-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TMjhTNmwc1DrmJscK+yUTsNbtqYsDfWzfs1cRKsplzex6X4mtr8J29GvNCd6068+ 9nW6p91ktLmEG9uNm3830Q== 0000950142-04-000146.txt : 20040115 0000950142-04-000146.hdr.sgml : 20040115 20040115154547 ACCESSION NUMBER: 0000950142-04-000146 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040113 FILED AS OF DATE: 20040115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INTERNATIONAL MANAGED CARE BERMUDA LP CENTRAL INDEX KEY: 0001276297 STATE OF INCORPORATION: D0 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04527344 MAIL ADDRESS: STREET 1: C/O INSURANCE PARTNERS LP CEDER HOUSE STREET 2: 41 CEDAR AVE P O BOX HM 1179 CITY: HAMILTON STATE: D0 ZIP: 000000 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CERES GROUP INC CENTRAL INDEX KEY: 0000215403 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 341017531 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 17800 ROYALTON RD CITY: STRONGSVILLE STATE: OH ZIP: 44136 BUSINESS PHONE: 2165722400 MAIL ADDRESS: STREET 1: 17800 ROYALTON RD CITY: STRONGSVILLE STATE: OH ZIP: 44136 FORMER COMPANY: FORMER CONFORMED NAME: CENTRAL RESERVE LIFE CORP DATE OF NAME CHANGE: 19920703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INSURANCE PARTNERS OFFSHORE LP CENTRAL INDEX KEY: 0001012383 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04527343 BUSINESS ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON BERMUDA HM1 BUSINESS PHONE: 8173908500 MAIL ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON HM12 STATE: D0 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INSURANCE GENPAR MGP LP / BERMUDA CENTRAL INDEX KEY: 0001012384 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04527341 BUSINESS ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON BERMUDA HM1 BUSINESS PHONE: 8092952244 MAIL ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON HM12 STATE: D0 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INSURANCE GENPAR LP / BERMUDA CENTRAL INDEX KEY: 0001012386 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04527342 BUSINESS ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON BERMUDA HM1 BUSINESS PHONE: 8092952244 MAIL ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON HM12 STATE: D0 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INSURANCE GENPAR MGP LTD /BERMUDA CENTRAL INDEX KEY: 0001012387 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04527340 BUSINESS ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON BERMUDA HM1 BUSINESS PHONE: 8092952244 MAIL ADDRESS: STREET 1: CEDAR HOUSE STREET 2: 41 CEDAR AVE CITY: HAMILTON HM12 STATE: D0 4 1 form4-imcberm_011304ex.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP X0201 4 2004-01-13 0 0000215403 CERES GROUP INC CERG 0001276297 INTERNATIONAL MANAGED CARE BERMUDA LP CEDAR HOUSE, 41 CEDAR AVE. P.O.BOX HM 11779 HAMILTON D0 HM EX BERMUDA 0 0 1 0 0001012383 INSURANCE PARTNERS OFFSHORE LP CEDAR HOUSE 41 CEDAR AVE HAMILTON BERMUDA HM1 BERMUDA 0 0 1 0 0001012386 INSURANCE GENPAR LP / BERMUDA CEDAR HOUSE 41 CEDAR AVE HAMILTON BERMUDA HM1 BERMUDA 0 0 1 0 0001012384 INSURANCE GENPAR MGP LP / BERMUDA CEDAR HOUSE 41 CEDAR AVE HAMILTON BERMUDA HM1 BERMUDA 0 0 1 0 0001012387 INSURANCE GENPAR MGP LTD /BERMUDA CEDAR HOUSE 41 CEDAR AVE HAMILTON BERMUDA HM1 BERMUDA 0 0 1 0 Common Stock, par value $0.001 per share 2004-01-13 4 J 0 456543 0 D 1369628 D On January 13, 2004, International Managed Care (Bermuda), L.P. ("IMC Bermuda") distributed 456,543 shares of the Issuer's Common Stock to its partners in a pro rata distribution, in which 454,338 of such shares were distributed to Insurance Partners Offshore (Bermuda), L.P. ("IP Bermuda"), its general partner. IP Bermuda distributed all of the shares it received to its partners in a pro rata distribution. No consideration was paid in connection with these distributions. All of the securities reported herein are held for the account of IMC Bermuda., a Bermuda limited partnership. IP Bermuda, a Bermuda limited partnership, is the general partner of IMC Bermuda. Insurance GenPar (Bermuda), L.P., a Bermuda limited partnership ("Insurance GenPar Bermuda"), is the general partner of IP Bermuda. Insurance GenPar (Bermuda) MGP, L.P., a Bermuda limited partnership ("IBMGPLP"), is the general partner of Insurance GenPar Bermuda. Insurance GenPar (Bermuda) MGP, Ltd., a Bermuda corporation ("IBMGPI"), is the general partner of IBMGPLP. Pursuant to Rule 16a-1(a)(2)(ii)(B) under the Securities Exchange Act of 1934, as amended (the "Act"), IP Bermuda, Insurance GenPar Bermuda, IBMGPLP and IBMGPI are deemed to be beneficial owners of the shares beneficially owned by IMC Bermuda only to the extent of the greater of its respective direct or indirect interest in the profits or capital account of IMC Bermuda. Pursuant to Rule 16a-1(a)(4) under the Act, this filing shall not be deemed an admission that IP Bermuda, Insurance GenPar Bermuda, IBMGPLP or IBMGPI is, for purposes of Section 16 of the Act or otherwise, the beneficial owner of any securities owned by IMC Bermuda in excess of such amount. INTERNATIONAL MANAGED CARE (BERMUDA), L.P. By: Insurance Partners Offshore (Bermuda),L.P., its general partner By: Insurance GenPar (Bermuda),L.P., its general partner By: Insurance GenPar (Bermuda) MGP,L.P., its general partner By: Insurance GenPar (Bermuda) MGP,Ltd., its general partner By: /s/ Robert Spass Name: Robert Spass Title: President INSURANCE PARTNERS OFFSHORE (BERMUDA),L.P. By: Insurance GenPar (Bermuda),L.P., its general partner By: Insurance GenPar (Bermuda) MGP,L.P., its general partner By: Insurance GenPar (Bermuda) MGP,Ltd., its general partner By: /s/ Robert Spass Name: Robert Spass Title: President INSURANCE GENPAR (BERMUDA),L.P. By: Insurance GenPar (Bermuda) MGP,L.P., its general partner By: Insurance GenPar (Bermuda) MGP,Ltd., its general partner By: /s/ Robert Spass Name: Robert Spass Title: President INSURANCE GENPAR (BERMUDA) MGP,L. P. By: Insurance GenPar (Bermuda) MGP,Ltd., its general partner By: /s/ Robert Spass Name: Robert Spass Title: President INSURANCE GENPAR (BERMUDA) MGP, LTD. By: /s/ Robert Spass Name: Robert Spass Title: President Robert Spass (see Remarks) 2004-01-15 Robert Spass (see Remarks) 2004-01-15 Robert Spass (see Remarks) 2004-01-15 Robert Spass (see Remarks) 2004-01-15 Robert Spass (see Remarks) 2004-01-15 -----END PRIVACY-ENHANCED MESSAGE-----