0001209191-12-053163.txt : 20121115
0001209191-12-053163.hdr.sgml : 20121115
20121115115301
ACCESSION NUMBER: 0001209191-12-053163
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20121113
FILED AS OF DATE: 20121115
DATE AS OF CHANGE: 20121115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SMITH MARK HENRY
CENTRAL INDEX KEY: 0001538752
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14953
FILM NUMBER: 121207668
MAIL ADDRESS:
STREET 1: 9151 BOULEVARD 26
CITY: NORTH RICHLAND HILLS
STATE: TX
ZIP: 76180
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HealthMarkets, Inc.
CENTRAL INDEX KEY: 0000773660
STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321]
IRS NUMBER: 752044750
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9151 BOULEVARD 26
CITY: N RICHLAND HILLS
STATE: TX
ZIP: 76180
BUSINESS PHONE: 8172555200
MAIL ADDRESS:
STREET 1: 9151 BOULEVARD 26
CITY: N RICHLAND HILLS
STATE: TX
ZIP: 76180
FORMER COMPANY:
FORMER CONFORMED NAME: UICI
DATE OF NAME CHANGE: 19970630
FORMER COMPANY:
FORMER CONFORMED NAME: UNITED INSURANCE COMPANIES INC
DATE OF NAME CHANGE: 19920703
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2012-11-13
0
0000773660
HealthMarkets, Inc.
N/A
0001538752
SMITH MARK HENRY
9151 BOULEVARD 26
NORTH RICHLAND HILLS
TX
76180
0
0
0
1
EVP/Chief Agency Officer
Stock Option
9.58
2012-12-12
2021-12-12
Class A-1 Common Stock
75000
75000
D
Stock Option
10.15
2012-11-13
4
A
0
50000
10.15
A
2013-11-13
2022-11-13
Class A-1 Common Stock
50000
50000
D
The options become exercisable with respect to 20% of the stock option shares on each of the first five (5) anniversaries of the date of grant if the optionee remains in the continuous service as an employee of the Company (Issuer) or any subsidiary as of such date.
Mark H. Smith
By: /s/ Peggy G. Simpson, POA
2012-11-15
EX-24.4_444518
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby makes, constitutes and
appoints Peggy G. Simpson and Lisa Turner as the undersigned's true and lawful
attorney-in-fact, with full power and authority as hereinafter described on
behalf of and in the name, place and stead of the undersigned to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5 (including
any amendments thereto) with respect to the securities of HealthMarkets, Inc., a
Delaware corporation (the "Company"), with the United States Securities and
Exchange Commission, any national securities exchanges and the Company, as
considered necessary or advisable under Section 16(a) of the Securities Exchange
Act of 1934 and the rules and regulations promulgated thereunder, as amended
from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and
(3) perform any and all other acts which in the discretion of such
attorney-in-fact are necessary or desirable for and on behalf of the undersigned
in connection with the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, such
attorney-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;
(2) any documents prepared and/or executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney will be in such form and will
contain such information and disclosure as such attorney-in-fact, in his or her
discretion, deems necessary or desirable;
(3) neither the Company nor such attorney-in-fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirement of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under the Exchange Act,
including without limitation the reporting requirements under Section 16 of the
Exchange Act.
The undersigned hereby gives and grants the foregoing attorney-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about the foregoing
matters as fully to all intents and purposes as the undersigned might or could
do if present, hereby ratifying all that such attorney-in-fact of, for and on
behalf of the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked by
the undersigned in a signed writing delivered to such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 30th day of January, 2012.
/s/ MARK H. SMITH
Printed Name