Exhibit 1.1

                                   2,000,000

                             CRA Managed Care, Inc.

                                  Common Stock

                                ($.01 Par Value)


                             UNDERWRITING AGREEMENT


                                                            November __, 1996



Alex. Brown & Sons Incorporated
Dean Witter Reynolds Inc.
Montgomery Securities
J.P. Morgan Securities Inc.
As Representatives of the
    Several Underwriters
c/o  Alex. Brown & Sons Incorporated
135 East Baltimore Street
Baltimore, Maryland 21202

Gentlemen:

     CRA Managed Care, Inc., a Massachusetts corporation (the "COMPANY"), and 
certain shareholders of the Company (the "SELLING SHAREHOLDERS") propose to 
sell to the several underwriters (the "UNDERWRITERS") named in SCHEDULE I 
hereto for whom you are acting as representatives (the "REPRESENTATIVES") an 
aggregate of 2,000,000 shares of the Company's Common Stock, $.01 par value 
(the "FIRM SHARES"), of which 500,000 shares will be sold by the Company and 
1,500,000 shares will be sold by the Selling Shareholders.  The respective 
amounts of the Firm Shares to be so purchased by the several Underwriters are 
set forth opposite their names in SCHEDULE I hereto, and the respective 
amounts to be sold by the Selling Shareholders are set forth opposite their 
names in SCHEDULE II hereto.  The Company and the Selling Shareholders are 
sometimes referred to herein collectively as the "SELLERS."  The Company also 
proposes to sell at the Underwriters' option an aggregate of up to 300,000 
additional shares of the Company's Common Stock (the "OPTION SHARES") as set 
forth below.

     As the Representatives, you have advised the Company and the Selling 
Shareholders (a)  that you are authorized to enter into this Agreement on 
behalf of the several Underwriters, and  (b) that the several Underwriters 
are willing, acting severally and not jointly, to purchase the numbers of 
Firm Shares set forth opposite their respective names in SCHEDULE I, plus 
their pro rata portion of the Option Shares if you elect to exercise the 
over-allotment option in whole or in part for the accounts of the



                                     -2-

several Underwriters.  The Firm Shares and the Option Shares (to the extent 
the aforementioned option is exercised) are herein collectively called the 
"SHARES."

     In consideration of the mutual agreements contained herein and of the 
interests of the parties in the transactions contemplated hereby, the parties 
hereto agree as follows:

     1.   REPRESENTATIONS AND WARRANTIES OF THE COMPANY AND THE
          SELLING SHAREHOLDERS.

          (a)  The Company represents and warrants as of the date hereof, the 
               Closing Date and the Option Closing Date, as the case may be (as 
               such dates are hereinafter defined), to each of the Underwriters
               as follows:

          (i)  A registration statement on Form S-3 (File No. 333-[_________])
     with respect to the Shares has been carefully prepared by the Company in
     conformity with the requirements of the Securities Act of 1933, as amended
     (the "ACT"), and the Rules and Regulations (the "RULES AND REGULATIONS") of
     the Securities and Exchange Commission (the "COMMISSION") thereunder and
     has been filed with the Commissions.  The Company has complied with the
     conditions for the use of Form S-3.  Copies of such registration statement,
     including any amendments thereto, the preliminary prospectuses (meeting the
     requirements of the Rules and Regulations) contained therein and the
     exhibits, financial statements and schedules, as finally amended and
     revised, have heretofore been delivered by the Company to you and, to the
     extent applicable, were identical to the electronically transmitted copies
     thereof filed with the Commission pursuant to the Commission's Electronic
     Data Gathering, Analysis and Retrieval System ("EDGAR"), except to the
     extent permitted by Regulation S-T.  Such registration statement, together
     with any registration statement filed by the Company pursuant to Rule
     462(b) of the Act, herein referred to as the "REGISTRATION STATEMENT,"
     which shall be deemed to include all information omitted therefrom in
     reliance upon Rule 430A and contained in the Prospectus referred to below,
     has been declared effective by the Commission under the Act and no post-
     effective amendment to the Registration Statement has been filed as of the
     date of this Agreement.  "PROSPECTUS" means (a) the  form of prospectus
     first filed by the Company with the Commission pursuant to Rule 424(b) and
     430A or (b) the last preliminary prospectus included in the Registration
     Statement filed prior to the time it becomes effective or filed pursuant to
     Rule 424(a) under the Act that is delivered by the Company to the
     Underwriters for delivery to purchasers of the Shares, together with the
     term sheet or abbreviated term sheet filed with the Commission pursuant to
     Rule 424(b)(7) under the Act.   Each preliminary prospectus included in the
     Registration Statement prior to the time it becomes effective is herein
     referred to as a "PRELIMINARY PROSPECTUS."  Any reference herein to the
     Registration Statement, any Preliminary Prospectus or to the Prospectus
     shall be deemed to refer to and include any documents incorporated by
     reference therein, and, in the case of any reference herein to any
     Prospectus, also shall be deemed to include any documents incorporated by
     reference therein, any supplements or amendments thereto, filed with the
     Commission after the date of filing of the Prospectus under Rule 424(b) or
     Rule 430A, and prior to the termination of the offering of the Shares by
     the Underwriters.  For purposes of this Agreement, all references to the
     Registration Statement, any Preliminary Prospectus, the Prospectus, or any
     amendment or supplement to any of the foregoing, shall be deemed to include
     the respective copies thereof filed with the Commission pursuant to EDGAR.

          (ii)  The Company has been duly organized and is validly existing as a
     corporation in good standing under the laws of the Commonwealth of
     Massachusetts, with corporate power and authority to own or lease its
     properties and conduct its business as described in the Registration
     Statement.  Each of the subsidiaries of the Company as listed in EXHIBIT A
     hereto (collectively,




                                     -3-

     the "SUBSIDIARIES") has been duly organized and is validly existing as a 
     corporation in good standing under the laws of the jurisdiction of its 
     incorporation, with corporate power and authority to own or lease its 
     properties and conduct its business as described in the Registration 
     Statement. The Subsidiaries are the only subsidiaries, direct or 
     indirect, of the Company.  The Company and each of the Subsidiaries are 
     duly qualified to transact business in all jurisdictions in which the 
     conduct of their business requires such qualification and where the 
     failure to be so qualified would have a material adverse effect on the 
     business or results of operations of the Company or the Subsidiaries.  
     The outstanding shares of capital stock of each of the Subsidiaries have 
     been duly authorized and validly issued, are fully paid and 
     non-assessable and  are owned by the Company free and clear of all 
     liens, encumbrances and equities and claims; and no options, warrants or 
     other rights to purchase, agreements or other obligations to issue or 
     other rights to convert any obligations into shares of capital stock or 
     ownership interests in the Subsidiaries are outstanding.

           (iii)  The outstanding shares of Common Stock of the Company,
     including all shares to be sold by the Selling Shareholders, have been duly
     authorized and validly issued and are fully paid and non-assessable; the
     portion of the Shares and the Option Shares, if any, to be issued and 
     sold by the Company have been duly authorized and when issued and paid for 
     as contemplated herein will be validly issued, fully paid and non-
     assessable; and no preemptive rights of stockholders exist with respect to 
     any of the Shares or the issue and sale thereof.  Neither the filing of 
     the Registration Statement nor the offering or sale of the Shares as 
     contemplated by this Agreement gives rise to any rights, other than those 
     which have been waived or satisfied, for or relating to the registration 
     of any shares of Common Stock.

           (iv)  The information set forth under the caption "Capitalization" in
     the Prospectus is true and correct.  All of the Shares conform to the
     description thereof contained in the Registration Statement.  The  form of
     certificates for the Shares conforms to the corporate law of the
     jurisdiction of the Company's incorporation.

           (v)  The Commission has not issued an order preventing or suspending
     the use of any Prospectus relating to the proposed offering of the Shares
     nor instituted proceedings for that purpose.   The Registration Statement
     contains, and the Prospectus and any amendments or supplements thereto will
     contain, all statements which are required to be stated therein by, and
     will conform to, the requirements of the Act and the Rules and Regulations.
     The documents incorporated by reference in the Prospectus, at the time
     filed with the Commission conformed, in all respects to the requirements of
     the Securities Exchange Act of 1934 or the Act, as applicable, and the
     rules and regulations of the Commission thereunder.  The Registration
     Statement and any amendment thereto do not contain, and will not contain,
     any untrue statement of a material fact and do not omit, and will not omit,
     to state any material fact required to be stated therein or necessary to
     make the statements therein not misleading.  The Prospectus and any
     amendments and supplements thereto do not contain, and will not contain,
     any untrue statement of material fact; and do not omit, and will not omit,
     to state any material fact required to be stated therein or necessary to
     make the statements therein, in the light of the circumstances under which
     they were made, not misleading; PROVIDED, HOWEVER, that the Company makes
     no representations or warranties as to information contained in or omitted
     from the Registration Statement or the Prospectus, or any such amendment or
     supplement, in reliance upon, and in conformity with, written information
     furnished to the Company by or on behalf of any Underwriter through the
     Representatives, specifically for use in the preparation thereof.



                                     -4-

           (vi)  The consolidated financial statements of the Company and the
     Subsidiaries, together with related notes and schedules as set forth or
     incorporated by reference in the Registration Statement, present fairly the
     financial position and the results of operations and cash flows of the
     Company and the consolidated Subsidiaries, at the indicated dates and for
     the indicated periods.  Such financial statements and related schedules
     have been prepared in accordance with generally accepted principles of
     accounting, consistently applied throughout the periods involved, except as
     disclosed herein, and all adjustments necessary for a fair presentation of
     results for such periods have been made.  The summary financial and
     statistical data included or incorporated by reference in the Registration
     Statement presents fairly the information shown therein and such data has
     been compiled on a basis consistent with the financial statements presented
     therein and the books and records of the Company.  The pro forma financial
     statements and other pro forma financial information included in the
     Registration Statement and the Prospectus present fairly the information
     shown therein, have been prepared in accordance with the Commission's rules
     and guidelines with respect to pro forma financial statements, have been
     properly compiled on the pro forma bases described therein, and, in the
     opinion of the Company, the assumptions used in the preparation thereof are
     reasonable and the adjustments used therein are appropriate to give effect
     to the transactions or circumstances referred to therein.

           (vii)  Arthur Andersen LLP, who have certified certain of the
     financial statements filed with the Commission as part, or incorporated by
     reference in, of the Registration Statement, are independent public
     accountants as required by the Act and the Rules and Regulations.

           (viii)  There is no action, suit, claim or proceeding pending or, to
     the knowledge of the Company, threatened against the Company or any of the
     Subsidiaries before any court or administrative agency or otherwise which
     if determined adversely to the Company or any of its Subsidiaries might
     result in any material adverse change in the earnings, business, 
     management, properties, assets, rights, operations, condition (financial or
     otherwise) or prospects of the Company and of the Subsidiaries or to
     prevent the consummation of the transactions contemplated hereby, except as
     set forth in the Registration Statement.

           (ix)  The Company and the Subsidiaries have good and marketable title
     to all of the properties and assets reflected in the financial statements
     (or as described in the Registration Statement) hereinabove described,
     subject to no lien, mortgage, pledge, charge or encumbrance of any kind
     except those reflected in such financial statements (or as described in the
     Registration Statement) or which are not material in amount.  The Company
     and the Subsidiaries occupy their leased properties under valid and binding
     leases conforming in all material respects to the description thereof set
     forth in the Registration Statement.

           (x)  The Company and the Subsidiaries have filed all Federal, State,
     local and foreign income tax returns which have been required to be filed
     and have paid all taxes indicated by said returns and all assessments
     received by them or any of them to the extent that such taxes have become
     due.  All tax liabilities have been adequately provided for in the
     financial statements of the Company.

           (xi)  Since the respective dates as of which information is given in
     the Registration Statement, as it may be amended or supplemented, there has
     not been any material adverse change or any development involving a
     prospective material adverse change in or affecting the earnings, business,
     management, properties, assets, rights, operations, condition (financial or
     otherwise), or prospects of the Company and its Subsidiaries, whether or
     not occurring in the



                                     -5-

     ordinary course of business, and there has not been any material 
     transaction entered into or any material transaction that is probable of 
     being entered into by the Company or the Subsidiaries, other than 
     transactions in the ordinary course of business and changes and 
     transactions described in the Registration Statement, as it may be 
     amended or supplemented.  The Company and the Subsidiaries have no 
     material contingent obligations which are not disclosed in the Company's 
     financial statements which are included in the Registration Statement.

           (xii)  Neither the Company nor any of the Subsidiaries is or with the
     giving of notice or lapse of time or both, will be, in violation of or in
     default under  its Charter or By-laws or under any agreement, lease,
     contract, indenture or other instrument or obligation to which it is a
     party or by which it, or any of its properties, is bound and which default
     is of material significance in respect of the condition, financial or
     otherwise of the Company and its Subsidiaries or the business, management,
     properties, assets, rights, operations, condition (financial or otherwise)
     or prospects of the Company and the Subsidiaries.  The execution and
     delivery of this Agreement and the consummation of the transactions herein
     contemplated and the fulfillment of the terms hereof will not conflict with
     or result in a breach of any of the terms or provisions of, or constitute a
     default under, any indenture, mortgage, deed of trust or other agreement or
     instrument to which the Company or any Subsidiary is a party, or of the
     Charter or By-laws of the Company or any order, rule or regulation
     applicable to the Company or any Subsidiary of any court or of any
     regulatory body or administrative agency or other governmental body having
     jurisdiction.

           (xiii)  Each approval, consent, order, authorization, designation,
     declaration or filing by or with any regulatory, administrative or other
     governmental body necessary in connection with the execution and delivery
     by the Company of this Agreement and the consummation of the transactions
     herein contemplated (except such additional steps as may be required by the
     Commission, the National Association of Securities Dealers, Inc. (the
     "NASD") or such additional steps as may be necessary to qualify the Shares
     for public offering by the Underwriters under state securities or Blue Sky
     laws) has been obtained or made and is in full force and effect.

           (xiv) The Company and each of the Subsidiaries owns or possesses
     adequate licenses or other rights to use all patents, patent applications,
     trademarks, trademark applications, service marks, service mark
     applications, trade names, copyrights, manufacturing processes, formulae,
     trade secrets and know-how or other information (collectively,
     "INTELLECTUAL PROPERTY") described in the Prospectus as owned by or used by
     the Company or the Subsidiaries or which is necessary to the conduct of its
     business as now conducted by the Company or the Subsidiaries as described
     in the Prospectus.  The Company is not aware of any infringement of or
     conflict with the rights of claims or others with respect to any of the
     products or Intellectual Property of the Company or the Subsidiaries which
     could have a material adverse effect on the business or financial condition
     of the Company or the Subsidiaries.  The Company is not aware of any
     infringement of any of the Intellectual Property rights of the Company or
     the Subsidiaries by any third party which could have a material adverse
     effect on the business or financial condition of the Company or the
     Subsidiaries.

          (xv) The Company and each the Subsidiaries is conducting its business
     in compliance with all the laws, rules and regulations of the jurisdictions
     in which it is they are conducting business, except where the failure to so
     comply would not have, singly or in the aggregate, a material adverse
     effect on the business or financial condition of the Company or the
     Subsidiaries.



                                     -6-

     Without limiting the foregoing, the Company and each of the Subsidiaries 
     holds and is operating in compliance with all licenses, authorizations, 
     consents, approvals, certificates and permits (individually, a "PERMIT") 
     from any regulatory body or administrative agency or other governmental 
     body having jurisdiction including, without limitation, those Federal 
     and state workers' compensation laws that are applicable to the 
     operations of the Company or the Subsidiaries as now conducted or 
     proposed to be conducted as described in the Prospectus, all of which 
     Permits are current, except where the failure to so hold or comply with 
     any Permit would not have, singly or in the aggregate, a material 
     adverse effect on the business or financial condition of the Company or 
     the Subsidiaries.  The Company is not aware, nor has it received any 
     notice of, any pending or threatened proceedings, or any circumstances 
     which could lead them to believe that any such proceedings are imminent, 
     relating to the revocation or modification of any such Permit or 
     Approval which, singly or in the aggregate if the subject of an 
     unfavorable decision, ruling or finding, could have a material adverse 
     effect on the business or financial condition of the Company or the 
     Subsidiaries.

           (xvi)  Neither the Company, nor to the Company's knowledge, any of
     its affiliates, has taken or may take, directly or indirectly, any action
     designed to cause or result in, or which has constituted or which might
     reasonably be expected to constitute, the stabilization or manipulation of
     the price of the shares of Common Stock to facilitate the sale or resale of
     the Shares.   The Company acknowledges that the Underwriters may engage in
     passive market making transactions in the Shares on the Nasdaq National 
     Market in accordance with Rule 10b-6A under the Exchange Act.

           (xvii)  Neither the Company nor any Subsidiary is an "investment
     company" within the meaning of such term under the Investment Company Act
     of 1940 (the "1940 ACT") and the rules and regulations of the Commission
     thereunder.

           (xviii)  The Company maintains a system of internal accounting
     controls sufficient to provide reasonable assurances that (i) transactions
     are executed in accordance with management's general or specific
     authorization; (ii) transactions are recorded as necessary to permit
     preparation of financial statements in conformity with generally accepted
     accounting principles and to maintain accountability for assets; (iii)
     access to assets is permitted only in accordance with management's general
     or specific authorization; and (iv) the recorded accountability for assets
     is compared with existing assets at reasonable intervals and appropriate
     action is taken with respect to any differences.
     
          (xix)  The Company and each of its Subsidiaries carry, or are covered
     by, insurance in such amounts and covering such risks as is adequate for
     the conduct of their respective businesses and the value of their
     respective properties and as is customary for companies engaged in similar
     industries.

          (xx)  The Company is in compliance in all material respects with all
     presently applicable provisions of the Employee Retirement Income Security
     Act of 1974, as amended, including the regulations and published
     interpretations thereunder ("ERISA"); no "reportable event" (as defined in
     ERISA) has occurred with respect to any "pension plan" (as defined in
     ERISA) for which the Company would have any liability; the Company has not
     incurred and does not expect to incur liability under (i) Title IV of ERISA
     with respect to termination of, or withdrawal from, any "pension plan" or
     (ii) Sections 412 or 4971 of the Internal Revenue Code of 1986, as amended,
     including the regulations and published interpretations thereunder (the
     "CODE"); and



                                     -7-

     each "pension plan" for which the Company would have any liability that 
     is intended to be qualified under Section 401(a) of the Code is so 
     qualified in all material respects and nothing has occurred, whether by 
     action or by failure to act, which would cause the loss of such 
     qualification.

           (xxi)  The Company confirms as of the date hereof that it is in
     compliance with all provisions of  Section 1 of Laws of Florida, Chapter
     92-198, AN ACT RELATING TO DISCLOSURE OF DOING BUSINESS WITH CUBA, and the
     Company further agrees that if it commences engaging in business with the
     government of Cuba or with any person or affiliate located in Cuba after
     the date the Registration Statement becomes or has become effective with
     the Commission or with the Florida Department of  Banking and Finance (the
     "DEPARTMENT"), whichever date is later, or if the information reported or
     incorporated by reference in the Prospectus, if any, concerning the
     Company's business with Cuba or with any person or affiliate located in
     Cuba changes in any material way, the Company will provide the Department
     notice of such business or change, as appropriate, in a form acceptable to
     the Department.

          (b)  Each of the Selling Shareholders severally represents and
     warrants as follows:

          (i)  Such Selling Shareholder now has and at the Closing Date (as 
     such date is hereinafter defined), will have good and marketable title 
     to the Firm Shares to be sold by such Selling Shareholder, free and 
     clear of any liens, encumbrances, equities and claims, and full right, 
     power and authority to effect the sale and delivery of such Firm Shares; 
     and upon the delivery of, against payment for, such Firm Shares pursuant 
     to this Agreement, the Underwriters will acquire good and marketable 
     title thereto, free and clear of any liens, encumbrances, equities and 
     claims.

          (ii)  Such Selling Shareholder has full right, power and authority to
     execute and deliver this Agreement, the Power of Attorney and Custody
     Agreement referred to below and to perform its obligations under such
     Agreements.  The execution and delivery of this Agreement and the
     consummation by such Selling Shareholder of the transactions herein
     contemplated and the fulfillment by such Selling Shareholder of the terms
     hereof will not require any consent, approval, authorization, or other
     order of any court, regulatory body, administrative agency or other
     governmental body (except as may be required under the Act, state
     securities laws or Blue Sky laws) and will not result in a breach of any of
     the terms and provisions of, or constitute a default under, organizational
     documents of such Selling Shareholder, if not an individual, or any
     indenture, mortgage, deed of trust or other agreement or instrument to
     which such Selling Shareholder is a party, or of any order, rule or
     regulation applicable to such Selling Shareholder of any court or of any
     regulatory body or administrative agency or other governmental body having
     jurisdiction.

          (iii)  Such Selling Shareholder has not taken and will not take,
     directly or indirectly, any action designed to, or which has constituted,
     or which might reasonably be expected to cause or result in the
     stabilization or manipulation of the price of the Common Stock of the
     Company and, other than as permitted by the Act, the Selling Shareholder
     will not distribute any prospectus or other offering material in connection
     with the offering of the Shares.

          (iv)  Without having undertaken to determine independently the
     accuracy or completeness of either the representations and warranties of
     the Company contained herein or the information contained in the
     Registration Statement, such Selling Shareholder has no reason



                                     -8-

     to believe that the representations and warranties of the Company 
     contained in this Section 1 are not true and correct, is familiar with 
     the Registration Statement and has no knowledge of any material fact, 
     condition or information not disclosed in the Registration Statement 
     which has adversely affected or may adversely affect the business of the 
     Company or any of the Subsidiaries; and the sale of the Firm Shares by 
     such Selling Shareholder pursuant hereto is not prompted by any 
     information concerning the Company or any of the Subsidiaries which is not 
     set forth in the Registration Statement or the documents incorporated by 
     reference therein.  The information pertaining to such Selling Shareholder 
     under the caption "Selling Shareholders" in the Prospectus is complete and 
     accurate in all material respects.

     2.   PURCHASE, SALE AND DELIVERY OF THE FIRM SHARES.

          (a)  On the basis of the representations, warranties and covenants
     herein contained, and subject to the conditions herein set forth, the
     Sellers agree to sell to the Underwriters and each Underwriter agrees,
     severally and not jointly, to purchase, at a price of [NET PRICE] per
     share, the number of Firm Shares set forth opposite the name of each
     Underwriter in SCHEDULE I hereof, subject to adjustments in accordance with
     Section 9 hereof.  The number of Firm Shares to be purchased by each
     Underwriter from each Seller shall be as nearly as practicable in the same
     proportion to the total number of Firm Shares being sold by each Seller as
     the number of Firm Shares being purchased by each Underwriter bears to the
     total number of Firm Shares to be sold hereunder.  The obligations of the
     Company and of each of the Selling Shareholders shall be several and not
     joint.

          (b)  Certificates in negotiable form for the total number of the
     Shares to be sold hereunder by the Selling Shareholders have been placed in
     custody with CRA Managed Care, Inc. as custodian (the "CUSTODIAN") pursuant
     to the Power of Attorney and Custody Agreement (the "Power of Attorney and
     Custody Agreement") executed by each Selling Shareholder for delivery of
     all Firm Shares to be sold hereunder by the Selling Shareholders.  Each 
     of the Selling Shareholders specifically agrees that the Firm Shares 
     represented by the certificates held in custody for the Selling 
     Shareholders under the Power of Attorney and Custody Agreement are subject 
     to the interests of the Underwriters hereunder, that the arrangements 
     made by the Selling Shareholders for such custody are to that extent 
     irrevocable, and that the obligations of the Selling Shareholders 
     hereunder shall not be terminable by any act or deed of the Selling 
     Shareholders (or by any other person, firm or corporation including the 
     Company, the Custodian or the Underwriters) or by operation of law 
     (including the death of an individual Selling Shareholder or the 
     dissolution of a corporate Selling Shareholder) or by the occurrence of any
     other event or events, except as set forth in the Power of Attorney and
     Custody Agreement.  If any such event should occur prior to the delivery to
     the Underwriters of the Firm Shares hereunder, certificates for the Firm 
     Shares shall be delivered by the Custodian in accordance with the terms 
     and conditions of this Agreement as if such event has not occurred.  The
     Custodian is authorized to receive and acknowledge receipt of the proceeds
     of sale of the Shares held by it against delivery of such Shares.

          (c)  Payment for the Firm Shares to be sold hereunder is to be made by
     wire transfer in same-day funds, payable to the order of the Company for
     the shares to be sold by it and to the order of  "CRA Managed Care, Inc.,
     as Custodian" for the shares to be sold by the Selling Shareholders, in
     each case against delivery of certificates therefor to the Representatives
     for the several accounts of the Underwriters.  Such payment and delivery
     are to be made at the offices of



                                     -9-

     Alex. Brown & Sons Incorporated, 135 East Baltimore Street, Baltimore, 
     Maryland, at 10:00 a.m., Baltimore time, on the third business day after 
     the date of this Agreement or at such other time and date not later than 
     five business days thereafter as you and the Company shall agree upon, 
     such time and date being herein referred to as the "CLOSING DATE."  (As 
     used herein, "BUSINESS DAY" means a day on which the New York Stock 
     Exchange is open for trading and on which banks in New York are open for 
     business and not permitted by law or executive order to be closed.)  The 
     certificates for the Firm Shares will be delivered in such denominations 
     and in such registrations as the Representatives request in writing not 
     later than the second full business day prior to the Closing Date, and 
     will be made available for inspection by the Representatives at least 
     one business day prior to the Closing Date.

          (d)  In addition, on the basis of the representations and 
     warranties herein contained and subject to the terms and conditions 
     herein set forth, the Company hereby grants an option to the several 
     Underwriters to purchase the Option Shares at the price per share as set 
     forth in the first paragraph of this Section 2.  The option granted 
     hereby may be exercised in whole or in part by giving written notice (i) 
     at any time before the Closing Date and (ii) only once thereafter within 
     30 days after the date of this Agreement, by you, as Representatives of 
     the several Underwriters, to the Company setting forth the number of 
     Option Shares as to which the several Underwriters are exercising the 
     option, the names and denominations in which the Option Shares are to be 
     registered and the time and date at which such certificates are to be 
     delivered. The time and date at which certificates for Option Shares are 
     to be delivered shall be determined by the Representatives but shall not 
     be earlier than three nor later than 10 full business days after the 
     exercise of such option, nor in any event prior to the Closing Date 
     (such time and date being herein referred to as the "OPTION CLOSING 
     DATE").  If the date of exercise of the option is three or more days 
     before the Closing Date, the notice of exercise shall set the Closing 
     Date as the Option Closing Date.  The number of Option Shares to be 
     purchased by each Underwriter shall be in the same proportion to the 
     total number of Option Shares being purchased as the number of Firm 
     Shares being purchased by such Underwriter bears to the total number of 
     Firm Shares, adjusted by you in such manner as to avoid fractional 
     shares.  The option with respect to the Option Shares granted hereunder 
     may be exercised only to cover over-allotments in the sale of the Firm 
     Shares by the Underwriters.  You, as Representatives of the several 
     Underwriters, may cancel such option at any time prior to its expiration 
     by giving written notice of such cancellation to the Company.  To the 
     extent, if any, that the option is exercised, payment for the Option 
     Shares shall be made on the Option Closing Date in New York Clearing 
     House funds by certified or bank cashier's check drawn to the order of 
     the Company for the Option Shares to be sold by it against delivery of 
     certificates therefor at the offices of Alex. Brown & Sons Incorporated, 
     135 East Baltimore Street, Baltimore, Maryland.



                                     -10-

     3.   OFFERING BY THE UNDERWRITERS.

          It is understood that the several Underwriters are to make a public
     offering of the Firm Shares as soon as the Representatives deem it
     advisable to do so.  The Firm Shares are to be initially offered to the
     public at the initial public offering price set forth in the Prospectus. 
     The Representatives may from time to time thereafter change the public
     offering price and other selling terms.  To the extent, if at all, that any
     Option Shares are purchased pursuant to Section 2 hereof, the Underwriters
     will offer them to the public on the foregoing terms.

          It is further understood that you will act as the Representatives for
     the Underwriters in the offering and sale of the Shares in accordance with
     a Master Agreement Among Underwriters entered into by you and the several
     other Underwriters.

     4.   COVENANTS OF THE COMPANY AND THE SELLING SHAREHOLDERS.

          (a)  The Company covenants and agrees with the several Underwriters
     that:

          (i)  The Company will (A) prepare and timely file with the Commission
     under Rule 424(b) of the Rules and Regulations a Prospectus containing
     information previously omitted at the time of effectiveness of the
     Registration Statement in reliance on Rule 430A of the Rules and
     Regulations, and (B) not file any amendment to the Registration Statement
     or supplement to the Prospectus of which the Representatives shall not
     previously have been advised and furnished with a copy or to which the
     Representatives shall have reasonably objected in writing or which is not
     in compliance with the Rules and Regulations.  To the extent applicable,
     the copies of the Registration Statement and each amendment thereto
     (including all exhibits filed therewith), any Preliminary Prospectus or
     Prospectus (in each case, as amended or supplemented) furnished to the
     Underwriters will be identical to the electronically transmitted copies
     thereof filed with the Commission pursuant to EDGAR, except to the extent
     permitted by Regulation S-T.

           (ii)  The Company will advise the Representatives promptly (A) when
     the Registration Statement or any post-effective amendment thereto shall
     have become effective, (B) of receipt of any comments from the Commission,
     (C) of any request of the Commission for amendment of the Registration
     Statement or for supplement to the Prospectus or for any additional
     information, and (D) of the issuance by the Commission of any stop order
     suspending the effectiveness of the Registration Statement or the use of
     the Prospectus or of the institution of any proceedings for that purpose. 
     The Company will use its best efforts to prevent the issuance of any such
     stop order preventing or suspending the use of the Prospectus and to obtain
     as soon as possible the lifting thereof, if issued.

           (iii)  The Company will cooperate with the Representatives in
     endeavoring to qualify the Shares for sale under the securities laws of
     such jurisdictions as the Representatives may



                                     -11-

     reasonably have designated in writing and will make such applications, 
     file such documents, and furnish such information as may be reasonably 
     required for that purpose, provided the Company shall not be required to 
     qualify as a foreign corporation or to file a general consent to service 
     of process in any jurisdiction where it is not now so qualified or 
     required to file such a consent.  The Company will, from time to time, 
     prepare and file such statements, reports, and other documents, as are 
     or may be required to continue such qualifications in effect for so long 
     a period as the Representatives may reasonably request for distribution 
     of the Shares.

          (iv)  The Company will deliver to, or upon the order of, the
     Representatives, from time to time, as many copies of any Preliminary
     Prospectus as the Representatives may reasonably request.  The Company will
     deliver to, or upon the order of, the Representatives during the period
     when delivery of a Prospectus is required under the Act, as many copies of
     the Prospectus in final form, or as thereafter amended or supplemented, as
     the Representatives may reasonably request.  The Company will deliver to
     the Representatives at or before the Closing Date, four signed copies of
     the Registration Statement and all amendments thereto including all
     exhibits filed therewith, and will deliver to the Representatives such
     number of copies of the Registration Statement, but without exhibits, and
     of all amendments thereto, as the Representatives may reasonably request.

          (v)  The Company will comply with the Act and the Rules and
     Regulations, and the Securities Exchange Act of 1934 (the "EXCHANGE ACT"),
     and the rules and regulations of the Commission thereunder, so as to permit
     the completion of the distribution of the Shares as contemplated in this
     Agreement and the Prospectus.  If during the period in which a prospectus
     is required by law to be delivered by an Underwriter or dealer, any event
     shall occur as a result of which, in the judgment of the Company or in the
     reasonable opinion of the Underwriters, it becomes necessary to amend or
     supplement the Prospectus in order to make the statements therein, in the
     light of the circumstances existing at the time the Prospectus is delivered
     to a purchaser, not misleading, or, if it is necessary at any time to amend
     or supplement the Prospectus to comply with any law, the Company promptly
     either (i) will prepare and file with the Commission an appropriate
     amendment to the Registration Statement or supplement to the Prospectus or
     (ii) prepare and file with the Commission an appropriate filing under the
     Exchange Act which shall be incorporated by reference in the Prospectus so
     that the Prospectus as so amended or supplemented will not, in the light of
     the circumstances when it is so delivered, be misleading, or so that the
     Prospectus will comply with the law.

           (vi)  The Company will make generally available to its security
     holders, as soon as it is practicable to do so, but in any event not later
     than 15 months after the effective date of the Registration Statement, an
     earning statement (which need not be audited) in reasonable detail,
     covering a period of at least 12 consecutive months beginning after the
     effective date of the Registration Statement, which earning statement shall
     satisfy the requirements of Section 11(a) of the Act and Rule 158 of the
     Rules and Regulations and will advise you in writing when such statement
     has been so made available.

          (vii)  The Company will, for a period of five years from the Closing
     Date, deliver to the Representatives copies of annual reports and copies of
     all other documents, reports and information furnished by the Company to
     its stockholders or filed with any securities exchange pursuant to the
     requirements of such exchange or with the Commission pursuant to the Act or
     the Exchange Act.  The Company will deliver to the Representatives similar
     reports with respect to significant subsidiaries, as that term is defined
     in the Rules and Regulations, which are not



                                     -12-

     consolidated in the Company's financial statements.  To the extent 
     applicable, such reports or documents shall be identical to the 
     electronically transmitted copies thereof filed with the Commission 
     pursuant to EDGAR, except to the extent permitted by Regulation S-T.

          (viii)  No offering, sale, short sale or other disposition of any
     shares of Common Stock of the Company or other securities convertible into
     or exchangeable or exercisable for shares of  Common Stock  or derivative
     of Common Stock  (or agreement for such) will be made for a period of 90
     days after the date of this Agreement, directly or indirectly, by the
     Company otherwise than hereunder or with the prior written consent of 
     Alex. Brown & Sons Incorporated, except that the Company may, without such
     consent, issue shares upon the exercise of options outstanding on the date
     of this Agreement issued pursuant to the Company's stock option plans.

          (ix)  The Company will use its best efforts to list, subject to notice
     of issuance, the Shares on the National Association of Securities Dealers
     Automated Quotations ("NASDAQ") National Market.

           (x)  The Company has caused each director and certain specified
     shareholders of the Company to furnish to you, on or prior to the
     date of this agreement, a letter or letters, in form and substance
     satisfactory to the Underwriters, pursuant to which each such person shall
     agree not to: (A) offer to sell, contract to sell, transfer or otherwise
     dispose of, directly or indirectly, any shares of Common Stock, any
     options, rights or warrants to purchase any shares of Common Stock
     (including any stock appreciation right, or similar right with an exercise
     or conversion privilege at a price related to, or derived from, the market
     price of the Common Stock) or any securities convertible into or
     exchangeable for shares of Common Stock owned directly by such person or
     with respect to which such person has the power of disposition (including,
     without limitation, shares of Common Stock which such person may be deemed
     to beneficially own in accordance with the rules and regulations
     promulgated under the Exchange Act); or (B) engage in any hedging
     transactions with respect to the Common Stock that may have an impact on
     the market price of the Common Stock for a period beginning on the date of
     such letters and expiring 90 days following the date the Registration
     Statement is declared effective by the Commission (the "LOCKUP PERIOD"),
     directly or indirectly ("LOCKUP AGREEMENTS"); PROVIDED, HOWEVER, such
     officers, directors and specified shareholders shall be permitted to make
     the following transfers:  (i) transfers of up to an aggregate of 50,000
     shares of Common Stock made by gift, PROVIDED the donee thereof agrees in
     writing to be bound by the terms hereof; (ii) transfers to the transferor's
     affiliates, as such term is defined in Rule 405 promulgated under the
     Securities Act, PROVIDED that each transferee agrees in writing to be bound
     by the terms hereof; (iii) transfers made with the prior written consent of
     Alex. Brown & Sons Incorporated; and (iv) transfers pursuant to the
     Registration Statement.

           (xi)  The Company shall apply the net proceeds of its sale of the
     Shares as set forth in the Prospectus and shall file such reports with the
     Commission with respect to the sale of the Shares and the application of
     the proceeds therefrom as may be required in accordance with Rule 463 under
     the Act. 

           (xii)  The Company shall not invest, or otherwise use the proceeds
     received by the Company from its sale of the Shares in such a manner as
     would require the Company or any of the Subsidiaries to register as an
     investment company under the 1940 Act.



                                     -13-

           (xiii)  The Company will maintain a transfer agent and, if necessary
     under the jurisdiction of incorporation of the Company, a registrar for the
     Common 
     Stock.

           (xiv)  The Company will not take, directly or indirectly, any action
     designed to cause or result in, or that has constituted or might reasonably
     be expected to constitute, the stabilization or manipulation of the price
     of any securities of the Company. 

          (b)  Each of the Selling Shareholders covenants and agrees with the
     several Underwriters that:

                    (i) Such Selling Shareholder will not: (A) offer to sell,
          contract to sell, transfer or otherwise dispose of, directly or
          indirectly, any shares of Common Stock, any options, rights or
          warrants to purchase any shares of Common Stock (including any stock
          appreciation right, or similar right with an exercise or conversion
          privilege at a price related to, or derived from, the market price of
          the Common Stock) or any securities convertible into or exchangeable
          for shares of Common Stock owned directly by such Selling Shareholder
          or with respect to which such Selling Shareholder has the power of
          disposition (including, without limitation, shares of Common Stock
          which such Selling Shareholder may be deemed to beneficially own in
          accordance with the rules and regulations promulgated under the
          Exchange Act; or (B) engage in any hedging transactions with respect
          to the Common Stock that may have an impact on the market price of the
          Common Stock during the Lockup Period, directly or indirectly, by such
          Selling Shareholder otherwise than hereunder or with the prior written
          consent of Alex. Brown & Sons Incorporated; PROVIDED, HOWEVER, such
          Selling Shareholder shall be permitted to make the following
          transfers:  (i) transfers of up to an aggregate of 50,000 shares of
          Common Stock made by gift, PROVIDED the donee thereof agrees in
          writing to be bound by the terms hereof; (ii) transfers to the
          transferor's affiliates, as such term is defined in Rule 405
          promulgated under the Securities Act, PROVIDED that each transferee
          agrees in writing to be bound by the terms hereof; (iii) transfers
          made with the prior written consent of Alex. Brown & Sons
          Incorporated; and (iv) transfers pursuant to the Registration
          Statement.

                         (ii)  In order to document the Underwriters' compliance
          with the reporting and withholding provisions of the Tax Equity and
          Fiscal Responsibility Act of 1982 and the Interest and Dividend Tax
          Compliance Act of 1983 with respect to the transactions herein
          contemplated, each of the Selling Shareholders agrees to deliver to
          you prior to or at the Closing Date a properly completed and executed
          United States Treasury Department Form W-9 (or other applicable form
          or statement specified by Treasury Department regulations in lieu
          thereof).

                         (iii)  Such Selling Shareholder will not take, directly
          or indirectly, any action designed to cause or result in, or that has
          constituted or might reasonably be expected to constitute, the
          stabilization or manipulation of the price of any securities of the
          Company.



                                     -14-

     5.   COSTS AND EXPENSES.

          The Company will pay all costs, expenses and fees incident to the
     performance of the obligations of the Company and the Selling Shareholders
     under this Agreement, including, without limiting the generality of the
     foregoing, the following:  accounting fees of the Company; the fees and
     disbursements of counsel for the Company and the Selling Shareholders; the
     cost of printing and delivering to, or as requested by, the Underwriters
     copies of the Registration Statement, Preliminary Prospectuses, the
     Prospectus, this Agreement, the Agreement among Underwriters, the
     Underwriters' Selling Memorandum, the Underwriters' Questionnaire, the
     Underwriters' Invitation Letter, the Power of Attorney, the Additional
     Listing Application, the Blue Sky Survey and any supplements or amendments
     thereto; the filing fees of the Commission; the filing fees and expenses
     (including fees and disbursements of counsel to the Underwriters) incident
     to securing any required review by the NASD of the terms of the sale of the
     Shares; the Additional Listing Fee of the Nasdaq National Market; and the
     expenses, including the fees and disbursements of counsel for the
     Underwriters, incurred in connection with the qualification of the Shares
     under State securities or Blue Sky laws.  The Selling Shareholders have
     agreed with the Company to reimburse the Company for a portion of such
     expenses.  To the extent, if at all, that any of the Selling Shareholders
     engage special legal counsel to represent them in connection with this
     offering, the fees and expenses of such counsel shall be borne by such
     Selling Shareholder.  Any transfer taxes imposed on the sale of the Shares
     to the several Underwriters will be paid by the Sellers pro rata. The
     Company agrees to pay all costs and expenses of the Underwriters, including
     the fees and disbursements of counsel for the Underwriters, incident to the
     offer and sale of directed shares of the Common Stock by the Underwriters
     to employees and persons having business relationships with the Company and
     its Subsidiaries.  The Company shall not, however, be required to pay for
     any of the Underwriters' expenses (other than those related to
     qualification under  NASD regulation and State securities or Blue Sky laws)
     except that, if this Agreement shall not be consummated because the
     conditions in Section 6 hereof are not satisfied, or because this Agreement
     is terminated by the Representatives pursuant to Section 11 hereof, or by
     reason of any failure, refusal or inability on the part of the Company or
     the Selling Shareholders to perform any undertaking or satisfy any
     condition of this Agreement or to comply with any of the terms hereof on
     their part to be performed, unless such failure to satisfy said condition
     or to comply with said terms be due to the default or omission of any
     Underwriter, then the Company shall reimburse the several Underwriters for
     reasonable out-of-pocket expenses, including fees and disbursements of
     counsel, reasonably incurred in connection with investigating, marketing
     and proposing to market the Shares or in contemplation of performing their
     obligations hereunder; but the Company and the Selling Shareholders shall
     not in any event be liable to any of the several Underwriters for damages
     on account of loss of anticipated profits from the sale by them of the
     Shares.
          
     6.   CONDITIONS TO OBLIGATIONS OF THE UNDERWRITERS.

          The several obligations of the Underwriters to purchase the Firm
     Shares on the Closing Date and the Option Shares, if any, on the Option
     Closing Date are subject to the accuracy, as of the Closing Date or the
     Option Closing Date, as the case may be, of the representations and
     warranties of the Company and the Selling Shareholders contained herein,
     and to the performance by the Company and the Selling Shareholders of their
     covenants and obligations hereunder and to the following additional
     conditions:



                                     -15-

          (a)  The Registration Statement and all post-effective amendments
     thereto shall have become effective and any and all filings required by
     Rule 424 and Rule 430A of the Rules and Regulations shall have been made,
     and any request of the Commission for additional information (to be
     included in the Registration Statement or otherwise) shall have been
     disclosed to the Representatives and complied with to their reasonable
     satisfaction.  No stop order suspending the effectiveness of the
     Registration Statement, as amended from time to time, shall have been
     issued and no proceedings for that purpose shall have been taken or, to the
     knowledge of the Company or the Selling Shareholders, shall be contemplated
     by the Commission and no injunction, restraining order, or order of any
     nature by a Federal or State court of competent jurisdiction shall have
     been issued as of the Closing Date or Option Closing Date, as the case may
     be, which would prevent the issuance of the Shares.

          (b)  The Representatives shall have received on the Closing Date or
     the Option Closing Date, as the case may be, the opinion of Hutchins,
     Wheeler & Dittmar, A Professional Corporation, counsel for the Company and
     the Selling Shareholders, dated the Closing Date or the Option Closing
     Date, as the case may be, addressed to the Underwriters (and stating that
     it may be relied upon by counsel to the Underwriters) to the effect that:

                         (i)  The Company has been duly organized and is validly
          existing as a corporation in good standing under the laws of the
          Commonwealth of Massachusetts, with corporate power and authority to
          own or lease its properties and conduct its business as now conducted
          and described in the Registration Statement; each of the Subsidiaries
          has been duly organized and is validly existing as a corporation in
          good standing under the laws of the jurisdiction of its incorporation,
          with corporate power and authority to own or lease its properties and
          conduct its business now conducted and as described in the
          Registration Statement; the Company and each of the Subsidiaries are
          duly qualified to transact business in all jurisdictions in which the
          conduct of their business requires such qualification, or in which the
          failure to qualify would have a materially adverse effect upon the
          business of the Company and the Subsidiaries; and the outstanding
          shares of capital stock of each of the Subsidiaries have been duly
          authorized and validly issued and are fully paid and non-assessable
          and are owned by the Company or a Subsidiary; and, to the best of such
          counsel's knowledge, the outstanding shares of capital stock of each
          of the Subsidiaries is owned free and clear of all liens, encumbrances
          and equities and claims, and no options, warrants or other rights to
          purchase, agreements or other obligations to issue or other rights to
          convert any obligations into any shares of capital stock or of
          ownership interests in the Subsidiaries are outstanding.

                         (ii)  The Company has authorized and outstanding
          capital stock as set forth under the caption "Capitalization" in the
          Prospectus; the authorized shares of the Company's Common Stock have
          been duly authorized; the outstanding shares of the Company's Common
          Stock, including the Shares to be sold by the Selling Shareholders,
          have been duly authorized and validly issued and are fully paid and
          non-assessable; all of the Shares conform to the description thereof
          contained in the Prospectus; the certificates for the Shares, assuming
          they are in the form of the specimen filed with the Commission,  are
          in due and proper form; the shares of Common Stock, including the
          Option Shares, if any, to be sold by the Company pursuant to this
          Agreement have been duly authorized and will be validly issued, fully
          paid and non-assessable when issued



                                     -16-

          and paid for as contemplated by this Agreement; and no preemptive 
          rights of stockholders exist with respect to any of the Shares or 
          the issue or sale thereof.

                         (iii)  Except as described in or contemplated by the
          Prospectus, to the knowledge of such counsel, there are no outstanding
          securities of the Company convertible or exchangeable into or
          evidencing the right to purchase or subscribe for any shares of
          capital stock of the Company and there are no outstanding or
          authorized options, warrants or rights of any character obligating the
          Company to issue any shares of its capital stock or any securities
          convertible or exchangeable into or evidencing the right to purchase
          or subscribe for any shares of such stock; and except as described in
          the Prospectus, to the knowledge of such counsel, no holder of any
          securities of the Company or any other person has the right,
          contractual or otherwise, which has not been satisfied or effectively
          waived,  to cause the Company to sell or otherwise issue to them, or
          to permit them to underwrite the sale of, any of the Shares or the
          right to have any shares of  Common Stock or other securities of the
          Company included in the Registration Statement or the right, as a
          result of the filing of the Registration Statement, to require
          registration under the Act of any shares of Common Stock or other
          securities of the Company.

                         (iv)  The Registration Statement has become effective
          under the Act and, to the best of the knowledge of such counsel, no
          stop order proceedings with respect thereto have been instituted or
          are pending or threatened under the Act.

                         (v)  The Registration Statement, all Preliminary
          Prospectuses, the Prospectus and each amendment or supplement thereto
          and each document incorporated by reference therein comply as to form
          in all material respects with the requirements of the Act or the
          Securities Exchange Act of 1934, as applicable and the applicable
          rules and regulations thereunder (except that such counsel need
          express no opinion as to the financial statements and related
          schedules or incorporated by reference therein).  The conditions for
          the use of Form S-3, set forth in the General Instructions thereto,
          have been satisfied.

                         (vi) The statements under the captions "Risk Factors -
          Potential Adverse Impact of Government Regulation," "Business - 
          Government Regulation," and "Description of Capital Stock"
          in the Prospectus, insofar as such statements constitute a 
          summary of documents referred to therein or matters of law, are 
          accurate summaries and fairly and correctly present the information 
          called for with respect to such documents and matters; and such 
          counsel does not know of any Federal or state laws, rules or 
          regulations relating to the provisions of workers' compensation 
          managed care services by the Company in the jurisdictions in which 
          the Company or any Subsidiaries conduct their business which are 
          required to be described in the Registration Statement or the 
          Prospectus that are not described as required.



                                     -17-

                         (vii)  Such counsel does not know of any contracts or
          documents required to be filed as exhibits to or incorporated by
          reference into the Registration Statement or described in the
          Registration Statement or the Prospectus which are not so filed,
          incorporated by reference or described as required, and such contracts
          and documents as are summarized in the Registration Statement or the
          Prospectus are fairly summarized in all material respects.

                         (viii)  Such counsel knows of no material legal or
          governmental proceedings pending or threatened against the Company or
          any of the Subsidiaries except as set forth in the Prospectus.

                         (ix)  The execution and delivery of this Agreement and
          the consummation of the transactions herein contemplated do not and
          will not conflict with or result in a breach of any of the terms or
          provisions of, or constitute a default under, the Charter or By-laws
          of the Company, or any agreement or instrument known to such counsel
          to which the Company or any of the Subsidiaries is a party or by which
          the Company or any of the Subsidiaries may be bound.

                         (x)  This Agreement has been duly authorized, executed
          and delivered by the Company. 

                         (xi)  No approval, consent, order, authorization,
          designation, declaration or filing by or with any regulatory,
          administrative or other governmental body is necessary in connection
          with the execution and delivery of this Agreement and the consummation
          of the transactions herein contemplated (other than as may be required
          by the NASD or as required by State securities and Blue Sky laws as to
          which such counsel need express no opinion) except such as have been
          obtained or made, specifying the same. 

                          (xii)  The Company is not, and will not become, as a
          result of the consummation of the transactions contemplated by this
          Agreement, and application of the net proceeds therefrom as described
          in the Prospectus, required to register as an investment company under
          the 1940 Act. 

                         (xiii)  This Agreement has been duly authorized,
          executed and delivered on behalf of the Selling Shareholders. 

                         (xiv)  Each Selling Shareholder has full legal right,
          power and authority, and any approval required by law (other than as
          required by State securities and Blue Sky laws as to which such
          counsel need express no opinion), to sell, assign, transfer and
          deliver the portion of the Shares to be sold by such Selling
          Shareholder. 

                         (xv)  The Power of Attorney and Custody Agreement
          executed and delivered by each Selling Shareholder is valid and
          binding.  

                         (xvi)  The Underwriters (assuming that they are bona
          fide purchasers within the meaning of the Uniform Commercial Code)
          have acquired good and marketable title to the Shares being sold by
          each Selling Shareholder on the Closing Date, and the Option Closing
          Date, as the case may be, free and clear of all liens, encumbrances,
          equities and claims. 



                                     -18-

                         (xvii)    Such counsel has not been advised, and based
          on (i) a review of the Company's files which have been provided to us,
          (ii) inquiry of senior management of the Company and (iii) a review of
          the published workers' compensation rules and regulations of the
          states set forth on SCHEDULE III hereto, such counsel has no reason 
          to believe that the Company or any of its Subsidiaries does not hold
          all Permits from any regulatory body or administrative agency or other
          governmental body having jurisdiction that are applicable to the
          operations of the Company or its Subsidiaries as now conducted or
          proposed to be conducted as described in the Prospectus, all of which
          Permits are current, except where the failure to so hold or comply
          with any Permit would not have, singly or in the aggregate, a material
          adverse effect on the business or financial condition of the Company
          or its Subsidiaries.  To the knowledge of such counsel, there are no
          proceedings, pending or threatened, relating to the revocation or
          modification of any such Permit which, singly or in the aggregate if
          the subject of an unfavorable decision, ruling or finding, could have
          a material adverse effect on the business or financial condition of
          the Company or its Subsidiaries.
          
          In rendering such opinion Hutchins, Wheeler & Dittmar, A Professional
     Corporation, may rely as to matters governed by the laws of states other
     than Massachusetts or Federal laws on local counsel in such jurisdictions
     and as to the matters set forth in subparagraphs (xiii), (xiv) and (xv) on
     opinions of other counsel representing the respective Selling Shareholders,
     provided that in each case Hutchins, Wheeler & Dittmar, A Professional
     Corporation, shall state that they believe that they and the Underwriters
     are justified in relying on such other counsel.  In addition to the matters
     set forth above, such opinion shall also include a statement to the effect
     that nothing has come to the attention of such counsel which leads them to
     believe that (i) the Registration Statement, at the time it became
     effective under the Act (but after giving effect to any modifications
     incorporated therein pursuant to Rule 430A under the Act) and as of the
     Closing Date or the Option Closing Date, as the case may be, contained an
     untrue statement of a material fact or omitted to state a material fact
     required to be stated therein or necessary to make the statements therein
     not misleading, and (ii) the Prospectus, or any supplement thereto, on the
     date it was filed pursuant to the Rules and Regulations and as of the
     Closing Date or the Option Closing Date, as the case may be, contained an
     untrue statement of a material fact or omitted to state a material fact
     necessary in order to make the statements therein, in the light of the
     circumstances under which they are made, not misleading (except that such
     counsel need express no view as to financial statements, schedules and
     statistical information therein).  With respect to such statement,
     Hutchins, Wheeler & Dittmar, A Professional Corporation, may state that
     their belief is based upon the procedures set forth therein, but is without
     independent check and verification.

          (c)  The Representatives shall have received from Testa, Hurwitz &
     Thibeault, LLP, counsel for the Underwriters, an opinion dated the Closing
     Date or the Option Closing Date, as the case may be, substantially to the
     effect specified in subparagraphs (ii), (iii), and (iv) of Paragraph (b) of
     this Section 6, and that the Company is a duly organized and validly
     existing corporation under the laws of the Commonwealth of Massachusetts. 
     In rendering such opinion Testa, Hurwitz & Thibeault, LLP may rely as to
     all matters governed other than by the laws of the Commonwealth of
     Massachusetts or Federal laws on the opinion of counsel referred to in
     Paragraph (b) of this Section 6.  In addition to the matters set forth
     above, such opinion shall also include a statement to the effect that
     nothing has come to the attention of such counsel which leads them to
     believe that (i) the Registration Statement, or any amendment thereto, as
     of the



                                     -19-

     time it became effective under the Act (but after giving effect to any 
     modifications incorporated therein pursuant to Rule 430A under the Act) 
     and as of the Closing Date or the Option Closing Date, as the case may 
     be, contained an untrue statement of a material fact or omitted to state 
     a material fact required to be stated therein or necessary to make the 
     statements therein not misleading, and (ii) the Prospectus, or any 
     supplement thereto, on the date it was filed pursuant to the Rules and 
     Regulations and as of the Closing Date or the Option Closing Date, as 
     the case may be, contained an untrue statement of a material fact or 
     omitted to state a material fact, necessary in order to make the 
     statements therein, in the light of the circumstances under which they 
     are made, not misleading (except that such counsel need express no view 
     as to financial statements, schedules and statistical information 
     therein).  With respect to such statement Testa, Hurwitz & Thibeault, 
     LLP may state that their belief is based upon the procedures set forth 
     therein, but is without independent check and verification.

          (d)  The Representatives shall have received at or prior to the
     Closing Date from Testa, Hurwitz & Thibeault, LLP a memorandum or summary,
     in form and substance satisfactory to the Representatives, with respect to
     the qualification for offering and sale by the Underwriters of the Shares
     under the State securities or Blue Sky laws of such jurisdictions as the
     Representatives may reasonably have designated to the Company.

          (e)  You shall have received, on each of the date hereof, the Closing
     Date and the Option Closing Date, as the case may be, a letter dated the
     date hereof, the Closing Date or the Option Closing Date, as the case may
     be, in form and substance satisfactory to you, of Arthur Andersen LLP
     confirming that they are independent public accountants within the meaning
     of the Act and the applicable published Rules and Regulations thereunder
     and stating that in their opinion the financial statements and schedules
     examined by them and included in the Registration Statement comply in form
     in all material respects with the applicable accounting requirements of the
     Act and the related published Rules and Regulations; and containing such
     other statements and information as is ordinarily included in accountants'
     "comfort letters" to underwriters with respect to the financial statements
     and certain financial and statistical information contained in the
     Registration Statement and Prospectus.  

          (f)  The Representatives shall have received on the Closing Date or
     the Option Closing Date, as the case may be, a certificate or certificates
     of the Chief Executive Officer and the Chief Financial Officer of the
     Company to the effect that, as of the Closing Date or the Option Closing
     Date, as the case may be, each of them severally represents as follows:

                         (i)  The Registration Statement has become effective
          under the Act and no stop order suspending the effectiveness of the
          Registration Statement has been issued, and no proceedings for such
          purpose have been taken or are, to his knowledge, contemplated by the
          Commission;

                         (ii)  He does not know of any litigation instituted or
          threatened against the Company of a character required to be disclosed
          in the Registration Statement which is not so disclosed; he does not
          know of any material contract required to be filed as an exhibit to
          the Registration Statement which is not so filed; and the
          representations and warranties of the Company contained in Section 1
          hereof are true and correct as of the Closing Date or the Option
          Closing Date, as the case may be;



                                     -20-

                         (iii)  All filings required to have been made pursuant
          to Rules 424 or 430A under the Act have been made;

                         (iv)  He has carefully examined the Registration
          Statement and the Prospectus and, in his opinion, as of the effective
          date of the Registration Statement, the statements contained in the
          Registration Statement were true and correct, and such Registration
          Statement and Prospectus did not omit to state a material fact
          required to be stated therein or necessary in order to make the
          statements therein not misleading, and, in his opinion, since the
          effective date of the Registration Statement, no event has occurred
          which should have been set forth in a supplement to or an amendment of
          the Prospectus which has not been so set forth in such supplement or
          amendment; and 

                         (v)  Since the respective dates as of which information
          is given in the Registration Statement and Prospectus, there has not
          been any material adverse change or any development involving a
          prospective material adverse change in or affecting the condition,
          financial or otherwise, of the Company and its Subsidiaries or the
          earnings, business, management, properties, assets, rights,
          operations, condition (financial or otherwise) or prospects of the
          Company and the Subsidiaries, whether or not arising in the ordinary
          course of business;
                    
                         (vi)  All of the representations and warranties of the
          Company contained in this Underwriting Agreement are true and correct
          on and as of the date hereof and on and as of the Closing Date or the
          Option Closing Date, as the case may be, with the same force and
          effect as if made on and as of the Closing Date or the Option Closing
          Date, as the case may be, except for representations and warranties
          made as of a specific date, which were true and correct as of such
          date;
          
                         (vii)  Each of the conditions specified in Section 6 of
          this Underwriting Agreement has been, as of the Closing Date or the
          Option Closing Date, as the case may be, satisfied in all respects;
          and 
          
                         (viii)  The Company has performed and/or complied with
          all of its agreements and covenants required to be performed or
          complied with under this Underwriting Agreement as of or prior to the
          Closing Date or the Option Closing Date, as the case may be.
          
          (g)  The Representatives shall have received on the Closing Date a 
     certificate of each Selling Shareholder to the effect that, as of the 
     Closing Date each such Selling Shareholder shall represent as follows:
          
                         (i)   All of the representations and warranties of 
          such Selling Shareholder contained in this Underwriting Agreement 
          are true and correct on and as of the date hereof and on and as of 
          the Closing Date with the same force and effect as if made on and 
          as of the Closing Date except for representations and warranties 
          made as of a specific date, which were true and correct as of such 
          date; and
          


                                     -21-

                         (ii)  Such Selling Shareholder has performed and/or
          complied with all of such Selling Shareholder's agreements and
          covenants required to be performed or complied with under this
          Underwriting Agreement as of or prior to the Closing Date.
          
          (h)  The Company and the Selling Shareholders shall have furnished to
     the Representatives such further certificates and documents confirming the
     representations and warranties, covenants and conditions contained herein
     and related matters as the Representatives may reasonably have requested.

          (i)  The Firm Shares and Option Shares, if any, have been approved for
     designation upon notice of issuance on the Nasdaq National Market.

          (j)  The Lockup Agreements described in Section 4 (a)(x) are in full
     force and effect.

          The opinions and certificates mentioned in this Agreement shall be
     deemed to be in compliance with the provisions hereof only if they are in
     all material respects satisfactory to the Representatives and to Testa,
     Hurwitz & Thibeault, LLP, counsel for the Underwriters.

          If any of the conditions hereinabove provided for in this Section 6
     shall not have been fulfilled when and as required by this Agreement to be
     fulfilled, the obligations of the Underwriters hereunder may be terminated
     by the Representatives by notifying the Company of such termination in
     writing or by telegram at or prior to the Closing Date or the Option
     Closing Date, as the case may be.

          In such event, the Selling Shareholders, the Company and the
     Underwriters shall not be under any obligation to each other (except to the
     extent provided in Sections 5 and 8 hereof).

     7.   CONDITIONS TO THE OBLIGATIONS OF THE COMPANY AND THE SELLING 
          SHAREHOLDERS.

          The obligations of the Company and the Selling Shareholders to sell
     and deliver the portion of the Shares required to be delivered as and when
     specified in this Agreement are subject to the conditions that at the
     Closing Date or the Option Closing Date, as the case may be, no stop order
     suspending the effectiveness of the Registration Statement shall have been
     issued and in effect or proceedings therefor initiated or threatened.

     8.   INDEMNIFICATION.

          (a)  The Company and the Selling Shareholders, jointly and severally,
     agree to indemnify and hold harmless each Underwriter and each person, if
     any, who controls any Underwriter within the meaning of the Act, against
     any losses, claims, damages or liabilities to which such Underwriter or any
     such controlling person may become subject under the Act or otherwise,
     insofar as such losses, claims, damages or liabilities (or actions or
     proceedings in respect thereof) arise out of or are based upon  (i) any
     untrue statement or alleged untrue statement of any material fact contained
     in the Registration Statement, any Preliminary Prospectus, the Prospectus
     or any amendment or supplement thereto, or  (ii) the omission or alleged
     omission to state therein a material fact required to be stated therein or
     necessary to make the statements therein not misleading; and will reimburse
     each Underwriter and each such controlling person upon



                                     -22-

     demand for any legal or other expenses reasonably incurred by such 
     Underwriter or such controlling person in connection with investigating 
     or defending any such loss, claim, damage or liability, action or 
     proceeding and expenses reasonably incurred in responding to a subpoena 
     or governmental inquiry related to the offering of the Shares, whether 
     or not such Underwriter or controlling person is a party to any action 
     or proceeding; PROVIDED, HOWEVER, that the Company and the Selling 
     Shareholders will not be liable in any such case to the extent that any 
     such loss, claim, damage or liability arises out of or is based upon an 
     untrue statement or alleged untrue statement, or omission or alleged 
     omission made in the Registration Statement, any Preliminary Prospectus, 
     the Prospectus, or such amendment or supplement, in reliance upon and in 
     conformity with written information furnished to the Company by or 
     through the Representatives specifically for use in the preparation 
     thereof.  In no event, however, shall the liability of any Selling 
     Shareholder for indemnification under this Section 8(a) exceed the 
     lesser of (i) proportion of the total of such losses, claims, damages or 
     liabilities indemnified or contributed against equal to the proportion 
     of the total Shares sold hereunder which is being sold by such Selling 
     Shareholder, or  (ii) the proceeds received by such Selling Shareholder 
     from the Underwriters in the offering.    This indemnity agreement will 
     be in addition to any liability which the Company or the Selling 
     Shareholders may otherwise have.

          (b)  Each Underwriter severally and not jointly will indemnify and
     hold harmless the Company, each of its directors, each of its officers who
     have signed the Registration Statement, the Selling Shareholders, and each
     person, if any, who controls the Company or the Selling Shareholders within
     the meaning of the Act, against any losses, claims, damages or liabilities
     to which the Company or any such director, officer, Selling Shareholder or
     controlling person may become subject under the Act or otherwise, insofar
     as such losses, claims, damages or liabilities (or actions or proceedings
     in respect thereof) arise out of or are based upon (i)  any untrue
     statement or alleged  untrue statement of any material fact contained in
     the Registration Statement, any Preliminary Prospectus, the Prospectus or
     any amendment or supplement thereto, or (ii) the omission or the alleged
     omission to state therein a material fact required to be stated therein or
     necessary to make the statements therein not misleading in the light of the
     circumstances under which they were made; and will reimburse any legal or
     other expenses reasonably incurred by the Company or any such director,
     officer, Selling Shareholder or controlling person in connection with
     investigating or defending any such loss, claim, damage, liability, action
     or proceeding; PROVIDED, HOWEVER, that each Underwriter will be liable in
     each case to the extent, but only to the extent, that such untrue statement
     or alleged untrue statement or omission or alleged omission has been made
     in the Registration Statement, any Preliminary Prospectus, the Prospectus
     or such amendment or supplement, in reliance upon and in conformity with
     written information furnished to the Company by or through the
     Representatives specifically for use in the preparation thereof.  This
     indemnity agreement will be in addition to any liability which such
     Underwriter may otherwise have.

          (c)  In case any proceeding (including any governmental investigation)
     shall be instituted involving any person in respect of which indemnity may
     be sought pursuant to this Section 8, such person (the "INDEMNIFIED PARTY")
     shall promptly notify the person against whom such indemnity may be sought
     (the "INDEMNIFYING PARTY") in writing.  No indemnification provided for in
     Section 8(a) or (b) shall be available to any party who shall fail to give
     notice as provided in this Section 8(c) if the party to whom notice was not
     given was unaware of the proceeding to which such notice would have related
     and was prejudiced by the failure to give such notice, but the failure to
     give such notice shall not relieve the indemnifying party or parties from
     any liability which it or they may have to the indemnified party for
     contribution or otherwise than on



                                     -23-

     account of the provisions of Section 8(a) or (b).  In case any such 
     proceeding shall be brought against any indemnified party and it shall 
     notify the indemnifying party of the commencement thereof, the 
     indemnifying party shall be entitled to participate therein and, to the 
     extent that it shall wish, jointly with any other indemnifying party 
     similarly notified, to assume the defense thereof, with counsel 
     satisfactory to such indemnified party and shall pay as incurred the 
     fees and disbursements of such counsel related to such proceeding.  In 
     any such proceeding, any indemnified party shall have the right to 
     retain its own counsel at its own expense.  Notwithstanding the 
     foregoing, the indemnifying party shall pay as incurred the fees and 
     expenses of the counsel retained by the indemnified party in the event  
     (i) the indemnifying party and the indemnified party shall have mutually 
     agreed to the retention of such counsel or (ii) the named parties to any 
     such proceeding (including any impleaded parties) include both the 
     indemnifying party and the indemnified party and representation of both 
     parties by the same counsel would be inappropriate due to actual or 
     potential differing interests between them.  It is understood that the 
     indemnifying party shall not, in connection with any proceeding or 
     related proceedings in the same jurisdiction, be liable for the 
     reasonable fees and expenses of more than one separate firm for all such 
     indemnified parties.  Such firm shall be designated in writing by you in 
     the case of parties indemnified pursuant to Section 8(a) and by the 
     Company and the Selling Shareholders in the case of parties indemnified 
     pursuant to Section 8(b).  The indemnifying party shall not be liable 
     for any settlement of any proceeding effected without its written 
     consent but if settled with such consent or if there be a final judgment 
     for the plaintiff, the indemnifying party agrees to indemnify the 
     indemnified party from and against any loss or liability by reason of 
     such settlement or judgment.  In addition, the indemnifying party will 
     not, without the prior written consent of the indemnified party, settle 
     or compromise or consent to the entry of any judgment in any pending or 
     threatened claim, action or proceeding of which indemnification may be 
     sought hereunder (whether or not any indemnified party is an actual or 
     potential party to such claim, action or proceeding) unless such 
     settlement, compromise or consent includes an unconditional release of 
     each indemnified party from all liability arising out of such claim, 
     action or proceeding.

          (d)  If the indemnification provided for in this Section 8 is
     unavailable to or insufficient to hold harmless an indemnified party under
     Section 8(a) or (b) above in respect of any losses, claims, damages or
     liabilities (or actions or proceedings in respect thereof) referred to
     therein, then each indemnifying party shall contribute to the amount paid
     or payable by such indemnified party as a result of such losses, claims,
     damages or liabilities (or actions or proceedings in respect thereof) in
     such proportion as is appropriate to reflect the relative benefits received
     by the Company and the Selling Shareholders on the one hand and the
     Underwriters on the other from the offering of the Shares.  If, however,
     the allocation provided by the immediately preceding sentence is not
     permitted by applicable law or if the indemnified party failed to give the
     notice required under Section 8(c) above, then each indemnifying party
     shall contribute to such amount paid or payable by such indemnified party
     in such proportion as is appropriate to reflect  not only such relative
     benefits but also the relative fault of the Company and the Selling
     Shareholders on the one hand and the Underwriters on the other in
     connection with the statements or omissions which resulted in such losses,
     claims, damages or liabilities, (or actions or proceedings in respect
     thereof), as well as any other relevant equitable considerations.  The
     relative benefits received by the Company and the Selling Shareholders on
     the one hand and the Underwriters on the other shall be deemed to be in the
     same proportion as the total net proceeds from the offering (before
     deducting expenses) received by the Company and the Selling Shareholders
     bear to the total underwriting discounts and commissions received by the
     Underwriters, in each case as set forth in the table on the cover page of
     the Prospectus.  The



                                     -24-

     relative fault shall be determined by reference to, among other things, 
     whether the untrue or alleged untrue statement of a material fact or the 
     omission or alleged omission to state a material fact relates to 
     information supplied by the Company or the Selling Shareholders on the 
     one hand or the Underwriters on the other and the parties' relative 
     intent, knowledge, access to information and opportunity to correct or 
     prevent such statement or omission.

          The Company, the Selling Shareholders and the Underwriters agree that
     it would not be just and equitable if contributions pursuant to this
     Section 8(d) were determined by pro rata allocation (even if the
     Underwriters were treated as one entity for such purpose) or by any other
     method of allocation which does not take account of the equitable
     considerations referred to above in this Section 8(d).  The amount paid or
     payable by an indemnified party as a result of the losses, claims, damages
     or liabilities (or actions or proceedings in respect thereof) referred to
     above in this Section 8(d) shall be deemed to include any legal or other
     expenses reasonably incurred by such indemnified party in connection with
     investigating or defending any such action or claim.  Notwithstanding the
     provisions of this subsection (d), (i) no Underwriter shall be required to
     contribute any amount in excess of the underwriting discounts and
     commissions applicable to the Shares purchased by such Underwriter, and
     (ii) no person guilty of fraudulent misrepresentation (within the meaning
     of Section 11(f) of the Act) shall be entitled to contribution from any
     person who was not guilty of such fraudulent misrepresentation, and (iii)
     no Selling Shareholder shall be required to contribute any amount in excess
     of the lesser of (A) that proportion of the total of such losses, claims,
     damages or liabilities indemnified or contributed against equal to the
     proportion of the total Shares sold hereunder which is being sold by such
     Selling Shareholder, or (B) the proceeds received by such Selling
     Shareholder from the Underwriters in the offering.  The Underwriters'
     obligations in this Section 8(d) to contribute are several in proportion to
     their respective underwriting obligations and not joint.

          (e)  In any proceeding relating to the Registration Statement, any
     Preliminary Prospectus, the Prospectus or any supplement or amendment
     thereto, each party against whom contribution may be sought under this
     Section 8 hereby consents to the jurisdiction of any court having
     jurisdiction over any other contributing party, agrees that process issuing
     from such court may be served upon him or it by any other contributing
     party and consents to the service of such process and agrees that any other
     contributing party may join him or it as an additional defendant in any
     such proceeding in which such other contributing party is a party.

          (f)  Any losses, claims, damages, liabilities or expenses for which an
     indemnified party is entitled to indemnification or contribution under this
     Section 8 shall be paid by the indemnifying party to the indemnified party
     as such losses, claims, damages, liabilities or expenses are incurred.  The
     indemnity and contribution agreements contained in this Section 8 and the
     representations and warranties of the Company set forth in this Agreement
     shall remain operative and in full force and effect, regardless of (i) any
     investigation made by or on behalf of any Underwriter or any person
     controlling any Underwriter, the Company, its directors or officers or any
     persons controlling the Company, (ii) acceptance of any Shares and payment
     therefor hereunder, and (iii) any termination of this Agreement.  A
     successor to any Underwriter, or to the Company, its directors or officers,
     or any person controlling the Company, shall be entitled to the benefits of
     the indemnity, contribution and reimbursement agreements contained in this
     Section 8.

     9.   DEFAULT BY UNDERWRITERS.



                                     -25-

          If on the Closing Date or the Option Closing Date, as the case may be,
     any Underwriter shall fail to purchase and pay for the portion of the
     Shares which such Underwriter has agreed to purchase and pay for on such
     date (otherwise than by reason of any default on the part of the Company or
     a Selling Shareholder), you, as Representatives of the Underwriters, shall
     use your reasonable efforts to procure within 36 hours thereafter one or
     more of the other Underwriters, or any others, to purchase from the Company
     and the Selling Shareholders such amounts as may be agreed upon and upon
     the terms set forth herein, the Firm Shares or Option Shares, as the case
     may be, which the defaulting Underwriter or Underwriters failed to
     purchase.  If during such 36 hours you, as such Representatives, shall not
     have procured such other Underwriters, or any others, to purchase the Firm
     Shares or Option Shares, as the case may be, agreed to be purchased by the
     defaulting Underwriter or Underwriters, then  (a) if the aggregate number
     of shares with respect to which such default shall occur does not exceed
     10% of the Firm Shares or Option Shares, as the case may be, covered
     hereby, the other Underwriters shall be obligated, severally, in proportion
     to the respective numbers of Firm Shares or Option Shares, as the case may
     be, which they are obligated to purchase hereunder, to purchase the Firm
     Shares or Option Shares, as the case may be, which such defaulting
     Underwriter or Underwriters failed to purchase, or  (b) if the aggregate
     number of shares of Firm Shares or Option Shares, as the case may be, with
     respect to which such default shall occur exceeds 10% of the Firm Shares or
     Option Shares, as the case may be, covered hereby, the Company and the
     Selling Shareholders or you as the Representatives of the Underwriters will
     have the right, by written notice given within the next 36-hour period to
     the parties to this Agreement, to terminate this Agreement without
     liability on the part of the non-defaulting Underwriters or of the Company
     or of the Selling Shareholders except to the extent provided in Section 8
     hereof.  In the event of a default by any Underwriter or Underwriters, as
     set forth in this Section 9, the Closing Date or Option Closing Date, as
     the case may be, may be postponed for such period, not exceeding seven
     days, as you, as Representatives, may determine in order that the required
     changes in the Registration Statement or in the Prospectus or in any other
     documents or arrangements may be effected.  The term "UNDERWRITER" includes
     any person substituted for a defaulting Underwriter.  Any action taken
     under this Section 9 shall not relieve any defaulting Underwriter from
     liability in respect of any default of such Underwriter under this
     Agreement.

     10.  NOTICES.

          All communications hereunder shall be in writing and, except as
     otherwise provided herein, will be mailed, delivered, telecopied or
     telegraphed and confirmed as follows:  if to the Underwriters, to Alex.
     Brown & Sons Incorporated, 135 East Baltimore Street, Baltimore, Maryland
     21202, Attention:  Steven R. Schuh; with a copy to Alex. Brown & Sons
     Incorporated, 135 East Baltimore Street, Baltimore, Maryland 21202,
     Attention: General Counsel; if to the Company or the Selling Shareholders,
     to CRA Managed Care, Inc., 312 Union Wharf, Boston, Massachusetts  02109,
     Attention:  Donald J. Larson, with a copy to James Westra, Hutchins,
     Wheeler & Dittmar, A Professional Corporation, 101 Federal Street, Boston,
     Massachusetts  02110.

     11.  TERMINATION.

          This Agreement may be terminated by you by notice to the Company as
     follows:



                                     -26-

          (a)  at any time prior to the earlier of  (i) the time the Shares are
     released by you for sale by notice to the Underwriters, or  (ii) 11:30 a.m.
     on the first business day following the date of this Agreement;

          (b)  at any time prior to the Closing Date if any of the following has
     occurred: (i) since the respective dates as of which information is given
     in the Registration Statement and the Prospectus, any material adverse
     change or any development involving a prospective material adverse change
     in or affecting the condition, financial or otherwise, of the Company and
     its Subsidiaries or the earnings, business, management, properties, assets,
     rights, operations, condition (financial or otherwise) or prospects of the
     Company and its Subsidiaries, whether or not arising in the ordinary course
     of business, (ii) any outbreak or escalation of hostilities or declaration
     of war or national emergency or other national or international calamity or
     crisis or change in economic or political conditions if the effect of such
     outbreak, escalation, declaration, emergency, calamity, crisis or change on
     the financial markets of the United States would, in your reasonable
     judgment, make it impracticable to market the Shares or to enforce
     contracts for the sale of the Shares, or (iii) suspension of trading in
     securities generally on the New York Stock Exchange or the American Stock
     Exchange or limitation on prices (other than limitations on hours or
     numbers of days of trading) for securities on either such Exchange, (iv)
     the enactment, publication, decree or other promulgation of any federal or
     state statute, regulation, rule or order of any court or other governmental
     authority which in your opinion materially and adversely affects or may
     materially and adversely affect the business or operations of the Company,
     (v) declaration of a banking moratorium by United States or New York State
     authorities, (vi) the suspension of trading of the Company's common stock
     by the Commission on the Nasdaq National Market or (vii) the taking of any
     action by any Federal or state or local governmental body or agency in
     respect of its monetary or fiscal affairs which in your reasonable opinion
     has a material adverse effect on the securities markets in the United
     States; or

          (c)  as provided in Sections 6 and 9 of this Agreement.

          This Agreement also may be terminated by you, by notice to the 
     Company as to any obligation of the Underwriters to purchase the Option 
     Shares, upon the occurrence at any time prior to the Option Closing Date 
     of any of the events described in subparagraph (b) above or as provided 
     in Sections 6 and 9 of this Agreement.

     12.  SUCCESSORS.

     This Agreement has been and is made solely for the benefit of the 
Underwriters, the Company and the Selling Shareholders and their respective 
successors, executors, administrators, heirs and assigns, and the officers, 
directors and controlling persons referred to herein, and no other person 
will have any right or obligation hereunder.  No purchaser of any of the 
Shares from any Underwriter shall be deemed a successor or assign merely 
because of such purchase.

     13.  INFORMATION PROVIDED BY UNDERWRITERS.  

     The Company, the Selling Shareholders and the Underwriters acknowledge 
and agree that the only information furnished or to be furnished by any 
Underwriter to the Company for inclusion in any Prospectus or the 
Registration Statement consists of the information set forth in the last 
paragraph on the front cover page (insofar as such information relates to the



                                     -27-

Underwriters), information provided in connection with Item 502(d) of 
Regulation S-K under the Act and the information under the caption 
"Underwriting" in the Prospectus.

     14.  MISCELLANEOUS.

     The reimbursement, indemnification and contribution agreements contained 
in this Agreement and the representations, warranties and covenants in this 
Agreement shall remain in full force and effect regardless of  (a) any 
termination of this Agreement,  (b) any investigation made by or on behalf of 
any Underwriter or controlling person thereof, or by or on behalf of the 
Company or its directors or officers and (c) delivery of and payment for the 
Shares under this Agreement; the other covenants of the Company and the 
Selling Shareholders in this Agreement shall remain in full force and effect 
regardless of (a) any investigation made by or on behalf of any underwriter 
or controlling person and (b) delivery of and payment for the Shares under 
this Agreement.

     This Agreement may be executed in two or more counterparts, each of 
which shall be deemed an original, but all of which together shall constitute 
one and the same instrument.

     This Agreement shall be governed by, and construed in accordance with, 
the laws of the State of Maryland.

     If the foregoing letter is in accordance with your understanding of our
agreement, please sign and return to us the enclosed duplicates hereof,
whereupon it will become a binding agreement among the Selling Shareholders, the
Company and the several Underwriters in accordance with its terms. 

     It is understood that your acceptance of this letter on behalf of each of
the Underwriters is pursuant to the authority set forth in a form of Agreement
among Underwriters, the form of which shall be submitted to the Company for
examination, upon request, but without warranty on your part as to the authority
of the signers thereof.

     Any person executing and delivering this Agreement as Attorney-in-Fact for
a Selling Shareholder represents by so doing that he has been duly appointed as
Attorney-in-Fact by such Selling Shareholder pursuant to a validly existing and
binding Power of Attorney which authorizes such Attorney-in-Fact to take such
action.


                 [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK.]



                                     -28-

                              Very truly yours,

                              CRA MANAGED CARE, INC.


                              By: ______________________________________
                                  Donald J. Larson, President

                              Selling Shareholders listed on SCHEDULE II


                              By: ______________________________________
                                  Donald J. Larson, Attorney-in-Fact


The foregoing Underwriting Agreement
is hereby confirmed and accepted as
of the date first above written.

ALEX. BROWN & SONS INCORPORATED
DEAN WITTER REYNOLDS INC.
MONTGOMERY SECURITIES
J. P. MORGAN & CO.

As Representatives of the several
Underwriters listed on Schedule I

By:  Alex. Brown & Sons Incorporated

By: _________________________________________
     Patrick A. O'Shea, Authorized Officer




                                   SCHEDULE I


                            SCHEDULE OF UNDERWRITERS



                                                   Number of Firm Shares
          Underwriter                                 to be Purchased
          -----------                              ---------------------

Alex. Brown & Sons Incorporated

Dean Witter Reynolds Inc.

Montgomery Securities

J.P. Morgan & Co.


                                                       ------------
                                                       ------------
            Total                                        2,000,000




                                   SCHEDULE II


                        SCHEDULE OF SELLING SHAREHOLDERS


                                                  Number of Firm Shares
        Selling Shareholder                             to be Sold
        -------------------                       ---------------------

The Silverman 1996
Grantor Retained Annuity Trust                             175,000

Donald J. Larson                                           158,634

J.H. Whitney & Co. and affiliates                        1,074,296

Kimberly A. Sutphin                                         25,000

Henry J. Roth                                               35,000

Howard J. Entin                                             10,000

Ryan J. Conlon                                               7,000

John Eric Griffiths                                          5,000

Paul M. Baker                                                5,729

John Sbarbaro                                                2,500

Nick Hilger                                                  1,841
                                                         ---------
        Total                                            1,500,000
                                                         ---------
                                                         ---------


                               SCHEDULE III


                                  STATES


                                California
                                 Colorado
                                Connecticut
                                  Florida
                                 Illinois
                                   Maine
                               Massachusetts
                                 Michigan
                                New Jersey
                                  New York
                               North Carolina
                                    Ohio
                                Pennsylvania
                                  Tennessee
                                    Texas
                                     Utah
                                   Virginia
                                  Washington





                                   EXHIBIT A

                                  SUBSIDIARIES


                      CRA Managed Care of Washington, Inc.
                  (formerly known as Alta Pacific Corporation)

                       FOCUS Healthcare Management, Inc.

                                     3
                                  QMC , Inc.

                            Prompt Associates, Inc.