AMERICAN MEDICAL SECURITY GROUP INC 4

4 · AMERICAN MEDICAL SECURITY GROUP INC · Filed Dec 15, 2004

Form 4

Period: 2004-12-13

Exec VP & Chief Actuary

Transactions

Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$27.56/sh−35,000$964,688→ 0 total
Exercise: $5.19Exp: 2012-11-16→ Common Stock (35,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$22.00/sh−110,000$2,420,000→ 0 total
Exercise: $10.75Exp: 2011-08-01→ Common Stock (110,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$18.34/sh−42,500$779,450→ 0 total
Exercise: $14.41Exp: 2015-01-19→ Common Stock (42,500 underlying)
Disposition to Issuer
Employee stock option (right to buy)
2004-12-13$26.94/sh−68,000$1,831,750→ 0 total
Exercise: $5.81Exp: 2011-11-16→ Common Stock (68,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$22.55/sh−50,000$1,127,500→ 0 total
Exercise: $10.20Exp: 2013-11-28→ Common Stock (50,000 underlying)

Footnotes (5)

[F1]This option vested in four equal annual installments beginning August 2, 2000.
[F2]This option vested in four equal annual installments beginning November 17, 2000.
[F3]This option vested in four equal annual installments beginning November 17, 2001.
[F4]This option vested in four equal annual installments beginning November 29, 2002.
[F5]This option vested in four equal annual installments beginning January 20, 2003.

Documents

1 file