5 1 geldridgeform5-2002.txt FORM 5 GEORGE ELDRIDGE 1. Name and Address of Reporting Person Eldridge, George 6 International Drive Suite 190 Rye Brook, NY 10573 USA 2. Issuer Name and Ticker or Trading Symbol Universal American Financial Corp. (UHCO) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 12/2002 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Vice President 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person TABLE I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
+------------------------------+----------+----------+---------+--------------------------+--------------+-----------+------------+ |1. Title of Security |2. Trans- |2A.Execu- |3. Trans-|4. Securities Acquired (A)|5. Amount of |6. Owner- |7. Nature | | | action | action | action| or Disposed of (D) |Securities | ship | of In- | | | Date | Date | Code | |Beneficially | Form: | direct | | | | | | |Owned | Direct | Bene- | | | (Month/ | (Month/ | | |Following | (D) or | ficial | | | Day/ | Day/ | +-----------+---+----------+ Year | Indirect| Owner- | | | Year) | Year) | |Amount |A/D|Price | | (I) | ship | +------------------------------+----------+----------+---------+-----------+---+----------+--------------+-----------+------------+ Common Stock 12/31/2002 J 1950 A $0.0000 18156 D
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+----------+--------+-------+-------+---------+-----------+---------------------+----------------+----------+-------+-------+------+ |1. |2. |3. |3A. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | | |Number |Owner- | | | | | | | | | | | |of |ship | | | | | | | | | | | |Deriv- |Form of| | | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | | |of Underlying | |Secur- |ative |Nature| | |Conver- |Trans- |Execu- | |Number of | |Securities | |ities |Secur- |of | | |sion or |action |tion | |Derivative |Date Exercisable +-------+--------+ |Benefi-|ity: |In- | | |Exercise|Date |Date | |Securities |and Expiration Date | |Amount | |cially |Direct |direct| | |Price of| | |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |(Month/|(Month/|tion Code|Disposed(D)+----------+----------+ |Number |Price of | |In- |ficial| |Derivative|ative |Day/ |Day/ | +-----+-----+Date Exer-|Expira- | |of |Derivative|at End |direct |Owner-| |Security |Security|Year) |Year) | |(A) |(D) |cisable |tion Date |Title |Shares |Security |of Year|(I) |ship | +----------+--------+-------+-------+---------+-----+-----+----------+----------+-------+--------+----------+-------+-------+------+ Stock $3.15 08/01/2009 Common 20000 D Options Stock (Right to buy) Stock $3.15 07/31/2010 Common 22500 D Options Stock (Right to buy) Stock $3.88 02/28/2011 Common 10000 D Options Stock (Right to buy) Stock $6.45 03/28/2012 Common 7000 D Options Stock (Right to buy) Explanation of Responses: Shares purchased through 401(k) plan.
SIGNATURE OF REPORTING PERSON /s/ George Eldridge DATE 02/13/2003