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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
[X] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
________________________________________________________________________________
1. Name and Address of Reporting Person*
TPG PARTNERS II, L.P.
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(Last) (First) (Middle)
301 Commerce Street, Suite 3300
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(Street)
Fort Worth Texas 76102
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(City) (State) (Zip)
________________________________________________________________________________
2. Issuer Name and Ticker or Trading Symbol
Oxford Health Plans, Inc. (OXHP)
________________________________________________________________________________
3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
________________________________________________________________________________
4. Statement for Month/Year
December 2000
________________________________________________________________________________
5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[_] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
________________________________________________________________________________
7. Individual or Joint/Group Filing (Check applicable line)
[_] Form filed by one Reporting Person
[X] Form filed by more than one Reporting Person
________________________________________________________________________________
<PAGE>
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
SERIES D PREFERRED STOCK 12/22/00 J(1) 197,854.55926 D (1) 0 D
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SERIES E PREFERRED STOCK 12/22/00 J(1) 21,026.62087 D (1) 0 D
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COMMON STOCK 12/22/00 X(1) 8,789,173 A $17.75 8,789,173 D
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</TABLE>
* Additional Filing Persons: TPG Parallel II, L.P., TPG Investors II, L.P.
(1) On December 22, 2000, the Issuer, TPG Partners II, L.P. ("TPG"), TPG
Parallel II, L.P. ("TPG Parallel"), TPG Investors II, L.P. ("TPG Investors",
together with TPG and TPG Parallel, the "TPG Parties") and certain other
investors, consummated the transactions contemplated by an Exchange and
Repurchase Agreement, dated as of October 25, 2000 (the "Agreement") pursuant to
which, inter alia, (a) the Issuer purchased from the TPG Parties 62,873.36455
shares of Series D Preferred Stock and 9,234,828.01037 Series A Warrants for a
total consideration of $176,000,998.73 and (b) the TPG Parties exchanged
134,981.19471 shares of Series D Preferred Stock and 21,026.62087 shares of
Series E Preferred Stock for 8,789,173 shares of the Issuer's Common Stock to
exercise the remaining Series A and all of the Series B Warrants.
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
4(b)(v).
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SEC 1474 (7-96)
<PAGE>
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
SERIES A WARRANTS $17.75 12/22/00 (1) 12,640,001 Common Stock 12,640,001 (1) 0 D
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SERIES B WARRANTS $17.75 12/22/00 X 5,384,001 Common Stock 5,384,001 (1) 0 D
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</TABLE>
Explanation of Responses:
* Additional Filing Persons: TPG Parallel II, L.P., TPG Investors II, L.P.
(1) On December 22, 2000, the Issuer, TPG Partners II, L.P. ("TPG"), TPG
Parallel II, L.P. ("TPG Parallel"), TPG Investors II, L.P. ("TPG Investors",
together with TPG and TPG Parallel, the "TPG Parties") and certain other
investors, consummated the transactions contemplated by an Exchange and
Repurchase Agreement, dated as of October 25, 2000 (the "Agreement") pursuant to
which, inter alia, (a) the Issuer purchased from the TPG Parties 62,873.36455
shares of Series D Preferred Stock and 9,234,828.01037 Series A Warrants for a
total consideration of $176,000,998.73 and (b) the TPG Parties exchanged
134,981.19471 shares of Series D Preferred Stock and 21,026.62087 shares of
Series E Preferred Stock for 8,789,173 shares of the Issuer's Common Stock to
exercise the remaining Series A and all of the Series B Warrants.
TPG PARTNERS II, L.P.
By: TPG GenPar II, L.P., General Partner
By: TPG Advisors II, Inc., General Partner
By: /s/ Richard A. Ekleberry January 9, 2001
------------------------ ---------------
**Signature of Reporting Person Date
Name: Richard A. Ekleberry
Title: Vice President
TPG PARALLEL II, L.P.
By: TPG GenPar II, L.P., General Partner
By: TPG Advisors II, Inc., General Partner
By: /s/ Richard A. Ekleberry January 9, 2001
------------------------ ---------------
**Signature of Reporting Person Date
Name: Richard A. Ekleberry
Title: Vice President
TPG INVESTORS II, L.P.
By: TPG GenPar II, L.P., General Partner
By: TPG Advisors II, Inc., General Partner
By: /s/ Richard A. Ekleberry January 9, 2001
------------------------ ---------------
**Signature of Reporting Person Date
Name: Richard A. Ekleberry
Title: Vice President
** 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
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SEC 1474 (7-96)
