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}