SEC Form 4 · accession 0001140361-15-024291
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul G Gabos
Director
Period of report
Jun 11, 2015
Accepted (ET)
Jun 15, 2015 · 4:13 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,F3 | Jun 11, 2015 | P | 3,344 | $4.854 | A | 27,398 | D | |
| Class A Common StockF2,F3 | Jun 12, 2015 | P | 6,656 | $4.995 | A | 34,054 | 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 RightsF4 | $11.73 | holding | — | — | — | — | Mar 8, 2020 | Class A Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1The price reported in column 4 is a weighted average price. These securities were purchased in multiple transactions at prices ranging from $4.85 to $4.90, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of securities purchased at each separate price within the range set forth herein.
- F2The price reported in column 4 is a weighted average price. These securities were purchased in multiple transactions at prices ranging from $4.90 to $5.03, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of securities purchased at each separate price within the range set forth herein.
- F3Includes 9,054 restricted shares granted under the Issuer's Long Term Incentive Plan ("Plan") which are scheduled to vest 50% on May 19, 2016 and 50% on May 19, 2017, subject to the terms and conditions of the Plan and a Restricted Stock Award Agreement under the Plan.
- F4These stock-settled stock appreciation rights were granted under the Issuer's Long Term Incentive Plan and became fully vested on May 1, 2015, subject to the terms of the Plan and an award agreement under the Plan.