-----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, RU776+wL+GimQ0SA4qJoxn/h6DilrQGFigFtWxJYT6Wvov0tzSIrDYSKfrpdLkUY UrCYig0vFl5fdMX2Dd7xqg== 0001249013-04-000092.txt : 20040630 0001249013-04-000092.hdr.sgml : 20040630 20040630203158 ACCESSION NUMBER: 0001249013-04-000092 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040629 FILED AS OF DATE: 20040630 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: 04892771 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 X0202 4 2004-06-29 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 2004-06-29 4 M 0 20000 14.275 A 20000 D Common Stock 2004-06-29 4 S 0 20000 37.7717 D 0 D Non-Qualified Stock Option (right to buy) 14.275 2004-06-29 4 M 0 20000 0 D 2004-01-22 2013-01-22 Common Stock 20000 60000 D Exercise of stock option granted under the 1996 Stock Option Plan for Officers and Key Employees of PacifiCare Health Systems, Inc., as amended in a transaction exempt under Rule 16b-3. Jacqueline B Kosecoff 2004-06-30 -----END PRIVACY-ENHANCED MESSAGE-----