-----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, OZiXqIOy2Y8e8i/997BxkdNnO1Bc/FmkfoZfRQjtZANEZ/kJaDRYuswqs4puKufo jgPWtaBGX240L2xQ/VRb2g== 0000927016-99-003314.txt : 19990928 0000927016-99-003314.hdr.sgml : 19990928 ACCESSION NUMBER: 0000927016-99-003314 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990916 FILED AS OF DATE: 19990927 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MAXICARE HEALTH PLANS INC CENTRAL INDEX KEY: 0000722573 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 953615709 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-12024 FILM NUMBER: 99717957 BUSINESS ADDRESS: STREET 1: 1149 S BROADWAY ST STREET 2: SUITE 910 CITY: LOS ANGELES STATE: CA ZIP: 90015 BUSINESS PHONE: 2137652000 COMPANY DATA: COMPANY CONFORMED NAME: HAMBRO J O & PARTNERS LTD CENTRAL INDEX KEY: 0000940755 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER STATE OF INCORPORATION: X0 FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 10 PARK PLACE CITY: LONDON STATE: X0 MAIL ADDRESS: STREET 1: 10 PARK PLACE STREET 2: SW1A1LP CITY: LONDON STATE: X0 3 1 FORM 3 /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0104 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* J O Hambro Capital Management Limited ---------------------------------------------------------------------------- (Last) (First) (Middle) 10 Park Place ---------------------------------------------------------------------------- (Street) London SW1A 1LP England ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 9/16/99 -------------- 3. IRS Identification Number of Reporting Person if an Entity (Voluntary) -------------- 4. Issuer Name and Ticker or Trading Symbol Maxicare Health Plans, Inc. ("MAXI") ------------------------------------ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] Officer [x] 10% Owner [ ] Other (give title below) (specify below) ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- 7. Individual or Joint Group Filing (Check Applicable Line) ____ Form Filed by One Reporting Person x Form filed by More than One Reporting Person ---- TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- Common Stock, See "Explanation of $ .01 par value 1,869,500 I Responses." - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one reporting person, see Instrution 5(b) (v) FORM 3 (continued) TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: The securities listed in the table are owned by North Atlantic Smaller Companies Investment Trust plc, American Opportunity Trust plc, Oryx International Growth Fund Limited, and certain private clients of J O Hambro Capital Management Limited. The inclusion in this report of securities listed in the table shall not be deemed an admission that the reporting person is for the purpose of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose, the beneficial owner of such securities, and such beneficial ownership is expressly disclaimed. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. /s/ R. Barrett 9/24/99 ------------------------------- ----------------- **Signature of Reporting Person Date /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0104 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* J O Hambro Capital Management (Holdings) Limited ---------------------------------------------------------------------------- (Last) (First) (Middle) c/o J O Hambro Capital Management Limited 10 Park Place ---------------------------------------------------------------------------- (Street) London SWIA 1LP England ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 9/16/99 -------------- 3. IRS Identification Number of Reporting Person if an Entity (Voluntary) -------------- 4. Issuer Name and Ticker or Trading Symbol Maxicare Health Plans, Inc. ("MAXI") ------------------------------------ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] Officer [x] 10% Owner [ ] Other (give title below) (specify below) ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- 7. Individual or Joint Group Filing (Check Applicable Line) ____ Form Filed by One Reporting Person x Form filed by More than One Reporting Person ---- TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- Common Stock, See "Explanation of $ .01 par value 1,869,500 I Responses." - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 5(b) (v) FORM 3 (continued) TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: The securities listed in the table are owned by North Atlantic Smaller Companies Investment Trust plc, American Opportunity Trust plc, Oryx International Growth Fund Limited, and certain private clients of J O Hambro Capital Management Limited. The inclusion in this report of securities listed in the table shall not be deemed an admission that the reporting person is for the purpose of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose, the beneficial owner of such securities, and such beneficial ownership is expressly disclaimed. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. /s/ Nichola Pease 9/24/99 ------------------------------- ----------------- **Signature of Reporting Person Date /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0104 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Mills Christopher H. B. ---------------------------------------------------------------------------- (Last) (First) (Middle) c/o J O Hambro Capital Management Limited 10 Park Place ---------------------------------------------------------------------------- (Street) London SWIA 1LP England ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 9/16/99 -------------- 3. IRS Identification Number of Reporting Person if an Entity (Voluntary) -------------- 4. Issuer Name and Ticker or Trading Symbol Maxicare Health PLans, Inc. ("MAXI") ------------------------------------ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] Officer [x] 10% Owner [ ] Other (give title below) (specify below) ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- 7. Individual or Joint Group Filing (Check Applicable Line) ____ Form Filed by One Reporting Person x ____ Form filed by More than One Reporting Person TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- Common Stock, See "Explanation of $ .01 par value 1,869,500 I Responses." - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. FORM 3 (continued) TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: The securities listed in the table are owned by North Atlantic Smaller Companies Investment Trust plc, American Opportunity Trust plc, Oryx International Growth Fund Limited, and certain private clients of J O Hambro Capital Management Limited. The inclusion in this report of securities listed in the table shall not be deemed an admission that the reporting person is for the purpose of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose, the beneficial owner of such securities, and such beneficial ownership is expressly disclaimed. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. /s/ Christopher H. B. Mills 9/24/24 ------------------------------- ----------------- **Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----