FORM 3 |
UNITED STATES 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 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/15/2003 |
3. Issuer Name and Ticker or Trading Symbol
HUMANA INC [ HUM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Humana Inc.(1) | 48,895 | D | Humana Retirement & Savings Plan(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Humana Common(2) | 01/15/2001 | 01/15/2008 | Humana Common(1) | 8,700 | 15.5938 | D | |
Humana Common(2) | 01/09/2000 | 01/09/2007 | Humana Common(1) | 9,170 | 15.5938 | D | |
Humana Common(2) | 09/17/1999 | 09/17/2008 | Humana Common(1) | 6,090 | 15.5938 | D | |
Humana Common(2) | 09/17/1999 | 01/12/2005 | Humana Common(1) | 10,320 | 15.5938 | D | |
Humana Common(2) | 01/15/2002 | 01/15/2009 | Humana Common(1) | 10,000 | 19.25 | D | |
Humana Common(2) | 09/09/2002 | 09/09/2009 | Humana Common(1) | 15,000 | 9.5938 | D | |
Humana Common(2) | 03/13/2004 | 03/13/2013 | Humana Common(1) | 3,334 | 9.26 | D | |
Humana Common(2) | 03/13/2005 | 03/13/2013 | Humana Common(1) | 3,333 | 9.26 | D | |
Humana Common(2) | 03/13/2006 | 03/13/2013 | Humana Common(1) | 3,333 | 9.26 | D | |
Humana Phantom Stock Units(4) | 08/08/1988 | 08/08/1988 | Humana Common(1) | 357 | 0 | D |
Explanation of Responses: |
1. Each share of Common Stock contains a Right adopted on March 5, 1987, pursuant to the Company Rights Agreement, as amended and restated on February 14, 1996, and amended as of May 27, 1998 and March 1, 1999, which entitles holders of the Company's Common Stock, in the event certain specified events occur, to acquire 1/100 of a share of Series A Participating Preferred Stock at a price of $145 per fractional share. |
2. Right to buy pursuant to the Humana's 1996 Stock Incentive Plan for Employees. |
3. Reporting person has 6,312 shares held for her benefit, as of April 30, 2003, under the Humana Retirement & Savings Plan including a routine disposition of shares to fund an administrative fee assessment under a Tax-Conditioned Plan, both exempt under Rule 16b-3(c). |
4. Reporting person has 357 Phantom Stock Units held for her benefit, as of April 30, 2003, under the Humana Excess Plan, exempt under Rule 16b-3(d). |
Heidi S. Margulis | 05/19/2003 | |
** Signature of Reporting Person | Date | |
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). | ||
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |