-----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, BNLoj8nvFQEr6dWNlV2nHxiUS4+OWhPg7ZtkKhGKBJZLsiqG30VDTGcNS49Qhqz+ 7PGTC7MQV1DIiKQvfR2/1g== 0001317212-05-000038.txt : 20050308 0001317212-05-000038.hdr.sgml : 20050308 20050308191505 ACCESSION NUMBER: 0001317212-05-000038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20050304 FILED AS OF DATE: 20050308 DATE AS OF CHANGE: 20050308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frey James A II CENTRAL INDEX KEY: 0001318352 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 05667859 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 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2005-03-04 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 Units 2005-03-04 4 A 0 4401 0 A Common Stock 4401 4401 D Represents the deferral of a portion of the reporting person's annual bonus into Common Stock Units under the PacifiCare Health Systems, Inc. Third Amended and Restated Stock Unit Deferred Compensation Plan. 1,258 of the Common Stock Units are subject to forfeiture and vest on 3/4/2006. Upon distribution, the reporting person receives shares of PacifiCare Common Stock equal to the number of vested Common Stock Units held. The Common Stock Units will be distributed on the earlier of (i) the date, after 12/31/06, specified in an election made by the reporting person or (ii) the reporting person's termination of employment, death, disability or change of control of the Company. The Common Stock Units will be distributed in a lump sum or equal installments over 3 to 5 years as specified in an election made by the reporting person, except for distributions upon change of control which will be distributed in a lump sum. By: Ellen K. Erickson For: James A. Frey II 2005-03-08 EX-24 2 frey.txt EDGAR SUPPORTING DOCUMENT POWER OF ATTORNEY I, James A. Frey II, do hereby constitute and appoint Joseph S. Konowiecki, Michael E. Jansen, Ellen K. Erickson and Lisa C. Poland, or each one of them separately, as my true and lawful attorneys and agents, to do any and all lawful acts and things in my name and on my behalf, and to execute any and all instruments, forms or filings in my name and on my behalf, which said attorneys and agents, or each one of them separately, may deem necessary or advisable in order for me to comply with the disclosure requirements of Section 16(a) of the Securities Exchange Act of 1934, and any related rules, regulations, and requirements of the Securities and Exchange Commission; and do hereby ratify and confirm all that said attorneys and agents, or each one of them separately, shall do or cause to be done by virtue thereof. Date: February 15, 2005 James A. Frey II -----END PRIVACY-ENHANCED MESSAGE-----