-----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, BjXXPHzDKiM4Diy6ECJBCDFwTsbBiTdi7n1m7TG9wbP34N70/UurQ8cG0ce8ZeLN 63whohrYKx8CXrurFVF0zA== 0000049071-04-000017.txt : 20040210 0000049071-04-000017.hdr.sgml : 20040210 20040210163948 ACCESSION NUMBER: 0000049071-04-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040209 FILED AS OF DATE: 20040210 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: 04582473 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 4 2004-02-09 0000049071 HUMANA INC HUM 0001070038 JONES DAVID A SR/KY HUMANA INC. 500 WEST MAIN STREET LOUISVILLE KY 40202 1 0 0 0 Humana Common 2004-02-09 4 G 0 50 0 D 649598 D Humana Common 757974 I See Footnote Humana Common 2519 I See Footnote Humana Common 610140 I See Footnote Humana Common 30000 I See Footnote Humana Common 375406 I See Footnote Humana Common 4750034 I See Footnote Options 21.25 1999-01-02 2008-01-02 Humana Common 5000 5000 D Options 18.7813 2000-01-04 2009-01-04 Humana Common 5000 5000 D Options 10.19 2004-01-02 2013-01-02 Humana Common 5000 5000 D Options 23.05 2005-01-02 2014-01-02 Humana Common 2500 2500 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 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 beneficial 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. Right to buy pursuant to Humana Inc.'s 2003 Stock Incentive Plan. David A. Jones 2004-02-09 -----END PRIVACY-ENHANCED MESSAGE-----