SEC Form 4 · accession 0001209191-17-030168
MOLINA HEALTHCARE, INC. · MOH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
J Mario Molina M.D.
Director
Period of report
May 2, 2017
Accepted (ET)
May 4, 2017 · 8:58 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001179929
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2,F3 | May 2, 2017 | A | 603 | $59.75 | A | 363,528 | I | Trust |
| Common StockF2,F3 | May 2, 2017 | F | 106,674 | $59.75 | D | 256,854 | I | Trust |
| Common StockF5 | holding | — | — | — | 469,184 | I | Trust | |
| Common StockF6 | holding | — | — | — | 122,956 | I | Trust | |
| Common StockF7 | holding | — | — | — | 18,920 | I | Trust | |
| Common StockF8 | holding | — | — | — | 18,920 | I | Trust | |
| Common StockF9 | holding | — | — | — | 18,920 | I | Trust | |
| Common StockF10 | holding | — | — | — | 19,280 | I | Trust | |
| Common StockF11 | holding | — | — | — | 1,362 | I | Trust | |
| Common StockF12 | holding | — | — | — | 1,362 | I | Trust | |
| Common StockF13 | holding | — | — | — | 1,361 | I | Trust | |
| Common StockF14 | holding | — | — | — | 1,361 | I | Trust | |
| Common StockF15 | holding | — | — | — | 65,282 | I | Trust | |
| Common StockF16 | holding | — | — | — | 25,082 | I | Trust | |
| Common StockF17 | holding | — | — | — | 137,972 | I | Trust | |
| Common StockF18 | holding | — | — | — | 83,087 | I | Trust | |
| Common StockF19 | holding | — | — | — | 83,087 | I | Trust | |
| Common StockF20 | holding | — | — | — | 200,000 | I | Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares were issued in connection with Dr. Molina's service as an outside director of the Issuer.
- F10The shares are owned by Dr. Molina, as trustee of the Carley A.F. Fox Trust No. 2 dated 5/14/2003.
- F11The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for David M.F. Molina dated 12/3/2008.
- F12The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Mary Clare F. Molina dated 12/3/2008.
- F13The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Colleen A.F. Fox dated 12/3/2008.
- F14The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Carley F. Fox dated 12/3/2008.
- F15The shares are owned by JMB GRAT 1209/4 for the benefit of Josephine M. Battiste, of which Dr. Molina is sole trustee.
- F16The shares are owned by JMM GRAT 1208/5, of which Dr. Molina is beneficiary.
- F17The shares are owned by JMM GRAT 911/4, of which Dr. Molina is the beneficiary.
- F18The shares are owned by Dr. Molina, as trustee of the Katherine Rose Battiste Trust IV.
- F19The shares are owned by Dr. Molina, as trustee of the Julius Avery Battiste Trust IV.
- F2Represents the closing price of the Issuer's common stock on May 2, 2017.
- F20The shares are owned by JMM GRAT 716/3, of which Dr. Molina is the beneficiary.
- F3The shares are held by the M/T Molina Family Trust, of which Dr. Molina and his spouse are trustees and beneficiaries.
- F4The shares were applied to the payment of withholding taxes arising in connection with the accelerated vesting of 204,420 shares on May 2, 2017, subject to restrictions.
- F5The shares are owned by the J. Marion Molina Separate Property Trust, of which Dr. Molina is sole trustee.
- F6The shares are owned by Dr. Molina's spouse, Therese A. Molina, as trustee of the MM GRAT 915/3.
- F7The shares are owned by Dr. Molina, as trustee of the David M.F. Molina Trust No. 2 dated 5/14/2003.
- F8The shares are owned by Dr. Molina, as trustee of the Mary Clare F. Molina Trust No. 2 dated 5/14/2003.
- F9The shares are owned by Dr. Molina, as trustee of the Colleen A.F. Fox Trust No. 2 dated 5/14/2003.