0001179929-20-000018.txt : 20200110
0001179929-20-000018.hdr.sgml : 20200110
20200110205547
ACCESSION NUMBER: 0001179929-20-000018
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20200110
FILED AS OF DATE: 20200110
DATE AS OF CHANGE: 20200110
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Keim Mark Lowell
CENTRAL INDEX KEY: 0001690677
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-31719
FILM NUMBER: 20522390
MAIL ADDRESS:
STREET 1: 440 LINCOLN STREET
STREET 2: E-6
CITY: WORCESTER
STATE: MA
ZIP: 01653
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
FORMER COMPANY:
FORMER CONFORMED NAME: MOLINA HEALTHCARE INC
DATE OF NAME CHANGE: 20020812
4
1
wf-form4_157870772795221.xml
FORM 4
X0306
4
2020-01-10
0
0001179929
MOLINA HEALTHCARE, INC.
MOH
0001690677
Keim Mark Lowell
2180 HARVARD STREET
SUITE 400
SACRAMENTO
CA
95815
0
1
0
0
Executive Vice President
Common Stock
2020-01-10
4
F
0
1064
143.35
D
19185
D
The shares were applied to the payment of withholding taxes arising in connection with the vesting of 2,939 shares on January 10, 2020.
Represents the actual selling price per share of all 1,064 shares.
The shares vest as follows: 2,939 shares are subject to vesting on each of January 10, 2021, and January 10, 2022; and 1,391 shares are subject to vesting on each of March 1, 2020, and March 1, 2021; and 5,780 shares are subject to vesting in one-third increments on each of March 1, 2020, March 1, 2021, and March 1, 2022.
Jeff D. Barlow, by power of attorney for Mark Lowell Keim
2020-01-10
EX-24
2
limitedpowerofattorney-keim.txt
LIMITED POWER OF ATTORNEY
LIMITED POWER OF ATTORNEY FOR SECTION 16(a) FILINGS
Know all by these presents that the undersigned hereby constitutes and
appoints Jeff D. Barlow and Codruta Boggs, and each acting singly, the
undersigned's true and lawful attorney-in-fact to:
1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer, director and/or stockholder of Molina Healthcare,
Inc. (the "Company"), Forms 3, 4, and 5 and amendments thereto in
accordance with Section 16(a) of the Securities Exchange Act of 1934 and
the rules thereunder; and
2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Form
3, 4, or 5 or amendments thereto and timely file such form with the
United States Securities and Exchange Commission (the "SEC") and any stock
exchange or similar authority.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of the
rights and powers herein granted, as fully to all intents and purposes as
the undersigned might or could do if personally present, with full power
of substitution or revocation, hereby ratifying and confirming all that
such attorney-in-fact, or such attorney-in-fact's substitute or
substitutes, shall lawfully do or cause to be done by virtue of this
Power of Attorney and the rights and powers herein granted. The
undersigned acknowledges that the foregoing attorneys-in-fact, in serving
in such capacity at the request of the undersigned, are not assuming, nor
is the Company assuming, any of the undersigned's responsibilities to
comply with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect
to the undersigned's holdings of and transaction in securities of the
Company, unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact. This Power of Attorney may
be filed with the SEC as a confirming statement of the authority granted
herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 9th day of March 2018.
/s/ Mark Lowell Keim
Signature
Mark Lowell Keim
Printed Name
Exhibit 24
{00386893;1}