0001179110-11-006034.txt : 20110405 0001179110-11-006034.hdr.sgml : 20110405 20110405174303 ACCESSION NUMBER: 0001179110-11-006034 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110401 FILED AS OF DATE: 20110405 DATE AS OF CHANGE: 20110405 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MAYHEW KARIN D CENTRAL INDEX KEY: 0001213932 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12718 FILM NUMBER: 11741265 MAIL ADDRESS: STREET 1: 21650 OXNARD STREET, 22ND FLOOR CITY: WOODLAND HILLS STATE: CA ZIP: 91367 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTH NET INC CENTRAL INDEX KEY: 0000916085 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 954288333 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 21650 OXNARD ST CITY: WOODLAND HILLS STATE: CA ZIP: 91367 BUSINESS PHONE: 8186766000 MAIL ADDRESS: STREET 1: 225 N MAIN ST CITY: PUEBLO STATE: CO ZIP: 81003 FORMER COMPANY: FORMER CONFORMED NAME: FOUNDATION HEALTH SYSTEMS INC DATE OF NAME CHANGE: 19970513 FORMER COMPANY: FORMER CONFORMED NAME: HEALTH SYSTEMS INTERNATIONAL INC DATE OF NAME CHANGE: 19940207 FORMER COMPANY: FORMER CONFORMED NAME: HN MANAGEMENT HOLDINGS INC/DE/ DATE OF NAME CHANGE: 19931213 4 1 edgar.xml FORM 4 - X0303 4 2011-04-01 0 0000916085 HEALTH NET INC HNT 0001213932 MAYHEW KARIN D 21650 OXNARD STREET WOODLAND HILLS CA 91367 0 1 0 0 SVPOrganization Effectiveness Common Stock 2011-04-01 4 M 0 20000 22.64 A 107334 D Common Stock 2011-04-01 4 S 0 20000 33.1438 D 87334 D Common Stock 1984 I By Son Stock Option (Right to Buy) 22.64 2011-04-01 4 M 0 20000 0 D 2003-08-12 2012-08-12 Common Stock 20000 0 D Exercise of a stock option granted to the Reporting Person on August 12, 2002 under the Issuer's 1997 Stock Option Plan, as amended (the "Grant"), in a transaction exempt under Rule 16b-3 of the Securities Exchange Act of 1934, as amended (the "Act"). The exercise of the Grant was effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person in accordance with Rule 10b5-1 of the Act. The price reported in Column 4 is a weighted average price. The shares were sold in multiple transactions at prices ranging from $33.00 to $33.27, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. These sales of Common Stock by the Reporting Person on April 1, 2011, as reported on this Form 4, were effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person in accordance with Rule 10b5-1 of the Act. Includes shares held by the Karin Mayhew 2006 Revocable Trust, of which the Reporting Person is the sole trustee and beneficiary. Reporting Person disclaims beneficial ownership of all such shares held by her son and this report should not be deemed an admission that the Reporting Person is the beneficial owner of such shares for purposes of Section 16 or for any other purpose. The Grant became exercisable in 25% increments on each of the first, second, third and fourth anniversaries of the grant date of August 12, 2002. Represents unexercised options from the Grant beneficially owned by the Reporting Person. /s/ Karin D. Mayhew 2011-04-05