0001179110-11-007291.txt : 20110504
0001179110-11-007291.hdr.sgml : 20110504
20110504162536
ACCESSION NUMBER: 0001179110-11-007291
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110429
FILED AS OF DATE: 20110504
DATE AS OF CHANGE: 20110504
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JACOBS GARY
CENTRAL INDEX KEY: 0001179661
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35149
FILM NUMBER: 11810606
MAIL ADDRESS:
STREET 1: SIX INTERNATIONAL DR
STREET 2: STE 190
CITY: RYE BROOK
STATE: NY
ZIP: 10573-1068
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: UNIVERSAL AMERICAN CORP.
CENTRAL INDEX KEY: 0001514128
STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324]
IRS NUMBER: 274683816
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: SIX INTERNATIONAL DRIVE, SUITE 190
CITY: RYE BROOK
STATE: NY
ZIP: 10573
BUSINESS PHONE: 914-934-5200
MAIL ADDRESS:
STREET 1: SIX INTERNATIONAL DRIVE, SUITE 190
CITY: RYE BROOK
STATE: NY
ZIP: 10573
FORMER COMPANY:
FORMER CONFORMED NAME: UNIVERSAL AMERICAN SPIN CORP.
DATE OF NAME CHANGE: 20110228
3
1
edgar.xml
FORM 3 -
X0203
3
2011-04-29
0
0001514128
UNIVERSAL AMERICAN CORP.
UAM
0001179661
JACOBS GARY
6 INTERNATIONAL DRIVE
RYE BROOK
NY
10573
0
1
0
0
SVP, Corporate Development
Common Stock
285977
D
Common Stock
10597
I
By 401(k) Plan
Issued pursuant to the merger, effective as of April 29, 2011, contemplated by the Agreement and Plan of Merger, dated December 30, 2010, by and between Universal American Corp. (subsequently renamed Caremark Ulysses Holding Corp.) CVS Caremark Corporation and Ulysses Merger Sub, L.L.C.
The information in this report is based on a 401(k) plan statement dated as of December 31, 2010.
/s/ Tony L. Wolk, (POA)
2011-05-04