0001567619-20-005851.txt : 20200306 0001567619-20-005851.hdr.sgml : 20200306 20200306174545 ACCESSION NUMBER: 0001567619-20-005851 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200304 FILED AS OF DATE: 20200306 DATE AS OF CHANGE: 20200306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Southwell Gavin CENTRAL INDEX KEY: 0001678010 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35811 FILM NUMBER: 20695988 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 NORTH FLORIDA AVE., SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Benefytt Technologies, 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 FORMER COMPANY: FORMER CONFORMED NAME: Health Insurance Innovations, Inc. DATE OF NAME CHANGE: 20121031 4 1 doc1.xml FORM 4 X0306 4 2020-03-04 0 0001561387 Benefytt Technologies, Inc. BFYT 0001678010 Southwell Gavin C/O HEALTH INSURANCE INNOVATIONS, INC. 15438 NORTH FLORIDA AVE., SUITE 201 TAMPA FL 33613 1 1 0 0 President and CEO Class A Common Stock 2020-03-04 4 F 0 19675 25.67 D 554471 D Stock Appreciation Rights 6.10 2023-04-26 Class A Common Stock 20000 20000 D Stock Appreciation Rights 5.96 2023-09-06 Class A Common Stock 33333 33333 D Stock Appreciation Rights 10.30 2023-11-15 Class A Common Stock 100000 100000 D Represents withholding of shares by Issuer to satisfy tax liability of Reporting Person incident to vesting of restricted stock. These stock-settled stock appreciation rights were granted under the Issuer's Long Term Incentive Plan and are exercisable in full. These stock-settled stock appreciation rights were granted on November 15, 2016 under the Issuer's Long Term Incentive Plan and vest 25% on each of the first four anniversaries of the date of grant, subject to the terms of the Plan and award agreement under the Plan. /s/ Curt P. Creely, Attorney in Fact for Gavin Southwell 2020-03-06