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