-----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, SWwvs2h/E2/eJTPaqp3SgjzFv03V2JV6gE1iLQFouTws30lSKJ6NXmC5PtY1IiFE UVCawmuP2XjdTZnxnJX03g== 0001317212-05-000004.txt : 20050225 0001317212-05-000004.hdr.sgml : 20050225 20050225192214 ACCESSION NUMBER: 0001317212-05-000004 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050217 FILED AS OF DATE: 20050225 DATE AS OF CHANGE: 20050225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frey James A II CENTRAL INDEX KEY: 0001318352 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 05642951 BUSINESS ADDRESS: BUSINESS PHONE: (714) 226-3500 MAIL ADDRESS: STREET 1: 5995 PLAZA DRIVE 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 3 1 primary_doc.xml PRIMARY DOCUMENT X0202 3 2005-02-17 0 0001027974 PACIFICARE HEALTH SYSTEMS INC /DE/ PHS 0001318352 Frey James A II 5995 PLAZA DRIVE CYPRESS CA 90630 0 1 0 0 EVP, Major Accounts Common Stock 3436.079 D Common Stock 5428 I By 401(k) plan Non-Qualified Stock Option (right to buy) 9 2012-03-18 Common Stock 50000 D Non-Qualified Stock Option (right to buy) 14.275 2013-01-22 Common Stock 12750 D Non-Qualified Stock Option (right to buy) 32.37 2014-01-29 Common Stock 15000 D Restricted Stock Unit Common Stock 32000 D Granted under the 1996 Stock Option Plan for Officers and Key Employees of PacifiCare Health Systems, Inc., as amended, which is a Rule 16b-3 plan. The options vest in four cumulative annual installments of 25 percent each beginning on the first anniversary of the grant date. Represents 17,000 restricted stock units granted on 01/22/03 and 15,000 restricted stock units granted on 01/29/04 under the 1996 Stock Option Plan for officers and employees. The 2004 grant vests in three cumulative installments over a 4 year period as follows: 1/3 each vests on the 2nd and 3rd anniversaries of the grant date; and the remaining 1/3 vests on the 4th anniversary of the grant date. The 2004 grant is subject to mandatory deferral into restricted stock units as follows: (i) 50% of the shares must be deferred until the earlier of retirement or termination; and (ii) the remaining 50% of the shares must be deferred for 4 years. The 2003 grant vests in 4 equal annual installments of 25% commencing on the 1st anniversary of the grant date. The 2004 grant is subject to mandatory deferral into restricted stock units as follows: (i) 100% must be deferred until retirement or termination; or (ii) 100% must be deferred for at least 4 years from the grant date. On February 17, 2005 the Board of Directors of Issuer designated the reporting person as a Section 16 Insider. James A Frey II 2005-02-25 -----END PRIVACY-ENHANCED MESSAGE-----