4//SEC Filing
Health Insurance Innovations, Inc. 4
Accession 0001140361-16-087585
CIK 0001561387operating
Filed
Nov 21, 7:00 PM ET
Accepted
Nov 22, 4:24 PM ET
Size
14.2 KB
Accession
0001140361-16-087585
Insider Transaction Report
Form 4
Kosloske Michael W
DirectorChief Executive Officer10% Owner
Transactions
- Award
Stock Appreciation Rights
2016-11-19+106,173→ 106,173 totalExercise: $9.80Exp: 2023-11-19→ Common Stock (106,173 underlying)
Holdings
- 100
Class A Common Stock
- 7,203(indirect: See Footnote)
Class A Common Stock
- 26,079(indirect: See Footnote)
Class A Common Stock
- 6,841,667(indirect: See Footnote)
Class A Common Stock
Transactions
- Award
Stock Appreciation Rights
2016-11-19+106,173→ 106,173 totalExercise: $9.80Exp: 2023-11-19→ Common Stock (106,173 underlying)
Holdings
- 100
Class A Common Stock
- 7,203(indirect: See Footnote)
Class A Common Stock
- 6,841,667(indirect: See Footnote)
Class A Common Stock
- 26,079(indirect: See Footnote)
Class A Common Stock
Kosloske Lori
Chief Compliance OfficerOther
Transactions
- Award
Stock Appreciation Rights
2016-11-19+106,173→ 106,173 totalExercise: $9.80Exp: 2023-11-19→ Common Stock (106,173 underlying)
Holdings
- 26,079(indirect: See Footnote)
Class A Common Stock
- 6,841,667(indirect: See Footnote)
Class A Common Stock
- 100
Class A Common Stock
- 7,203(indirect: See Footnote)
Class A Common Stock
Transactions
- Award
Stock Appreciation Rights
2016-11-19+106,173→ 106,173 totalExercise: $9.80Exp: 2023-11-19→ Common Stock (106,173 underlying)
Holdings
- 7,203(indirect: See Footnote)
Class A Common Stock
- 6,841,667(indirect: See Footnote)
Class A Common Stock
- 26,079(indirect: See Footnote)
Class A Common Stock
- 100
Class A Common Stock
Footnotes (4)
- [F1]By Lori Kosloske. Michael Kosloske and Lori Kosloske are husband and wife.
- [F2]By Michael W. Kosloske 2012 Descendants Trust Agreement dated December 7, 2012, Lori Kosloske as Directing Trustee.
- [F3]This number of shares consists of 6,772,451 shares of Class B Common Stock held of record by Health Plan Intermediaries, LLC ("HPI") and 69,216 shares of Class B Common Stock held by Health Plan Intermediaries Sub, LLC ("HPIS"). Michael Kosloske is the sole member and primary manager of HPI, and has sole voting and dispositive power over the shares held by HPI. HPI is the sole managing member of HPIS and has sole voting and dispositive power over the shares held by HPIS. Mr. Kosloske, by virtue of his control of HPI and HPI's control of HPIS, may be deemed to beneficially own all the shares of Class B Common Stock held of record by each of HPI and HPIS. The shares of Class B Common Stock, together with the Series B Membership Interests of HPI, are exchangeable, at Mr. Kosloske's election, for equal numbers of shares of Class A Common Stock. This exchange right has no expiration date.
- [F4]These stock-settled stock appreciation rights were granted to Michael Kosloske under the Issuer's Long-Term Incentive Plan and vest 50% on the first anniversary of grant date and 25% on each of the second and third anniversaries, subject to the terms of the Long-Term Incentive Plan and an award agreement under the Long-Term Incentive Plan.
Documents
Issuer
Health Insurance Innovations, Inc.
CIK 0001561387
Entity typeoperating
IncorporatedDE
Related Parties
1- filerCIK 0001561387
Filing Metadata
- Form type
- 4
- Filed
- Nov 21, 7:00 PM ET
- Accepted
- Nov 22, 4:24 PM ET
- Size
- 14.2 KB