SIERRA HEALTH SERVICES INC
EXHIBIT
<DOCUMENT>
<TYPE>EX-10
<SEQUENCE>3
<FILENAME>exh10-1.htm
<DESCRIPTION>EXHIBIT
<TEXT>
<HTML>
<HEAD>
<TITLE>exhibit</TITLE>
</HEAD>
<BODY>

<B><P ALIGN="RIGHT">Exhibit 10.1</b></P>

<B><P ALIGN="CENTER"></P>
<P ALIGN="CENTER">AMENDMENT NO. 1</p>
<P ALIGN="center"></P>
<P ALIGN="CENTER">TO</p>
<P ALIGN="center"></P>
<P ALIGN="CENTER">EMPLOYMENT AGREEMENT</P>
<P ALIGN="JUSTIFY"></P>
</B><P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;This Amendment No. 1 (the "Amendment") to Employment Agreement is hereby made and entered into as of this 23rd day of April, 2004, by and between Sierra Health Services,  Inc., a Nevada corporation (hereinafter referred to as "Employer") and<U>&#9;<B>William R. Godfrey</B>
</U>&nbsp;(hereinafter referred to as "Employee").</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;WHEREAS, the Employer and Employee are parties to that certain Employment Agreement dated as of <B> <U>&#9;December 10, 1999&#9;&#9;</B></U>; and</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;WHEREAS, the parties hereto desire to amend certain terms thereof on the terms and conditions hereinafter set forth; and</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;WHEREAS, the Compensation Committee of the Board of Directors of Employer have reviewed and approved this Amendment.</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;NOW, THEREFORE, in consideration of the foregoing premises, and for other good and valuable consideration, the sufficiency of which is hereby acknowledged, the parties hereto agree as follows:</P>
<P ALIGN="JUSTIFY"></P>

<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
<U>Article II, Paragraph 1, Term of Employment - Term of Agreement, is hereby deleted and replaced with the</u><br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<u>following sentence:</P>
</U><P ALIGN="JUSTIFY"></P>
<dir>
<dir>
<P ALIGN="JUSTIFY">Unless earlier terminated by the mutual agreement of the parties hereto, this Agreement shall terminate at <B><U>December 31, 2005</B> </U>or, if Employee has become entitled to any benefit under Article VII due to termination of employment on or before <B><U>December 31, 2005</B></U>, at such date as Employer has no further obligations to Employee under Article VII; provided, however, that the provisions of Article V and Article VI (and this clause of Article II) shall survive any termination of this Agreement.</P>
<P ALIGN="JUSTIFY"></P>
</dir>
</dir>

<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<U>Effective Date.</U>  This Amendment shall be effective as of April 23, 2004.</P>
<P ALIGN="JUSTIFY"></P></DIR>
</DIR>

<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<U>Continued Effect.</U>  Except as otherwise modified hereby, the Agreement shall &#9;continue in full force and effect.</P>
<P ALIGN="JUSTIFY"></P></DIR>
</DIR>

<P ALIGN="JUSTIFY">&#9;</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;IN WITNESS WHEREOF, the undersigned have executed this Amendment as of the date first above written.</P>
</FONT><P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY">SIERRA HEALTH SERVICES, INC.</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY">BY:________________________________<br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Frank E. Collins<br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Senior Vice President, Legal and Administration</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY">EMPLOYEE</P>
<P ALIGN="JUSTIFY">&nbsp;</P>
<P ALIGN="JUSTIFY"></P>
<P ALIGN="JUSTIFY">BY:________________________________<br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;William R. Godfrey&#9;</P>

<P>&nbsp;</P></BODY>
</HTML>

</TEXT>
</DOCUMENT>
