4 1 wpv1112796.txt STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 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(h) of the Investment Company Act of 1940 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ________________________________________________________________________________ 1. Name and Address of Reporting Person* Warburg, Pincus Ventures, L.P. -------------------------------------------------------------------------------- (Last) (First) (Middle) 466 Lexington Avenue -------------------------------------------------------------------------------- (Street) New York New York 10017 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Coventry Health Care, Inc. (CVH) ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Day/Year October 15, 2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] 10% Owner [ ] Officer (give title below) [X] Other (specify below) Trustee ------------------------ ________________________________________________________________________________ 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 ================================================================================
5. Amount of 6. 4. Securities Owner- 2. 2A. 3. Securities Acquired (A) or Beneficially ship Trans- Deemed Trans- Disposed of (D) Owned Form: 7. action Execution action (Instr. 3, 4 and 5) Following Direct Nature of Date Date, if any Code ----------------------------- Reported (D) or Indirect 1. (Month/ (Month/ (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Day/ Day/ ---------- Amount or Price (Instr. 3 (I) Ownership (Instr. 3) Year) Year) Code V (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, 10/15/02 J(2) 2,021,999 D N/A 12,127,384 D(1) par value $0.01 per share ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, 10/15/02 J 2,286 (3) N/A 7,110 D par value $0.01 per share ==================================================================================================================================== 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). 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 control number. Page 1 of 6
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. 7. Number of Title and Amount Derivative 6. of Underlying 4. Securities Date Securities 2. 3A. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) Conver- Deemed action or Disposed Expiration Date ---------------- 1. sion or 3. Execution Code of(D) (Month/Day/Year) Amount Title of Exercise Trans- Date, (Instr. (Instr. 3, ---------------- or Derivative Price of action Date if any 8) 4 and 5) Date Expira- Number Security Derivative (Month/ (Month/ ------ ------------ Exer- tion of (Instr. 3) Security Day/Year) Day/Year) Code V (A) (D) cisable Date Title Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== [TABLE CONTINUED BELOW]
[CONTINUATION OF TABLE FROM ABOVE]
9. Number of 10. Derivative Ownership Securities Form of 11. 8. Beneficially Derivative Nature Price of Owned Follow- Security of Indirect Derivative ing Reported Direct (D) or Beneficial Security Transaction(s) Indirect (I) Ownership (Instr. 5) (Instr. 4) (Instr. 4) (Instr. 4) --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- ========================================================= Explanation of Responses: (1) Please see Continuation Sheet. (2) Please see Continuation Sheet. (3) Please see Continuation Sheet.
WARBURG, PINCUS VENTURES, L.P. By: Warburg, Pincus & Co., General Partner /s/ Scott A. Arenare 10/17/02 --------------------------------------------- ----------------------- **Signature of Reporting Person Date Name: Scott A. Arenare Title: Partner ** 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 provided is insufficient, see Instruction 6 for procedure. Page 2 of 6 Warburg, Pincus Ventures, L.P. 466 Lexington Avenue New York, New York 10017 Coventry Health Care, Inc. (CVH) October 15, 2002 Continuation Sheet Form 4 Statement of Changes in Beneficial Ownership Explanation of Responses: (1)The stockholders are Warburg, Pincus Ventures, L.P., a Delaware limited partnership ("Ventures"), and Warburg, Pincus Equity Partners, L.P., a Delaware limited partnership, and certain affiliated funds (collectively, "Equity Partners"). Equity Partners owns 10,000,000 shares of Common Stock and Ventures owns 2,127,384 shares of Common Stock. Pursuant to a Voting Trust Agreement, dated April 15, 1997 (the "Ventures Voting Trust"), among Patrick T. Hackett, Joel Ackerman and Jonathan S. Leff, as Trustees (collectively, the "Trustees") and Ventures, Ventures vested the power to vote all of the shares of Common Stock owned by it irrevocably in the Ventures Voting Trust until April 17, 2007; provided, however, that Ventures may terminate the Ventures Voting Trust upon written notice to the Trustees if Ventures is deemed to own beneficially (within the meaning of Rule 13d-3 under the Securities Exchange Act of 1934, as amended (the "Exchange Act")) less than ten percent (10%) of the then outstanding shares of Common Stock. Pursuant to a Voting Trust Agreement, dated July 1, 2000 (the "Equity Partners Voting Trust" and, together with the Ventures Voting Trust the "Voting Trusts"), among the Trustees and Equity Partners, Equity Partners vested the power to vote all of the shares of Common Stock owned by it irrevocably in the Equity Partners Voting Trust until July 1, 2010; provided, however, that Equity Partners may terminate the Equity Partners Voting Trust upon written notice to the Trustees if Equity Partners is deemed to own beneficially (within the meaning of Rule 13d-3 under the Exchange Act) less than ten percent (10%) of the then outstanding shares of Common Stock. By reason of the provisions of Rule 16a-1 of the Exchange Act, the Voting Trusts and the Trustees may be deemed to be the beneficial owners of the Common Stock held by Ventures and Equity Partners, although the Voting Trusts and each of the Trustees disclaim beneficial ownership of such Common Stock. The sole general partner of Ventures and Equity Partners is Warburg, Pincus & Co., a New York general partnership ("WP"). Warburg Pincus LLC (formerly E.M. Warburg, Pincus & Co., LLC), a New York limited liability company ("WPLLC"), manages Equity Partners and Ventures. Lionel I. Pincus is the managing partner of WP and the managing member of WPLLC and may be deemed to control both WP and WPLLC. The members of WPLLC are substantially the same as the partners of WP. By reason of the provisions of Rule 16a-1 of the Exchange Act, WP and WPLLC may be deemed to be the beneficial owners of the Common Stock held by Equity Partners and Ventures, although both WP and WPLLC disclaim beneficial ownership of the Common Stock except to the extent of any indirect pecuniary interest therein. Page 3 of 6 Warburg, Pincus Ventures, L.P. 466 Lexington Avenue New York, New York 10017 Coventry Health Care, Inc. (CVH) October 15, 2002 Mr. Ackerman and Mr. Moorhead, directors of Coventry Health Care, Inc., are general partners of WP and members of WPLLC. As such, each of Mr. Ackerman and Mr. Moorhead may be deemed to have an indirect pecuniary interest (within the meaning of Rule 16a-1 of the Exchange Act) in an indeterminate portion of the shares beneficially owned by Equity Partners, Ventures, WPLLC, WP and the Voting Trusts. Each of Mr. Ackerman and Mr. Moorhead disclaims beneficial ownership of such shares except to the extent of any indirect pecuniary interest therein. In addition, Mr. Hackett, Mr. Ackerman and Mr. Leff are each Trustees under the Voting Trusts. As such, Mr. Hackett, Mr. Ackerman and Mr. Leff each may be deemed to have an indirect pecuniary interest (within the meaning of Rule 16a-1 of the Exchange Act) in an indeterminate portion of the shares beneficially owned by Equity Partners, Ventures, WPLLC, WP and the Voting Trusts. Mr. Hackett, Mr. Ackerman and Mr. Leff each disclaim beneficial ownership of such shares except to the extent of any indirect pecuniary interest therein. (2)On October 15, 2002, Ventures distributed an aggregate of 2,021,999 shares of Common Stock to its partners. (3) As a result of the October 15, 2002 distribution, Mr. Moorhead received 2,286 shares of Common Stock. Mr. Moorhead individually and directly owns an additional 4,824 shares of Common Stock acquired before such distribution. Page 4 of 6 Warburg, Pincus Ventures, L.P. 466 Lexington Avenue New York, New York 10017 Coventry Health Care, Inc. (CVH) October 15, 2002 1. Name: Joel Ackerman (Director and Trustee) Address: 466 Lexington Avenue New York, New York 10017 2. Name: Patrick T. Hackett (Trustee) Address: 466 Lexington Avenue New York, New York 10017 3. Name: Jonathan S. Leff (Trustee) Address: 466 Lexington Avenue New York, New York 10017 4. Name: Rodman W. Moorhead, III (Director) Address: 466 Lexington Avenue New York, New York 10017 5. Name: Warburg, Pincus & Co. (General Partner) Address: 466 Lexington Avenue New York, New York 10017 6. Name: Warburg Pincus LLC (formerly E.M. Warburg, Pincus & Co., LLC) (Manager of WPV) Address: 466 Lexington Avenue New York, New York 10017 7. Name: Warburg, Pincus Equity Partners, L.P. Address: 466 Lexington Avenue New York, New York 10017 Designated Filer: Warburg, Pincus Ventures, L.P. Issuer & Ticker Symbol: Coventry Health Care, Inc. (CVH) Period Covered By Form: October 15, 2002 Page 5 of 6 Warburg, Pincus Ventures, L.P. 466 Lexington Avenue New York, New York 10017 Coventry Health Care, Inc. (CVH) October 15, 2002 WARBURG, PINCUS & CO. By: /s/ Scott A. Arenare 10/17/02 ------------------------- -------- Name: Scott A. Arenare Date Title: Partner WARBURG PINCUS LLC By: /s/ Scott A. Arenare 10/17/02 ------------------------- -------- Name: Scott A. Arenare Date Title: Managing Director WARBURG, PINCUS EQUITY PARTNERS, L.P. By: Warburg, Pincus & Co., General Partner By: /s/ Scott A. Arenare 10/17/02 -------------------- -------- Name: Scott A. Arenare Date Title: Partner Director and Trustee /s/ Joel Ackerman 10/17/02 ------------------------------ -------- Joel Ackerman Date Trustee /s/ Patrick T. Hackett 10/17/02 ------------------------------ -------- Patrick T. Hackett Date Trustee /s/ Jonathan S. Leff 10/17/02 ------------------------------ -------- Jonathan S. Leff Date Director /s/ Rodman W. Moorhead, III 10/17/02 ------------------------------ -------- Rodman W. Moorhead, III Date Page 6 of 6