SEC Form 4 · accession 0001140361-16-056929
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael D Hershberger
Officer — CFO, Secretary and Treasurer
Period of report
Sep 16, 2015
Accepted (ET)
Mar 8, 2016 · 10:19 am EST
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 | Sep 16, 2015 | A | 30,000 | $0.00 | A | 169,462 | 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 RIghtsF2 | $4.99 | Sep 16, 2015 | A | 30,000 | A | — | Sep 16, 2022 | Common Stock | 30,000 | 30,000 | D |
Explanation of responses
- F1Consists of 30,000 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.
- F2These 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.
Remarks
This filing reflects grants previously reported on Form 8-K on September 22, 2015.