0001179929-17-000161.txt : 20170705 0001179929-17-000161.hdr.sgml : 20170705 20170705175210 ACCESSION NUMBER: 0001179929-17-000161 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170630 FILED AS OF DATE: 20170705 DATE AS OF CHANGE: 20170705 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MOLINA HEALTHCARE INC CENTRAL INDEX KEY: 0001179929 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 134204626 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 OCEANGATE, SUITE 100 CITY: LONG BEACH STATE: CA ZIP: 90802 BUSINESS PHONE: 5624353666 MAIL ADDRESS: STREET 1: 200 OCEANGATE, SUITE 100 CITY: LONG BEACH STATE: CA ZIP: 90802 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Barlow Jeff D. CENTRAL INDEX KEY: 0001555603 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31719 FILM NUMBER: 17948891 MAIL ADDRESS: STREET 1: 300 UNIVERSITY AVENUE, SUITE 100 CITY: SACRAMENTO STATE: CA ZIP: 95825 4 1 wf-form4_149929150301097.xml FORM 4 X0306 4 2017-06-30 0 0001179929 MOLINA HEALTHCARE INC MOH 0001555603 Barlow Jeff D. 300 UNIVERSITY AVENUE SUITE 100 SACRAMENTO CA 95825 0 1 0 0 Chief Legal Officer Common Stock 2017-06-30 4 A 0 432 54.26 A 60444 D The shares were acquired under the Molina Healthcare, Inc. 2011 Employee Stock Purchase Plan. Represents the closing price of Issuer's common stock on December 30, 2016. The purchase price is based on the stock's lower market price as of the two following dates: (1) January 1, 2017, the first day of the ESPP offering period, and (2) June 30, 2017, the last day of the ESPP offering period. The shares vest as follows: (i) 9,474 shares shall vest in one-third increments over three years, on each of March 1, 2018, March 1, 2019, and March 1, 2020; (ii) 3,132 shares shall vest based on the Company's 2017 after tax profit margin; (iii) 3,132 shares shall vest based on the Company's 2018 after tax profit margin; (iv) 3,132 shares shall vest based upon the Company's 2017 STARS ratings; (v) 4,698 shares shall vest upon the Company's achievement of certain business development targets; (vi) 6,263 shares shall vest in two increments on each of March 7, 2018 and March 7, 2019; continued (vii) 1,885 shares shall vest based on the Company's 2017 annual premium revenue achievement; (viii) 1,885 shares shall vest based on the Company's 2017 net profit margin achievement; (ix) 1,885 shares shall vest based on pre-tax income in fiscal year 2017; (x) 1,885 shares shall vest upon the Company's achieving a three-year Total Stockholder Return (TSR) for the three-year period ending December 31, 2017 as determined by ISS calculations that is greater than the median TSR achieved by the Company's 2015 ISS peer group; and (xi) 1,885 shares shall vest on April 1, 2018; the remainder of the shares are vested. Jeff D. Barlow 2017-07-05