-----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, KKLaDBUXc22dIzHBi+jjCenkbHEfeABt0oy5CZ3CGR+KKWp++VYJnFEiyrnDwbMk mZ7/++VeWyjDtq8QODZbrw== 0001249013-04-000162.txt : 20041119 0001249013-04-000162.hdr.sgml : 20041119 20041119193844 ACCESSION NUMBER: 0001249013-04-000162 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041117 FILED AS OF DATE: 20041119 DATE AS OF CHANGE: 20041119 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOWLUS BRADFORD A CENTRAL INDEX KEY: 0001209505 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 041159086 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: 1231 BUSINESS ADDRESS: STREET 1: 5995 PLAZA DRIVE CITY: CYPRESS STATE: CA ZIP: 90630-5028 BUSINESS PHONE: 714-952-1121 MAIL ADDRESS: STREET 1: 5995 PLAZA DRIVE CITY: CYPRESS STATE: CA ZIP: 90630-5028 FORMER COMPANY: FORMER CONFORMED NAME: N T HOLDINGS INC DATE OF NAME CHANGE: 19961204 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-11-17 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001209505 BOWLUS BRADFORD A 5995 PLAZA DRIVE CYPRESS CA 90630 0 1 0 0 Pres & CEO, Health Plan Div Common Stock 2004-11-17 4 M 0 83900 26.938 A 101137.98 D Common Stock 2004-11-17 4 S 0 83900 47 D 17237.98 D Common Stock 729 I By 401(k) plan Non-Qualified Stock Option (right to buy) 26.938 2004-11-17 4 M 0 83900 0 D 2001-08-24 2010-08-24 Common Stock 83900 100000 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. The stock option exercise was made pursuant to the reporting person's 10b5-1 plan. Bowlus, Bradford A 2004-11-17 -----END PRIVACY-ENHANCED MESSAGE-----