-----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, PEFsPLQhZa0Yi4Lt4+d18LX51FsU4KPcFN0eRB2eYCiXuZoCZ6k7VihwdaHgXMN+ CWiizajsxar6y/b1YiIJMg== 0001249013-04-000061.txt : 20040323 0001249013-04-000061.hdr.sgml : 20040323 20040323185433 ACCESSION NUMBER: 0001249013-04-000061 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040319 FILED AS OF DATE: 20040323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARTSHORN TERRY O CENTRAL INDEX KEY: 0001209518 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 04685851 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 2004-03-19 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001209518 HARTSHORN TERRY O 5995 PLAZA DRIVE CYPRESS CA 90630 1 0 0 0 Common Stock 2004-03-19 4 M 0 1568 12.75 A 75568 D Common Stock 2004-03-19 4 S 0 1568 38.9746 D 74000 D Common Stock 2004-03-19 4 M 0 10000 8.15 A 84000 D Common Stock 2004-03-19 4 S 0 10000 38.9746 D 74000 D Common Stock 2004-03-19 4 M 0 5988 8.01 A 79988 D Common Stock 2004-03-19 4 S 0 5988 38.9746 D 74000 D Common Stock 2004-03-19 4 S 0 20000 38.9746 D 20000 I by Partnership Common Stock 2004-03-19 4 S 0 10000 38.9746 D 55464 I by Trust-Hart2 Non-Qualified Stock Option (right to buy) 8.01 2004-03-19 4 M 0 5988 0 D 2001-07-02 2011-07-02 Common Stock 5988 0 D Non-Qualified Stock Option (right to buy) 8.15 2004-03-19 4 M 0 10000 0 D 2001-06-29 2011-06-30 Common Stock 10000 0 D Non-Qualified Stock Option (right to buy) 12.75 2004-03-19 4 M 0 1568 0 D 2001-02-05 2011-02-05 Common Stock 1568 20000 D The reported securities are held by the Hartshorn Family Limited Partnership of which the reporting person and his spouse hold a 1% general partnership interest. On March 19, 2004, the Hartshorn Family Limited Partnership sold 20,000 shares of PacifiCare common stock for an aggregate sale price of $779,492 (the "Transaction"). The reporting person did not receive any of the proceeds from the Transaction. The reporting person disclaims beneficial ownership of the PacifiCare common stock held by the Hartshorn Family Limited Partnership except to the extent of his pecuniary interest therein. Exercise of stock option granted under the Amended and Restated 2000 Non-Employee Directors Stock Plan of PacifiCare Health Systems, Inc. in a transaction exempt under Rule 16b-3. Exercise of stock option granted under the Amended and Restated 1996 Non-Officer Directors Stock Plan of PacifiCare Health Systems, Inc. in a transaction exempt under Rule 16b-3. Terry O Hartshorn 2004-03-23 -----END PRIVACY-ENHANCED MESSAGE-----