X0304 4 2011-10-19 1 0001010247 FPIC INSURANCE GROUP INC FPIC 0001347535 DIVITA CHARLES III 1000 RIVERSIDE AVENUE SUITE 800 JACKSONVILLE FL 32204 0 1 0 0 Chief Financial Officer Common Stock 2011-10-19 4 D 0 44219 D 0 D Common Stock 2011-10-19 4 D 0 6086 D 0 I Indirectly by 401(k) Plan Employee Stock Option (right to buy) 15.366 2011-10-19 4 D 0 12603 26.634 D 2013-12-12 Common Stock 12603 0 D Employee Stock Option (right to buy) 20.253 2011-10-19 4 D 0 5625 21.747 D 2015-01-20 Common Stock 5625 0 D Employee Stock Option (right to buy) 23.513 2011-10-19 4 D 0 8773 18.487 D 2016-01-06 Common Stock 8773 0 D Employee Stock Option (right to buy) 26.246 2011-10-19 4 D 0 13165 15.754 D 2017-01-08 Common Stock 13165 0 D Includes 5,716 restricted shares issued under the issuer's Omnibus Incentive Plan the restrictions on which lapsed immediately prior to the effective time of the Merger pursuant to the Merger Agreement. Also includes 186 shares deemed to have been acquired pursuant to the FPIC Insurance Group, Inc. Employee Stock Purchase Plan, under which the election to participate was made beginning in January 2011. The deemed acquisition is exempt from Section 16(b) pursuant to Rule 16(b)-3(c). Pursuant to the Agreement and Plan of Merger between the issuer, The Doctors Company and Fountain Acquisition Corp. (the "Merger Agreement"), these shares were converted into the right to receive $42.00 per share in cash immediately prior to the effective time of the Merger (the "Merger") of Fountain Acquisition Corp. with and into the issuer. Represents the equivalent number of shares held as units for reporting person's account by the Company's 401(k) plan. Pursuant to the Merger Agreement, this option was cancelled immediately prior to the effective time of the Merger exchange for an amount in cash equal to the product of (i) the number of shares for which this option had been exercisable and (ii) the excess of $42.00 per share over the exercise price of $15.366 per share in cash. The option vested in equal installments on December 12, 2004, 2005 and 2006. Pursuant to the Merger Agreement, this option was cancelled immediately prior to the effective time of the Merger exchange for an amount in cash equal to the product of (i) the number of shares for which this option had been exercisable and (ii) the excess of $42.00 per share over the exercise price of $20.253 per share in cash. The option vested in equal installments on January 20, 2006, 2007 and 2008. Pursuant to the Merger Agreement, this option was cancelled immediately prior to the effective time of the Merger exchange for an amount in cash equal to the product of (i) the number of shares for which this option had been exercisable and (ii) the excess of $42.00 per share over the exercise price of $23.513per share in cash. The option vested in equal installments on January 6, 2007, 2008 and 2009. Pursuant to the Merger Agreement, this option was cancelled immediately prior to the effective time of the Merger exchange for an amount in cash equal to the product of (i) the number of shares for which this option had been exercisable and (ii) the excess of $42.00 per share over the exercise price of $26.246 per share in cash. The option vested in equal installments on January 8, 2008, 2009 and 2010. T. Malcolm Graham, Attorney-in-Fact 2011-10-19