0001977977-23-000001.txt : 20231129 0001977977-23-000001.hdr.sgml : 20231129 20231129172222 ACCESSION NUMBER: 0001977977-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Investment Company Act Section 3(c) ITEM INFORMATION: Section 3(c)(7) FILED AS OF DATE: 20231129 DATE AS OF CHANGE: 20231129 EFFECTIVENESS DATE: 20231129 FILER: COMPANY DATA: COMPANY CONFORMED NAME: General Catalyst Group XII - Health Assurance, L.P. CENTRAL INDEX KEY: 0001977977 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-498401 FILM NUMBER: 231453387 BUSINESS ADDRESS: STREET 1: 20 UNIVERSITY ROAD, 4TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 BUSINESS PHONE: (617) 234-7000 MAIL ADDRESS: STREET 1: 20 UNIVERSITY ROAD, 4TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 D 1 primary_doc.xml X0708 D LIVE 0001977977 General Catalyst Group XII - Health Assurance, L.P. 20 UNIVERSITY ROAD, 4TH FLOOR CAMBRIDGE MA MASSACHUSETTS 02138 (617) 234-7000 DELAWARE None None Limited Partnership true 2023 N/A General Catalyst Partners XII, L.P. 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer General Partner of the Issuer N/A General Catalyst GP XII, LLC 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer General Partner of the Issuer's General Partner N/A General Catalyst Group Management, LLC 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer Investment manager of the Issuer Hemant Taneja 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer Member of the General Partner of the Issuer's General Partner David P. Fialkow 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer Member of the General Partner of the Issuer's General Partner Joel E. Cutler 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer Member of the General Partner of the Issuer's General Partner Kenneth Chenault 20 University Road, 4th Floor Cambridge MA MASSACHUSETTS 02138 Executive Officer Member of the General Partner of the Issuer's General Partner Pooled Investment Fund Venture Capital Fund false Decline to Disclose 06b 3C 3C.7 false true false true false 0 Campbell Lutyens & Co. Inc. 133376 None None 630 Fifth Avenue, 36th Floor New York NY NEW YORK 10111 DE DELAWARE HI HAWAII TX TEXAS MA MASSACHUSETTS MD MARYLAND IA IOWA ME MAINE ID IDAHO MI MICHIGAN UT UTAH MN MINNESOTA MO MISSOURI IL ILLINOIS IN INDIANA MS MISSISSIPPI MT MONTANA AK ALASKA AL ALABAMA VA VIRGINIA AR ARKANSAS NC NORTH CAROLINA ND NORTH DAKOTA NE NEBRASKA RI RHODE ISLAND AZ ARIZONA NH NEW HAMPSHIRE NJ NEW JERSEY VT VERMONT NM NEW MEXICO FL FLORIDA NV NEVADA WA WASHINGTON NY NEW YORK SC SOUTH CAROLINA SD SOUTH DAKOTA WI WISCONSIN OH OHIO GA GEORGIA OK OKLAHOMA CA CALIFORNIA WV WEST VIRGINIA WY WYOMING OR OREGON KS KANSAS CO COLORADO KY KENTUCKY CT CONNECTICUT PA PENNSYLVANIA LA LOUISIANA TN TENNESSEE DC DISTRICT OF COLUMBIA false Goldman Sachs & Co. LLC 361 None None 200 West Street New York NY NEW YORK 10282 All States true Indefinite 0 Indefinite false 0 0 true 0 true Placement agent fees are to be paid based upon an established fee schedule. Such fees are offset dollar-for-dollar against the management fees payable by the Issuer, as further disclosed is the Issuer's LPA. 0 true An affiliate of the General Partner will receive a management fee for management services. The management fee is disclosed in the Issuer's confidential materials. false General Catalyst Group XII - Health Assurance, L.P. Christopher McCain Christopher McCain Chief Legal Officer of the GP of the Issuer's GP 2023-11-28