-----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, Re8CZDgOpu6lvImT7XITtVqIEcSR9IPwLOQpY5Qil94TI9vYdRLxwTX32t7DDtiX E7cfwfkhKXM517MQYSiiVA== 0001249013-04-000054.txt : 20040224 0001249013-04-000054.hdr.sgml : 20040224 20040224184128 ACCESSION NUMBER: 0001249013-04-000054 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040220 FILED AS OF DATE: 20040224 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOSECOFF JACQUELINE B CENTRAL INDEX KEY: 0001209524 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 04625824 MAIL ADDRESS: STREET 1: 5995 PLAZA DR CITY: CYPRESS STATE: CA ZIP: 90630 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 2004-02-20 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001209524 KOSECOFF JACQUELINE B 5995 PLAZA DRIVE CYPRESS CA 90630 0 1 0 0 EVP, Pharmaceutical Services Common Stock Units 2004-02-20 4 A 0 11210 0 A Common Stock 11210 42710 D The Common Stock Units were accrued under the PacifiCare Health Systems, Inc. Third Amended and Restated Stock Unit Deferred Compensation Plan (the "Plan"). Upon distribution, a participant receives shares of Common Stock equal to the number of Common Stock Units deferred. Distribution is triggered by termination of employment, death, disability or change of control of the Company. Amounts deferred under the Plan will be distributed in a lump sum or equal installments over three to five years, except for distributions upon change of control which will be paid out in a lump sum of shares of stock. The Plan also permits early distributions while a Participant is still employed so long as such election is made at least two years from the last day of the plan year for which the bonus is earned. Jacqueline B Kosecoff 2004-02-24 -----END PRIVACY-ENHANCED MESSAGE-----