SEC Form 4 · accession 0001140361-16-067625
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul E Avery
Director
Period of report
May 25, 2016
Accepted (ET)
May 27, 2016 · 5:08 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 | May 25, 2016 | A | 6,646 | $0.00 | A | 20,720 | 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 | $13.97 | holding | — | — | — | — | Mar 8, 2020 | Class A Common Stock | 30,000 | 30,000 | D |
Explanation of responses
- F1These restricted shares were granted under the Issuer's Long Term Incentive Plan ("Plan") and are scheduled to vest 50% on May 25, 2017 and 50% on May 25, 2018, subject to the terms and conditions of the Plan and a Restricted Stock Award Agreement under the Plan.
- F2Includes 9,054 restricted shares previously granted under the 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.
- F3These stock-settled stock appreciation rights were previously granted under the Issuer's Long Term Incentive Plan and are scheduled to vest as to 33-1/3% on August 6, 2013, 33-1/3% on May 1, 2014, and and 33-1/3% on May 1, 2015, subject to the terms of the Plan and an award agreement under the Plan.