SEC Form 4 · accession 0001140361-17-035053
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 7, 2017
Accepted (ET)
Sep 11, 2017 · 4:50 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 7, 2017 | M | 893 | $12.13 | A | 224,894 | D | |
| Class A Common StockF1 | Sep 7, 2017 | D | 326 | $33.25 | D | 224,568 | D | |
| Class A Common Stock | Sep 7, 2017 | S | 567 | $33.25 | D | 224,001 | D | |
| Class A Common Stock | Sep 7, 2017 | M | 5,000 | $6.77 | A | 229,001 | D | |
| Class A Common StockF1,F2 | Sep 7, 2017 | D | 1,037 | $32.6538 | D | 227,964 | D | |
| Class A Common StockF2 | Sep 7, 2017 | S | 3,963 | $32.6538 | 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 RightsF3 | $12.13 | Sep 7, 2017 | M | 893 | D | — | Jul 14, 2021 | Class A Common Stock | 893 | 5,107 | D |
| Stock Appreciation RightsF4 | $6.77 | Sep 7, 2017 | M | 5,000 | D | — | May 25, 2021 | Class A Common Stock | 5,000 | 26,039 | D |
| Stock Appreciation RightsF5 | $4.95 | holding | — | — | — | — | Jul 1, 2022 | Class A Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1Shares retained by the issuer to satisfy the exercise price of stock appreciation rights exercised by the reporting person.
- F2The price reported in Column 4 is a weighted average price. The shares were sold in multiple transactions at prices ranging from $32.65 to $32.70, 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.
- 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.
- F4These 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.
- F5These 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.