-----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, HYGRQn4qD4TTan7kD2RejOQwbtpgJ78rniIh3K4mQOtXyptGrNQNDThWp+7Nwx/j +7ZP9wxuwJM5pzoSFCsjYg== 0000950129-04-001666.txt : 20040330 0000950129-04-001666.hdr.sgml : 20040330 20040330140237 ACCESSION NUMBER: 0000950129-04-001666 CONFORMED SUBMISSION TYPE: NT 10-K PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040330 EFFECTIVENESS DATE: 20040330 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MAXICARE HEALTH PLANS INC CENTRAL INDEX KEY: 0000722573 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 953615709 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: NT 10-K SEC ACT: 1934 Act SEC FILE NUMBER: 000-12024 FILM NUMBER: 04699803 BUSINESS ADDRESS: STREET 1: 1149 S BROADWAY ST STREET 2: SUITE 910 CITY: LOS ANGELES STATE: CA ZIP: 90015 BUSINESS PHONE: 2137652000 NT 10-K 1 v97743ntnt10vk.txt FORM 12B-25 - PERIOD ENDED DECEMBER 31, 2003 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 NOTIFICATION OF LATE FILING FORM 12b-25 Commission File Number 0-12024 [Check One]: [X] Form 10-K [ ] Form 20-F [ ] Form 11-K [ ] Form 10-Q [ ] Form N-SAR For Period Ended: December 31, 2003 [ ] Transition Report on Form 10-K [ ] Transition Report on Form 20-F [ ] Transition Report on Form 11-K [ ] Transition Report on Form 10-Q [ ] Transition Report on Form N-SAR For the Transition Period Ended: ------------------------------------ Read Attached Instruction Sheet Before Preparing Form. Please Print or Type. Nothing in this form shall be constructed to imply that the Commission has verified any information contained herein If the notification relates to a portion of the filing checked above, identify the Item[s] to which the notification relates: PART I - REGISTRANT INFORMATION Full Name of Registrant: Maxicare Health Plans, Inc. Former Name if Applicable: Address of Principal Executive Office: 11231 South La Cienega Boulevard, Los Angeles, California 90045 PART II - RULES 12b-25(b) and (c) If the subject report could not be filed without unreasonable effort or expense and the registrant seeks relief pursuant to Rules 12b-25(b), the following should be completed. [Check box if appropriate] [a] The reasons described in reasonable detail in Part III of this form could not be eliminated without unreasonable effort or expense; [X] [b] The subject annual report, semi-annual report, transition report on Form 10-K, Form 20-F, Form 11-K, Form N-SAR, or portion thereof, will be filed on or before the fifteenth calendar day following the prescribed due date; or the subject quarterly report of transition report on Form 10-Q, or portion thereof will be filed on or before the fifth calendar day following the prescribed due date; and [c] The accountant's statement or other exhibit required by Rule 12b-25(c) has been attached if applicable. PART III - NARRATIVE State below in reasonable detail the reasons why the Form 10-K, 20-F, 11-K, 10-Q, or N-SAR, or the transition report or portion thereof, could not be filed within the prescribed time period. As a result of delays in developing and verifying data necessary to complete the financial statement disclosure, the Form 10-K cannot be filed on time without unreasonable effort and expense. PART IV - OTHER INFORMATION [1] Name and telephone number of person to contact in regard to this notification Patricia Fitzpatrick (310) 665-9865 [Name] [Area Code] [Telephone Number] [2] Have all other periodic reports required under Section 13 or 15[d] of the Securities Exchange Act of 1934 or Section 30 of the Investment Company Act of 1940 during the preceding 12 months [or for such shorter period that the registrant was required to file such reports] been filed? If answer is no, identify report[s]. [X] Yes [ ] No [3] Is it anticipated that any significant change in results of operations from the corresponding period for the last fiscal year will be reflected by the earnings statements to be included in the subject report or portion thereof? [ ] Yes [X] No If so, attach an explanation of the anticipated change, both narratively and quantitatively, and, if appropriate, state the reasons why a reasonable estimate of the results cannot be made. MAXICARE HEALTH PLANS, INC. [Name of Registrant as Specified in Charter] has caused this notification to be signed on its behalf by the undersigned thereunto duly authorized. Date: March 30, 2004 By: /s/ Joseph White Chief Financial Officer -----END PRIVACY-ENHANCED MESSAGE-----