AMERICAN MEDICAL SECURITY GROUP INC 4

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

Form 4

Period: 2004-12-13

Sr VP, General Counsel, Sec.

Transactions

Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$22.50/sh−35,000$787,500→ 0 total
Exercise: $10.25Exp: 2010-09-27→ Common Stock (35,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$27.56/sh−5,000$137,813→ 0 total
Exercise: $5.19Exp: 2012-11-16→ Common Stock (5,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$18.34/sh−21,000$385,140→ 0 total
Exercise: $14.41Exp: 2015-01-19→ Common Stock (21,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$15.56/sh−11,616$180,745→ 0 total
Exercise: $17.19Exp: 2009-03-02→ Common Stock (11,616 underlying)
Disposition to Issuer
Common Stock
2004-12-13$32.75/sh−4,700$153,925→ 0 total
Disposition to Issuer
Common Stock
2004-12-13$32.75/sh−8,895.5$291,328→ 0 total(indirect: By 401(k))
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$26.94/sh−16,475$443,795→ 0 total
Exercise: $5.81Exp: 2011-11-16→ Common Stock (16,475 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$20.75/sh−25,000$518,750→ 0 total
Exercise: $12.00Exp: 2010-09-27→ Common Stock (25,000 underlying)
Disposition to Issuer
Employee Stock Option (right to buy)
2004-12-13$20.50/sh−4,770$97,785→ 0 total
Exercise: $12.25From: 1998-11-17Exp: 2010-11-16→ Common Stock (4,770 underlying)

Footnotes (8)

[F1]The reporting person acquired 139.9 shares of AMZ common stock under the issuer's 401(k) plan since November 24, 2003. Such acquisitions, which were not "discretionary transaction" as defined in Rule 16b-3(b) are exempt from Section 16b by virtue of Rule 16b-3(c) and are exempt from the reporting requirements of Section 16(a) by virtue of Rule 16a-3(f)(l)(i)(B).
[F2]This option became fully vested September 28, 1998.
[F3]This option vested in four equal annual installments beginning September 28, 1999.
[F4]This option vested in four equal annual installments beginning September 28, 1999.
[F5]This option vested in four equal annual installments beginning November 17, 2000.
[F6]This option vested in four equal annual installments beginning November 17, 2001.
[F7]This option vested in four equal annual installments beginning November 29, 2002.
[F8]This option vested in four equal annual installments beginning January 20, 2004.

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