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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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1. Name and Address of Reporting Person
Paul H. Warren
54 Thompson Street
New York, NY 10012
2. Date of Event Requiring Statement (Month/Day/Year)
12/8/1999
3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
4. Issuer Name and Ticker or Trading Symbol
HealthExtras, Inc.(HLEX)
5. Relationship of Reporting Person to Issuer (Check all applicable)
[X] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
6. If Amendment, Date of Original (Month/Day/Year)
7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
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Table I Non-Derivative Securities Beneficially Owned
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1)Title of Security 2)Amount of 3) 4)Nature of
Securities D Indirect
Beneficially or Beneficial
Owned I Ownership
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<S> <C> <C> <C>
Common Stock, $.01 par value per share None N/A N/A
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Table II Derivative Securitites Beneficially Owned
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1)Title of Derivative Security 2)Date Exercisable 3)Title and Amount of 4)Conver- 5)Ownership 6)Nature of
and Expiration Date Securities Underlying sion or Form of Indirect
(Month/Day/Year) Derivative Security exercise Derivative Beneficial
price of Security Ownership
Date Expira- Amount or Deri- Direct(D)
Exer- tion Number of vative or
cisable Date Title Shares Security Indirect(I)
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<S> <C> <C> <C> <C> <C> <C> <C>
None
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Explanation of Responses:
HEALTH PARTNERS, AN OWNER OF HEALTHEXTRAS, INC. COMMON STOCK, IS A GENERAL
PARTNERSHIP WHOSE GENERAL PARTNERS ARE CAPITAL Z FINANCIAL SERVICES FUND II,
L.P., CAPITAL Z FINANCIAL SERVICES PRIVATE FUND II, L.P. AND INTERNATIONAL
MANAGED CARE ADVISORS. MR. WARREN IS A DIRECTOR, OFFICER AND MEMBER OR
SHAREHOLDER, AS THE CASE MAY BE, OF CAPITAL Z MANAGEMENT, LLC, WHICH MANAGES
CAPITAL Z FINANCIAL SERVICES FUND II, L.P., CAPITAL Z FINANCIAL SERVICES PRIVATE
FUND II, L.P. AND CAPITAL Z PARTNERS, LTD., THE ULTIMATE GENERAL PARTNER OF
CAPITAL Z FINANCIAL SERVICES FUND II, L.P. AND CAPITAL Z FINANCIAL SERVICES
PRIVATE FUND II, L.P. MR. WARREN DISCLAIMS ANY BENEFICIAL OWNERSHIP OF THE
SHARES OF HEALTHEXTRAS, INC. OWNED BY HEALTHPARTNERS.
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<S> <C>
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** 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.
Potential persons who are to respond to the collection of
information contained in this form are not required to
respond unless the form displays a currently valid OMB Number.
By: /s/ Paul H. Warren
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Paul H. Warren December 8, 1999
**Signature of Reporting Person
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