-----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, FLlSrPu0dN35nNU78Hqi9A3HN5S/c3k86vZGdAjk1dHZM+KH5csIhS7nAZBTNuhZ aJpdKqhOKlRk5Wqrq3JpGQ== 0001144204-05-027913.txt : 20050902 0001144204-05-027913.hdr.sgml : 20050902 20050902121552 ACCESSION NUMBER: 0001144204-05-027913 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030930 FILED AS OF DATE: 20050902 DATE AS OF CHANGE: 20050902 ISSUER: 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 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEHMAN BROTHERS INC// CENTRAL INDEX KEY: 0000728586 STANDARD INDUSTRIAL CLASSIFICATION: SECURITY BROKERS, DEALERS & FLOTATION COMPANIES [6211] STATE OF INCORPORATION: DE FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13591 FILM NUMBER: 051066817 BUSINESS ADDRESS: STREET 1: LEHMAN BROTHERS INC. STREET 2: 3 WORLD FINANCIAL CENTER CITY: NEW YORK STATE: NY ZIP: 10285 BUSINESS PHONE: 2125267000 MAIL ADDRESS: STREET 1: LEHMAN BROTHERS INC. STREET 2: 3 WORLD FINANCIAL CENTER CITY: NEW YORK STATE: NY ZIP: 10285 FORMER NAME: FORMER CONFORMED NAME: SHEARSON LEHMAN BROTHERS INC DATE OF NAME CHANGE: 19920703 FORMER NAME: FORMER CONFORMED NAME: SHEARSON LEHMAN HUTTON INC /DE/ DATE OF NAME CHANGE: 19900828 FORMER NAME: FORMER CONFORMED NAME: SHEARSON LEHMAN BROTHERS INC /DE/ DATE OF NAME CHANGE: 19880323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LB I GROUP INC CENTRAL INDEX KEY: 0001045004 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13591 FILM NUMBER: 051066818 BUSINESS ADDRESS: STREET 1: 3 WORLD FINANCIAL CENTER STREET 2: 200 VASEY ST CITY: NEW YORK STATE: NY ZIP: 10285 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEHMAN BROTHERS HOLDINGS INC CENTRAL INDEX KEY: 0000806085 STANDARD INDUSTRIAL CLASSIFICATION: SECURITY BROKERS, DEALERS & FLOTATION COMPANIES [6211] STATE OF INCORPORATION: DE FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13591 FILM NUMBER: 051066819 BUSINESS ADDRESS: STREET 1: LEHMAN BROTHERS STREET 2: 745 SEVENTH AVENUE CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 2125267000 MAIL ADDRESS: STREET 1: LEHMAN BROTHERS STREET 2: 745 SEVENTH AVENUE CITY: NEW YORK STATE: NY ZIP: 10019 FORMER NAME: FORMER CONFORMED NAME: SHEARSON LEHMAN HUTTON HOLDINGS INC DATE OF NAME CHANGE: 19901017 3 1 v025150_ex.xml X0202 3 2003-09-30 0 0000768892 HEALTHAXIS INC HAXS 0000806085 LEHMAN BROTHERS HOLDINGS INC 745 SEVENTH AVENUE NEW YORK NY 10019 0 0 1 1 See Remark (1) below 0001045004 LB I GROUP INC 745 SEVENTH AVENUE NEW YORK NY 10019 0 0 1 1 See Remark (1) below 0000728586 LEHMAN BROTHERS INC// 745 SEVENTH AVENUE NEW YORK NY 10019 0 0 1 1 See Remark (1) below Series A Preferred Stock 15.50 Common Stock, $0.10 par value 325561 I See Remark (1) below. Warrants 203.40 2004-09-14 Common Stock, $0.10 par value 7374 I See Remark (1) below. The shares of Series A Preferred Stock (the "Series A Shares") are immediately convertible. The Series A Shares have no expiration date. The warrants are immediately exercisable. (1) This form is a joint filing with the following affiliates of the Reporting Person, Lehman Brothers Holdings Inc. ("Holdings"): Lehman Brothers Inc., a Delaware corporation ("LBI") and LB I Group Inc., a Delaware corporation ("LB I Group"). Holdings owns 100% of LBI, which owns 100% of LB I Group. Holdings, LBI and LB I Group may be deemed to be 10% owners of the Issuer. This report is being filed by Holdings. Other Joint Filers: LBI, 745 Seventh Avenue, New York, New York 10019; and LB I Group, 745 Seventh Avenue, New York, New York 10019. The signatory below is signing on behalf of all Joint Filers. /s/ Barrett S. DiPaolo 2005-09-01 -----END PRIVACY-ENHANCED MESSAGE-----