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) December 2, 2004
(December 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
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(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 8.01. Other Events.
On December 2, 2004, American Medical Security Group, Inc. ("AMS")
issued a press release announcing that the shareholders of AMS approved AMS's
proposed merger with PacifiCare Health Systems, Inc. at a special meeting of
shareholders held on December 2, 2004. The press release also announced that
on December 1, 2004, the Office of the Commissioner of Insurance for the State
of Wisconsin issued an order approving the proposed merger. 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 December 2, 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: December 2, 2004
EXHIBIT INDEX
Exhibit No. Document
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99 Press Release issued on December 2, 2004