SEC Form 4 · accession 0001140361-17-034739
Health Insurance Innovations, Inc. · HIIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sheldon Wang
Officer — Chief Technology Officer · Director
Period of report
Sep 5, 2017
Accepted (ET)
Sep 7, 2017 · 4:54 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 Stock | Sep 5, 2017 | M | 5,000 | $4.95 | A | 229,001 | D | |
| Class A Common StockF4 | Sep 5, 2017 | D | 799 | $30.95 | D | 228,202 | D | |
| Class A Common Stock | Sep 5, 2017 | S | 4,201 | $30.95 | D | 224,001 | D | |
| Class A Common Stock | Sep 6, 2017 | M | 5,000 | $4.95 | A | 229,001 | D | |
| Class A Common StockF4 | Sep 6, 2017 | D | 779 | $31.80 | D | 228,222 | D | |
| Class A Common Stock | Sep 6, 2017 | S | 4,221 | $31.80 | D | 224,001 | D | |
| Class A Common Stock | Sep 6, 2017 | M | 5,000 | $6.77 | A | 229,001 | D | |
| Class A Common StockF4 | Sep 6, 2017 | D | 1,065 | $3,180.00 | D | 227,936 | D | |
| Class A Common Stock | Sep 6, 2017 | S | 3,935 | $31.80 | D | 224,001 | D | |
| Class A Common Stock | Sep 6, 2017 | M | 5,000 | $6.77 | A | 229,001 | D | |
| Class A Common StockF4,F5 | Sep 6, 2017 | D | 1,050 | $32.25 | D | 227,951 | D | |
| Class A Common StockF5 | Sep 6, 2017 | S | 3,950 | $32.25 | D | 224,001 | 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 RightsF1 | $4.95 | Sep 5, 2017 | M | 5,000 | D | — | Jul 1, 2022 | Class A Common Stock | 5,000 | 25,000 | D |
| Stock Appreciation RightsF1 | $4.95 | Sep 6, 2017 | M | 5,000 | D | — | Jul 1, 2022 | Common Stock | 5,000 | 20,000 | D |
| Stock Appreciation RightsF2 | $6.77 | Sep 6, 2017 | M | 10,000 | D | — | May 25, 2021 | Common Stock | 10,000 | 31,039 | D |
| Stock Appreciation RightsF3 | $12.13 | holding | — | — | — | — | Jul 14, 2021 | Class A Common Stock | 6,000 | 6,000 | D |
Explanation of responses
- F1These stock-settled stock appreciation rights were previously granted under 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.
- F2These stock-settled stock appreciation rights were granted under the Issuer's Long Term Incentive Plan (the "Plan") and are vested as of the date of this Form 4.
- F3These stock-settled stock appreciation rights were previously granted under the 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.
- F4Shares retained by the issuer to satisfy the exercise price of stock appreciation rights exercised by the reporting person.
- F5The price reported in Column 4 is a weighted average price. The shares were sold in multiple transactions at prices ranging from $32.25 to $32.275, inclusive. The Reporting Person undertakes to provide the Company, any security holder of the Company, 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.