<PAGE>
<TABLE>
<CAPTION>
FORM 4 OMB APPROVAL
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[ ] Check this box if no longer subject to Section OMB Number: 3235-0287
16. Form 4 or Form 5 obligations may Expires: September 30, 1998
continue. See Instruction 1(b). Estimated average burden
hours per response 0.5
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
<S> <C> <C>
- ----------------------------------------- -------------------------------------------- ---------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to
Issuer (Check all applicable)
Warburg, Pincus Ventures, L.P. Coventry Health Care, Inc. (CVTY)
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(Last) (First) (Middle) 3. IRS or Social 4. Statement for [X] Director [X] 10% Owner
Security Number Month/Year [ ] Officer (give [X] Other (specify
of Reporting title below) below)
Person
466 Lexington Avenue (Voluntary) Trustee
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(Street) 5. If Amendment, Date of 7. Individual or Joint/Group Filing
Original (Month/Year) (Check Applicable Line)
[ ] Form filed by One Reporting Person
[X] Form filed by More than One Reporting
New York New York 10017 Person
- ----------------------------------------- ------------------ ------------------------- ---------------------------------------------
(City) (State) (Zip)
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<TABLE>
<CAPTION>
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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<S> <C> <C> <C> <C> <C> <C>
1. Title of Security (Instr. 3) 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Instr. 8) Owned at Direct Bene-
(Month/ End of (D) or ficial
Day/ Month Indirect Owner-
Year) (Instr. 3 (I) ship
and 4) (Instr. 4) (Instr. 4)
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Code V Amount (A) or (D) Price
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- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
- --------------------------------- ------------- ------ --- ------ ---------- ------- ----------------- ------------ ------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
SEC 1474 (7-96)
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
</TABLE>
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<TABLE>
<CAPTION>
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<S> <C> <C> <C> <C> <C> <C>
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1. Title of 2. Conver- 3.Trans- 4. Transac- 5. Number of 6. Date Exer- 7. Title and Amount of
Derivative sion or action tion Code Derivative cisable and Underlying Securities
Security Exercise Date (Instr. 8) Securities Expiration (Instr. 3 and 4)
(Instr. 3) Price of (Month/ Acquired (A) Date (Month/
Derivative Day/ or Disposed Day/Year)
Security Year) of (D)
(Instr.3, 4,
and 5)
Code V (A) (D) Date Expira- Amount or
Exer- tion Title Number of
cisable Date Shares
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Convertible December
Exchangeable Note 9/3/99 C $42,358,400 (1) 1, 2004
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Series A Preferred
Stock $10.00 9/3/99 C 4,235,840 (3) 4,235,840(4)
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- --------------------- -------------- ---------- ------ ------ ------ --------- -------- --------- ----------- -------------
- --------------------- -------------- ---------- ------ ------ ------ --------- -------- --------- ----------- -------------
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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.
</TABLE>
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<TABLE>
<CAPTION>
[CONTINUATION OF THE ABOVE CHART]
<S> <C> <C> <C>
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8. Title of 9. Number 10. Owner- 11. Nature
Derivative of Deriv- ship of In-
Security ative Form direct
(Instr. 3) Secur- of De- Bene-
ities rivative ficial
Bene- Secu- Owner-
ficially rity: ship
Owned Direct (Instr. 4)
at (D) or
End Indi-
of rect (I)
Month (Instr. 4)
(Instr. 4)
- --------------- --------------- ---------------- -------------------
I(2) By Warburg, Pincus
Ventures, L.P. and
Voting Trust (2)
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</TABLE>
SEC 1474 (7-96)
<PAGE>
Explanation of Responses:
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1) The Convertible Exchangeable Note may be exchanged for Series A Preferred
Stock at any time at the option of the Company.
2) Pursuant to a Voting Trust Agreement, dated April 15, 1997, among Patrick
T. Hackett, Joel Ackerman and Jonathan S. Leff, as Trustees (collectively,
the "Trustees") and Warburg, Pincus Ventures, L.P., a Delaware limited
partnership ("Ventures"), (as supplemented as of November 12, 1997, the
"Voting Trust"), Ventures vested the power to vote all of the shares of
Common Stock and all of the shares of Series A Preferred Stock which
Ventures may acquire upon conversion, exchange or exercise of the
Convertible Exchangeable Senior Subordinated Notes due 2004 (the "Notes")
and Warrants (the "Warrants," and, collectively with the Notes, the
"Securities") of the Company irrevocably in the Voting Trust until April
15, 2007; provided, however, that Ventures may terminate the Voting Trust
upon written notice to the Trustees if Ventures is deemed to own
beneficially (within the meaning of Rule 13d-3 under the Securities
Exchange Act of 1934, as amended (the "Exchange Act")) less than ten
percent (10%) of the then outstanding shares of Common Stock. By reason of
the provisions of Rule 16a-1 of the Exchange Act, the Voting Trust and the
Trustees may be deemed to be the beneficial owner of the Securities held by
Ventures, although the Voting Trust and each of the Trustees disclaim
beneficial ownership of such Securities.
Additionally, the sole general partner of Ventures is Warburg, Pincus &
Co., a New York general partnership ("WP"). Lionel I. Pincus is the
managing partner of WP and he may be deemed to control it. E.M. Warburg,
Pincus & Co., LLC, a New York limited liability company ("EMW"), many of
whose members are also general partners of WP, manages Ventures. By reason
of the provisions of Rule 16a-1 of the Exchange Act, WP and EMW may be
deemed to be the beneficial owner of the Securities held by Ventures,
although both WP and EMW disclaim beneficial ownership of such Securities
except to the extent of any indirect pecuniary interest therein. Mr.
Hackett and Mr. Moorhead, directors of the Company, are general partners of
WP and members of EMW. As such, each of Mr. Hackett and Mr. Moorhead may be
deemed to have an indirect pecuniary interest (within Rule 16a-1 of the
Exchange Act) in an indeterminate portion of the Securities beneficially
owned by Ventures, EMW, WP and the Voting Trust. Each of Mr. Hackett and
Mr. Moorhead disclaims beneficial ownership of such securities except to
the extent of any indirect pecuniary interest therein. In addition, Mr.
Hackett, Mr. Ackerman and Mr. Leff are each Trustees under the Voting
Trust. Mr. Hackett, Mr. Ackerman and Mr. Leff each disclaim beneficial
ownership of such Securities except to the extent of any indirect pecuniary
interest therein.
3) The Series A Preferred Stock may be exchanged for shares of Common Stock at
any time at the option of Ventures.
4) The number of shares of shares of Common Stock into which the Series A
Convertible Preferred Stock may be converted is subject to standard
anti-dilution provisions.
<PAGE>
1. Name: Rodman W. Moorhead, III (Director)
Address: 466 Lexington Avenue
New York, New York 10017
2. Name: Patrick T. Hackett (Director and Trustee)
Address: 466 Lexington Avenue
New York, New York 10017
3. Name: Joel Ackerman (Trustee)
Address: 466 Lexington Avenue
New York, New York 10017
4. Name: Jonathan S. Leff (Trustee)
Address: 466 Lexington Avenue
New York, New York 10017
5. Name: Warburg, Pincus & Co. (General Partner)
Address: 466 Lexington Avenue
New York, New York 10017
6. Name: E.M. Warburg, Pincus & Co., LLC (Manager of WPV)
Address: 466 Lexington Avenue
New York, New York 10017
Designated Filer: Warburg, Pincus Ventures, L.P.
Issuer & Ticker Symbol: Coventry Health Care, Inc. (CVTY)
Period Covered By Form: October 1999
<PAGE>
WARBURG, PINCUS VENTURES, L.P.
By: Warburg, Pincus & Co.,
General Partner
By: /s/ Stephen Distler October 12, 1999
------------------------------ ----------------
Stephen Distler Date
Partner
WARBURG, PINCUS & CO.
By: /s/ Stephen Distler October 12, 1999
------------------------------ ----------------
Stephen Distler Date
Partner
E.M. WARBURG, PINCUS & CO., LLC
By: /s/ Stephen Distler October 12, 1999
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Stephen Distler Date
Member
Director
/s/ Rodman W. Moorhead, III October 12, 1999
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Rodman W. Moorhead, III Date
Trustee & Director
/s/ Patrick T. Hackett October 12, 1999
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Patrick T. Hackett Date
Trustee
/s/ Joel Ackerman October 12, 1999
------------------------------ ----------------
Joel Ackerman Date
Trustee
/s/ Jonathan S. Leff October 12, 1999
------------------------------ ----------------
Jonathan S. Leff Date
