0001140361-17-023797.txt : 20170605
0001140361-17-023797.hdr.sgml : 20170605
20170605170625
ACCESSION NUMBER: 0001140361-17-023797
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170601
FILED AS OF DATE: 20170605
DATE AS OF CHANGE: 20170605
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Health Insurance Innovations, Inc.
CENTRAL INDEX KEY: 0001561387
STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411]
IRS NUMBER: 461282634
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 15438 N. FLORIDA AVENUE
STREET 2: SUITE 201
CITY: TAMPA
STATE: FL
ZIP: 33613
BUSINESS PHONE: 813-397-1187
MAIL ADDRESS:
STREET 1: 15438 N. FLORIDA AVENUE
STREET 2: SUITE 201
CITY: TAMPA
STATE: FL
ZIP: 33613
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Telkamp Bruce
CENTRAL INDEX KEY: 0001366007
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35811
FILM NUMBER: 17892004
MAIL ADDRESS:
STREET 1: 440 EAST MIDDLEFIELD ROAD
CITY: MOUNTAIN VIEW
STATE: CA
ZIP: 94043
4
1
doc1.xml
FORM 4
X0306
4
2017-06-01
0
0001561387
Health Insurance Innovations, Inc.
HIIQ
0001366007
Telkamp Bruce
C/O HEALTH INSURANCE INNOVATIONS, INC.
15438 N. FLORIDA AVE., SUITE 201
TAMPA
FL
33613
0
1
0
0
CEO of HealthPocket, Inc.*
Class A Common Stock
2017-06-01
4
M
0
11442
6.77
A
112943
D
Class A Common Stock
2017-06-01
4
D
0
3428
22.6
D
109515
D
Class A Common Stock
2017-06-01
4
S
0
8014
22.6
D
101501
D
Stock Appreciation Rights
6.77
2017-06-01
4
M
0
11442
0
D
2021-05-25
Class A Common Stock
11442
0
D
Stock Appreciation Rights
12.13
2021-07-14
Class A Common Stock
6000
6000
D
Stock Appreciation Rights
4.95
2022-07-01
Class A Common Stock
30000
30000
D
Shares retained by the issuer to satisfy the exercise price of stock appreciation rights exercised by the reporting person.
These stock-settled stock appreciation rights were granted under the Issuer's Long-Term Incentive Plan (the "Plan") and are all currently vested.
These stock-settled stock appreciation rights were previously granted under the Plan and are scheduled to vest in increments of 20%, 20%, 20%, and 40% on successive anniversary dates of the grant, subject to the terms of the Plan and an award agreement under the Plan.
These stock-settled stock appreciation rights were previously granted under the Plan and are scheduled to vest in increments of 25%, 25%, and 50% on successive anniversary dates of the grant, subject to the terms of the Plan and an award agreement under the Plan.
* HealthPocket, Inc. is a subsidiary of Issuer.
/s/ Michael Hershberger, Attorney-in-Fact for Bruce Telkamp
2017-06-05