SEC Form 4 · accession 0001140361-17-012540

Health Insurance Innovations, Inc. · HIIQ

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

Reporting owner

Bruce Telkamp

Officer — CEO of HealthPocket, Inc.* · Director

Period of report

Mar 15, 2017

Accepted (ET)

Mar 17, 2017 · 2:37 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
Class A Common Stock	Mar 15, 2017	M	4,000	$12.13	A	135,001	D
Class A Common Stock^F1	Mar 15, 2017	D	3,081	$15.995	D	131,920	D
Class A Common Stock	Mar 15, 2017	S	919	$16.8163	D	131,001	D
Class A Common Stock	Mar 15, 2017	M	6,500	$6.77	A	137,501	D
Class A Common Stock^F1	Mar 15, 2017	D	2,612	$16.8623	D	134,889	D
Class A Common Stock	Mar 15, 2017	S	3,888	$16.8706	D	131,001	D
Class A Common Stock	Mar 15, 2017	M	7,500	$6.77	A	138,501	D
Class A Common Stock^F1	Mar 15, 2017	D	3,078	$16.6865	D	135,423	D
Class A Common Stock	Mar 15, 2017	S	4,422	$16.8164	D	131,001	D
Class A Common Stock	Mar 16, 2017	M	7,000	$6.77	A	138,001	D
Class A Common Stock^F1	Mar 16, 2017	D	2,813	$16.8294	D	135,188	D
Class A Common Stock	Mar 16, 2017	S	4,187	$16.8155	D	131,001	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 Rights^F3	$6.77	Mar 15, 2017	M	6,500	D	—	May 25, 2021	Class A Common Stock	6,500	35,500	D
Stock Appreciation Rights^F3	$6.77	Mar 15, 2017	M	7,500	D	—	May 25, 2021	Class A Common Stock	7,500	28,000	D
Stock Appreciation Rights^F3	$6.77	Mar 16, 2017	M	7,000	D	—	May 25, 2021	Class A Common Stock	7,000	21,000	D
Stock Appreciation Rights^F4	$12.13	Mar 15, 2017	M	4,000	D	—	Jul 14, 2021	Class A Common Stock	4,000	6,000	D
Stock Appreciation Rights^F2	$6.77	holding	—	—	—	—	May 25, 2021	Class A Common Stock	84,000	84,000	D
Stock Appreciation Rights^F5	$4.95	holding	—	—	—	—	Jul 1, 2022	Class A Common Stock	30,000	30,000	D

Explanation of responses

F1Shares retained by the issuer to satisfy the exercise price of stock appreciation rights exercised by the reporting person.
F2These stock-settled stock appreciation rights were granted under the Plan and will vest as follows: (i) 42,000 on the first date on which the average trading price of the Company's Class A common stock is at or above $12.00 per share for the preceding 30 consecutive trading days, and (ii) 42,000 on the first date on which the average trading price of the Company's Class A common stock is at or above $16.00 per share for the preceding 30 consecutive trading days, all subject to the terms of the Plan and an award agreement under the Plan.
F3These stock-settled stock appreciation rights were previously granted under the Plan and will vest (either wholly or partially) based on the extent to which certain financial performance targets established by the Company's Board of Directors are achieved for the 2016 fiscal year.
F4These stock-settled stock appreciation rights were previously granted under the Issuer's Long-Term Incentive Plan and are scheduled to vest in increments of 20%, 20%, 20%, and 40% on successive anniversary dates of the grant, subject to the terms of the plan and an award agreement under the plan.
F5These stock-settled stock appreciation rights were previously granted under the Issuer's Long-Term Incentive Plan (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

* HealthPocket, Inc. is a subsidiary of Issuer.