SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Cruz Brandon M.

(Last) (First) (Middle)
214 WEST HURON ST.

(Street)
CHICAGO IL 60654

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/15/2020
3. Issuer Name and Ticker or Trading Symbol
GoHealth, Inc. [ GOCO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Strategy Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class B Common Stock 103,658,920 I By NVX Holdings, Inc.
Class B Common Stock 49,009 I By BCCJ, LLC
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
LLC Interests (1) (1) Class A Common Stock 103,658,920 (1) I By NVX Holdings, Inc.
LLC Interests (1) (1) Class A Common Stock 49,009 (1) I By BCCJ, LLC
Blizzard Management Feeder LLC Interests (2) (2) LLC Interests 3,122,505 (3) D
Explanation of Responses:
1. The LLC Interests may be redeemed by the Reporting Person at any time on or following the closing of the Initial Public Offering for shares of Class A Common Stock on a 1-to-1 basis.
2. 2,081,670 of the Blizzard Management Feeder LLC Interests ("Feeder Interests") are fully vested and currently exercisable. The remaining Feeder Interests will vest in five equal annual installments beginning on September 13, 2020 and have no expiration date
3. Feeder Interests are convertible at the option of the holder for LLC Interests on a 1-for-1 basis, which will be subsequently redeemed for an equal number of shares of Class A Common Stock.
Remarks:
Exhibit 24 - Power of Attorney.
/s/ Clinton P. Jones, Attorney-in-fact for Brandon M. Cruz 07/15/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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