SEC Form 4 · accession 0001140361-15-021368
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael A. Petrizzo Jr.
Officer — Exec VP, Gen. Counsel & Secy
Period of report
May 19, 2015
Accepted (ET)
May 21, 2015 · 4:21 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001561387
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1 | May 19, 2015 | P | 5,000 | $4.75 | A | 43,520 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Appreciation RightsF2 | $11.75 | holding | — | — | — | — | Oct 28, 2020 | Class A Common Stock | 175,000 | 175,000 | D |
Explanation of responses
- F1Includes 40,000 shares of restricted stock granted pursuant to the Issuer's Long Term Incentive Plan which vest as follows: 25% on the first anniversary of the date of grant; 25% on the second anniversary of the date of grant; and 50% on the third anniversary of the date of grant.
- F2Stock Appreciation Rights awarded pursuant to the issuer's Long Term Incentive Plan which vest as follows: 20% on the first anniversary of the date of grant, 20% on the second anniversary of the date of grant, 20% on the third anniversary of the date of grant and 40% on the fourth anniversary of the date of grant.