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