Health Net 2007 Annual Report Download - page 198

EXHIBIT A
[FORM OF SEPARATION AGREEMENT, WAIVER AND RELEASE OF CLAIMS]
This SEPARATION AGREEMENT, WAIVER AND RELEASE OF CLAIMS (this “Separation Agreement and Release”) is
made and entered into as of the dates set forth on the signature pages hereto by and between Health Net, Inc. and its affiliates and
subsidiaries (hereinafter referred to as the “Company”) and [EXECUTIVE NAME] (hereinafter referred to as the “Executive”).
WHEREAS, the Company and Executive are parties to an Employment Agreement dated as of [DATE] (the “Employment
Agreement”) and are entering into this Separation Agreement and Release as a condition to Executive’s receipt of a severance
payment thereunder (capitalized terms used but not defined herein shall have the meanings set forth in the Employment Agreement).
NOW, THEREFORE, the Company and Executive agree as follows:
A - 1
1. Executive’s employment with the Company will terminate on [TERM DATE ] (the “Termination Date”). Upon termination of
employment, Executive will not represent to anyone that he is an employee of the Company and will not say or do anything
purporting to bind the Company. Upon Executive’s termination of employment, Executive shall be deemed to have resigned
from all other positions with the Company, if any, held by Executive.
2. Executive’s termination of employment with the Company shall be considered a [DESCRIBE TYPE OF TERMINATION]
under the Employment Agreement, and Executive is therefore eligible to receive [DESCRIBE PAYMENTS AND OTHER
BENEFITS TO BE RECEIVED (SEVERANCE, BENEFIT CONTINUATION/COBRA, ETC.].
3. Executive acknowledges that all unused accrued vacation and unused personal absence time will be paid in Executive’s final
regular paycheck in keeping with the Company’s policy and practice or such shorter time as may be required by applicable law.
Executive further acknowledges that no further vacation/paid-time-off or other benefits will accrue after the Termination Date.
4. Executive’s participation in all Company employee benefit plans as an active employee shall cease on the Termination Date, and
Executive shall not be eligible to make contributions to or to receive Company matching contributions under the Health Net,
Inc. 401(k) Associate Savings Plan, or to make any deferrals pursuant to any deferred compensation plan of the Company after
the Termination Date (it being understood that Executive shall be entitled to all vested benefits accrued as of the date hereof
under the Company’s 401(k) Savings Plan and any deferred compensation plan). If, immediately prior to the Termination Date,
Executive participates in any Company employee welfare benefit plan, Executive’s participation in such plan shall continue on
the same terms and conditions, including the same co-payment terms, until 11:59 p.m. (Pacific Time) on the last day of the
month in which the Termination Date occurs.