0001140361-18-016496.txt : 20180402
0001140361-18-016496.hdr.sgml : 20180402
20180402173334
ACCESSION NUMBER: 0001140361-18-016496
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180329
FILED AS OF DATE: 20180402
DATE AS OF CHANGE: 20180402
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: 18730511
MAIL ADDRESS:
STREET 1: 440 EAST MIDDLEFIELD ROAD
CITY: MOUNTAIN VIEW
STATE: CA
ZIP: 94043
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
4
1
doc1.xml
FORM 4
X0306
4
2018-03-29
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
2017-09-01
4
M
0
2000
12.13
A
19500
D
Class A Common Stock
2017-09-01
4
D
0
668
36.1885
D
18832
D
Class A Common Stock
2017-09-01
4
S
0
1332
36.1885
D
17500
D
Class A Common Stock
2017-09-01
4
M
0
10000
4.95
A
27500
D
Class A Common Stock
2017-09-01
4
D
0
1362
36.1885
D
26138
D
Class A Common Stock
2017-09-01
4
S
0
8638
36.1885
D
17500
D
Stock Appreciation Rights
12.13
2017-09-01
4
M
0
2000
0
D
2021-07-14
Class A Common Stock
2000
4000
D
Stock Appreciation Rights
4.95
2017-09-01
4
M
0
10000
0
D
2022-07-01
Class A Common Stock
10000
20000
D
These stock-settled stock appreciation rights were previously granted under the Issuer's Long Term Incentive Plan, as amended ("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.
Shares retained by the issuer to satisfy the exercise price of stock appreciation rights exercised by the reporting person.
The price reported in Column 4 is a weighted average price. The shares were sold in multiple transactions at prices ranging from $36.00 to $36.35, inclusive. The Reporting Person undertakes to provide Health Insurance Innovations Inc. (the "Company"), any security holder of the Company, or the staff of the Securities & Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth herein.
* HealthPocket, Inc. is a subsidiary of Issuer.
/s/ Michael Hershberger, Attorney-in-Fact for Bruce Telkamp
2017-09-05