-----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, FEw+jajBvKymW1nsI97yU4k4A/dUKC42c/nQrmHPHvqzcoOKgdZ/2Q0gi4a1Rvil mH8eHFgtydcRa6IDl4/rKA== 0000049071-02-000004.txt : 20020414 0000049071-02-000004.hdr.sgml : 20020414 ACCESSION NUMBER: 0000049071-02-000004 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020130 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HUMANA INC CENTRAL INDEX KEY: 0000049071 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 610647538 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05975 FILM NUMBER: 02521486 BUSINESS ADDRESS: STREET 1: 500 W MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025801000 FORMER COMPANY: FORMER CONFORMED NAME: EXTENDICARE INC DATE OF NAME CHANGE: 19740404 FORMER COMPANY: FORMER CONFORMED NAME: HERITAGE HOUSE OF AMERICA INC DATE OF NAME CHANGE: 19671129 COMPANY DATA: COMPANY CONFORMED NAME: GELLERT MICHAEL E CENTRAL INDEX KEY: 0001018650 DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025803778 MAIL ADDRESS: STREET 1: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 5 1 edgar.txt FORM 5 - DECEMBER 31, 2001 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). ( ) Form 3 Holdings Reported ( ) Form 4 Transactions Reported 1. Name and Address of Reporting Person Gellert, Michael E. Windcrest Partners 122 East 42nd Street, 34th Floor New York, NY 10168-0130 USA 2. Issuer Name and Ticker or Trading Symbol Humana Inc. HUM 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year December 31, 2001 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) 7. Individual or Joint/Group Reporting (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | |Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership | |Date |Code| | Beneficially |(D)or | | | | | | A/| | Owned at |Indir | | | | | Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| Common (1) | | | | | |127,917 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common(1) |03/20/|J(4)|800 |D | |2,700 |I |(4) | |2001 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity | | | Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Option (2) |$17.625 | | | | |1/3/9|1/3/0|Common (1) |5,000 | |5,000 |D | | | | | | | |5 |4 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$22.4375| | | | |1/3/9|1/3/0|Common (1) |5,000 | |5,000 |D | | | | | | | |6 |5 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$26.9375| | | | |1/2/9|1/2/0|Common (1) |5,000 | |5,000 |D | | | | | | | |7 |6 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$18.9375| | | | |1/2/9|1/2/0|Common (1) |5,000 | |5,000 |D | | | | | | | |8 |7 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$21.25 | | | | |1/2/9|1/2/0|Common (1) |5,000 | |5,000 |D | | | | | | | |9 |8 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$18.7813| | | | |1/4/0|1/4/0|Common (1) |5,000 | |5,000 |D | | | | | | | |0 |9 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$7.875 | | | | |1/3/0|1/3/1|Common (1) |5,000 | |5,000 |D | | | | | | | |1 |0 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (2) |$14.7813| | | | |1/2/0|1/2/1|Common (1) |5,000 | |5,000 |D | | | | | | | |2 |1 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) Each share of Common Stock contains a Right adopted on March 5, 1987, pursuant to the Company's Rights Agreement, as amended and restated on February 14, 1996, and amended as of May 27, 1998 and March 1, 1999, which entitles holders of the Company's Common Stock, in the event certain specified events occur, to acquire 1/100 of a share of Series A Participating Preferred Stock at a price of $145 per fractional share. (2) Right to buy pursuant to the Company's 1989 Stock Option Plan for Non-Employee Directors. (3) Award of stock in lieu of director fees exempt under 16(b)-3(d)(1). (4) Distribution to trust beneficiary upon reaching age 30 - family member living outside of household, exempt under 16a-2(d)(1). Shares are held in family Trusts of which I am Trustee. I have sole voting and dispositive powers. I disclaim beneficial ownership of Company stock held by the Trusts except to the extent of my pecuniary interest. I became successor Trustee upon the death of my brother. Final paperwork was completed in February 2001. -----END PRIVACY-ENHANCED MESSAGE-----