0001514128-15-000032.txt : 20150608 0001514128-15-000032.hdr.sgml : 20150608 20150608173821 ACCESSION NUMBER: 0001514128-15-000032 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20150601 FILED AS OF DATE: 20150608 DATE AS OF CHANGE: 20150608 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: 44 SOUTH BROADWAY, 12TH FLOOR CITY: WHITE PLAINS STATE: NY ZIP: 10601 BUSINESS PHONE: 914-597-2900 MAIL ADDRESS: STREET 1: 44 SOUTH BROADWAY, 12TH FLOOR CITY: WHITE PLAINS STATE: NY ZIP: 10601 FORMER COMPANY: FORMER CONFORMED NAME: UNIVERSAL AMERICAN SPIN CORP. DATE OF NAME CHANGE: 20110228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thackery Adam C CENTRAL INDEX KEY: 0001643654 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35149 FILM NUMBER: 15919297 MAIL ADDRESS: STREET 1: 44 SOUTH BROADWAY STREET 2: 12TH FLOOR CITY: WHITE PLAINS STATE: NY ZIP: 10601 3 1 f3forath.xml PRIMARY DOCUMENT X0206 3 2015-06-01 0 0001514128 UNIVERSAL AMERICAN CORP. UAM 0001643654 Thackery Adam C 44 SOUTH BROADWAY SUITE 1200 WHITE PLAINS NY 10601 0 1 0 0 Chief Financial Officer Common Stock 61790. D Stock Option (Right to Buy) 6.73 2016-05-02 Common Stock 35000. D Stock Option (Right to Buy) 8.62 2017-02-09 Common Stock 32500. D Stock Option (Right to Buy) 6.93 2018-03-04 Common Stock 27625. D Stock Option (Right to Buy) 6.80 2019-02-06 Common Stock 26540. D Stock Options (Right to Buy) 9.16 2020-02-13 Common Stock 5224. D Stock Options (Right to Buy) 9.16 2020-02-13 Common Stock 5224. D Represents common stock including 27,568 shares of unvested restricted stock, including 6,114 Performance Shares which vest subject to the Company having met a specified target of stock price appreciation. Represents grant of stock options which vests in four equal annual installments beginning May 2, 2012. Represents grant of stock options which vests in four equal annual installments beginning February 9, 2013. Represents grant of stock options which vests in four equal annual installments beginning March 4, 2014. Represents grant of stock options which vests in four equal annual installments beginning February 6, 2015. Represents grant of Stock Options which vests in four equal annual installments beginning February 13, 2016. Represents grant of Performance Options which vest 25% per year over four years subject to the Company having met a specified target of stock price appreciation. Note: Also see attached Exhibit EX-24 Attachment A. /s/ Tony L. Wolk, (POA) 2015-06-08 EX-24 2 poa-awolk.txt ATTACHMENT A POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that the undersigned, Adam C. Thackery hereby appoints TONY L. WOLK to be the undersigned's true and lawful attorney, and in his name, place and stead to execute, acknowledge, deliver and file Forms 3, 4 and 5 (including amendments thereto) with respect to securities of Universal American Corp. (the "Company"), required to be filed with the Securities and Exchange Commission, national securities exchanges and the Company pursuant to Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules and regulations thereunder, granting to Tony L. Wolk full power and authority to perform all acts necessary to the completion of such purposes. The undersigned agrees that the attorney-in-fact herein, Tony L. Wolk, may rely entirely on information furnished orally or in writing by the undersigned to such attorney-in-fact. The undersigned also agrees to indemnify and hold harmless the Company and the attorney-in-fact against any losses, claims, damages or liabilities (or actions in these respects) that arise out of or are based upon any untrue statements or omission of necessary facts in the information provided by the undersigned to the attorney-in-fact for purposes of executing, acknowledging, delivering or filing Forms 3, 4 or 5 (including amendments thereto) and agrees to reimburse the Company and the attorney-in- fact herein for any legal or other expenses reasonably incurred in connection with investigating or defending against any such loss, claim, damage, liability or action. The validity of this Power of Attorney shall not be affected in any manner by reason of the execution, at any time, of other powers of attorney by the undersigned in favor of persons other than those named herein. The undersigned agrees and represents to those dealing with its attorney-in-fact herein, Tony L. Wolk, that this Power of Attorney is for indefinite duration and may be voluntarily revoked only by written notice to such attorney-in-fact. WITNESS THE EXECUTED HEREOF this 27th day of May 2015. By:/s/Adam C. Thackery Name: Adam C. Thackery