SEC Form 4 · accession 0001209191-17-053356
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
Sep 15, 2017
Accepted (ET)
Sep 19, 2017 · 6:15 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 StockF5,F6 | Sep 15, 2017 | J | 18,920 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F7 | Sep 15, 2017 | J | 18,920 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F8 | Sep 15, 2017 | J | 18,920 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F9 | Sep 15, 2017 | J | 19,280 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F10 | Sep 15, 2017 | J | 42,126 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F11 | Sep 15, 2017 | J | 42,126 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F12 | Sep 15, 2017 | J | 42,124 | $0.00 | D | 0 | I | Trust |
| Common StockF13 | Sep 15, 2017 | J | 28,536 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F15 | Sep 15, 2017 | J | 83,087 | $0.00 | D | 0 | I | Trust |
| Common StockF5,F16 | Sep 15, 2017 | J | 83,087 | $0.00 | D | 0 | I | Trust |
| Common StockF1 | holding | — | — | — | 143,565 | I | Trust | |
| Common StockF2 | holding | — | — | — | 419,184 | I | Trust | |
| Common StockF3 | holding | — | — | — | 122,956 | I | Trust | |
| Common StockF14 | holding | — | — | — | 65,282 | I | Trust | |
| Common StockF17 | holding | — | — | — | 200,000 | I | Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares are held by the M/T Molina Family Trust, of which Dr. Molina and his spouse are trustees and beneficiaries.
- F10The 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.
- F11The 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.
- F12The 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.
- F13The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Carley F. Fox dated 12/3/2008.
- F14The shares are owned by JMB GRAT 1209/4 for the benefit of Josephine M. Battiste, of which Dr. Molina is sole trustee.
- F15The shares are owned by Dr. Molina, as trustee of the Katherine Rose Battiste Trust IV.
- F16The shares are owned by Dr. Molina, as trustee of the Julius Avery Battiste Trust IV.
- F17The shares are owned by JMM GRAT 716/3, of which Dr. Molina is the beneficiary.
- F2The shares are owned by the J. Marion Molina Separate Property Trust, of which Dr. Molina is sole trustee.
- F3The shares are owned by Dr. Molina's spouse, Therese A. Molina, as trustee of the MM GRAT 915/3.
- F4On September 15, 2017 the Trustee resigned and was replaced with a corporate trustee.
- F5Price not applicable to resignation of trustee.
- F6The shares are owned by Dr. Molina, as trustee of the David M.F. Molina Trust No. 2 dated 5/14/2003.
- F7The shares are owned by Dr. Molina, as trustee of the Mary Clare F. Molina Trust No. 2 dated 5/14/2003.
- F8The shares are owned by Dr. Molina, as trustee of the Colleen A.F. Fox Trust No. 2 dated 5/14/2003.
- F9The shares are owned by Dr. Molina, as trustee of the Carley A.F. Fox Trust No. 2 dated 5/14/2003.