-----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, LpB9ino5oM6SYH8HqpRE4mulgln5FThWurDbKT5an3B3o/mJcMo9XlWaciZI4oEy QGfmG2VWgmM2HVOqZ737uw== 0000891836-98-000372.txt : 19980608 0000891836-98-000372.hdr.sgml : 19980608 ACCESSION NUMBER: 0000891836-98-000372 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980527 FILED AS OF DATE: 19980605 SROS: NYSE 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: 3 SEC ACT: SEC FILE NUMBER: 001-05975 FILM NUMBER: 98643101 BUSINESS ADDRESS: STREET 1: 500 W MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025803708 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: UNITED HEALTHCARE CORP CENTRAL INDEX KEY: 0000731766 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] OWNER IRS NUMBER: 411321939 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 300 OPUS CENTER STREET 2: 9900 BREN ROAD EAST CITY: MINNETONKA STATE: MN ZIP: 55343 BUSINESS PHONE: 6129361300 MAIL ADDRESS: STREET 1: PO BOX 1459 CITY: MINNEAPOLIS STATE: MN ZIP: 55440-1459 3 1 FORM 3 :----------: :---------------------------: : FORM 3 : : OMB APPROVAL : :----------: :---------------------------: :OMB NUMBER 3235-0104: :EXPIRES: September 30, 1998: :ESTIMATED AVERAGE BURDEN : :HOURS PER RESPONSE.... 0.5 : :---------------------------: U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 ================================================================================ 1. Name and Address of Reporting Person United HealthCare Corporation ----------------------------------------------------------------------------- (Last) (First) (Middle) 300 Opus Center 9900 Bren Road East ----------------------------------------------------------------------------- (Street) Minnetonka Minnesota 55343 ----------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) May 27, 1998 ----------------------------------------------------------------------------- ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) 41-1321939 ----------------------------------------------------------------------------- ================================================================================ 4. Issuer Name and Ticker or Trading Symbol Humana Inc. (HUM) ----------------------------------------------------------------------------- ================================================================================ 5. Relationship of Reporting Person to Issuer (Check all applicable) _____ Director _X__ 10% Owner _____ Officer (give title below) ____ Other (specify below) ----------------------------------------------------------------------------- ================================================================================ 6. If Amendment, Date of Original (Month/Day/Year) N/A ----------------------------------------------------------------------------- ================================================================================ 7. Individual or Joint/Group Filing (check Applicable Line) __X__ Form filed by One Report Person _____ Form filed by More than One Report Person ================================================================================ TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
1. Title of Security 2. Amount of Securities 3. Ownership 7. Nature of Indirect Beneficial Ownership (Instr. 4) Beneficially Owned Form: Direct (Instr. 5) (Instr. 4) (D) or Indirect (I) (Instr. 5) - ------------------- ----------------------- ------------------ ------------------------------------------- - -------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) (Print or Type Responses) SEC 1473 (7-96)
FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 1. Title of Derivative Security (Instr. 4) Option to purchase shares of Common Stock, par value 0.16 2/3 per share ("Common Stock"), of Humana Inc. ("Humana") --------------------------------------------------------------------------- ================================================================================ 2. Date Exercisable and Expiration Date (Month/Day/Year) Date Exercisable Expiration Date ------------------------ ------------------------ + + ================================================================================ 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) Title Amount or Number of Shares ------------------ -------------------------- Common Stock 33,000,000 ================================================================================ 4. Conversion or Exercise Price of Derivative Security $30.3375 per share --------------------------------------------------------------------------- ================================================================================ 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) D --------------------------------------------------------------------------- ================================================================================ 6. Nature of Indirect Beneficial Ownership (Instr. 5) N/A --------------------------------------------------------------------------- ================================================================================ Explanation of Responses: + Beneficial ownership of 33,000,000 shares of Common Stock (subject to adjustment as provided in the Stock Option Agreement (as defined below)) hereunder is being reported solely as a result of the Stock Option Agreement, dated as of May 27, 1998 (the "Stock Option Agreement"), between United HealthCare Corporation ("United HealthCare") and Humana. The option granted pursuant to the Stock Option Agreement (the "Option") may be exercised, in whole or in part, only upon the happening of certain events as set forth in the Stock Option Agreement, none of which events has happened as of the date hereof. The Option expires upon the happening of certain events as set forth in the Stock Option Agreement. United HealthCare expressly disclaims ownership of shares of Common Stock which may be purchased by it pursuant to the terms of the Stock Option Agreement. United HealthCare Corporation By: /s/ David J. Lubben June 5, 1998 ------------------------------------ -------------- Name: David J. Lubben Date Title: General Counsel and Secretary **Signature of Reporting Person ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Page 2 SEC 1473 (7-96) -----END PRIVACY-ENHANCED MESSAGE-----