WYOMING HEALTH FUNDS ALLIANCE

MEMBER PARTICIPATION AGREEMENT

Effective with the date of all signatures below, __________________________(hereinafter "Member") hereby is granted and agreed to participate on behalf of itself and its eligible participants in the Wyoming Health Funds Alliance ( hereinafter "WHFA" ) under the following terms:

1.) It is understood that Wyoming Health Funds Alliance is to nonprofit corporation organized to assist members in the maintenance of community health through health care cost containment.

2.) Members agree to participate in the WHFA and to appoint two (2) representative to the corporation: one (1) from among its labor trustees or plan committee members and one (1) from among its management trustees or plan committee members. Member agrees to comply with the articles of incorporation and bylaws, both as from time to time amended, and acknowledge receipt of a copy of the current articles and bylaws.

3.) Members agree to pay to WHFA a one-time, nonrefundable contribution of two dollars ( $2.00 ) per participant residing in the State of Wyoming, plus other participants designated by the Member, which Member had on the last day of the month ending next prior to the effective date of this Member Participation Agreement. The purpose of this contribution is to provide initial funding of cost and to provide for future efforts at health care cost containment. The Member does not agree to make any contribution beyond that set forth in this paragraph.

4.) Member may cancel its participation in the WHFA at any time by delivery of a written statement of cancellation to the registered agent of the corporation and to its Chairman. The WHFA may remove Member from membership.

5.) WHFA will attempt to negotiate health benefit arrangement with various providers or provider networks and agrees to make available to Member the advantage of each and every such arrangement which it develops.

The WHFA does not promise any particular program or result.

WYOMING HEALTH FUNDS ALLIANCE ___________________________________( MEMBER )

By:_________________________________( CHAIRPERSON )

By:_________________________________( CHAIR )

By:_________________________________( VICE-CHAIRPERSON )

By:_________________________________( SECRETARY )