-----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, R3BailNqOXYVSRAs2EdQdj71zOx78m6rm5JVtMHJ7zuWx5WqqRqB8s9nOC+W1oK4 GpB2ZIuXRVFiSyDiGBQu8w== 0000950142-04-001088.txt : 20040405 0000950142-04-001088.hdr.sgml : 20040405 20040405180541 ACCESSION NUMBER: 0000950142-04-001088 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040401 FILED AS OF DATE: 20040405 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 LP CENTRAL INDEX KEY: 0001012376 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04718747 BUSINESS ADDRESS: STREET 1: 201 MAIN ST CITY: FORT WORTH STATE: TX ZIP: 76102 BUSINESS PHONE: 8173908500 MAIL ADDRESS: STREET 1: 201 MAIN STREET CITY: FORT WORTH STATE: TX ZIP: 76102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INTERNATIONAL MANAGED CARE LLC CENTRAL INDEX KEY: 0001276295 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08483 FILM NUMBER: 04718748 MAIL ADDRESS: STREET 1: C/O INSURANCE PARTNERS LP STREET 2: 54 THOMPSON ST CITY: NEW YORK STATE: NY ZIP: 10012 4 1 form4-imcllc_040104ex.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP X0201 4 2004-04-01 0 0000215403 CERES GROUP INC CERG 0001276295 INTERNATIONAL MANAGED CARE LLC C/O INSURANCE PARTNERS, L.P. 201 MAIN STREET FORT WORTH TX 76102 0 0 1 0 0001012376 INSURANCE PARTNERS LP C/O INSURANCE PARTNERS, L.P. 54 THOMPSON STREET NEW YORK NY 10012 0 0 1 0 Common Stock, par value $0.001 per share 2004-04-01 4 J 0 1344925 0 D 1467039 D On April 1, 2004, International Managed Care, LLC ("IMC Delaware") distributed 1,344,925 shares of the Issuer's Common Stock to its partners in a pro rata distribution, in which 1,331,476 of such shares were distributed to Insurance Partners, L.P. ("IP Delaware"), its managing member. IP Delaware 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 Delaware, a Delaware limited liability company. IP Delaware, a Delaware limited partnership, is the managing member of IMC Delaware. Pursuant to Rule 16a-1(a)(2)(ii)(B) under the Securities Exchange Act of 1934, as amended (the "Act"), IP Delaware is deemed to be the beneficial owner of the shares beneficially owned by IMC Delaware only to the extent of the greater of its direct or indirect interest in the profits or capital account of IMC Delaware. Pursuant to Rule 16a-1(a)(4) under the Act, this filing shall not be deemed an admission that IP Delaware is, for purposes of Section 16 of the Act or otherwise, the beneficial owner of any securities owned by IMC Delaware in excess of such amount. INTERNATIONAL MANAGED CARE, LLC By: Insurance Partners,L.P., its managing member By: Insurance GenPar,L.P., its general partner By: Insurance GenPar MGP,L.P., its general partner By: Insurance GenPar MGP,Inc., its general partner By: /s/ Robert A. Spass Name:Robert A. Spass Title:President INSURANCE PARTNERS,L.P. By: Insurance GenPar,L.P., its general partner By: Insurance GenPar MGP,L.P., its general partner By: Insurance GenPar MGP,Inc., its general partner By: /s/ Robert A. Spass Name:Robert A. Spass Title:President Robert A. Spass (see Remarks) 2004-04-05 Robert A. Spass (see Remarks) 2004-04-05 -----END PRIVACY-ENHANCED MESSAGE-----