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*
Srivastava Sanjeev K

(Last) (First) (Middle)
C/O BRIGHT HEALTH GROUP, INC.
8000 NORMAN CENTER DRIVE, SUITE 1200

(Street)
MINNEAPOLIS MN 55437

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Bright Health Group Inc. [ BHG ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
CEO, NEUEHEALTH
3. Date of Earliest Transaction (Month/Day/Year)
05/06/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
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 05/06/2021 M 593,748 A $1.773 593,748 D
Common Stock 05/06/2021 M 27,180 A $1.773 620,928 D
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
Restricted Stock Units (1) 06/28/2021 A 1,050,000 (2)(3) (2)(3) Common Stock 1,050,000 $0 1,050,000 D
Stock Options (Right to Buy) $1.773 05/06/2021 M 593,748 (4) 11/04/2029 Common Stock 593,748 $0 906,252 D
Stock Options (Right to Buy) $1.773 05/06/2021 M 27,180 (5) 02/19/2030 Common Stock 27,180 $0 41,487 D
Stock Options (Right to Buy) $2.3 (6) 11/19/2030 Common Stock 300,000 300,000 D
Explanation of Responses:
1. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock ("Common Stock").
2. These performance-based restricted stock units ("PSUs") shall vest if the performance conditions described below are met.
3. These PSUs shall vest as follows if the following price per share goals are met.
4. These stock options vest over four years as follows: (a) 25% vested on September 16, 2020 and (b) 1/48 of the original grant amount (of 1,500,000) vests in monthly installments for the following three years.
5. These stock options vest over four years as follows: (a) 25% vested on September 16, 2020, and (b) 1/48 of the original grant amount (of 68,667) vests in monthly installments for the following three years.
6. These stock options vest over four years as follows: (a) 25% vests on December 18, 2021, and (b) 1/48 of the original grant amount vests in monthly installments for the following three years.
/s/ Eric Halverson for Sanjeev K. Srivastava, Attorney-in-Fact 06/30/2021
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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