SEC Form 4 · accession 0000950157-17-000197
Evolent Health, Inc. · EVH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Seth Blackley
Officer — President
Period of report
Feb 1, 2017
Accepted (ET)
Feb 3, 2017 · 7:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001628908
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1,F2 | Feb 1, 2017 | A | 41,096 | $0.00 | A | 865,944 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class A Common Stock Option (right to buy)F3 | $18.25 | Feb 1, 2017 | A | 91,912 | A | — | Feb 1, 2027 | Class A Common Stock | 91,912 | 91,912 | D |
Explanation of responses
- F1Represents restricted stock units granted to Mr. Blackley pursuant to the Evolent Health, Inc. 2015 Omnibus Incentive Compensation plan.
- F2Securities vest at a rate of 25% annually beginning February 1, 2018.
- F3Securities vest at a rate of 25% annually beginning February 1, 2018.