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