0001209191-12-017379.txt : 20120312
0001209191-12-017379.hdr.sgml : 20120310
20120312094834
ACCESSION NUMBER: 0001209191-12-017379
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120308
FILED AS OF DATE: 20120312
DATE AS OF CHANGE: 20120312
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MOLINA J MARIO MD
CENTRAL INDEX KEY: 0001246792
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-31719
FILM NUMBER: 12682542
MAIL ADDRESS:
STREET 1: C/O MOLINA HEALTHCARE, INC.
STREET 2: ONE GOLDEN SHORE DRIVE
CITY: LONG BEACH
STATE: CA
ZIP: 90802
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2012-03-08
0
0001179929
MOLINA HEALTHCARE INC
MOH
0001246792
MOLINA J MARIO MD
300 UNIVERSITY AVE., SUITE 100
SACRAMENTO
CA
95825
1
1
0
1
President & CEO
Settlor-Molina Siblings Trust
Common Stock
2012-03-08
4
S
0
15200
33.0754
D
84594
D
Common Stock
461132
D
Common Stock
120869
I
Trustee of trust
Common Stock
43050
I
Manager of limited liability company
Common Stock
107309
I
Trustee of trust
Common Stock
43131
I
Trust
Common Stock
240000
I
General partner of family partnership
Common Stock
250000
I
Trust
Common Stock
1362
I
Trust
Common Stock
1362
I
Trust
Common Stock
1361
I
Trust
Common Stock
1361
I
Trust
Stock Option (Right to Buy)
20.88
2017-03-01
Common Stock
54000
54000
D
Represents the weighted average sale price of all sales on the Transaction Date. The range of prices for the transactions was $33.00 to $33.21. The Reporting Person undertakes to provide full information about the transactions to the Commission upon request.
The shares were issued pursuant to the Issuer's Equity Incentive Plan and are fully vested. An additional 11,700 vest on March 1, 2013 and 5,850 vest on March 1, 2014.
The shares are owned by Dr. Molina and his spouse as community property.
The shares are owned by the J. Marion Molina Separate Property Trust, of which Dr. Molina is sole trustee.
The shares are owned by the Molina Family, LLC, of which Dr. Molina is the sole manager.
The shares are owned by JMB GRAT 1209/4 for the benefit of Josephine M. Battiste, of which Dr. Molina is sole trustee.
The shares are owned by JMM GRAT 1208/5, of which Dr. Molina is beneficiary.
The shares are owned by the Molina Family Partnership, L.P., of which Dr. Molina is the sole general partner. Dr. Molina and his spouse each hold a 0.5% ownership interest in the partnership. The remaining 99% of ownership interests in the partnership are held in equal amounts by the Joseph Marion Molina, M.D. Annuity Trust No. 1, the Joseph Marion Molina, M.D. Annuity Trust No. 2 and the Joseph Marion Molina, M.D. Annuity Trust No. 3. Dr. Molina is trustee and certain immediate family members of Dr. Molina are the beneficiaries of these trusts.
The shares are owned by JMM GRAT 911/4, of which Dr. Molina is the beneficiary.
The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for David M.F. Molina dated 12/3/2008.
The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Mary Clare F. Molina dated 12/3/2008.
The shares are woned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Carly F. Fox dated 12/3/2008.
The shares are owned by Dr. Molina's spouse, Therese A. Molina, Trustee of the Remainder Trust for Colleen A.F. Fox dated 12/3/2008.
The options are fully vested.
/s/ Joseph M. Molina, M.D., by Karen Calhoun, Attorney-in-Fact
2012-03-12