SEC Form 4 · accession 0001140361-17-025358
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Gavin Southwell
Officer — President and CEO · Director
Period of report
Jun 14, 2017
Accepted (ET)
Jun 16, 2017 · 4:21 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 | Jun 14, 2017 | A | 100,000 | $0.00 | A | 317,777 | 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 | $6.10 | holding | — | — | — | — | Apr 26, 2023 | Class A Common Stock | 20,000 | 20,000 | D |
| Stock Appreciation RightsF3 | $5.96 | holding | — | — | — | — | Sep 6, 2023 | Class A Common Stock | 33,333 | 33,333 | D |
| Stock Appreciation RightsF4 | $10.30 | holding | — | — | — | — | Nov 15, 2023 | Class A Common Stock | 100,000 | 100,000 | D |
Explanation of responses
- F1These restricted shares were granted under the Issuer's Long-Term Incentive Plan, as amended ("Plan"), and are scheduled to vest 25% on each of the first four anniversaries of the grant date, subject to the terms and conditions of the Plan and a Restricted Stock Award Agreement under the Plan.
- F2These stock-settled stock appreciation rights were granted under the Plan and vest 50% on the first anniversary of grant date and 50% on the second anniversary of grant date, subject to the terms of the Plan and an award agreement under the Plan.
- F3These stock-settled stock appreciation rights were granted under the Plan and vest 25% on the first anniversary of grant date, 25% on the second anniversary of grant date, and 50% on the third anniversary of grant date, subject to the terms of the Plan and an award agreement under the Plan.
- F4These stock-settled stock appreciation rights were granted under the Plan and vest 25% on each of the first four anniversaries of the date of grant, subject to the terms of the Plan and an award agreement under the Plan.