UnitedHealth Group (UNH)

14.2 “Bust-Up” Provision

Notwithstanding any other provisions in this Settlement Agreement, Defendants reserve the right, in their sole and absolute discretion, to terminate this Settlement Agreement within thirty (30) days after receipt of the categories of items to be furnished by the Claims Administrator set forth in Section 14.1 by delivering a notice of termination to Settlement Class Counsel, with a copy to the Court, prior to the commencement of the Final Settlement Hearing, if they determine that any of the following conditions has occurred with respect to Opt-Outs: (a) the number of Plan Member Opt-Outs exceeds 2% of the number of Plan Members who were mailed the Mailed Notice; (b) the number of Out-of-Network Health Care Provider Opt-Outs exceeds 1% of the number of Out-Of-Network Health Care Providers who were mailed the Mailed Notice; (c) the aggregate difference between billed charges incurred in 2007 on Covered Out-Of-Network Services or Supplies, and the corresponding Allowed Amounts determined, by and for Plan Members who were mailed the Mailed Notice and Opted-Out, exceeds $40 million; or (d) the aggregate difference between charges billed in 2007 for Covered Out-Of-Network Services or Supplies by Out-Of-Network Health Care Providers who were mailed the Mailed Notice and Opted-Out, and the corresponding Allowed Amounts, exceeds $40 million.