SEC Form 4 · accession 0001140361-15-026761
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael D Hershberger
Officer — SVP of Finance
Period of report
Jul 1, 2015
Accepted (ET)
Jul 6, 2015 · 4:10 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,F2 | Jul 1, 2015 | A | 40,000 | $0.00 | A | 139,462 | 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 RIghtsF3 | $4.95 | Jul 1, 2015 | A | 30,000 | A | — | Jul 1, 2022 | Common Stock | 30,000 | 30,000 | D |
Explanation of responses
- F1Consists of 40,000 shares of restricted stock granted under the Issuer's Long-Term Incentive Plan (the "Plan") which vest in increments of 25%, 25%, and 50% on successive anniversary dates of the grant, subject to the terms of the Plan and an award agreement under the Plan.
- F2This total reflects the disposition of an aggregate of 48,500 shares in 2014 at a time when the reporting person was temporarily not subject to the reporting requirements of Section 16 (such dispositions consisting of the withholding of restricted shares by the issuer to satisfy tax obligations and the sale of shares under a plan of sale under Rule 10b5-1(c)).
- F3These stock-settled stock appreciation rights were granted under the Plan and are scheduled to vest in increments of 25%, 25%, and 50% on successive anniversary dates of the grant, subject to the terms of the Plan and an award agreement under the Plan.