-----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, IIYDq+q25MQ2pPFKKWEdrBCt8kB0T3SHgZZZ/j9uPg9jdkTJM1wMS3bitsasSY/g 9oOCu1pfS2HjoXlY1kih+g== 0000950134-05-003024.txt : 20050214 0000950134-05-003024.hdr.sgml : 20050214 20050214160947 ACCESSION NUMBER: 0000950134-05-003024 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050214 DATE AS OF CHANGE: 20050214 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ASHKER MICHAEL CENTRAL INDEX KEY: 0001249619 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: HEALTHAXIS STREET 2: 5215 N. O'CONNOR BLVD. CITY: IRVING STATE: TX ZIP: 75039 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHAXIS INC CENTRAL INDEX KEY: 0000768892 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 232214195 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-38359 FILM NUMBER: 05610307 BUSINESS ADDRESS: STREET 1: 2500 DEKALB PIKE CITY: NORRISTOWN STATE: PA ZIP: 19401 BUSINESS PHONE: 6102792500 MAIL ADDRESS: STREET 1: 2500 DEKALB PIKE STREET 2: PO BOX 511 CITY: NORRISTOWN STATE: PA ZIP: 19404-0511 FORMER COMPANY: FORMER CONFORMED NAME: PROVIDENT AMERICAN CORP DATE OF NAME CHANGE: 19920703 SC 13G 1 d22510bsc13g.htm SCHEDULE 13G sc13g
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934
(Amendment No. )*

Healthaxis Inc.


(Name of Issuer)

Common Stock, par value $0.10 per share


(Title of Class of Securities)

42219D


(CUSIP Number)

December 31, 2004


(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

        o Rule 13d-1 (b)

        o Rule 13d-1 (c)

        þ Rule 13d-1 (d)

*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the notes).

 


 

             
13G
CUSIP No. 42219D Page 2 of 5

  1. Name of Reporting Person:
Michael Ashker
I.R.S. Identification Nos. of above persons (entities only):

  2. Check the Appropriate Box if a Member of a Group:
    (a) o  
    (b) o  

  3. SEC Use Only:

  4. Citizenship or Place of Organization:
USA

Number of
Shares
Beneficially
Owned by
Each Reporting
Person With
5. Sole Voting Power:
187,609

6. Shared Voting Power:
0

7. Sole Dispositive Power:
187,609

8.Shared Dispositive Power:
0

  9.Aggregate Amount Beneficially Owned by Each Reporting Person:
187,609

  10.Check if the Aggregate Amount in Row (9) Excludes Certain Shares:
o

  11.Percent of Class Represented by Amount in Row (9):
5.1%

  12.Type of Reporting Person:
IN

2


 

CUSIP No. 44219D  13G

ITEM 1.

  (a)   Name of Issuer: Healthaxis Inc.
 
  (b)   Address of Issuer’s Principal Executive Offices: 5215 N. O’Connor Blvd., 800 Central Tower, Irving, Texas 75039

ITEM 2.

  (a)   Name of Person Filing: Michael Ashker
 
  (b)   Address of Principal Business Office or, if none, Residence: c/o Healthaxis Inc., 5215 N. O’Connor Blvd., 800 Central Tower, Irving, Texas 75039
 
  (c)   Citizenship: USA
 
  (d)   Title of Class of Securities: Common Stock, par value $0.10 per share
 
  (e)   CUSIP Number: 42219D

ITEM 3.  If this statement is filed pursuant to Rule 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

  (a)   o Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).
 
  (b)   o Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).
 
  (c)   o Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).
 
  (d)   o Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8).
 
  (e)   o An investment adviser in accordance with Section 240.13d-1(b)(1)(ii)(E);
 
  (f)   o An employee benefit plan or endowment fund in accordance with Section 240.13d-1(b)(1)(ii)(F);
 
  (g)   o A parent holding company or control person in accordance with Section 240.13d-1(b)(1)(ii)(G);
 
  (h)   o A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
 
  (i)   o A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);
 
  (j)   o Group, in accordance with Rule 13d-1(b)(1)(ii)(J).

ITEM 4. Ownership.

Page 3 of 5 Pages


 

CUSIP No. 42219D  13G

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

  (a)   Amount beneficially owned: 187,609
 
  (b)   Percent of class: 5.1%
 
  (c)   Number of shares as to which the person has:

  (i)   Sole power to vote or to direct the vote: 187,609
 
  (ii)   Shared power to vote or to direct the vote: 0
 
  (iii)   Sole power to dispose or to direct the disposition of: 187,609
 
  (iv)   Shared power to dispose or to direct the disposition of: 0

ITEM 5. Ownership of Five Percent or Less of a Class.

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following. o

ITEM 6. Ownership of More than Five Percent on Behalf of Another Person.

Not applicable.

ITEM 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.

Not applicable.

ITEM 8. Identification and Classification of Members of the Group.

Not applicable.

ITEM 9. Notice of Dissolution of Group.

Not applicable.

ITEM 10. Certification.

Not applicable.

Page 4 of 5 pages


 

CUSIP No. 42219D  13G

Signature

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

       
 
  February 14, 2005  
   
  Date  
 
   
  /s/ Michael Ashker  
   
  Signature  
 
   
  Michael Ashker  
   
  Name/Title  

ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT CONSTITUTE FEDERAL CRIMINAL VIOLATIONS (SEE 18 U.S.C. 1001)

Page 5 of 5 pages

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