SEC Form 4 · accession 0001140361-16-077620
TIVITY HEALTH, INC. · TVTY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert E. Dries
Officer — Chief Financial Officer
Period of report
Aug 22, 2016
Accepted (ET)
Aug 23, 2016 · 3:48 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000704415
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 22, 2016 | A | 33,000 | $0.00 | A | 33,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Market Stock UnitsF2 | — | Aug 22, 2016 | A | 33,000 | A | — | — | Common stock | 33,000 | 33,000 | D |
Explanation of responses
- F1Reflects restricted stock units that vest 33% on 8/22/2017, 33% on 8/22/2018, and 34% on 8/22/2019.
- F2Reflects an award of Market Stock Units. Each Market Stock Unit represents a contingent right to receive one share of Healthways, Inc. common stock ("Common Stock"). The number of shares of Common Stock shown above represents the award at the "target" performance level. The actual number of shares of Common Stock that may be issued to the reporting person upon vesting of the Market Stock Units ranges from a minimum of 0% to a maximum of 180% of the "target" performance level, depending on annualized total shareholder return of the Common Stock over a three-year performance period beginning on August 22, 2016.