SEC Form 4 · accession 0000950157-17-001362

OneBeacon Insurance Group, Ltd. · OB

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — SVP & Chief Accounting Officer

Period of report

Sep 28, 2017

Accepted (ET)

Sep 28, 2017 · 4:22 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001369817

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Shares^F1	Sep 28, 2017	D	5,638	$18.10	D	0	D
Class A Common Shares^F2	Sep 28, 2017	D	1,356	$18.10	D	0	I	in 401(k) ESOP

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Phantom Stock Units^F3	—	Sep 28, 2017	D	19,853	D	—	—	Class A Common Shares	19,853	0	D

F1Disposition in connection with the merger (the "Merger") between Intact Acquisition Co. Ltd. and OneBeacon Insurance Group, Ltd. ("OneBeacon"), exempt pursuant to Rule 16b-3, in which each outstanding Class A common share of OneBeacon ("Class A Share") was converted into the right to receive an amount in cash equal to $18.10 per share.
F2Disposition in connection with the Merger, exempt pursuant to Rule 16b-3, in which each outstanding Class A Share was converted into the right to receive an amount in cash equal to $18.10 per share.
F3In connection with the Merger, each outstanding phantom stock unit of OneBeacon was converted into the right to receive an amount in cash equal to the product of (i) the sum of $18.10 plus any accrued dividend equivalents in respect of a Class A Share subject to such phantom stock unit, multiplied by (ii) the number of Class A Shares subject to such phantom stock unit immediately prior to the effective time of the Merger; such cash amount shall continue to be subject to service-based vesting conditions.