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OMB APPROVAL
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OMB Number 3235-0287
Expires: September 30, 1998
Estimated average burden
hours per response ....... 0.5
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U.S. 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
[ ] Check this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Brown Brothers
Harriman & Co.
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(Last) (First) (Middle)
63 Wall Street
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(Street)
New York New York 10005
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
WellCare Management Group, Inc./WELL
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
6/99
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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)
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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 Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
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>
Common Stock,
par value $0.01 per share 1,250,000 I (4)
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
SEC 1474 (9-96)
<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>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of 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>
Senior Convertible
Preferred Stock
Series B ("Series Common
B Preferred Stock") N/A 6/11/99(1) J(1) 100,000 N/A Immed.(2) N/A Stock 10,000,000(3) (1) 100,000 I (4)
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</TABLE>
Explanation of Responses:
(1) The 1818 Fund II, L.P. (the "Fund") exchanged an 8% Senior Subordinated
Convertible Note due 12/31/02 in the principal amount of $15,000,000 issued by
WellCare Management Group, Inc. (the "Company") to the Fund for 100,000 shares
of Series B Preferred Stock pursuant to an Exchange Agreement, dated June 11,
1999, by and between the Fund and the Company.
(2) At the later of (i) the amendment to the Company's certificate of
incorporation to increase the total number of authorized shares of Common Stock,
par value $0.01 per share, of the Company ("Common Stock") by 55,000,000 shares
and (ii) the obtainment of all governmental and regulatory approvals necessary
for the conversion of shares of Series B Preferred Stock into shares of Common
Stock of the Company, each outstanding share of Series B Preferred Stock will be
automatically converted into 100 shares of Common Stock (subject to
anti-dilution protection).
(3) Subject to anti-dilution protection.
(4) By The Fund. Brown Brothers Harriman & Co. ("BBH") is the general partner of
the Fund. The amounts reported herein represent 100% of the securities
beneficially owned by the Fund. BBH's pecuniary interest in the securities is
limited to its percentage interest in the Fund.
/s/ Lawrence C. Tucker June 25, 1999
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**Signature of Reporting Person Date
Lawrence C. Tucker
General Partner of Brown Brothers Harriman & Co.
** 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 provided is insufficient, see Instruction 6 for procedures.
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 (9-96)
