0001628908-23-000017.txt : 20230223 0001628908-23-000017.hdr.sgml : 20230223 20230223185225 ACCESSION NUMBER: 0001628908-23-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230221 FILED AS OF DATE: 20230223 DATE AS OF CHANGE: 20230223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Blackley Seth CENTRAL INDEX KEY: 0001643346 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37415 FILM NUMBER: 23661676 MAIL ADDRESS: STREET 1: 800 N. GLEBE ROAD, SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evolent Health, Inc. CENTRAL INDEX KEY: 0001628908 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741] IRS NUMBER: 320454912 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 NORTH GLEBE RD, SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 BUSINESS PHONE: 571-389-6000 MAIL ADDRESS: STREET 1: 800 NORTH GLEBE RD, SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 4 1 wf-form4_167719632820675.xml FORM 4 X0306 4 2023-02-21 0 0001628908 Evolent Health, Inc. EVH 0001643346 Blackley Seth C/O EVOLENT HEALTH, INC. 800 N. GLEBE ROAD, SUITE 500 ARLINGTON VA 22203 1 1 0 0 Chief Executive Officer Class A Common Stock 2023-02-21 4 A 0 206211 0 A 628248 D Class A Common Stock 2023-02-21 4 F 0 87786 28.08 D 540462 D Represents the number of shares received upon the settlement of the first tranche of performance-based share units (PSUs) awarded to the reporting person on March 1, 2021, following the certification of achievement of specified performance metrics. The shares underlying the first tranche of the PSU award vested at the conclusion of the performance period on December 31, 2022. Includes restricted stock units granted under awards reported on Table 1 of Form 4s previously filed with the Securities and Exchange Commission. This number represents shares of Class A Common Stock withheld to satisfy the tax withholding obligation due upon vesting of PSUs. /s/ Jonathan Weinberg, Attorney-in-fact 2023-02-23