive number, the Reinsurer shall pay to the Ceding Company the Provisional Profit Share Amount promptly following the calculation of the Provisional Profit Share Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  5)

If such Provisional Partial Reimbursement Amount is a positive number, the Ceding Company shall remit to the Reinsurer the Provisional Partial Reimbursement Amount promptly following the Ceding Company’s receipt of the calculation of the Provisional Partial Reimbursement Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of each Subscription Year pursuant to Article 15.

 

  6)

Within fifteen (15) Business Days after the confirmation of the accounts for the fourth quarter of the year following the Subscription Year, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Profit Sharing Formula and Partial Reimbursement Formula for such Subscription Year for this

 

Agreement CR 4652    Page 17


  Agreement, using the then-current amounts of premiums, claims, risk adjustment, XOL premiums, claims and IBNR and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. The Provisional Profit Share Amount shall be deducted from the Formula result for such Subscription Year to arrive at the “Profit-Sharing Adjustment”. The Provisional Partial Reimbursement Amount shall be deducted from the Partial Reimbursement Formula result to arrive at the “Partial Reimbursement Adjustment”.

 

  7)

If such Profit Share Adjustment is a positive number, the Reinsurer shall pay to the Ceding Company the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  8)

If such Profit Share Adjustment is a negative number, the Ceding Company shall pay to the Reinsurer the Profit Share Adjustment promptly following the calculation of the Profit Share Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  9)

If such Partial Reimbursement Adjustment is a positive number, the Ceding Company shall remit to the Reinsurer the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  10)

If such Partial Reimbursement Adjustment is a negative number, the Reinsurer shall remit to the Ceding Company the Partial Reimbursement Adjustment promptly following the Ceding Company’s receipt of the calculation of the Partial Reimbursement Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 6.

 

  11)

The Ceding Company shall continue to provide the Reinsurer with quarterly accounts with respect to a given Subscription Year in accordance with Article 15 until the time of the first quarterly report that does not show any positive IBNR for such Subscription Year under this Agreement or any of the Companion Agreements. At such time, the Reinsurer shall deliver final calculations of the Profit-Sharing Formula and Partial Reimbursement Formula for such Subscription Year and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 6 to 10. For purposes of this Section, such terms shall be applied mutatis mutandis, except that references in Article 12, Section 6 to “Provisional Profit Share Amount” shall be understood to mean “Provisional Profit Share Amount plus any previously paid Profit Share Adjustment” and in Article 12, Section 6 “Provisional Partial Reimbursement Amount” shall be understood to mean “Provisional Partial Reimbursement Amount plus any previously paid Partial Reimbursement Adjustment”.

 

  12)

Within fifteen (15) Business Days after the confirmation of the accounts for the final calendar quarter of the final Subscription Year of the Initial Term pursuant to Article 15, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Collective Experience Refund for such Initial Term of this Agreement, using the available amounts of premiums, claims, risk adjustment, XOL premiums and claims and IBNR and in accordance with Annex 3 – Reinsurance Commissions & Profit Share Information, with each of the resulting amounts reduced by [***]% to arrive at the “Provisional Collective Experience Refund Amount”.

 

Agreement CR 4652    Page 18


  13)

If such Provisional Collective Experience Refund Amount is a positive number, the Reinsurer shall pay to the Ceding Company the Provisional Collective Experience Refund Amount promptly following the calculation of the Provisional Collective Experience Refund Amount, but in any event no later than forty-five (45) days after the confirmation of the accounts for the final calendar quarter of the third Subscription Year pursuant to Article 15.

 

  14)

Within fifteen (15) Business Days after the confirmation of the accounts for the fourth quarter of the year following the Initial Term, the Reinsurer shall deliver to the Ceding Company the Reinsurer’s calculation of the Collective Experience Refund Formula for such Initial Term of this Agreement, using the then-current amounts of premiums, claims, risk adjustment, XOL premiums, claims and IBNR and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 14 to 16. The Provisional Collective Experience Refund Amount shall be deducted from the Formula result for such Subscription Year to arrive at the “Collective Experience Refund Adjustment”.

 

  15)

If such Collective Experience Refund Adjustment is a positive number, the Reinsurer shall pay to the Ceding Company the Collective Experience Refund Adjustment promptly following the calculation of the Collective Experience Refund Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 14.

 

  16)

If such Collective Experience Refund Adjustment is a negative number, the Ceding Company shall pay to the Reinsurer the Collective Experience Refund Adjustment promptly following the calculation of the Collective Experience Refund Adjustment, but in any event no later than forty-five (45) days after the confirmation of the account as set forth in Article 12, Section 14.

 

  17)

The Ceding Company shall continue to provide the Reinsurer with quarterly accounts with respect to all Subscription Years in accordance with Article 15 until the time of the first quarterly report that does not show any positive IBNR for any Subscription Year under the Initial Term of this Agreement or any of the Companion Agreements. At such time, the Reinsurer shall deliver final calculations of the Collective Experience Refund Formula for such Initial Term and payment of any applicable amount shall be made in accordance with the terms of Article 12, Sections 14 to 16. For purposes of this Section, such terms shall be applied mutatis mutandis, except that references in Article 12, Section 14 to “Provisional Collective Experience Refund Amount” shall be understood to mean “Provisional Collective Experience Refund Amount plus any previously paid Collective Experience Refund Adjustment”.

 

Agreement CR 4652    Page 19


ARTICLE 13

FOLLOW THE FORTUNES

In proportion to the Reinsurer’s Quota Share the Reinsurer shall, subject to the terms and conditions of this Agreement, follow the fortunes of the Ceding Company in respect of risks which the Ceding Company has accepted under Policies covered under this Agreement.

ARTICLE 14

INFORMATION

The Ceding Company shall report to the Reinsurer all information in respect of the Policies as set out in Annex 4 – Data Reporting.

ARTICLE 15

ACCOUNTS

 

  1)

Within thirty (30) days after the 31st March, 30th June, 30th September and 31st December of each year, the Ceding Company shall prepare and submit to the Reinsurer quarterly accounts showing the accounting items as specified in Annex 7 – Reinsurance Balance Calculation. For the avoidance of doubt, the quarterly account for any given Subscription Year shall continue to be submitted by the Ceding Company following the end of such Subscription Year for so long as there is still a positive amount of IBNR for such Subscription Year.

 

  2)

Accounts shall be confirmed by the Reinsurer within thirty (30) days upon receipt. This also applies if the confirmation can only be given for part of the accounts. Such partial confirmation shall also specify the objections to that part of the accounts on which confirmation cannot be given.

 

  3)

Any net balance of account, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Reinsurer shall be remitted by the Ceding Company promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts. Any balance, as described in Annex 7 – Reinsurance Balance Calculation, due in favor of the Ceding Company shall be remitted by the Reinsurer promptly following receipt of the confirmation, but not later than forty-five (45) days after receipt of the accounts.

 

  4)

In case that confirmation can only be given for part of the accounts, the balance shall nevertheless be settled in full without delay. Should there be any items incorrect in or missing from a statement of account, such errors or omissions shall be corrected in the next statement of account, unless the discrepancy is Material. In such a case, correction and settlement of the discrepancy shall be completed as promptly as possible.

 

  5)

If the balance is not paid in due time such outstanding balance shall accrue interest on late payment, calculated from the confirmation date due to the date of actual payment, at the interest rate equal to the greater of (i) [***] and (ii) [***] plus [***]. If for any reason such rate is no longer published in the Wall Street Journal, the Parties shall agree on a replacement index that most closely approximates such rate.

 

Agreement CR 4652    Page 20


The Parties acknowledge and agree that settlement of all amounts due from one Party to the other Party hereunder for the period covering the Effective Time to the date hereof shall be settled as part of the first quarterly settlement following the date hereof.

ARTICLE 16

CURRENCY

All payments made, all amounts advised and all accounts prepared by either Party in accordance with the terms of this Agreement shall be in U.S. Dollars, with all payments paid in cash via wire transfer to an account designated by the receiving Party.

ARTICLE 17

SET OFF

Any debits or credits incurred on and after the Effective Time in favor of or against either the Ceding Company or the Reinsurer with respect to this Agreement are deemed mutual debits or credits, as the case may be, and shall be set off and recouped, and only the net balance shall be allowed or paid. To the extent permitted by applicable law, this Article 17 shall apply notwithstanding the initiation or commencement of a liquidation, insolvency, rehabilitation, conservation, supervision or similar proceeding by or against the Ceding Company or the Reinsurer.

ARTICLE 18

RIGHT OF INSPECTION, COORDINATION

 

  1)

The Reinsurer shall have the right, at any time, to inspect, through any duly authorized person or entity named in advance, all papers, books, accounts, documents and other records referring to the business reinsured under this Agreement at the head office of the Ceding Company or at any other place mutually agreed upon during the Ceding Company’s normal business hours. Notification of such visits shall be given two (2) weeks in advance but in urgent cases at least forty-eight (48) hours in advance.

 

  2)

Upon request, the Ceding Company shall supply, or be caused to supply, to the Reinsurer, at the Reinsurer’s expense, copies of the whole or any part of such papers, books, accounts, documents and ether records relating to the business covered under this Agreement. Notwithstanding termination of this Agreement, the Reinsurer’s right of inspection under this Article 18 will continue until all of the Reinsurer’s obligations under this Agreement have been terminated or fully discharged.

 

  3)

For the avoidance of doubt, all rights of inspection and any records requested or disclosed under this Article 18 will be subject to Article 24.

 

Agreement CR 4652    Page 21


  4)

The Reinsurer shall have full access to, and open lines of communications with, the senior management of the Ceding Company in connection with this Agreement. Each Party shall appoint an individual as its primary point of operational contact for the administration and operation of this Agreement to act as a representative. Each Parties’ representative shall have overall responsibility for coordinating, on behalf of the respective Party, the performance of the Party’s obligations hereunder and acting as a day-to-day contact with the other Party’s representative. Either Party may change its respective representative hereunder by providing five (5) days advance written notice to the other Party, provided that at all times the Ceding Company’s representative shall be a senior officer of the Ceding Company.

ARTICLE 19

ERRORS AND OMISSIONS

 

  1)

ln the event that any error, omission or delay should occur in connection with the performance of this Agreement, including any error or omission being reflected in the accounts, such error, omission or delay will not invalidate the rights and obligations of the Parties arising from this Agreement, even when this error or omission has been discovered after the settlement of the respective balance. Any errors and omissions shall be corrected by the Parties promptly upon discovery.

 

  2)

An error or omission is defined as an unintentional failure and the result of an innocent oversight or misunderstanding which needs to be demonstrated to the satisfaction of the Party not in default. Unintentional failure and the result of an innocent oversight or misunderstanding which results from a faulty business organization or structure of a party is not considered to be an error or an omission for the purposes of this Article 19. If it is not possible to restore each Party to the position it would have occupied but for the error or omission, the Parties, shall endeavor in good faith to promptly resolve the situation in a manner that most closely approximates the intent of the Parties, as evidenced by this Agreement. Any resolution made to correct such an error or omission will not set a precedent for any similar subsequent error or omission. The provisions of this Article shall not relieve either Party of its obligation to perform within the time periods specified for such obligations in this Agreement or as otherwise mutually agreed. The Reinsurer will not provide reinsurance for Policies that do not satisfy the parameters of this Agreement.

 

  3)

Notwithstanding the foregoing and as otherwise provided herein, any liability of the Reinsurer shall be subject to the Ceding Company neither having committed gross negligence and/or intentional misconduct, fraud and/or criminal acts, with respect to underwriting or claims assessment, but having complied with the usual business, insurance and reinsurance practices. Otherwise, the Reinsurer shall have the right to refuse its liability.

 

Agreement CR 4652    Page 22


ARTICLE 20

ARBITRATION

 

1)

If a dispute controversy or claim arises between the Parties in connection with or in relation to this Agreement, the Parties undertake in good faith to use all reasonable best efforts to settle such dispute by oral or written consent directly with each other.

 

2)

Where the Parties are unable to reach agreement in accordance with Article 20. Section1 above, any dispute, controversy or claim arising between the Parties in connection with or in relation to this Agreement, including formation and validity, and whether arising before or after termination of this Agreement, shall be referred to an arbitration tribunal in the manner set out below.

 

  i.

To initiate arbitration, either Party shall notify the other Party in writing of its desire to arbitrate. The notice shall identify the claimant, the contract at issue, and the nature of the claims and/or issues. The arbitration will be deemed to have been commenced on the date the notice of arbitration is received

 

  ii.

There will be three arbitrators who will each have no less than ten (10) years of insurance or industry experience, who are knowledgeable regarding reinsurance and who are active or retired executive officers of insurance or reinsurance companies. The arbitrators shall not be under the control of any Party, shall not have ever worked for or performed substantial services for either Party, nor shall any member of the panel have a financial interest in the outcome of the dispute. Within thirty (30) days following the commencement of the arbitration proceedings, each Party will provide the other with the identification of their appointed arbitrator, and provide a copy of the arbitrator’s curriculum vitae. If either Party refuses or neglects to appoint an arbitrator within thirty (30) days following the commencement of the arbitration proceedings, the other Party may appoint the second arbitrator to act as the appointed arbitrator for the defaulting Party by providing notice and a copy of the arbitrator’s curriculum vitae. Each Party’s appointed arbitrator shall propose a candidate to serve as a third arbitrator (the “Umpire”), which shall be subject to the mutual agreement of the Parties. In the event the two Party-appointed arbitrators fail to reach an agreement on an Umpire within sixty (60) days of their appointment, then either Party may petition ARIAS-U.S. to appoint the Umpire and each Party shall cooperate and take whatever action is required to give effect to the ARIAS-U.S. umpire appointment procedures. Notwithstanding the previous sentence, the Parties may agree on an alternative Umpire appointment procedure.

 

  iii.

The three (3) arbitrators shall decide by majority. If no majority can be reached the opinion of the Umpire shall prevail. He shall also act as chairman of the tribunal and conduct the arbitration proceedings.

 

  iv.

In the event any arbitrator fails, refuses, or becomes unable to act as such before an award has been rendered, a successor shall be selected in the same manner as the original arbitrator. In the event of the death of an arbitrator or if an arbitrator is unable to continue, another shall in such case

 

Agreement CR 4652    Page 23


  be appointed in such arbitrator’s stead by the Party who made the original appointment. In the event of the death of the Umpire, or if the Umpire is unable to continue, the arbitrators shall agree upon the appointment of a new chairman within thirty (30) days in accordance with the procedures set forth above.

 

3)

The arbitration tribunal shall have power to fix all procedural rules for the holding of the arbitration including discretionary power to make orders as to any matters which it may consider proper in the circumstances of the case with regard to pleadings, investigation of facts, the disclosure and inspection of documents, examination of witnesses and any other matter whatsoever relating to the conduct of the arbitration and may receive and act upon such evidence, whether oral or written, strictly admissible or not, as it shall in its discretion think fit.

 

4)

The cost of the arbitration shall be borne by the non-prevailing Party. If a Party prevails in part, then the other Party shall bear the cost to that extent. Each Party shall, however, bear the costs of its own legal representation and assistance.    The amount of the cost of the arbitration shall be determined as agreed between the Parties and the arbitrators prior to the arbitration. The arbitration tribunal shall, as a part of its award, specifically state the cost of the arbitration and the manner of its payment.

 

5)

The arbitration shall take place in New York, New York (USA) and the arbitration tribunal shall apply the law of the State of New York as the proper law of this Agreement. In addition, the arbitration tribunal shall observe the customs and practices of the reinsurance business.

 

6)

The award of the arbitration tribunal shall be in writing and state the reasons upon which it is based. Judgment upon the award may be entered in any court having jurisdiction thereof. The award shall be final and binding and not subject to appeal. The Parties undertake to carry out the same without delay. If either of the Parties should fail to carry out any award, the other may apply for its enforcement to a court of relevant jurisdiction in any territory in which the Party in default is domiciled or has assets or carries on business.

 

7)

The arbitrators may consolidate an arbitration under this Agreement with any arbitration arising under or relating to any of the Companion Agreements or any other agreement between the Parties entered into pursuant hereto, as the case may be, provided that the subject of the disputes thereunder arise out of or relate to the same or substantially similar set of facts or transactions. Such consolidated arbitration shall be determined by the arbitrator appointed for the arbitration proceeding that was commenced first in time.

 

8)

Notwithstanding the foregoing, a matter regarding the failure of a Party to settle a confirmed and undisputed balance may be brought before a court of relevant jurisdiction.

 

9)

This Article 20 shall survive termination of this Agreement.

 

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ARTICLE 21

JURISDICTION - APPLICABLE LAW

 

1)

EXCEPT AS OTHERWISE SET FORTH HEREIN, THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS, INCLUDING AS TO VALIDITY, INTERPRETATION AND EFFECT, BY THE LAWS OF THE STATE OF NEW YORK WITHOUT GIVING EFFECT TO ITS PRINCIPLES OR RULES OF CONFLICT OF LAWS, TO THE EXTENT SUCH PRINCIPLES OR RULES ARE NOT MANDATORILY APPLICABLE BY STATUTE AND WOULD PERMIT OR REQUIRE THE APPLICATION OF THE LAWS OF ANOTHER JURISDICTION.

 

2)

The Parties shall (i) submit themselves to the jurisdiction of a court of competent jurisdiction within New York, and (ii) comply with all the requirements necessary to give such court jurisdiction over the Parties. Furthermore, the Reinsurer shall designate the Florida Commissioner of Insurance Regulation as its true and lawful attorney upon whom service of process may be effected and simultaneous notification may, at the Reinsurer’s election, be provided to a designated attorney in the event any such service of process is effected. Furthermore, the Ceding Company shall designate its general counsel as its true and lawful attorney upon whom service of process may be effected.

 

3)

This Article 21 shall not be read to conflict with or override the obligations of the parties to arbitrate their disputes as provided for in the Arbitration Article. This Article is intended as an aid to compelling arbitration or enforcing such arbitration or arbitral award, not as an alternative to the Arbitration Article for resolving disputes arising out of this Agreement.

 

4)

This Article 21 shall survive termination of this Agreement.

ARTICLE 22

NORMAL TERMINATION

 

1)

This Agreement may be terminated [***].

 

2)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch in accordance with Article 34.

 

3)

Termination of this Agreement at the end of the Initial Term or any Renewal Term shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder does not extend to any claims incurred after the Agreement termination date because all Policies terminate on 31 December of the Subscription Year and any

 

Agreement CR 4652    Page 25


  renewal of a ceded Policy after the Agreement termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December.

 

4)

Unless otherwise provided herein, if the Parties agree to terminate this Agreement on a cut-off basis as provided hereunder, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

ARTICLE 23

SPECIAL TERMINATION

 

1)

Either Party affected by one of the events mentioned in Article 23, Section 3 below shall notify the other Party in writing within thirty (30) days after its occurrence. The termination to be effective at the end of such thirty (30) days period.

 

2)

Except in respect of termination by the Reinsurer pursuant to Article 23, Section 3(viii) or for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv), termination of this Agreement in accordance with this Article 23 shall not affect the Parties obligations with respect to the Policies ceded hereunder prior to date of termination, but no additional new Policies shall be ceded after the termination date. For the avoidance of doubt, the Reinsurer’s liability hereunder would not extend to any claims incurred after 31 December of the Subscription Year and any renewal of a ceded Policy after the termination date will not be ceded or covered under the Agreement. For the further avoidance of doubt, the Reinsurer shall remain liable for any claims incurred under each such Policy on or prior to 31 December of the Agreement termination year but reported after such 31 December).

 

3)

This Agreement may be terminated at any time (including during the Initial Term) on a run-off basis (except as otherwise stated in paragraphs (iv) and (viii) below which shall be terminated on a cut-off basis) with respect to Policies issued prior to the applicable termination date by giving written notice to the other Party:

 

  i.

If the Ceding Company has become insolvent or is unable to pay its debts or has a Risk-Based Capital ratio of less than [***]% of its Authorized Control Level Risk Based Capital (each term as defined in the insurance laws and regulations in the Ceding Company’s state of domicile) or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

  ii.

If the Reinsurer has become insolvent or is unable to pay its debts or has lost [***] of its paid up capital or has had the authority to transact any class of insurance withdrawn, suspended or made conditional by any court or regulatory authority.

 

Agreement CR 4652    Page 26


  iii.

If the other Party ceases writing insurance and/or reinsurance and elects to run-off its existing business or if the performance of the whole or any part of this Agreement that Materially affects the interests of either of the Parties is prohibited or rendered impossible de jure or de facto for a period exceeding ninety (90) days.

 

  iv.

If the other Party fails to fulfill its material obligations under this Agreement within two (2) months after being requested in writing to do so; provided, that this Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company if the Ceding Company fails to pay any Reinsurer Premium in accordance with Article 7, the Reinsurer notifies the Ceding Company in writing of such failure and such failure remains uncured five (5) days after such notice.

 

  v.

If the other Party merges with or becomes acquired or controlled by any company, corporation or individual(s) who did not control it directly or indirectly at the inception of this Agreement and if (i) such company’s, corporation’s, or individual(s)’ financial strength rating is below A- Standard & Poor’s or A- A.M. Best and/or (ii) if such company, corporation, or individual(s) is not rated.

 

  vi.

If the Reinsurer’s financial strength rating is downgraded below A- Standard & Poor’s or A- A.M. Best and/or the Reinsurer loses its rating.

 

  vii.

If the Party giving notice or the other Party is definitively prevented from performing its obligations under this Agreement because of a “force majeure” i.e. an event beyond the control of a Party, which could not reasonably have been foreseen at the time of the conclusion of this Agreement and whose effects cannot be avoided by appropriate measures. If the prevention is temporary, this Agreement may be terminated by either Party by notification to the other Party after ninety (90) days of non-performance due to a “force majeure”.

 

  viii.

This Agreement may be terminated with immediate effect on a cut-off basis by the Reinsurer upon written notice to the Ceding Company pursuant to Article 6.

 

  ix.

If the Reinsurer terminates this Agreement pursuant to Article 9, Section 10 (with 30-day notice).

 

  x.

If the Reinsurer terminates this Agreement pursuant to Article 4, Section 2 (with 30-day notice).

 

  xi.

If the Reinsurer terminates this Agreement pursuant to Article 1, Section 4.

 

  xii.

If the Reinsurer terminates this Agreement, pursuant to Article 29, Section 3.

 

4)

Notice of termination shall be given in writing (registered letter, facsimile or any other means of communication that leaves a record of such communication) and addressed to the head office of the Party to receive the notice, or to any other address indicated for that purpose. Such notice is considered served upon dispatch or where communications between the Parties are interrupted upon attempted dispatch.

 

Agreement CR 4652    Page 27


5)

If the Parties agree to terminate this Agreement on a cut-off basis, the Reinsurer shall be fully and finally released of its liability under this Agreement against payment of its share of any outstanding balances agreed upon by the Parties.

 

6)

If this Agreement is terminated in accordance with the terms of this Article 23, the Reinsurer Premium due to the Reinsurer to the termination date will be calculated pro rata temporis to the Reinsurer Premium payable in respect of the annual period during which the termination date falls. In the event this Agreement is terminated pursuant to Article 23, Section 3(iv) or Section 3(viii), all figures relating to the Ceding Company used in the calculations set forth in Article 12 shall be based only on the period in which the Agreement is in effect.

 

7)

For the avoidance of doubt if this Agreement is terminated by the Reinsurer for the Ceding Company’s failure to pay Reinsurer Premium pursuant to Article 23, Section 3(iv) and Section 3(viii), the Reinsurer shall remain liable for covered losses incurred up to and including the date of the Ceding Company’s failure to pay such Reinsurer Premium under this Agreement, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement.

 

8)

Additionally, if any Companion Agreement is terminated, the Reinsurer shall have the right to terminate this Agreement on 31 December of the termination year of the Companion Agreement (including during the Initial Term) in accordance with Article 23, Section 2 above.

 

9)

If this Agreement is terminated by the Reinsurer pursuant to Article 23, Section 3(viii) and/or (iv), the Reinsurer shall remain liable for covered losses incurred up to and including the termination date thereunder, but the Reinsurer shall otherwise be fully and finally released from any liability under this Agreement and this Agreement shall be terminated on a cut-off basis.

ARTICLE 24

CONFIDENTIALITY

 

1)

The Parties agree that the Confidential Information constitutes confidential or proprietary information of the disclosing party unless expressly indicated otherwise by the disclosing party and the Parties agree that they shall only use the Confidential Information for the purposes of this Agreement.

 

2)

Neither Party, except with the express prior written consent of the other, shall directly or indirectly, communicate, disclose or divulge to any third party any Confidential Information, subject always to compliance with all applicable Privacy and Security Laws. A “third party” is anyone other than the Parties or their subsidiaries, affiliates, parent company, employees, retrocessionaire, agents, subcontractors, representatives, auditors or other professional advisers. For purposes of this Agreement, “Privacy and Security Laws” means any applicable data privacy, data security, or data protection law or regulation, including without limitation, in the

 

Agreement CR 4652    Page 28


  United States of America, the Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations, including, without limitation, the amendments and associated regulations enacted and implemented pursuant to the Health Information Technology for Economic and Clinical Health Act (HITECHA).

 

3)

Each Party shall use their best efforts to ensure that its respective employees, retrocessionaires, agents, subcontractors, representatives and auditors and other professional advisors, are fully informed of the provisions of this Article 27 and that they will be bound by the provisions of this Article 27 as if a signatory hereto.

 

4)

Where disclosure is required by a court order or by an arbitrator or by a regulatory, legal or regulatory authority, such disclosures will not constitute a breach of confidentiality, provided always that the Party from whom such disclosure is requested shall immediately advise the other Party in order to allow each Party the opportunity to take such protective steps as may be appropriate.

 

5)

Notwithstanding the foregoing, the Parties are not required to keep confidential Confidential Information which:

 

  i.

was publicly known prior to the time of disclosure by one Party to the other Party;

 

  ii.

has become publicly known and made generally available after disclosure to one Party through no fault of such Party;

 

  iii.

was already in the lawful possession of one Party at the time of the disclosure by the other Party;

 

  iv.

has been obtained by a Party from a third party lawfully in possession of such information and without a breach of such Party’s obligations of confidentiality; or

 

  v.

has been independently developed by one Party without use of or reference to other Party’s Confidential Information.

 

6)

The foregoing exceptions shall not apply to Personal Data.

 

7)

Each of the Parties agrees that the other shall be fully informed of any breach in these confidentiality provisions of which either Party becomes aware.

 

8)

This Article 24 shall survive termination of this Agreement.

ARTICLE 25

SEVERABILITY, LAPSE

If any provision of this Agreement is determined to be invalid or unenforceable, such determination shall not affect or impair the validity or the enforceability of the remaining provisions of the Agreement. The invalid or unenforceable provision shall be construed by the Parties hereto in such manner that the economic aim originally pursued with this provision without being invalid or unenforceable can be reached as far as it is possible. This Article 25 shall survive termination of this Agreement.

 

Agreement CR 4652    Page 29


ARTICLE 26

ENTIRE AGREEMENT, MODIFICATION

 

1)

This Agreement sets forth the entire agreement between the Parties with respect to its subject matter. This Agreement replaces and supersedes all other prior written, oral or electronic communications and treaties of any kind relating to the subject matter of this Agreement.

 

2)

Any amendment to this Agreement shall be made by addendum attached to this Agreement, embodying such amendments as may be agreed upon, and will be regarded as part of this Agreement and be equally binding. Notwithstanding the above, any amendment may also be made by issuing a revised and restated version of this Agreement. Any amendment shall be null and void unless made in writing and signed by both Parties hereto, and to the extent this Agreement required prior approval by the commissioner of the insurance department or other applicable regulatory body of the Ceding Company’s state of domicile, such amendment or addendum shall be null and void without the prior approval of such commissioner or their equivalent.

 

3)

This Agreement shall be binding upon and inure to the benefit of the Parties and their respective successors, permitted assigns and legal representatives. Except as otherwise provided herein, neither this Agreement nor any right or obligation hereunder may be assigned or delegated by any Party (in whole or in part) to a third party without the prior written consent of the other Party hereto. Any purported assignment or delegation not in compliance with the provisions of this Agreement will be void ab initio and of no force or effect.

 

4)

This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together shall be deemed to be one and the same agreement. A signed copy of this Agreement delivered by facsimile, e-mail or other means of electronic transmission shall be deemed to have the same legal effect as delivery of an original signed copy of this Agreement.

ARTICLE 27

UTMOST GOOD FAITH

This Agreement is governed by the principle of utmost good faith and was concluded on mutual trust leading the relationship between the Parties hereto as well as of usual insurance and reinsurance practice in terms of prudent and reasonable underwriting, claims assessment and administration.

 

Agreement CR 4652    Page 30


ARTICLE 28

SANCTION CLAUSE

Neither the Reinsurer nor the Ceding Company shall be deemed to provide cover and neither the Reinsurer nor the Ceding Company shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose either the Reinsurer or the Ceding Company to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ARTICLE 29

ANTI-BRIBERY

 

1)

The parties acknowledge and agree that:

 

  i.

They are committed to prevent bribery; and

 

  ii.

They have implemented and will maintain within their organization policies to prevent any such actions by their officers, representatives, employees or any other third party acting on their behalf.

 

2)

To the extent permitted by applicable law, each Party shall notify the other Party immediately upon becoming aware that an activity carried out in connection with this Agreement has or may have contravened this obligation or any applicable anti-bribery law or regulation.

 

3)

Each party may terminate this Agreement on a run-off basis upon written notice—as of right and without any judicial authorization—if during the term of the Agreement the other Party is convicted of an act of bribery or fails to comply with any anti-bribery law or regulation even if not connected to this Agreement. To the extent permitted by applicable law, such Party shall indemnify the other Party, its officers, employees, affiliates, agents, subcontractors, or any other third party acting on its behalf, against any losses, liabilities, damages, costs (including legal fees) and expenses incurred related thereto.

ARTICLE 30

ANTI-MONEY LAUNDERING

 

1)

The Reinsurer is not subject to anti-money laundering and counter-terrorist financing provisions. The Reinsurer will not however provide services to individuals or entities that are subject to assets freeze measures. The Ceding Company shall therefore apply any appropriate measure to fight against money laundering and terrorist financing, as defined by the FATF recommendations.

 

2)

Pursuant to Article 30, Section 1 above and to the extent permitted by the applicable law, the Reinsurer may at any time request evidence from the Ceding Company as to its policyholders, the Policies, or any other matters connected thereto in the context of anti-money laundering and counter-terrorism financing.

 

Agreement CR 4652    Page 31


ARTICLE 31

DATA PRIVACY

 

1)

The Parties acknowledge and agree that they:

 

  i.

are committed to protect Personal Data in accordance with applicable law and regulation; and

 

  ii.

have implemented and will maintain within their organization policies and technical security measures preventing any such privacy breaches (e.g., of confidentiality) by their officers, representatives, employees or any other third party acting on their behalf.

 

2)

Personal Data received by either the Reinsurer or the Ceding Company from the other shall not be:

 

  i.

used by the receiving party other than in connection with performing its obligations under this Agreement; or for the purpose of any retrocession arrangements; or

 

  ii.

commercially exploited by the receiving party; or

 

  iii.

transferred abroad without the Ceding Company having implemented appropriate safeguards in accordance with the applicable law and regulation;

 

3)

In particular, without prejudice to the generality of the foregoing, the Ceding Company confirms that it has obtained and undertakes that it will obtain on a continuing basis all requisite consents from its policyholders both for its own compliance purposes, for the purposes of this Agreement and for the purposes of any facultative business and retrocession arrangements to be entered into by the Reinsurer.

 

4)

To the extent permitted by the applicable law, each Party shall notify the other Party immediately upon becoming aware of privacy breaches related to Personal Data.

 

5)

The Parties shall establish a Technical Committee consisting of an equal number of one (1) or more representative(s) of each of the Reinsurer and the Ceding Company, which shall meet on a quarterly basis to monitor the assessment and evolution of the ceded liabilities and risks.

 

6)

This Article 31, Sections 1-4 shall survive termination of this Agreement.

ARTICLE 32

CORPORATE RESPONSIBILITY

 

1)

The Parties acknowledges that the AXA Group adheres to certain principles designed to ensure that the AXA Group does business in a socially responsible manner by promoting sustainable development in its business through commitments towards its principal stakeholders (customers, suppliers, employees, environment,

 

Agreement CR 4652    Page 32


  shareholders and community) as more fully set forth in the AXA Compliance and Ethics Guide located at http://www.axa.com/en/governance/disclosure/ethics. The AXA Group encourages its suppliers to be socially and environmentally responsible. The AXA Compliance and Ethics Guide may be supplemented or amended at any time at the sole discretion of the Reinsurer. In the event of any change to the AXA Compliance and Ethics Guide, the Reinsurer shall promptly send the newly revised version to the Ceding Company.

 

2)

In addition, as part of AXA Group’s principles and practices of sustainable development, the AXA Group requires its consultants to observe the following three main specific International Labour Organization (ILO) principles: (i) refrain from using, or accepting that their own suppliers and sub-contractors make use of child labour (under 15 years of age) or forced labour; (ii) ensure staff safe and healthy working conditions and environment, respecting individual and collective liberties; and (iii) promote non-discrimination (sex, race, religion or political conviction) as regards staff recruitment and management. For more information, see the ILO website: http://www.ilo.org/public/english/standards/index.htm

 

3)

The Ceding Company agrees to use commercially reasonable efforts to comply with these standards. The Parties agree to negotiate in utmost good faith to resolve any dispute that may arise regarding the adequacy of such efforts. In the event such negotiations are not successful, such dispute shall be resolved in accordance with the terms of Articles 20 and 21.

 

4)

In the event that either Party becomes aware that any of its business practices are contrary to the foregoing ILO principles, such Party agrees to use its commercially reasonable efforts to remedy the practice in question and notify the other Party of the correction it made. In the event the Party does not appropriately address the issue in question or if it commits subsequent violations, the other Party may as of right and without any prior formality to terminate this Agreement on a run-off basis for breach of this Article 32 without liability of any kind (other than payment of amounts due and owing pursuant to this Agreement in connection with a run-off termination).

ARTICLE 33

INSOLVENCY

 

1)

Reinsurance Claims shall be payable by the Reinsurer on the basis of the liability of the Ceding Company under the Policies reinsured without diminution because of insolvency of the Ceding Company. In the event of insolvency of the Ceding Company, payments by the Reinsurer shall be made directly to the Ceding Company or its liquidator, receiver or statutory successor except (i) where this Agreement specifically provides another payee for such reinsurance in the event of the insolvency of the Ceding Company, or (ii) the Reinsurer, with the consent of the direct insureds, has assumed such policy obligations of the Ceding Company as its direct obligations to the payees under such policies, in substitution for the obligations of the Ceding Company to such payees.

 

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2)

The rehabilitator, conservator, liquidator, receiver or statutory successor of the insolvent Ceding Company shall give written notice to the Reinsurer of the pendency of the claim against the Ceding Company on any policy reinsured hereunder within a reasonable time after such claim is filed in the insolvency proceeding, and during the pendency of such claim, the Reinsurer may investigate such claim and interpose, at its own expense, in the proceeding where such claim is to be adjudicated any defense or defenses which it may deem available to the Ceding Company or its rehabilitator, conservator, liquidator, receiver or statutory successor. Such expense shall be chargeable, subject to court approval, against the insolvent Ceding Company as part of the expense of the conservation or liquidation to the extent of a proportionate share of the benefit, which may accrue to the Ceding Company solely as a result of the defense undertaken by the Reinsurer.

ARTICLE 34

NOTICES, CONSTRUCTION, DEFINITIONS

 

1)

All notices, requests and other communications to any party hereunder shall be in writing (including registered letter, facsimile transmission, electronic mail or any other means of communication that leaves a record of such communication) and shall be given:

 

  i.

if to the Ceding Company, to:

Oscar Insurance Company of Florida

75 Varick St.

5th Floor

New York, NY 10013

Attention: Legal

####

 

  ii.

if to the Reinsurer, to:

####

AXA LIFE & HEALTH INTERNATIONAL SOLUTIONS

313 Terrasses de l’Arche

92727 NANTERRE CEDEX FRANCE

####

with copy to:

####

AXA France

313 Terrasses de l’Arche

92727 NANTERRE CEDEX

France

or such other address or facsimile number as such Party may hereafter specify for the purpose by notice to the other Parties hereto. All such notices, requests and other communications shall be deemed received on the date of receipt by the recipient thereof if received prior to 5:00 p.m. on a Business Day in the place of receipt. Otherwise, any such notice, request or communication shall be deemed to have been received on the next succeeding Business Day in the place of receipt.

 

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2)

Interpretation of this Agreement shall be governed by the following rules of construction: (a) words in the singular shall be held to include the plural and vice versa, and words of one gender shall be held to include the other gender as the context requires; (b) references to the terms Preamble, Recitals, Article, Section, paragraph, Annex, Schedule and Exhibit are references to the Preamble, Recitals, Articles, Sections, paragraphs, Annexes, Schedules and Exhibits to this Agreement unless otherwise specified; (c) references to “$” shall mean U.S. dollars; (d) the word “including” and words of similar import shall mean “including without limitation,” unless otherwise specified; (e) the word “or” shall not be exclusive; (f) the words “herein,” “hereof,” “hereunder” or “hereby” and similar terms are to be deemed to refer to this Agreement as a whole and not to any specific Section; (g) the headings are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement; (h) this Agreement shall be construed without regard to any presumption or rule requiring construction or interpretation against the party drafting or causing any instrument to be drafted; (i) if a word or phrase is defined, the other grammatical forms of such word or phrase have a corresponding meaning; (j) references to any statute, listing rule, rule, standard, regulation or other law include a reference to (A) the corresponding rules and regulations and (B) each of them as amended, modified, supplemented, consolidated, replaced or rewritten from time to time; (k) references to any section of any statute, listing rule, rule, standard, regulation or other law include any successor to such section; (l) references to any person or entity include such person’s or entity’s predecessors or successors, whether by merger, consolidation, amalgamation, reorganization or otherwise; and (m) references to any contract (including this Agreement) or organizational document are to the contract or organizational document as amended, modified, supplemented or replaced from time to time, unless otherwise stated.

 

3)

For purposes of this Agreement, in addition to other terms operationally defined herein, the following terms have the respective meanings set forth below:

 

  i.

“ACA-Compliant” refers to a major medical health insurance policy that conforms to the regulations set forth in the Patient Protection and Affordable Care Act.

 

  ii.

ACA Fees” means any “health insurer provider” or similar fee imposed by any governmental authority in connection with the Patient Protection and Affordable Care Act (“ACA”), including under Section 9010 thereof and including any assessments or fees imposed by any governmental authority of any state or other jurisdiction in connection with the existence or operation of, or participation in, any health insurance exchange or marketplace of such state or jurisdiction, or any other similar fee imposed under any other applicable law.

 

  iii.

Agreement” has the definition set forth in the Preamble.

 

  iv.

Annual Business Update” has the definition set forth in Article 1, Section 4.

 

  v.

ARIAS-U.S.” means the AIDA Reinsurance and Insurance Arbitration Society.

 

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  vi.

AXA Group” means the group of companies to which the Reinsurer is affiliated.

 

  vii.

Business Day” means any day other than a Saturday, a Sunday or any other day on which banking institutions in New York City or in France are required or authorized by applicable law to be closed. Any reference herein to a day that is not a Business Day shall be deemed to be a calendar day.

 

  viii.

Ceding Company” has the definition set forth in the Preamble.

 

  ix.

Collective Experience Refund Formula” has the definition set forth in Article 12, Section 2(iii).

 

  x.

Collective Experience Refund Adjustment” has the definition set forth in Article 12, Section 14.

 

  xi.

Companion Agreements” has the definition set forth in Article 5, Section 3.

 

  xii.

Confidential Information” means the information, data, analyses, studies, statements, representations and any other materials provided by the Ceding Company or the Reinsurer to the other in connection with the placement of and the course of performance under this Agreement.

 

  xiii.

Consolidated MLR” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xiv.

Cut-off” means that the Ceding Company shall relieve the Reinsurer of all liability hereunder for claims incurred after the date of termination of the Agreement. In case of cut-off termination, the Reinsurer shall refund to the Ceding Company the part of the Premium paid to the Reinsurer applicable to the unexpired liability on Policies in force.

 

  xv.

Effective Time” has the definition set forth in Article 2, Section 1.

 

  xvi.

Extra-Contractual Obligations” has the definition set forth in Article 9, Section 8.

 

  xvii.

FATF” means the Financial Action Task Force (on Money Laundering).

 

  xviii.

IBNR” means reserves for claims incurred but not reported.

 

  xix.

Initial Term” has the definition set forth in Article 2, Section 1.

 

  xx.

Insurance Companies” means collectively, the Ceding Company and each party to a Companion Agreement, excluding the Reinsurer.

 

  xxi.

Material/Materially” as generally referred to herein shall mean a term or provision that significantly impacts: (i) the terms or obligations of a Party hereunder, such as subject matter, price, quantity, services, terms of payment, business performance, operations, conditions (financial or otherwise), or prospects, and/or (ii) the ability of a Party hereunder to perform its obligations under this Agreement.

 

Agreement CR 4652    Page 36


  xxii.

Medical Loss Ratio” has the definition set forth in Annex 6 – Current Year and Consolidated Medical Loss Ratio Formulas.

 

  xxiii.

Net Reinsurance Premium” has the definition set forth in Article 7, Section 2.

 

  xxiv.

Party” or “Parties” has the definition set forth in the Preamble.

 

  xxv.

Partial Reimbursement Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxvi.

Partial Reimbursement Formula” has the definition set forth in Article 12, Section 2.

 

  xxvii.

Personal Data” means and includes any of the following information that is acquired by, provided to, created by or maintained by a Party or any third party acting on behalf of a Party in connection with this Agreement: (i) any information that identifies or can reasonably be used to identify an individual, such as first and last name, social security number or other government issued number or identifier, date of birth, home or other physical address, e-mail address or other online contact information, financial account number, credit or debit card number, biometric data, mother’s maiden name, or other personally identifiable information; and (ii) personally identifiable financial or insurance information, including but not limited to “non-public personal information” as that term is defined in the Gramm-Leach-Bliley Act, as amended, and implementing regulations, 15 U.S.C. § 6809(4).

 

  xxviii.

Policies” has the definition set forth in Article 1, Section 1.

 

  xxix.

Policies Documentation” has the definition set forth in Article 1, Section 3.

 

  xxx.

Privacy and Security Laws” has the definition set forth in Article 24, Section 2.

 

  xxxi.

Profit Sharing Adjustment” has the definition set forth in Article 12, Section 6.

 

  xxxii.

Profit Sharing Formula” has the definition set forth in Article 12, Section 2(ii).

 

  xxxiii.

Provisional Collective Experience Refund Amount” has the definition set forth in Article 12, Section 12.

 

  xxxiv.

Provisional Partial Reimbursement Amount” has the definition set forth in Article 12, Section 3.

 

Agreement CR 4652    Page 37


  xxxv.

Provisional Profit Share Amount” has the definition set forth in Article 12, Section 3.

 

  xxxvi.

Qualifying Assets” has the definition set forth in Article 10, Section 4(ii).

 

  xxxvii.

Reinsurance Claim” has the definition set forth in Article 9, Section 1.

 

  xxxviii.

Reinsurer” has the definition set forth in the Preamble.

 

  xxxix.

Reinsurer Premium” has the definition set forth in Article 7, Section 1.

 

  xl.

Reinsurer’s Quota Share” shall mean [***]% for Subscription Year 2021 and any Subscription Year subsequent to Subscription Year 2021.

 

  xli.

Statutory Reserves” means, as of the date of determination, the aggregate amount of reserves of the Ceding Company in respect of the Policies calculated in accordance with statutory accounting practices prescribed or permitted by the insurance regulator in the Ceding Company’s state of domicile and determined in accordance with the methodology set forth on Annex 5 – Statutory Reserves & IBNR Calculation Methodology.

 

  xlii.

Subscription Year” means a calendar year during which Policies are issued.

 

  xliii.

Third party” has the definition set forth in Article 24, Section 2.

 

  xliv.

Trust Account” has the definition set forth in Article 10, Section 3(i).

 

  xlv.

Trust Agreement” has the definition set forth in Article 10, Section 3(i).

 

  xlvi.

Trust Funds Withheld Account” has the definition set forth in Article 10, Section 5(iii).

 

  xlvii.

Trustee” has the definition set forth in Article 10, Section 3(i).

 

  xlviii.

Umpire” has the definition set forth in Article 20, Section 2(ii).

 

  xlix.

XOL” has the definition set forth in Article 7, Section 2.

 

4)

This Article 34 shall survive termination of this Agreement.

[Reminder of page intentionally left blank. Signature page to follow.]

 

Agreement CR 4652    Page 38


In witness whereof, the Parties hereto by their respective duly authorized representatives have executed this Agreement, in good faith, in duplicate for and on behalf of:

 

The Ceding Company
Date and place:
New York, NY, on         1/29/2021
Signature:
By:   /s/ Siddhartha Sankaran
Title:   CFO
The Reinsurer
Date and place:
Paris, on January 29th, 2021
Signature:
By:   /s/ Jacques de Peretti
Title:   CEO AXA France Vie

 

Agreement CR 4652    Page 39


ANNEX 1 – SCOPE

Policies Covered

This Agreement applies to all ACA-Compliant individual health insurance policies and ACA-Compliant small group health insurance policies corresponding to the Policy Documentation and issued or renewed by the Ceding Company in the State of Florida providing coverage commencing:

 

   

For the first Subscription Year: on January 1, 2021 or thereafter, and with a period of insurance expiring on December 31, 2021.

 

   

For the second Subscription Year: on January 1, 2022 or thereafter, and with a period of insurance expiring on December 31, 2022.

 

   

For the third Subscription Year: on January 1, 2023 or thereafter, and with a period of insurance expiring on December 31, 2023.

The Policies ceded under this Agreement are only those in effect as of January 1, 2021 or issued or renewed between January 1, 2021 and the date of termination of this Agreement.

 

Agreement CR 4652    Page 40


ANNEX 2 – TERRITORIAL SCOPE

This Agreement shall only apply to all Policies issued by the Ceding Company in the State of [***] to insureds having their principal residence in this State.

 

Agreement CR 4652    Page 41


ANNEX 3—REINSURANCE COMMISSIONS & PROFIT SHARE INFORMATION

For illustrative purposes only, the definite fees and total margins for both parties shall be calculated based on the formulas in Article 12, Section 2.

 

MLR (as
defined in
Annex 6)

    Oscar
Commission
    AXA
Fees
    COR     Profit      Redistrib
rate
     PS for
Oscar
     PS for
AXA
     Oscar
Total
     AXA
Total
 
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]       [***]        [***]        [***]        [***]        [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  
  [***]       [***]       [***]       [***]          [***]              [***]        [***]  

 

Agreement CR 4652    Page 42


ANNEX 4 – DATA REPORTING

Monthly reporting dashboards:

 

   

Portfolio : number of policies/persons by month covered by global/ metal /state

 

   

Portfolio distribution (per gender/age) by global/metal/state

 

   

Premiums by month global / per metal / per state

 

   

Claims (split by % of reserves and paid by global/ metal/ state) (IBNR global / metal / state) (by month of occurrence)

 

   

Claims by benefits category split by global/ metal / state

 

   

Inpatient hospital

 

   

Outpatient hospital

 

   

Professional

 

   

Other medical

 

   

Capitation

 

   

Prescription drug

 

   

MLR by global / state / metal (current year, and n-1 year)

Risk adjustment estimate

Quarterly Basis (according to regulatory possibilities)

 

   

Cash flows (quarterly basis)

 

   

Reinsurance balance settlement report

 

   

Anonymized dataset

 

   

Information about the insureds (biometrical & contract related data): age (birthdate), gender, state & address, subscription date, premium paid

 

   

Information about claims: customer paths, medical facilities used, hospitalization (length/costs), details about professional, other medical, prescription drug, fraud

On an annual basis (June)

Presentation by the OSCAR Technical team to AXA of the level of premium changes requests per state for the upcoming year and of the related repricing drivers

 

Agreement CR 4652    Page 43


ANNEX 5 – STATUTORY RESERVES & IBNR CALCULATION METHODOLOGY

Statutory reserves include:

 

   

Incurred but not reported claims (IBNR)

 

   

Claims in course of settlement

 

   

Claims due and unpaid

 

   

Provisions for Adverse Deviation (PAD)

Actuarial Process Narrative

The Ceding Company’s current reserves processes include monthly valuations for all actuarial liabilities based on models developed in-house incorporating the most current views of the claim data available from our data warehouse.

Reserves:

The In-house reserve model incorporates different methodologies based on the amount and recency of the claim. The completion factor development method is utilized for claims under $[***] and is supplemented by expected per member loss expectations where the data is immature in the most recent months. A seriatim methodology is utilized for claims over $[***], supplemented by case management data supplied by our clinical and claims operations areas. A pooling charge, based on historical experience, is incorporated for recent months where claims have not exceeded the $[***] threshold. Claims reserve triangle analytical cohorts are segmented by individual or small group and state. All reserves are determined at the cohort level incorporating the current inventory of claims as well as claims in course of settlement from provider payment disputes.

The reserve model incorporates historical reserve testing and detail on prior period development down to the incurral month. Reserves accrued are best-estimates with an explicit margin for adverse deviation, currently set at [***]%, as well as an accrual for unpaid claim adjustment expenses. All margins are reviewed at least annually for appropriateness based on historical runout. Claims reserve triangles are inclusive of medical and behavioral health claims only. Pharmacy claims are analyzed separately and assumed to not have any runout.

 

Agreement CR 4652    Page 44


ANNEX 6 – CURRENT YEAR AND CONSOLIDATED MEDICAL LOSS RATIO FORMULAS

Medical Loss Ratio Definition

All claims and premiums refer to the current Subscription Year

Numerator: [***]

Denominator: [***]

Consolidated MLR Definition

Numerator: [***]

Denominator: [***]

 

Agreement CR 4652    Page 45


ANNEX 7 – REINSURANCE BALANCE CALCULATION

(1) Income: quota share of:

[***]

(2) Outgo: quota share of:

[***]

[***]

[***]

[***]

Reinsurance balance = (1) - (2)

(3) [***]

(4) [***]

(5) [***]

(6) [***]

Technical result (for information) = (1) - (2) – ((4) - (3)) – ((6) - (5))

 

Agreement CR 4652    Page 46


ANNEX 8 – LIMITATION OF LIABILITY CALCULATION

State A—[***]

 

     State A     State B     State C     Ceding Company     Total  

Gross Premiums

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Gross Claims

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

MLR

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Ceded Premiums

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Ceded Claims

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

AXA Ceded MLR

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Retained Premiums

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Retained Claims

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 
     Ceded Claims Calculation                          

Claims Ceded (up to local attachment point)

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Claims Ceded (above local attachment point)

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Allocation of Claims Retained

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

Total Claims

     [ ***]      [ ***]      [ ***]      [ ***]      [ ***] 

 

Agreement CR 4652    Page 47

Exhibit 16.1

November 6, 2020

Securities and Exchange Commission

100 F Street, N.E.

Washington, D.C. 20549-7561

Dear Sirs/Madams:

We have read the Change in Accountants disclosure of Mulberry Health Inc.’s Form S-1 dated November 6, 2020, and we agree with the statements made therein.

Yours truly,

/s/ DELOITTE & TOUCHE LLP

Exhibit 16.2

Concurrence Letter to SEC

November 6, 2020

U.S. Securities and Exchange Commission

Office of the Chief Accountant

100 F Street, NE

Washington, DC 20549

Re: Mulberry Health Inc.

Dear Sir or Madam:

We have read the disclosures regarding the change in independent registered public accounting firms included under the caption “Change in Accountants” in the Registration Statement and Prospectus and agree with the statements concerning our Firm contained therein.

Very truly yours,

/s/ GRANT THORNTON LLP

Exhibit 21.1

Subsidiaries of Oscar Health, Inc.

 

Legal Name    Jurisdiction of Incorporation

Mulberry Insurance Agency

   Delaware

Mulberry Management Corporation

   Delaware

Mulberry Ohio Management Corporation

   Ohio

Oscar Buckeye State Insurance Corporation

   Ohio

Oscar Garden State Insurance Corporation

   New Jersey

Oscar Golden State Managed Care (HMO)

   California

Oscar Health Plan of California

   California

Oscar Health Plan of Georgia

   Georgia

Oscar Health Plan of New York, Inc.

   New York

Oscar Health Plan of North Carolina

   North Carolina

Oscar Health Plan of Pennsylvania, Inc.

   Pennsylvania

Oscar Health Plan, Inc.

   Arizona

Oscar Insurance Company

   Texas

Oscar Insurance Company of Florida

   Florida

Oscar Insurance Corporation

   New York

Oscar Insurance Corporation of New Jersey

   New Jersey

Oscar Insurance Corporation of Ohio

   Ohio

Oscar Managed Care of South Florida, Inc.

   Florida

Exhibit 23.1

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We have issued our report dated December 16, 2020, with respect to the December 31, 2019 consolidated financial statements of Oscar Health, Inc. contained in the Registration Statement and Prospectus. We consent to the use of the aforementioned report in the Registration Statement and Prospectus, and to the use of our name as it appears under the caption “Experts”.

/s/ GRANT THORNTON LLP

Hartford, Connecticut

February 5, 2021

Exhibit 23.2

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We hereby consent to the use in this Registration Statement on Form S-1 of Oscar Health, Inc. of our report dated February 4, 2021 relating to the financial statements of Oscar Health, Inc., which appears in this Registration Statement. We also consent to the reference to us under the heading “Experts” in such Registration Statement.

/s/ PricewaterhouseCoopers LLP

Philadelphia, Pennsylvania

February 5, 2021