SEC Form 4 · accession 0001140361-16-056443
Evolent Health, Inc. · EVH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Chad Pomeroy
Officer — Chief Technology Officer
Period of report
Mar 1, 2016
Accepted (ET)
Mar 3, 2016 · 7:17 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 | Mar 1, 2016 | A | 21,908 | $0.00 | A | 318,908 | 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 | $10.27 | Mar 1, 2016 | A | 48,685 | A | — | Mar 1, 2026 | Class A Common Stock | 48,685 | 217,785 | D |
Explanation of responses
- F1Represents restricted stock units granted to Mr. Pomeroy pursuant to the Evolent Health, Inc. 2015 Omnibus Incentive Compensation Plan.
- F2Securities vest at a rate of 25% annually beginning March 1, 2017.
- F3Securities vest at a rate of 25% annually beginning March 1, 2017.