-----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, E2JcDiiBrX/zEcGvqz9oR0DnTlNQrhkFnIDx/1wAIlDBs+p7t1bEbjQg6Ei6IlLb VqRotq5NzmY6f70Ar0rp0g== 0000903423-01-000013.txt : 20010123 0000903423-01-000013.hdr.sgml : 20010123 ACCESSION NUMBER: 0000903423-01-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20010109 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: 1504803 BUSINESS ADDRESS: STREET 1: 48 MONROE TURNPIKE CITY: TRUMBULL STATE: CT ZIP: 06611 BUSINESS PHONE: 2034597000 MAIL ADDRESS: STREET 1: 48 MONROE TURNPIKE CITY: TRUMBULL STATE: CT ZIP: 06611 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: TEXAS PACIFIC GROUP STREET 2: 301 COMMERCE STREET, SUITE 3300 CITY: FT WORTH STATE: TX ZIP: 76102 BUSINESS PHONE: 8178714000 MAIL ADDRESS: STREET 1: TEXAS PACIFIC GROUP STREET 2: 301 COMMERCE STREET, SUITE 3300 CITY: FT WORTH STATE: TX ZIP: 76102 4 1 0001.txt OMB APPROVAL OMB Number: 3235-0287 Expired: December 31, 2001 Estimated average burden hours per response......0.5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 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 [X] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ________________________________________________________________________________ 1. Name and Address of Reporting Person* TPG PARTNERS II, L.P. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 301 Commerce Street, Suite 3300 - -------------------------------------------------------------------------------- (Street) Fort Worth Texas 76102 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Oxford Health Plans, Inc. (OXHP) ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year December 2000 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify 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 ================================================================================ 6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ SERIES D PREFERRED STOCK 12/22/00 J(1) 197,854.55926 D (1) 0 D - ------------------------------------------------------------------------------------------------------------------------------------ SERIES E PREFERRED STOCK 12/22/00 J(1) 21,026.62087 D (1) 0 D - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 12/22/00 X(1) 8,789,173 A $17.75 8,789,173 D ====================================================================================================================================
* Additional Filing Persons: TPG Parallel II, L.P., TPG Investors II, L.P. (1) On December 22, 2000, the Issuer, TPG Partners II, L.P. ("TPG"), TPG Parallel II, L.P. ("TPG Parallel"), TPG Investors II, L.P. ("TPG Investors", together with TPG and TPG Parallel, the "TPG Parties") and certain other investors, consummated the transactions contemplated by an Exchange and Repurchase Agreement, dated as of October 25, 2000 (the "Agreement") pursuant to which, inter alia, (a) the Issuer purchased from the TPG Parties 62,873.36455 shares of Series D Preferred Stock and 9,234,828.01037 Series A Warrants for a total consideration of $176,000,998.73 and (b) the TPG Parties exchanged 134,981.19471 shares of Series D Preferred Stock and 21,026.62087 shares of Series E Preferred Stock for 8,789,173 shares of the Issuer's Common Stock to exercise the remaining Series A and all of the Series B Warrants. 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). Page 1 of 2 SEC 1474 (7-96) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================ 10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ SERIES A WARRANTS $17.75 12/22/00 (1) 12,640,001 Common Stock 12,640,001 (1) 0 D - ------------------------------------------------------------------------------------------------------------------------------------ SERIES B WARRANTS $17.75 12/22/00 X 5,384,001 Common Stock 5,384,001 (1) 0 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: * Additional Filing Persons: TPG Parallel II, L.P., TPG Investors II, L.P. (1) On December 22, 2000, the Issuer, TPG Partners II, L.P. ("TPG"), TPG Parallel II, L.P. ("TPG Parallel"), TPG Investors II, L.P. ("TPG Investors", together with TPG and TPG Parallel, the "TPG Parties") and certain other investors, consummated the transactions contemplated by an Exchange and Repurchase Agreement, dated as of October 25, 2000 (the "Agreement") pursuant to which, inter alia, (a) the Issuer purchased from the TPG Parties 62,873.36455 shares of Series D Preferred Stock and 9,234,828.01037 Series A Warrants for a total consideration of $176,000,998.73 and (b) the TPG Parties exchanged 134,981.19471 shares of Series D Preferred Stock and 21,026.62087 shares of Series E Preferred Stock for 8,789,173 shares of the Issuer's Common Stock to exercise the remaining Series A and all of the Series B Warrants. TPG PARTNERS II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner By: /s/ Richard A. Ekleberry January 9, 2001 ------------------------ --------------- **Signature of Reporting Person Date Name: Richard A. Ekleberry Title: Vice President TPG PARALLEL II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner By: /s/ Richard A. Ekleberry January 9, 2001 ------------------------ --------------- **Signature of Reporting Person Date Name: Richard A. Ekleberry Title: Vice President TPG INVESTORS II, L.P. By: TPG GenPar II, L.P., General Partner By: TPG Advisors II, Inc., General Partner By: /s/ Richard A. Ekleberry January 9, 2001 ------------------------ --------------- **Signature of Reporting Person Date Name: Richard A. Ekleberry Title: Vice President ** 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 Page 2 of 2 SEC 1474 (7-96) -----END PRIVACY-ENHANCED MESSAGE-----