SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Thackery Adam C

(Last) (First) (Middle)
44 SOUTH BROADWAY
SUITE 1200

(Street)
WHITE PLAINS NY 10601

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/01/2015
3. Issuer Name and Ticker or Trading Symbol
UNIVERSAL AMERICAN CORP. [ UAM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 61,790(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (2) 05/02/2016 Common Stock 35,000 $6.73 D
Stock Option (Right to Buy) (3) 02/09/2017 Common Stock 32,500 $8.62 D
Stock Option (Right to Buy) (4) 03/04/2018 Common Stock 27,625 $6.93 D
Stock Option (Right to Buy) (5) 02/06/2019 Common Stock 26,540 $6.8 D
Stock Options (Right to Buy) (6) 02/13/2020 Common Stock 5,224 $9.16 D
Stock Options (Right to Buy) (7) 02/13/2020 Common Stock 5,224 $9.16 D
Explanation of Responses:
1. 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.
2. Represents grant of stock options which vests in four equal annual installments beginning May 2, 2012.
3. Represents grant of stock options which vests in four equal annual installments beginning February 9, 2013.
4. Represents grant of stock options which vests in four equal annual installments beginning March 4, 2014.
5. Represents grant of stock options which vests in four equal annual installments beginning February 6, 2015.
6. Represents grant of Stock Options which vests in four equal annual installments beginning February 13, 2016.
7. 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.
Remarks:
Note: Also see attached Exhibit EX-24 Attachment A.
/s/ Tony L. Wolk, (POA) 06/08/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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