-----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, O0Ps4O9Re7/RM1DTh/pfpfb7JdHE9qkijKHaDF0p35DV1cbPaV94bce9Xcl0lfxa oYnFC3+MEQ+9RpVt6zMOhg== 0000878897-03-000096.txt : 20030925 0000878897-03-000096.hdr.sgml : 20030925 20030925172210 ACCESSION NUMBER: 0000878897-03-000096 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030923 FILED AS OF DATE: 20030925 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: MILLER SAMUEL V CENTRAL INDEX KEY: 0001081113 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13154 FILM NUMBER: 03910671 BUSINESS ADDRESS: STREET 1: AMERICAN MEDICAL SECURITY GROUP INC STREET 2: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 BUSINESS PHONE: 9206615418 MAIL ADDRESS: STREET 1: AMERICAN MEDICAL SECURITY GROUP INC STREET 2: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-09-23 0 0000878897 AMERICAN MEDICAL SECURITY GROUP INC AMZ 0001081113 MILLER SAMUEL V AMERICAN MEDICAL SECURITY GROUP INC 3100 AMS BLVD GREEN BAY WI 54313 0 1 0 0 Chairman, President and CEO Common Stock 2003-09-23 4 M 0 37000 5.8125 A 142006 D Common Stock 2003-09-23 4 M 0 13000 10.25 A 155006 D Common Stock 2003-09-23 4 S 0 50000 22.5 D 105006 D Employee Stock Option (Right to Buy) 5.8125 2003-09-23 4 M 0 37000 0 D 2000-11-17 2011-11-16 Common Stock 37000 37000 D Employee Stock Option (Right to Buy) 10.25 2003-09-23 4 M 0 13000 0 D 1999-09-28 2010-09-27 Common Stock 13000 87000 D Option vests in four (4) equal annual installments beginning 11/17/00. Option vests in four (4) equal annual installments beginning 9/28/99. Samuel V. Miller 2003-09-25 -----END PRIVACY-ENHANCED MESSAGE-----