X0202 4 2004-12-13 1 0000878897 AMERICAN MEDICAL SECURITY GROUP INC AMZ 0001181965 MOORE TIMOTHY J C/O AMERICAN MEDICAL SECURITY GROUP INC 3100 AMS BLVD GREEN BAY WI 54313 0 1 0 0 Sr VP, General Counsel, Sec. Common Stock 2004-12-13 4 D 0 4700 32.75 D 0 D Common Stock 2004-12-13 4 D 0 8895.5 32.75 D 0 I By 401(k) plan Employee Stock Option (right to buy) 17.19 2004-12-13 4 D 0 11616 15.56 D 2009-03-02 Common Stock 11616 0 D Employee Stock Option (right to buy) 10.25 2004-12-13 4 D 0 35000 22.5 D 2010-09-27 Common Stock 35000 0 D Employee Stock Option (right to buy) 12 2004-12-13 4 D 0 25000 20.75 D 2010-09-27 Common Stock 25000 0 D Employee Stock Option (right to buy) 12.25 2004-12-13 4 D 0 4770 20.5 D 1998-11-17 2010-11-16 Common Stock 4770 0 D Employee Stock Option (right to buy) 5.8125 2004-12-13 4 D 0 16475 26.9375 D 2011-11-16 Common Stock 16475 0 D Employee Stock Option (right to buy) 5.1875 2004-12-13 4 D 0 5000 27.5625 D 2012-11-16 Common Stock 5000 0 D Employee Stock Option (right to buy) 10.2 2004-12-13 4 D 0 25000 22.55 D 2013-11-28 Common Stock 25000 0 D Employee Stock Option (right to buy) 14.41 2004-12-13 4 D 0 21000 18.34 D 2015-01-19 Common Stock 21000 0 D The reporting person acquired 139.9 shares of AMZ common stock under the issuer's 401(k) plan since November 24, 2003. Such acquisitions, which were not "discretionary transaction" as defined in Rule 16b-3(b) are exempt from Section 16b by virtue of Rule 16b-3(c) and are exempt from the reporting requirements of Section 16(a) by virtue of Rule 16a-3(f)(l)(i)(B). This option became fully vested September 28, 1998. This option vested in four equal annual installments beginning September 28, 1999. This option vested in four equal annual installments beginning September 28, 1999. This option vested in four equal annual installments beginning November 17, 2000. This option vested in four equal annual installments beginning November 17, 2001. This option vested in four equal annual installments beginning November 29, 2002. This option vested in four equal annual installments beginning January 20, 2004. Timothy J. Moore 2004-12-15