SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MOLINA J MARIO MD

(Last) (First) (Middle)
15302 CENTRAL AVENUE

(Street)
CHINO CA 91710

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MOLINA HEALTHCARE INC [ MOH ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Former Director
3. Date of Earliest Transaction (Month/Day/Year)
12/11/2017
4. If Amendment, Date of Original Filed (Month/Day/Year)
12/13/2017
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 12/11/2017 S(1) 48,388 D $73.7133(2) 1,039,395 I Trust(3)
Common Stock 12/12/2017 S(1) 101,612 D $74.1379(4) 937,783 I Trust(3)
Common Stock 12/11/2017 S(1) 53,240 D $74.0923(5) 61,125 I Trust(6)
Common Stock 63,799 I Trust(7)
Common Stock 65,282 I Trust(8)
Common Stock 151,630 I Trust(9)
Common Stock 106,000 I Foundation(10)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Sale pursuant to the Rule 10b5-1 Trading Plan of Dr. Molina.
2. Represents the weighted average sale price of all sales on the Transaction Date. The range of prices for the transactions was $73.50 to $73.89. The Reporting Person undertakes to provide full information about the transactions to the Commission upon request.
3. The shares are owned by the J. Marion Molina Separate Property Trust, of which Dr. Molina is sole trustee.
4. Represents the weighted average sale price of all sales on the Transaction Date. The range of prices for the transactions was $73.48 to $75.53. The Reporting Person undertakes to provide full information about the transactions to the Commission upon request.
5. Represents the weighted average sale price of all sales on the Transaction Date. The range of prices for the transactions was $73.50 to $74.45. The Reporting Person undertakes to provide full information about the transactions to the Commission upon request.
6. The shares are held by the M/T Molina Family Trust, of which Dr. Molina and his spouse are trustees and beneficiaries.
7. The shares are owned by Dr. Molina's spouse, Therese A. Molina, as trustee of the MM GRAT 915/3.
8. The shares are owned by JMB GRAT 1209/4 for the benefit of Josephine M. Battiste, of which Dr. Molina is sole trustee.
9. The shares are owned by JMM GRAT 716/3, of which Dr. Molina is the beneficiary.
10. The shares are owned by the Molina Family Foundation, of which Dr. Molina is president.
Remarks:
Dr. Molina resigned from the Issuer's board of directors on December 13, 2017. This amendment corrects the number of shares sold in the first transaction.
/s/ Joseph M. Molina, M.D., by Karen Calhoun, Attorney-in-Fact 12/13/2017
** 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 4 (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).
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