SEC Form 4 · accession 0001375551-15-000014
DCP Holding CO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen T Schuler
Director
Period of report
Dec 31, 2014
Accepted (ET)
Jan 5, 2015 · 12:23 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001361025
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class B Common SharesF1 | Jan 2, 2015 | A | 19 | $0.00 | A | 142 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom StockF3,F2 | — | Dec 31, 2014 | P | 2 | A | — | — | Class B Common Shares | 2 | 184 | D |
Explanation of responses
- F1Restricted Share Units granted to Reporting Person pursuant to Issuer's 2006 Dental Care Plus Management Equity incentive Plan. Each Restricted Share Unit is the economic equivalent of one Class B Common Share of Issuer. The Restricted Share Units are subject to forfeiture if Reporting Person does not attend 75% of the regularly scheduled meetings of the Board of Directors during 2015.
- F2Each share of Phantom Stock is the economic equivalent of one Class B Common Share of Issuer.
- F3The Reporting Person acquired the Phantom Stock by electing to defer compensation into Phantom Stock under the Issuer's Deferred Compensation Plan. Pursuant to such election, the Phantom Stock will be settled in cash upon the Reporting Person's termination of membership on the Issuer's Board of Directors.