SEC Form 4 · accession 0001127602-15-010192
INSULET CORP · PODD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Allison Dorval
Officer — Chief Financial Officer
Period of report
Mar 2, 2015
Accepted (ET)
Mar 4, 2015 · 7:06 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001145197
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | Mar 2, 2015 | A | 10,253 | $0.00 | A | 39,080 | D | |
| Common StockF4,F3,F5 | Mar 3, 2015 | F | 851 | $31.37 | D | 38,229 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F6 | $32.51 | Mar 2, 2015 | A | 14,607 | A | — | Mar 2, 2025 | Common Stock | 14,607 | 14,607 | D |
Explanation of responses
- F1The 10,253 restricted stock units vest one-third of the total units on March 2, 2016, one-third of the total units on March 2, 2017 and one-third of the total units on March 2, 2018, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
- F2Includes 5,000 restricted stock units granted on April 1, 2012, which vest one-half of the total units on April 1, 2015 and one-half of the total units on April 1, 2016; 6,000 restricted stock units granted on March 1, 2013, which vest one-half of the total units on March 1, 2016 and one-half of the total units on March 1, 2017; and 8,000 restricted stock units granted on March 3, 2014, which vest one-third of the total units on March 3, 2015, one-third of the total units on March 3, 2016 and one-third of the total units on March 3, 2017, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
- F3Includes an aggregate of 342 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on December 31, 2013.
- F4This transaction represents the withholding of shares received upon the vesting of restricted stock units to cover the associated tax obligations.
- F5Includes 5,000 restricted stock units granted on April 1, 2012, which vest one-half of the total units on April 1, 2015 and one-half of the total units on April 1, 2016; 6,000 restricted stock units granted on March 1, 2013, which vest one-half of the total units on March 1, 2016 and one-half of the total units on March 1, 2017; 5,334 restricted stock units granted on March 3, 2014, which vest one-half of the total units on March 3, 2016 and one-half of the total units on March 3, 2017; and 10,253 restricted stock units granted on March 2, 2015, which vest one-third of the total units on March 2, 2016, one-third of the total units on March 2, 2017 and one-third of the total units on March 2, 2018. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
- F6This option is subject to a four-year vesting period, with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment.