SEC Form 4 · accession 0001213774-17-000004
INDEPENDENCE HOLDING CO · IHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David T Kettig
Officer — President and COO · Director
Period of report
Nov 16, 2017
Accepted (ET)
Nov 17, 2017 · 5:33 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000701869
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 16, 2017 | M | 27,500 | $9.99 | A | 132,056 | D | |
| Common Stock | Nov 16, 2017 | F | 18,507 | $27.65 | D | 113,549 | D | |
| Common Stock | Nov 16, 2017 | D | 25,000 | $27.65 | D | 88,549 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to buy)F2 | $9.99 | Nov 16, 2017 | M | 27,500 | D | — | Mar 19, 2018 | Common Stock | 27,500 | 0 | D |
| Stock Option (Right to buy)F3 | $27.65 | Nov 16, 2017 | A | 27,500 | A | — | Nov 16, 2022 | Common Stock | 27,500 | 27,500 | D |
| Stock Appreciation RightF3 | $27.65 | Nov 16, 2017 | A | 11,000 | A | — | Nov 16, 2022 | Common Stock | 11,000 | 11,000 | D |
Explanation of responses
- F1Represents a "net exercise" of stock option. The reporting person received 8,993 shares of common stock on net exercise of option to purchase 27,500 shares of common stock. The Company witheld 18,507 shares of common stock underlying the option for payment of the exercise price and applicable taxes, based on the closing stock price on November 16, 2017 of $27.65.
- F2Fully vested as of the date hereof.
- F3Vests in three equal annual installments beginning on the one-year anniversary of the grant date.