-----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, H/xQZBGOA/ZqOdAJAuY+ru9AiYtFLEzTeP4fnQzrHFEhiErVuywztHtFV+jjDSmB gqqSAGARbGt55LWrDuU+Zg== 0000878897-99-000002.txt : 19990108 0000878897-99-000002.hdr.sgml : 19990108 ACCESSION NUMBER: 0000878897-99-000002 CONFORMED SUBMISSION TYPE: 10-Q/A PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 19980630 FILED AS OF DATE: 19990107 FILER: 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 FILING VALUES: FORM TYPE: 10-Q/A SEC ACT: SEC FILE NUMBER: 001-13154 FILM NUMBER: 99501762 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 10-Q/A 1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-Q/A Amendment No. 1 to [X] Quarterly Report Pursuant To Section 13 Or 15(d) Of The Securities Exchange Act Of 1934 FOR THE QUARTERLY PERIOD ENDED JUNE 30, 1998 OR [ ] Transition Report Pursuant To Section 13 Or 15(d) Of The Securities Exchange Act Of 1934 For the transition period from to Commission File Number 1-13154 AMERICAN MEDICAL SECURITY GROUP, INC. (Exact name of Registrant as specified in its charter) WISCONSIN 39-1431799 (State of Incorporation) (I.R.S. Employer Identification No.) 3100 AMS BOULEVARD, GREEN BAY, WISCONSIN 54313 (Address of principal executive offices) (Zip Code) (920) 661-1500 (Registrant's telephone number, including area code) United Wisconsin Services, Inc. 401 West Michigan Street, Milwaukee, Wisconsin 53203-2896 (Former name and former address) Indicate by check mark whether registrant (1) has filed all documents and reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes __X__ No _____ Indicate the number of shares outstanding of each of the issuer's classes of common stock, as of the latest practicable date. Common stock, outstanding as of July 31, 1998 was 16,569,578. AMERICAN MEDICAL SECURITY GROUP, INC. AMENDMENT NO. 1 TO QUARTERLY REPORT ON FORM 10-Q DATED JUNE 30, 1998 The undersigned Registrant hereby amends the following items, financial statements, exhibits or other portions of its Quarterly Report for the period ended June 30, 1998 on Form 10-Q as set forth herein. PART II. OTHER INFORMATION ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS The Annual Meeting of shareholders of the Company was held on May 27, 1998 for the purpose of (i) electing three directors for terms expiring at the 2001 Annual Meeting of Shareholders, and (ii) amending the Company's Equity Incentive Plan (the "Equity Incentive Plan") to increase the number of shares available for grant under the Equity Incentive Plan and to increase the number of shares which may be granted to individual participants under the Equity Incentive Plan. All three of the Company's nominees were elected, and the amendment of the Equity Incentive Plan was approved. The voting results for the proposals were as follows:
Election of Directors for Terms Expiring in 2001: Michael D. Dunham: Carol N. Skornicka: For 14,821,907 shares For 14,824,412 shares Withheld 802,076 shares Withheld 799,571 shares Abstained 0 Abstained 0 Broker Non-Votes 0 Broker Non-Votes 0 Eugene A. Menden: For 14,823,652 shares Withheld 800,331 shares Abstained 0 Broker Non-Votes 0 Amendment of Equity Incentive Plan: For 10,194,611 shares Against 3,912,232 shares Abstained 33,013 shares Broker Non-Votes 1,484,127 shares
Further information concerning these matters, including the names of the directors whose terms continued after the meeting, is contained in the Company's Proxy Statement dated April 15, 1998 with respect to the 1998 Annual Meeting of Shareholders. 2 ITEM 6. EXHIBITS AND REPORTS ON FORM 8-K (a) EXHIBITS See the Exhibit Index following the Signature page in this report, which is incorporated herein by reference. A Restated Financial Data Schedule for American Medical Security Group, Inc. for the six months ended June 30, 1997, which was inadvertently omitted from the original filing of this Form 10-Q, is filed herewith. In addition, an amended Restated Financial Data Schedule for the nine months ended September 30, 1997 is filed herewith. A Restated Financial Data Schedule for the three months ended March 31, 1997, is not required to be filed because the adoption of SFAS No. 128 at December 31, 1997 did not result in a change in reported earnings per share data for the three months ended March 31, 1997. (b) REPORTS ON FORM 8-K No reports on Form 8-K were filed during the quarter for which this report is filed. 3 SIGNATURES Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this amendment to be signed on its behalf by the undersigned thereunto duly authorized. DATE: December 30, 1998 ----------------- AMERICAN MEDICAL SECURITY GROUP, INC. /s/ Gary D. Guengerich ------------------------------------- Gary D. Guengerich Executive Vice President and Chief Financial Officer (Principal Financial Officer and Chief Accounting Officer and duly authorized to sign on behalf of the Registrant) 4 AMERICAN MEDICAL SECURITY GROUP, INC. ("AMSG") (COMMISSION FILE NO. 1-13154)
EXHIBIT INDEX TO FORM 10-Q QUARTERLY REPORT FOR QUARTER ENDED JUNE 30, 1998 INCORPORATED HEREIN FILED EXHIBIT NO. DESCRIPTION BY REFERENCE TO HEREWITH 10.1 United Wisconsin Services, Inc. X Equity Incentive Plan, as revised effective July 1, 1998 10.2 Acquisition Agreement between United X Wisconsin Services, Inc. and Victoria Hekkers dated July 2, 1998 10.3 United Wisconsin Services, Inc. 1992 X Stock Appreciation Rights Plan (Adopted July 1, 1998) 10.4 1995 Director Stock Option Plan of X United Wisconsin Services, Inc. (As Amended July 24, 1998) 27.1 Financial Data Schedule X 27.2 Restated Financial Data Schedule X* (six months ended 6/30/97) 27.3 Amended Restated Financial Data X* Schedule (nine months ended 9/30/97) - ------------- *Filed with Amendment No. 1.
EX-27.2 2 EXHIBIT 27.2 RESTATED FDS JUNE 30, 1997
7 THIS RESTATED FINANCIAL DATA SCHEDULE CONTAINS SUMMARY FINANCIAL INFORMATION EXTRACTED FROM THE UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS OF AMERICAN MEDICAL SECURITY GROUP, INC. (F/K/A UNITED WISCONSIN SERVICES, INC.) FOR THE SIX MONTHS ENDED JUNE 30, 1997, AS ADJUSTED TO REFLECT THE ADOPTION OF SFAS NO. 128 AND THE RESTATEMENT OF THE CONSOLIDATED FINANCIAL STATEMENTS FOR CONTINUING OPERATIONS, AND IS QUALIFIED IN ITS ENTIRETY BY REFERENCE TO SUCH FINANCIAL STATEMENTS. 1,000 U.S. DOLLARS 6-MOS DEC-31-1997 JAN-01-1997 JUN-30-1997 1 275,089 5,403 0 23,376 0 0 303,868 8,441 0 0 659,256 0 24,286 135,558 0 125,188 0 0 16,429 303,151 659,256 493,915 10,538 0 14,378 378,062 0 130,311 1,807 1,167 640 8,293 0 0 8,933 .55 .54 0 0 0 0 0 0 0
EX-27.3 3 EXHIBIT 27.3 RESTATED FDS SEPTEMBER 30, 1997
7 THIS AMENDED FINANCIAL DATA SCHEDULE AMENDS THE RESTATED FINANCIAL DATA SCHEDULE FILED AS EXHIBIT 27.2 TO THE FORM 10-Q FOR THE QUARTER ENDED SEPTEMBER 30, 1998 AND CONTAINS SUMMARY FINANCIAL INFORMATION EXTRACTED FROM THE UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS OF AMERICAN MEDICAL SECURITY GROUP, INC. (F/K/A UNITED WISCONSIN SERVICES, INC.) FOR THE NINE MONTHS ENDED SEPTEMBER 30, 1997, AS ADJUSTED TO REFLECT THE RESTATEMENT OF THE CONSOLIDATED FINANCIAL STATEMENTS FOR CONTINUING OPERATIONS, AND IS QUALIFIED IN ITS ENTIRETY BY REFERENCE TO SUCH FINANCIAL STATEMENTS. 1,000 U.S. DOLLARS 9-MOS DEC-31-1997 JAN-01-1997 SEP-30-1997 1 268,249 4,134 0 17,232 0 0 289,615 10,874 0 0 638,251 0 19,157 114,438 0 124,888 0 0 16,480 309,181 638,251 716,329 16,582 0 20,088 546,993 0 187,806 5,198 2,209 2,989 12,355 0 0 15,344 .93 .92 0 0 0 0 0 0 0
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