X0202 4 2004-12-20 0 0000813562 NATIONAL MEDICAL HEALTH CARD SYSTEMS INC NMHC 0001302101 Smith James Francis 26 HARBOR PARK DRIVE PORT WASHINGTON NY 11050 0 1 0 0 Chief Executive Officer, Pres Option to Purchase Common Stock 22.45 2004-12-20 4 A 0 26552 22.45 A 2008-12-20 2014-12-20 Common Stock 26552 126552 D Cliff Vesting after 4 year term. Accelerated vesting if following conditions are met: 50% Vested after 2 years (if greater than or equal to 30% Avg. NI Growth) 75% Vested after 3 years (if greater than or equal to 30% Avg. NI Growth) 100% Vested after 3 years (if greater than or equal to 35% Avg. NI Growth) /s/ James Smith 2004-12-21