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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. 1)/1/
eBenX
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(Name of Issuer)
Common Stock, $.01 par value
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(Title of Class of Securities)
278668108
---------
(CUSIP Number)
Frederick R. Blume
Managing Partner
CB Health Ventures, L.L.C.
One Boston Place, Suite 4010, Boston, MA 02108 617-450-9800
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(Name, Address and Telephone Number of Person Authorized to Receive Notices and
Communications)
December 9, 1999
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(Date of Event which Requires Filing of this Statement)
If the filing person has previously filed a statement on Schedule 13G to report
the acquisition which is the subject of this Schedule 13D, and is filing this
schedule because of Rule 13d-1(e), 13d-1(f) or 13d-1(g), check the following box
[_].
Note: Schedules filed in paper format shall include a signed original and five
copies of the schedules, including all exhibits. See Rule 13d-7(b) for other
parties to whom copies are to be sent.
/1/ The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which would
alter disclosures provided in a prior cover page.
The Information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
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Page 2 of 4 Pages
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CUSIP NUMBER 278668108
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NAME OF REPORTING PERSON
1 I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
CB Healthcare Fund, L.P. 06-1501255
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
2 (a) [X]
(b) [_]
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SEC USE ONLY
3
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SOURCE OF FUNDS*
4
00
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEMS 2(d) or 2(e) [_]
5 N/A
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CITIZENSHIP OR PLACE OF ORGANIZATION
6
State of Delaware
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SOLE VOTING POWER
7
NUMBER OF
2,500
SHARES -----------------------------------------------------------
SHARED VOTING POWER
BENEFICIALLY 8
OWNED BY 1,229,508
-----------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
9
REPORTING
2,500
PERSON -----------------------------------------------------------
SHARED DISPOSITIVE POWER
WITH 10
1,229,508
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
11
1,232,008
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES*
12
[_]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
13
7.73%
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TYPE OF REPORTING PERSON*
14
PN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
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Page 3 of 4 Pages
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CUSIP NUMBER 278668108
Item 4. Purpose of Transaction.
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Securities were acquired in a private placement of preferred stock
which converted to common shares effective with eBenX's initial public
offering December 9, 1999.
Item 5. Interest in Securities of the Issuer.
------------------------------------
CB Healthcare Fund, L.P. is interested in long term capital gains from
this investment.
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Page 4 of 4 Pages
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CUSIP NUMBER 278668108
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
hereby certify that the information set forth in this statement is true,
complete and correct.
DATED: February 14, 2000
CB Healthcare Fund, L.P.
By: /s/ Frederick R. Blume
Title: Managing Partner
of CB Health Ventures, L.L.C.
the General Partner of
CB Healthcare Fund, L.P.
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Schedule B
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Stockholder No. of Shares
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CB Healthcare Fund, L.P. 1,229,508
One Boston Place, Suite 4010
Boston, MA 02108
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Partner of CB Health Ventures, L.L.C.
CB Healthcare Fund's General Partner
Frederick R. Blume 2,500
One Boston Place sole voting power
Boston, MA 02108 -----------------
1,229,508
Venture Capital Fund Manager shared voting
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Daniel M. Cain
Manager CB Health Ventures, L.L.C. 1,229,508
and Partner, Cain Brothers shared voting
Mr. Cain is director of eBenX
CB Health Ventures, L.L.C.
452 Fifth Avenue #2500
New York, New York 10018
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Enrico Petrillo, M.D.
Manager CB Health Ventures, L.L.C. 1,229,508
One Boston Place, Suite 4010 shared voting
Boston, MA 02108
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Robert B. Schulz
Manager CB Health Ventures, L.L.C. 1,229,508
452 Fifth Avenue #2500 shared voting
New York, NY 10018
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