SEC Form 4 · accession 0001140361-16-087457
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
Nov 17, 2016
Accepted (ET)
Nov 21, 2016 · 6:04 pm 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 | Nov 17, 2016 | S | 12,500 | $10.2566 | D | 160,369 | D | |
| Class A Common StockF2 | Nov 18, 2016 | S | 20,000 | $9.9921 | D | 140,369 | D | |
| Class A Common StockF3 | Nov 21, 2016 | S | 7,000 | $10.5771 | D | 133,369 | 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 | $10.45 | holding | — | — | — | — | May 21, 2021 | Common Stock | 25,000 | 25,000 | D |
| Stock Appreciation RIghtsF5 | $4.95 | holding | — | — | — | — | Jul 1, 2022 | Common Stock | 30,000 | 30,000 | D |
| Stock Appreciation RIghtsF5 | $4.99 | holding | — | — | — | — | Sep 16, 2022 | Common Stock | 30,000 | 30,000 | D |
| Stock Appreciation RIghtsF5 | $5.20 | holding | — | — | — | — | Sep 16, 2023 | Common Stock | 40,972 | 40,972 | D |
Explanation of responses
- F1The price in Column 4 is a weighted average price. The prices actually received ranged from $10.00 to $10.70. The reporting person has provided to the issuer, and will provide to any security holder of the issuer, or the SEC staff, upon request, information regarding the number of shares sold at each price within the range for all transactions reported in this Form 4 utilizing a weighted average price.
- F2The price in Column 4 is a weighted average price. The prices actually received ranged from $9.85 to $10.15. The reporting person has provided to the issuer, and will provide to any security holder of the issuer, or the SEC staff, upon request, information regarding the number of shares sold at each price within the range for all transactions reported in this Form 4 utilizing a weighted average price.
- F3The price in Column 4 is a weighted average price. The prices actually received ranged from $10.55 to $10.60. The reporting person has provided to the issuer, and will provide to any security holder of the issuer, or the SEC staff, upon request, information regarding the number of shares sold at each price within the range for all transactions reported in this Form 4 utilizing a weighted average price.
- F4These stock-settled stock appreciation rights were granted under the Issuer's Long-Term Incentive Plan and vest 20% on the first three anniversaries of grant date and 40% on the fourth anniversary, subject to the terms of the Long-Term Incentive Plan and an award agreement under the Long-Term Incentive Plan.
- F5These stock-settled stock appreciation rights were granted under the Issuer's Long-Term Incentive Plan and vest 50% on the first anniversary of grant date and 25% on each of the second and third anniversaries, subject to the terms of the Long-Term Incentive Plan and an award agreement under the Long-Term Incentive Plan.