-----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, GeAJjM4cpAfwS42KwTa/mR5s3asgX1Pp5HzVK6ALzGtGCOVqel5w8ksdcyIo3nl5 dOxZaI9VgIJaFUprGBoKWg== 0001209191-05-006007.txt : 20050201 0001209191-05-006007.hdr.sgml : 20050201 20050201174626 ACCESSION NUMBER: 0001209191-05-006007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050128 FILED AS OF DATE: 20050201 DATE AS OF CHANGE: 20050201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GALOWICH RONALD H CENTRAL INDEX KEY: 0001183706 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 033-87986 FILM NUMBER: 05566859 MAIL ADDRESS: STREET 1: C/O FIRST HEALTH GROUP CORP STREET 2: 3200 HIGHLAND AVENUE CITY: DOWNERS GROVE STATE: IL ZIP: 60515 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST HEALTH GROUP CORP CENTRAL INDEX KEY: 0000812910 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 363307583 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3200 HIGHLAND AVENUE CITY: DOWNERS GROVE STATE: IL ZIP: 60515 BUSINESS PHONE: 6307377900 MAIL ADDRESS: STREET 1: 3200 HIGHLAND AVENUE CITY: DOWNERS GROVE STATE: IL ZIP: 60515 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHCARE COMPARE CORP/DE/ DATE OF NAME CHANGE: 19920703 4 1 boc91665_2rhg.xml MAIN DOCUMENT DESCRIPTION X0202 4 2005-01-28 1 0000812910 FIRST HEALTH GROUP CORP FHCC 0001183706 GALOWICH RONALD H 3200 HIGHLAND AVENUE DOWNERS GROVE IL 60515 1 0 0 0 Common Stock 2005-01-28 4 D 0 149755 D 0 D Option to Purchase 8.125 2005-01-28 4 D 0 12000 10.625 D 1995-05-24 2005-05-24 Common Stock 12000 0 D Option to Purchase 11.7813 2005-01-28 4 D 0 16000 6.9688 D 1996-05-21 2006-05-21 Common Stock 16000 0 D Option to Purchase 11.3438 2005-01-28 4 D 0 16000 7.4063 D 1997-05-20 2007-05-20 Common Stock 16000 0 D Option to Purchase 14.7813 2005-01-28 4 D 0 16000 3.9688 D 1998-05-19 2008-05-19 Common Stock 16000 0 D Option to Purchase 9.5625 2005-01-28 4 D 0 20000 9.1875 D 1999-05-18 2009-05-18 Common Stock 20000 0 D Option to Purchase 16.1875 2005-01-28 4 D 0 20000 2.5625 D 2000-05-16 2010-05-16 Common Stock 20000 0 D Option to Purchase 25.925 2005-01-28 4 D 0 20000 1.25 D 2001-05-22 2011-05-22 Common Stock 20000 0 D Option to Purchase 28.02 2005-01-28 4 D 0 20000 1.25 D 2002-05-15 2012-05-15 Common Stock 20000 0 D Option to Purchase 25.22 2005-01-28 4 D 0 20000 1.25 D 2003-05-13 2013-05-13 Common Stock 20000 0 D Option to Purchase 15.23 2005-01-28 4 D 0 20000 3.52 D 2004-05-13 2014-05-13 Common Stock 20000 0 D Disposed of pursuant to the merger agreement, dated October 13, 2004, by and among Coventry Health Care, Inc. ("Coventry"), Coventry Merger Sub Inc., and the issuer, in exchange for (a) 0.1791 shares of Coventry common stock having a market value of $54.75 per share on the effective date of the merger and (b) $9.375 in cash, per share. On January 28, 2005, these options were cancelled pursuant to the issuer's option tender offer in exchange for payment for each underlying share of common stock equal to the greater of: (a) the amount by which $18.75 exceeded the exercise price of the option, if any, or (b) $1.25. /s/ Thomas M. Mastri, Attorney in Fact for Ronald H. Galowich 2005-02-01 -----END PRIVACY-ENHANCED MESSAGE-----