For Immediate Release

Contact:
Scott Harris
Milliman Care Guidelines
+1 206 381.8160
scott.harris@milliman.com

James S. Loughman
Donley Communications
+1 212 751.6126

Milliman Care Guidelines Announces License Agreement with Sierra Health Services, Inc.

Milliman Guidelines to be Used Exclusively in Sierra’s Clinical Care Decisions

SEATTLE - February 2, 2004 - Milliman Care Guidelines, a Division of Milliman, announced today that Sierra Health Services, Inc. (NYSE:SIE) has licensed its evidence-based clinical guidelines, the Milliman Care Guidelines^®. The long-term agreement gives Sierra access to Ambulatory Care, Inpatient and Surgical Care, Recovery Facility Care, and Home Care.

The Care Guidelines are a focused summary of the current best medical evidence that reflect the actual working environment of today’s healthcare organizations. Developed by physicians, nurses, and other clinicians who understand the patient care environment, the Care Guidelines enable more informed and consistent clinical care decisions and promote the best possible care management.

“We are very impressed with the evolution of the Care Guidelines’ 8th Edition,” said Dana Zuckerman, RN MA, Executive Director of the Utilization Management Access Center of Health Plan of Nevada, Inc., a wholly-owned subsidiary of Sierra. “ With the Care Guidelines, we now have an easy to use, comprehensive resource. When we enter the system, the full list of annotated evidence-based references is immediately available, which allows us to better document the rationale behind a particular decision - other than ’Yes or No’,” Zuckerman added. Cost was also an important issue for Sierra. “The Care Guidelines are affordable,” Zuckerman noted, “and that, too, enhances our ability to provide quality care.”

Sierra Health Services, Inc., based in Las Vegas, Nevada, is a diversified healthcare services company that operates health maintenance organizations, indemnity and workers’ compensation insurers, military health programs, preferred provider organizations, and multi-specialty medical groups. Sierra’s subsidiaries serve over 1.2 million people through health benefit plans for employers, government programs, and individuals. For more information, visit the company’s website at www.sierrahealth.com.

Milliman Care Guidelines is a Division of Milliman, and provides its clinical Care Guidelines to many of the firm’s clients in the hospital and insurance industries. Milliman, Inc., headquartered in Seattle, serves the full spectrum of business, financial, government and union organizations. Founded in 1947, Milliman is located in 37 cities throughout the United States and in Bermuda, Hong Kong, London, Sao Paolo, Seoul, and Tokyo. It is a founding member of Milliman Global, an international organization serving insurance, employee benefits and healthcare clients worldwide. Milliman employs approximately 1,750 people, including a professional staff of over 700 qualified consultants and actuaries. The firm has consulting practices in property and casualty insurance, pensions, employee benefits, healthcare, life insurance, and risk management. To obtain more information, please visit the Milliman Care Guidelines website at www.careguidelines.com or call 888 464.4746.