5 1 millerform502.txt WILLIAM MILLER FORM 5 2002 LIVE 5 1 NASD 0000939106 Officer Health Management Systems, Inc. 0000861179 13-2770433 12/31/02 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) Miller III, William F. 401 Park Avenue South New York, New York 10016 2. Issuer Name and Ticker or Trading Symbol Health Management Systems, Inc. (HMSY) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/02 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Chief Executive Officer and Chairman 7. Individual or Joint/Group Filing (Check Applicable Line) [X] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Security 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 07/10/02 B 2,913 A $2.43 595,575 D Direct Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right $3.41 12/19/02 A 87,975 (1) 12/19/12 to buy) Non-Qualified Stock Option $1.31 01/10/01 A 750,000 (2) 01/10/11 (right to buy) Non-Qualified Stock Option $3.41 12/19/02 A 37,025 (1) 12/19/12 (right to buy) Non-Qualified Stock Option $2.48 04/17/02 G 37,500 (1) 12/12/11 (right to buy) Non-Qualified Stock Option $2.48 04/17/02 G 37,500 (1) 12/12/11 (right to buy) Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right 12/19/02 Common Stock 87,975 87,975 D Direct to buy) Non-Qualified Stock Option 01/10/01 Common Stock 750,000 750,000 D Direct (right to buy) Non-Qualified Stock Option 12/19/02 Common Stock 37,025 37,025 D Direct (right to buy) Non-Qualified Stock Option 04/17/02 Common Stock 37,500 37,500 I by Daughter (3) (right to buy) Non-Qualified Stock Option 04/17/02 Common Stock 37,500 37,500 I by Son (3) (right to buy) Explanation of Responses: (1) Options vest in 1/3 increments with 1/3 vesting on grant date, and 1/3 on each of the next two anniversary dates. (2) Options will vest as follows: 100,000 vesting on first anniversary, and 81,250 at the end of each quarterly period thereafter. (3) These options are held in trusts for the benefit of the children of the reporting person, who still has beneficial ownership of the options.
SIGNATURE OF REPORTING PERSON /S/ By: Philip Rydzewski For: William F. Miller III DATE 02/13/03