UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-K
CURRENT REPORT
PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
Date of Report (Date of earliest event reported) NOVEMBER 5, 2004 (NOVEMBER 1,
2004)
AMERICAN MEDICAL SECURITY GROUP, INC.
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(Exact name of registrant as specified in its charter)
Wisconsin 1-13154 39-1431799
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(State or other jurisdiction of (Commission (IRS Employer
incorporation) File Number) Identification No.)
3100 AMS Boulevard
Green Bay, Wisconsin 54313
(Address of principal executive offices) (Zip Code)
Registrant's telephone number, including area code (920) 661-1111
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(Former name or former address, if changed since last report.)
Check the appropriate box below if the Form 8-K filing is intended to
simultaneously satisfy the filing obligation of the registrant under any of the
following provisions (see General Instruction A.2. below):
[ ] Written communications pursuant to Rule 425 under the Securities Act
(17 CFR 230.425)
[ ] Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR
240.14a-12)
[ ] Pre-commencement communications pursuant to Rule 14d-2(b) under the
Exchange Act (17 CFR 240.14d-2(b))
[ ] Pre-commencement communications pursuant to Rule 13e-4(c) under the
Exchange Act (17 CFR 240.13e-4(c))
Item 7.01. Regulation FD Disclosure.
On November 5, 2004, American Medical Security Group, Inc. ("AMS")
issued a press release announcing that on November 4, 2004, the Antitrust
Division of the Department of Justice and the Federal Trade Commission granted
early termination of the waiting period under the Hart-Scott-Rodino Antitrust
Improvements Act of 1976 applicable to AMS' proposed merger with PacifiCare
Health Systems, Inc. ("PacifiCare"). The press release also announced that the
date of the special meeting of shareholders of AMS, which will be held for the
purpose of approving the proposed merger with PacifiCare, has been set as
December 2, 2004. A copy of the press release is filed as Exhibit 99 hereto and
is incorporated herein by reference.
Item 9.01. Financial Statements and Exhibits.
(c) Exhibits
99 Press Release issued on November 5, 2004
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the
registrant has duly caused this report to be signed on its behalf by the
undersigned hereunto duly authorized.
AMERICAN MEDICAL SECURITY GROUP, INC.
By: /s/ Timothy J. Moore
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Name: Timothy J. Moore
Title: Senior Vice President of
Corporate Affairs, General
Counsel and Secretary
Date: November 5, 2004
EXHIBIT INDEX
EXHIBIT NO. DOCUMENT
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99 Press Release issued on November 5, 2004