Sierra Health and Life in Nevada

> 1997 HPN receives NCQA accreditation, the first HMO in Nevada to achieve this recognition.

> 1999 HPN, a Nevada-based HMO, signs a full-risk agreement with Health First, a Northern Nevada HMO, thereby improving the financial stability of HPN's Northern Nevada market.

> 2002 HPN and SHL receive Health Utilization Management accreditation from the American Accreditation Healthcare Commission (URAC).

> 2003 HPN is awarded an accreditation status of "Commendable" from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to measuring the quality of America's healthcare. Accreditation is for the Commercial HMO, Commercial POS and Medicare HMO product lines in Nevada, effective July 2003.

> 2006 HPN was informed by the Purchasing Department of the State of Nevada, Department of Administration, of its intent to award HPN a contract with the Division of Healthcare Financing and Policy (DHCFP) to provide certain Medicaid services.

HPN and SHL were selected by the Centers for Medicare & Medicaid Services (CMS) to participate for 2007 in the stand-alone prescription drug plan (PDP), Medicare Advantage HMO, Local and Regional PPO programs, and the Medicare Advantage Private Fee-For-Service (PFFS) program.

HPN is awarded an accreditation status of "Commendable" from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to measuring the quality of America's healthcare. Accreditation is for the Commercial HMO, Commercial POS and Medicare HMO product lines in Nevada, effective May 2006.