SEC Form 4 · accession 0001140361-15-025058

Health Insurance Innovations, Inc. · HIIQ

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).

Reporting owner

Officer — Exec VP, Gen. Counsel & Secy

Period of report

Jun 19, 2015

Accepted (ET)

Jun 22, 2015 · 5:01 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 Stock^F2	Jun 19, 2015	F	7,158	$4.79	D	36,362	D
Class A Common Stock^F2	Jun 19, 2015	F	4,733	$4.79	D	31,629	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Appreciation RIghts^F3	$4.72	holding	—	—	—	—	Jun 8, 2022	Class A Common Stock	25,000	25,000	D
Stock Appreciation Rights^F4	$11.75	holding	—	—	—	—	Oct 28, 2020	Class A Common Stock	175,000	175,000	D

F1Represents withholding of shares by Issuer to satisfy tax liability of Reporting Person incident to vesting of restricted stock.
F2Includes shares of restricted stock granted pursuant to the Issuer's Long Term Incentive Plan which have fully vested pursuant to the terms of a separation agreement between the Reporting Person and the Issuer.
F3These stock-settled stock appreciation rights were granted under the Issuer's Long-Term Incentive Plan and will vest upon successful completion of Reporting Person's employment transition period, which is expected to be August 31, 2015.
F4Stock Appreciation Rights awarded pursuant to the issuer's Long Term Incentive Plan which have already vested or are scheduled to vest (excluding 25,000 of the rights) on the Reporting Person's last day of employment with the Issuer, which is anticipated to be August 31, 2015.