-----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, WlWtqMrLZw2PLDSCtoJqrAK4kUXANjeZRkw2hIvlT8nhWTuEX5XfcY3khaVO7iEo 9nQrRqBqCUBdVOc9Z8af2w== 0000049071-04-000007.txt : 20040106 0000049071-04-000007.hdr.sgml : 20040106 20040106125813 ACCESSION NUMBER: 0000049071-04-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040102 FILED AS OF DATE: 20040106 ISSUER: 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 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JONES DAVID A SR/KY CENTRAL INDEX KEY: 0001070038 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05975 FILM NUMBER: 04508926 BUSINESS ADDRESS: STREET 1: C/O HUMANA INC STREET 2: 500 W MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025801000 MAIL ADDRESS: STREET 1: C/O HUMANA INC STREET 2: 500 W MAIN ST 27TH FL CITY: LOUISVILLE STATE: KY ZIP: 40202 4 1 edgar.xml PRIMARY DOCUMENT X0201 42004-01-02 0000049071 HUMANA INC HUM 0001070038 JONES DAVID A SR/KY HUMANA INC. 500 WEST MAIN STREET LOUISVILLE KY 40202 1000Humana Common2004-01-024A0250023.05A659428DHumana Common2004-01-024G030000D656428DHumana Com mon757974ISee FootnoteHumana Common2519ISee FootnoteHumana Common610 140ISee FootnoteHumana Common30000ISee FootnoteHumana Common375406 ISee FootnoteHumana Common4760659ISee FootnoteOptions18.78132000-01-042009-01-04Humana Common< footnoteId id="F1"/>50005000DOptions21.251999-01-022008-01-02Humana Common50005000DOptions10.192004-01-022013-01-02Humana Common50005000DOptions23.052004-01-024A0250023.05A2005-01-022014-01-02Humana Common25002500DEach share of Common Stock contains a Right adopted on March 5, 1987, pursuant to the Company 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.Shares held by DBJ Investments, Ltd., a limited partnership of which reporting person is a limited partner and DBJ, LLC is the General Partner. Reporting person and spouse are the members of DBJ, LLC. Reporting person disclaims beneficial ownership of Company stock held by the partnership except to the extent of his pecuniary interest.Shares held by Family Limited Partnership ("FLP") of which reporting person and his spouse are General Partners, and Trusts, established by reporting person and spouse, are Limited Partners together with a Family Charitable Foundation.Shares held by reporting person's spouse.Shares held by Jones Investments, Ltd., a partnership of which DBJ, LLC is the General Partner. Reporting person and spouse are the members of DBJ, LLC.Shares held by David A. Jones Revocable Trust (DAJ-RT) of which reporting person is Settlor and Trustee. Reporting person disclaims beneficial ownership of Company stock held by the DAJ-RT except to the extent of his pecuniary interest.Shares held by Betty A. Jones Revocable Trust (BJ-RT) of which she is Settlor and Trustee. Reporting person disclaims benefi cial ownership of Company stock held by the BJ-RT except to the extent of his pecuniary interest.Right to buy pursuant to Humana Inc.'s 1989 Stock Option Plan for Non-Employee Directors.Right to buy pursuant to Humana Inc.'s 1996 Incentive Stock Option Plan.Award of stock pursuant to Humana Inc.'s 2003 Stock Incentive Plan in lieu of director fees exempt under 16(b)-3(d)(1).Right to buy pursuant to Humana Inc.'s 2003 Stock Incentive Plan. David A. Jones2004-01-02 -----END PRIVACY-ENHANCED MESSAGE-----