-----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, LKTmnxxxf801PONgwHR+nTCIMQU1xwoR2lBT6wgm87wqhHzyBBQxgG8ceUkQMNww kX3Yq8wvBtAd62vJctV+CQ== 0000049071-04-000016.txt : 20040203 0000049071-04-000016.hdr.sgml : 20040203 20040203125344 ACCESSION NUMBER: 0000049071-04-000016 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040202 FILED AS OF DATE: 20040203 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: BLOEM JAMES H CENTRAL INDEX KEY: 0001133713 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05975 FILM NUMBER: 04561841 BUSINESS ADDRESS: STREET 1: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025801000 4 1 edgar.xml PRIMARY DOCUMENT X0201 4 2004-02-02 0000049071 HUMANA INC HUM 0001133713 BLOEM JAMES H HUMANA INC. 500 WEST MAIN STREET LOUISVILLE KY 40202 0 1 0 0 Sr. VP, CFO & Treasurer Humana Common 2004-02-02 4 F 0 17431 22.705 D 73961 D Humana Common 1060 I See Footnote Options 12.20 2011-02-01 Humana Common 16666 16666 D Options 9.70 2011-07-12 Humana Common 8333 8333 D Options 12.995 2012-03-13 Humana Common 20000 20000 D Options 9.26 2013-03-13 Humana Common 70000 70000 D Each 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 for reporting person's benefit as of December 31, 2003 under the Humana Retirement & Savings Plan including a routine disposition of shares to fund an administrative fee assessment under a Tax-Conditioned Plan, both exempt under Rule 16b-3(c). Stock options were granted to reporting person on 2/1/01 with the remaining unexercised options vesting as follows: 8,196 non-qualified stock options to vest on 2/1/04, and 8,470 incentive stock options to vest 2/1/04. Non-qualified stock options were granted to reporting person on 7/12/01 vesting in thirds from 7/12/02 to 7/12/04. Stock options were granted to reporting person on 3/13/02 with the remaining unexercised options vesting as follows: 10,000 non-qualified stock options to vest on 3/13/04 and 2,305 on 3/13/05, and 7,695 incentive stock options to vest in full on 3/13/05. Stock options were granted to reporting person on 3/13/03 to vest as follows: 59,201 non-qualified stock options to vest in three increments - 23,334 on 3/13/04, 23,333 on 3/13/05 and 12,534 on 3/13/06, respectively, and 10,799 incentive stock options to vest in full on 3/13/06. Right to buy pursuant to the Company's 1996 Stock Incentive Plan for Employees. The ending balances reflect correction of typographical error from 12/29/03 Form 4. James H. Bloem 2004-02-02 -----END PRIVACY-ENHANCED MESSAGE-----