-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, IBlcGet4B4YtRGNruQwM/SlKlKPOCHUgZghY1ZMvzQqKwJJV83MdR9kY4T0hNSCt Sp0vdItSqJfnOqwcqGgF9w== 0001249013-04-000033.txt : 20040202 0001249013-04-000033.hdr.sgml : 20040202 20040202212837 ACCESSION NUMBER: 0001249013-04-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040129 FILED AS OF DATE: 20040202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PHANSTIEL HOWARD G CENTRAL INDEX KEY: 0001069411 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 04560819 BUSINESS ADDRESS: STREET 1: 245 FISCHER AVE STE D-1 CITY: COSTA MESA STATE: CA ZIP: 92626 BUSINESS PHONE: 7147517400 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PACIFICARE HEALTH SYSTEMS INC /DE/ CENTRAL INDEX KEY: 0001027974 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 954591529 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 3120 LAKE CENTER DRIVE CITY: SANTA ANA STATE: CA ZIP: 92704 BUSINESS PHONE: 7148255200 MAIL ADDRESS: STREET 1: 3120 LAKE CENTER DRIVE CITY: SANTA ANA STATE: CA ZIP: 92704 FORMER COMPANY: FORMER CONFORMED NAME: N T HOLDINGS INC DATE OF NAME CHANGE: 19961204 4 1 edgardoc.xml PRIMARY DOCUMENT X0201 4 2004-01-29 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001069411 PHANSTIEL HOWARD G 5995 PLAZA DRIVE CYPRESS CA 90630 1 1 0 0 President & CEO Non-Qualified Stock Option (right to buy) 32.37 2004-01-29 4 A 0 250000 0 A 2005-01-29 2014-01-29 Common Stock 250000 250000 D Restricted Stock Unit 2004-01-29 4 A 0 83333 0 A Common Stock 83333 293333 D Granted under the 1996 Stock Option Plan for Officers and Key Employees of PacifiCare Health Systems, Inc., as amended, which is a Rule 16b-3 plan. The options vest in four cumulative annual installments of 25 percent each beginning on the first anniversary of the grant date. Restricted stock granted under the 1996 Stock Option Plan for Officers and Key Employees. The restricted stock vests in three cumulative installments over a 4 year period as follows: (i) 1/3rd vests on the second anniversary of the grant date; (ii) an additional 1/3rd vests on the third anniversary of the grant date; and (iii) the remaining 1/3rd vests on the fourth anniversary of the grant date. The grant is subject to mandatory deferral into restricted stock units as follows: (i) 50 percent of the shares must be deferred until the earlier of retirement or termination; and (ii) the remaining 50 percent of the shares must be deferred for 4 years. Within 45 days after the grant date, the reporting person may elect to defer the remaining 50 percent of the shares beyond the 4-year mandatory deferral period. In which case, the restricted stock will be distributed on the earlier of the date specified in such election, or on the reporting person's termination date. Howard G Phanstiel 2004-02-02 -----END PRIVACY-ENHANCED MESSAGE-----