-----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, MMql5OyvJ2IOwhCvJSnQnuCuAAtiuCj8Q42I+MLJPoONnLAnufGbgIPKQyIKhYyr 5C29pRWYYE7RlHetkAu1ow== 0000904454-08-000522.txt : 20081216 0000904454-08-000522.hdr.sgml : 20081216 20081216122951 ACCESSION NUMBER: 0000904454-08-000522 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081212 FILED AS OF DATE: 20081216 DATE AS OF CHANGE: 20081216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL AMERICAN CORP. CENTRAL INDEX KEY: 0000709878 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 112580136 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: SIX INTERNATIONAL DRIVE STREET 2: SUITE 190 CITY: RYE BROOK STATE: NY ZIP: 10573-1068 BUSINESS PHONE: 9149345200X319 MAIL ADDRESS: STREET 1: SIX INTERNATIONAL DRIVE STREET 2: SUITE 190 CITY: RYE BROOK STATE: NY ZIP: 10573-1068 FORMER COMPANY: FORMER CONFORMED NAME: UNIVERSAL AMERICAN FINANCIAL CORP DATE OF NAME CHANGE: 19960918 FORMER COMPANY: FORMER CONFORMED NAME: UNIVERSAL HOLDING CORP DATE OF NAME CHANGE: 19920703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLARK JOHN D CENTRAL INDEX KEY: 0001212995 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08506 FILM NUMBER: 081251771 BUSINESS ADDRESS: BUSINESS PHONE: 2128939500 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0303 4 2008-12-12 0000709878 UNIVERSAL AMERICAN CORP. UAM 0001212995 CLARK JOHN D C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 Common Stock 2008-12-12 4 J 0 4000000 D 3065617 I By Welsh, Carson, Anderson & Stowe IX, L.P. Common Stock 2008-12-12 4 J 0 21779 A 26711 D Distribution of shares by Welsh, Carson, Anderson & Stowe IX, L.P. to its partners. The Reporting Person is a managing member of the sole general partner Welsh, Carson, Anderson & Stowe IX, L.P. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him. The Reporting Person also indirectly beneficially owns 6,999,200 shares of Common Stock held by Welsh, Carson, Anderson & Stowe X, L.P. The Reporting Person is a managing member of the sole general partner Welsh, Carson, Anderson & Stowe X, L.P. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him. /s/David Mintz, Attorney-in-Fact 2008-12-12 -----END PRIVACY-ENHANCED MESSAGE-----