SEC Form 4 · accession 0001140361-17-027338
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
Jul 3, 2017
Accepted (ET)
Jul 6, 2017 · 4:20 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 StockF2 | Jul 3, 2017 | S | 5,000 | $23.219 | D | 105,369 | D | |
| Class A Common Stock | Jul 3, 2017 | F | 3,300 | $23.50 | D | 102,069 | 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
- F1Sale made pursuant to 10b5-1 plan executed on November 18, 2016.
- F2The price reported in Column 4 is a weighted average price. The shares were sold in multiple transactions at prices ranging from $22.90 to $23.65, inclusive. The Reporting Person undertakes to provide Health Insurance Innovations Inc., any security holder of Health Insurance Innovations Inc., or the staff of the Securities & Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth herein.
- F3Represents withholding of shares by Issuer to satisfy tax liability of Reporting Person incident to vesting of restricted stock.
- F4These stock-settled stock appreciation rights were granted under the Long Term Incentive Plan of Health Insurance Innovations, Inc. (the "Plan") and vest 20% on the first three anniversaries of grant date and 40% on the fourth anniversary, subject to the terms of the Plan and an award agreement under the Plan.
- F5These stock-settled stock appreciation rights were granted under the Plan and vest 25% on the first and second anniversaries of grant date and 50% on the third anniversary, subject to the terms of the Plan and an award agreement under the Plan.