-----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, HNt37djGA1ZuMMTsOLZ84LHnRxKFaU/ZXvWRTdtVs5+/K/tfTEFDlfRuhNNGEpaV EDNG1mOGo4qjIIrPZgqZ0w== 0001249013-04-000115.txt : 20040702 0001249013-04-000115.hdr.sgml : 20040702 20040702200550 ACCESSION NUMBER: 0001249013-04-000115 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040630 FILED AS OF DATE: 20040702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROSENSTOCK LINDA CENTRAL INDEX KEY: 0001268783 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 04901200 MAIL ADDRESS: STREET 1: 5995 PLAZA DRIVE STREET 2: MAIL STOP CY20-103 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 2004-06-30 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001268783 ROSENSTOCK LINDA 5995 PLAZA DRIVE CYPRESS CA 90630 1 0 0 0 Common Stock Units 2004-07-01 4 A 0 1003 0 A Common Stock 1003 1667 D Non-Qualified Stock Option (right to buy) 38.66 2004-06-30 4 A 0 7000 0 A 2004-06-30 2014-06-30 Common Stock 7000 7000 D The Common Stock Units were received in lieu of annual director fees as provided for under the Amended and Restated 2000 Non-Employee Directors Stock Plan of PacifiCare Health Systems, Inc. (the "Director Plan"). Under the Director Plan, non-employee directors may elect to defer a portion of their annual retainer fees (on a pre-tax basis) into Common Stock Units held in an account maintained for the director under the Director Plan. The number of Common Stock Units a director receives is based on the closing price of PacifiCare's common stock on the day the annual retainer fee would have been paid but for the deferral. When a director terminates his or her service as a director, a distribution from the director's Common Stock Unit account under the Director Plan is made in a single payment of shares of PacifiCare common stock. Represents an annual formula grant of an Option (right to buy) under the Amended and Restated 1996 Non-Employee Directors Stock Plan of PacifiCare Health Systems, Inc. (the "Director Plan") in a transaction exempt under Rule 16b-3. The Option is fully vested and exercisable on the date of grant (6/30/04); however, the underlying shares of PacifiCare common stock acquired upon exercise of the Option may not be sold or transferred within the first six months of the date of grant. Linda Rosenstock 2004-07-02 -----END PRIVACY-ENHANCED MESSAGE-----