-----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, P6vyTuQKz9s9OqZwErCRJ4iQ0kMGF+vOP60DC2pqFjgDM70wvZllL5FBXoRycIYc QfrfSLfcSutEXFC/1ZcVJw== 0000878897-03-000081.txt : 20030618 0000878897-03-000081.hdr.sgml : 20030618 20030618105147 ACCESSION NUMBER: 0000878897-03-000081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030616 FILED AS OF DATE: 20030618 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN MEDICAL SECURITY GROUP INC CENTRAL INDEX KEY: 0000878897 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 391431799 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 BUSINESS PHONE: 9206611111 MAIL ADDRESS: STREET 1: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 FORMER COMPANY: FORMER CONFORMED NAME: UNITED WISCONSIN SERVICES INC /WI DATE OF NAME CHANGE: 19930328 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ZIELINSKI THOMAS G CENTRAL INDEX KEY: 0001181962 STATE OF INCORPORATION: VA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13154 FILM NUMBER: 03748212 BUSINESS ADDRESS: STREET 1: C/O AMERICAN MECICAL SECURITY GROUP INC STREET 2: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 BUSINESS PHONE: 9206611111 MAIL ADDRESS: STREET 1: C/O AMERICAN MEDICAL SECURITY GROUP INC STREET 2: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 4 1 primary_doc.xml PRIMARY DOCUMENT 4 2003-06-16 0 0000878897 AMERICAN MEDICAL SECURITY GROUP INC AMZ 0001181962 ZIELINSKI THOMAS G 0 1 0 0 Exec Vice President/Operations Common Stock 2003-06-16 4 M 0 18200 5.1875 A 22200 D Common Stock 2003-06-16 4 S 0 18200 19.5 D 4000 D Common Stock 2003-06-17 4 M 0 1800 5.1875 A 5800 D Common Stock 2003-06-17 4 S 0 800 19.4 D 5000 D Common Stock 2003-06-17 4 S 0 200 19.45 D 4800 D Common Stock 2003-06-17 4 S 0 800 19.46 D 4000 D Employee Stock Option (right to buy) 5.1875 2003-06-16 4 M 0 18200 0 D 2001-11-17 2012-11-16 Common Stock 18200 36800 D Employee Stock Option (right to buy) 5.1875 2003-06-17 4 M 0 1800 0 D 2001-11-17 2012-11-16 Common Stock 1800 35000 D Option vested in four equal annual installments beginning 11/17/01. /s/ Thomas G. Zielinski 2003-06-17 -----END PRIVACY-ENHANCED MESSAGE-----