-----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, Ln4cgJZJzdrp/SGxnKVWa5/Y0+aR/UCoYcwFun1VXd09jEVRZ5Kq+GNQPFI9oHXC QEybLwWG3VLv42clOXr1IA== 0001181431-04-008669.txt : 20040212 0001181431-04-008669.hdr.sgml : 20040212 20040212155956 ACCESSION NUMBER: 0001181431-04-008669 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040210 FILED AS OF DATE: 20040212 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MOLINA HEALTHCARE INC CENTRAL INDEX KEY: 0001179929 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 134204626 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE GOLDEN SHORE DRIVE CITY: LONG BEACH STATE: CA ZIP: 90802 BUSINESS PHONE: 5624353666 MAIL ADDRESS: STREET 1: ONE GOLDEN SHORE DRIVE CITY: LONG BEACH STATE: CA ZIP: 90802 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KULICH ROMAN CENTRAL INDEX KEY: 0001246727 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31719 FILM NUMBER: 04591648 BUSINESS ADDRESS: STREET 1: C/O MOLINA HEALTHCARE OF MICHIGAN STREET 2: 100 WEST BIG BEAVER, SUITE 600 CITY: TROY STATE: MI ZIP: 48084 MAIL ADDRESS: STREET 1: C/O MOLINA HEALTHCARE OF MICHIGAN STREET 2: 100 WEST BIG BEAVER, SUITE 600 CITY: TROY STATE: MI ZIP: 48084 4 1 rrd32910.xml X0201 4 2004-02-10 0 0001179929 MOLINA HEALTHCARE INC MOH 0001246727 KULICH ROMAN C/O MOLINA HEALTHCARE, INC. ONE GOLDEN SHORE DRIVE LONG BEACH CA 90802 0 1 0 0 President & CEO of Subsidiary Stock Option (Right to Buy) 25.33 2004-02-10 4 A 0 20000 25.33 A 2005-02-10 2014-02-10 Common Stock 20000 20000 D The option vests one-third on each of 2/10/05, 2/10/06 and 2/10/07. Roman Kulich, by Karen Calhoun, Attorney-In-Fact 2004-02-12 -----END PRIVACY-ENHANCED MESSAGE-----