-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, M5MoaqzFdLph0eRBQoap39At8DPappM6MbI7vv7X5Fz2h70hPNwkufU5ZOH/5CgH UBwQrj/Ko52nglr/uTNePg== 0000897069-03-001131.txt : 20030926 0000897069-03-001131.hdr.sgml : 20030926 20030926131708 ACCESSION NUMBER: 0000897069-03-001131 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030924 FILED AS OF DATE: 20030926 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RUPP WILLIAM C CENTRAL INDEX KEY: 0001195101 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14177 FILM NUMBER: 03911954 BUSINESS ADDRESS: STREET 1: LUTHER MIDELFORT CLINIC STREET 2: 1400 BELLINGER ST CITY: EAU CLAIRE STATE: WI ZIP: 54702-1510 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COBALT CORP CENTRAL INDEX KEY: 0001062780 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 391931212 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 401 WEST MICHIGAN STREET CITY: MILWAUKEE STATE: WI ZIP: 53203-2896 BUSINESS PHONE: 4142266900 MAIL ADDRESS: STREET 1: 401 WEST MICHIGAN STREET CITY: MILWAUKEE STATE: WI ZIP: 52030-2896 FORMER COMPANY: FORMER CONFORMED NAME: UNITED WISCONSIN SERVICES INC DATE OF NAME CHANGE: 19981112 4 1 rup23.xml X0201 4 2003-09-24 0 0001062780 COBALT CORP CBZ 0001195101 RUPP WILLIAM C C/O LUTHER MIDELFORT CLINIC 1400 BELLINGER STREET EAU CLAIRE WI 54702-1510 1 0 0 0 Common Stock 2003-09-24 4 D 0 3000 0 D 0 D Director Stock Option (right to buy) 7.6500 2003-09-24 4 D 0 6000 0 D 2014-02-26 Common Stock 6000 0 D Director Stock Option (right to buy) 19.9900 2003-09-24 4 D 0 1000 0 D 2014-05-28 Common Stock 1000 0 D Director Stock Option (right to buy) 14.1000 2003-09-24 4 D 0 1000 0 D 2014-12-31 Common Stock 1000 0 D Disposed of pursuant to the merger agreement between issuer and WellPoint Health Networks Inc. (WellPoint) whereby each share of issuer common stock was canceled and replaced with the right to receive 0.1233 share of WellPoint common stock and $10.25 in cash. On September 24, 2003, the effective date of the merger, the closing price of WellPoint common stock was $76.30 per share. Grant to reporting person of option to buy shares of issuer common stock under the Cobalt Corporation Equity Incentive Plan. The option vested and became immediately exercisable at the effective time of the merger. The Form 4 filed on January 6, 2003 mistakenly reported the expiration date of this option as 12/31/2015. The correct expiration date is 12/31/2014. This option was converted into an option to purchase 0.2466 shares of WellPoint common stock (rounded down to the nearest whole share) for each share of issuer common stock subject to the original option. Such new option is otherwise subject to the same terms and conditions as the original option, except that the exercise price per share of WellPoint common stock is equal to the exercise price per share of issuer common stock under the original option divided by 0.2466 (rounded up to the nearest whole cent). By: Peter C. Underwood, Attorney-In-Fact 2003-09-25 -----END PRIVACY-ENHANCED MESSAGE-----