AMERICAN MEDICAL SECURITY GROUP INC 4

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

Form 4

Period: 2004-12-13

Executive VP of Operations

Transactions

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
Common Stock
2004-12-13$32.75/sh−8,500$278,375→ 0 total
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$23.88/sh−117,000$2,793,375→ 0 total
Exercise: $8.88Exp: 2011-08-22→ Common Stock (117,000 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)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$26.94/sh−43,000$1,158,313→ 0 total
Exercise: $5.81Exp: 2011-11-16→ Common Stock (43,000 underlying)
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)

Footnotes (5)

[F1]This option vested in four equal annual installments beginning August 23, 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, 2004.

Documents

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