-----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, Up2fsqFQbC96c2zkNU/PKKDxjC3+kbJdQp5rfzbUkTh688a6cKj9Ew2dXCScXe5O ygaHU1lMD32d0XdBbaRPNA== 0000903423-98-000312.txt : 19980911 0000903423-98-000312.hdr.sgml : 19980911 ACCESSION NUMBER: 0000903423-98-000312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980831 FILED AS OF DATE: 19980910 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OXFORD HEALTH PLANS INC CENTRAL INDEX KEY: 0000865084 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 061118515 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-19442 FILM NUMBER: 98707205 BUSINESS ADDRESS: STREET 1: 800 CONNECTICUT AVE CITY: NORWALK STATE: CT ZIP: 06854 BUSINESS PHONE: 2038521442 MAIL ADDRESS: STREET 1: 800 CONNECTICUT AVE CITY: NORWALK STATE: CT ZIP: 06854 COMPANY DATA: COMPANY CONFORMED NAME: TPG PARTNERS II LP CENTRAL INDEX KEY: 0001043167 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] OWNER IRS NUMBER: 752698246 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 201 MAIN ST STE 2420 CITY: FT WORTH STATE: TX ZIP: 76102 BUSINESS PHONE: 8178714000 MAIL ADDRESS: STREET 1: 201 MAIN ST STE 2420 CITY: FT WORTH STATE: TX ZIP: 76102 4 1 OMB APPROVAL OMB Number: 3235-0287 Expires: September 30, 1998 Estimated average burden hours per response......0.5 ====== FORM 4 ====== |_| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 ================================================================== 1. Name and Address of Reporting Person* TPG PARTNERS II, L.P. ----------------------------------------------- (Last) (First) (Middle) 201 Main Street, Suite 2420 ----------------------------------------------- (Street) Fort Worth Texas 76102 ----------------------------------------------- (City) (State) (Zip) ================================================================== 2. Issuer Name and Ticker or Trading Symbol OXFORD HEALTH PLANS, INC. (OXHP) ---------------------------------------- ================================================================== 3. IRS or Social Security Number of Reporting Person (Voluntary) ---------------------------------------- ================================================================== 4. Statement for Month/Year August, 1998 ---------------------------------------- ================================================================== 5. If Amendment, Date of Original (Month/Year) ---------------------------------------- ================================================================== 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director x 10% Owner ----- ----- Officer (give Other (specify ----- title below) ----- below) ================================================================== 7. Individual or Joint/Group Filing (Check Applicable Line) Form filed by One Reporting Person ----- x Form filed by More than One Reporting Person ----- ================================================================== Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
================================================================================================================================= 1. Title of 2. Transaction 3. Transaction 4. Securities Acquired 5. Amount of 6. Ownership 7. Nature of Security Date Code (A) or Disposed of (D) Securities Form: Direct Indirect (Instr. 3) (Month/Day/Year) (Instr. 8) (Instr. 3, 4 and 5) Beneficially (D) or Beneficial Owned at End of Indirect (I) Ownership ----------- ------------------------ Month (Instr. 4) (Instr. 4) (A) or (Instr. 3 and 4) Code V Amount (D) Price --------- --------------- ---- ----- -------- ------ ----- ---------------- ----------- ----------- - ---------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 4(b)(v). (Over) SEC 1474 (7-96) Page 1 of 3 FORM 4 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================================================================= 1. Title of 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriva- 6. Date Exercisable Derivative sion or action tion tive Securities and Expiration Security Exer- Date Code Acquired (A) or Date (Instr. 3) cise (Month/ (Instr. 8) Disposed of (D) (Month/Day/ Price of Day/ (Instr. 3, 4 and 5) Year) Deriva- Year) ------------------ tive Se- Date Expira- curity ----------- ------------------- Exer- tion Code V (A) (D) cisable Date ------------ -------- ------- ---- ----- ------ ----- -------- ------- Series B Warrants $17.75 8/28/98 J** 1,345,999 currently 5/13/08 - ----------------------------------------------------------------------------------------------------------------------
7. Title and Amount of 8. Price of 9. Number of 10. Ownership Form 11. Nature of Underlying Securities Derivative Derivative of Derivative Indirect (Instr. 3 and 4) Security Securities Security: Direct Beneficial (Instr. 5) Beneficially (D) or Indirect Ownership - -------------------------- Owned at End (I) (Instr. 4) Amount or of Month (Instr. 4) Number of (Instr. 4) Title Shares - ----------- -------- --------- ------------ -------------- ---------- Common Stock 1,345,999 See Explanation+ 5,384,001 D - ---------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: Additional Filing Persons: TPG Parallel II, L.P., TPG Investors II, L.P. 1 **On August 28, 1998, the Issuer's shareholders approved the issuance of common stock upon exercise of the Series B Warrants. + The price per share of Series A Preferred Stock and Series B Preferred Stock includes the Series A Warrants and Series B Warrants, respectively, acquired by the Reporting Person's assignees. Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. ___________________ 1 TPG Oxford LLC assigned all of its right, title and interest to all Non-Derivative and Derivative Securities of the Issuer held by it to TPG Partners II, L.P. on August 21, 1998. TPG Oxford LLC was dissolved on Auguts 29, 1998. Page 2 of 3 TPG PARTNERS II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner /s/ James O'Brien September 9, 1998 ------------------------------- ----------------- **Signature of Reporting Person Date Name: James O'Brien Title: Vice President TPG PARALLEL II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner /s/ James O'Brien September 9, 1998 ------------------------------- ----------------- **Signature of Reporting Person Date Name: James O'Brien Title: Vice President TPG INVESTORS II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner /s/ James O'Brien September 9, 1998 ------------------------------- ----------------- **Signature of Reporting Person Date Name: James O'Brien Title: Vice President Page 3 of 3 -----END PRIVACY-ENHANCED MESSAGE-----