0001062993-22-005765.txt : 20220225
0001062993-22-005765.hdr.sgml : 20220225
20220225163905
ACCESSION NUMBER: 0001062993-22-005765
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20200820
FILED AS OF DATE: 20220225
DATE AS OF CHANGE: 20220225
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: De Crescenzo Neil E.
CENTRAL INDEX KEY: 0001778464
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38961
FILM NUMBER: 22680945
MAIL ADDRESS:
STREET 1: C/O CHANGE HEALTHCARE INC.
STREET 2: 3055 LEBANON PIKE, SUITE 1000
CITY: NASHVILLE
STATE: TN
ZIP: 37214
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Change Healthcare Inc.
CENTRAL INDEX KEY: 0001756497
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 822152098
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 424 CHURCH STREET, SUITE 1400
CITY: NASHVILLE
STATE: TN
ZIP: 37219
BUSINESS PHONE: 615-932-3000
MAIL ADDRESS:
STREET 1: 424 CHURCH STREET, SUITE 1400
CITY: NASHVILLE
STATE: TN
ZIP: 37219
FORMER COMPANY:
FORMER CONFORMED NAME: HCIT Holdings, Inc.
DATE OF NAME CHANGE: 20181019
4/A
1
form4a.xml
AMENDED STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
X0306
4/A
2020-08-20
2021-12-30
0001756497
Change Healthcare Inc.
CHNG
0001778464
De Crescenzo Neil E.
C/O CHANGE HEALTHCARE INC.
424 CHURCH STREET, SUITE 1400
NASHVILLE
TN
37219
1
1
0
0
President & CEO
Common Stock
2020-08-20
4
M
0
49775
A
952410
D
Common Stock
2020-08-20
4
D
0
49775
12.93
D
902635
D
Common Stock
2021-06-17
4
M
0
65847
A
968482
D
Common Stock
2021-06-17
4
D
0
65847
23.07
D
902635
D
Common Stock
2021-08-01
4
M
0
49775
A
952410
D
Common Stock
2021-08-01
4
D
0
49775
21.71
D
902635
D
Common Stock
2021-12-28
4
M
0
49774
A
952409
D
Common Stock
2021-12-28
4
D
0
49774
21.44
D
902635
D
Common Stock
2021-12-28
4
F
0
54389
21.44
D
848246
D
Cash-Settled Restricted Stock Units
2020-08-20
4
M
0
49774
0.00
D
Common Stock
49774
99549
D
Cash-Settled Restricted Stock Units
2021-06-17
4
M
0
65847
0.00
D
Common Stock
65847
0
D
Cash-Settled Restricted Stock Units
2021-08-01
4
M
0
49775
0.00
D
Common Stock
49775
49774
D
Cash-Settled Restricted Stock Units
2021-12-28
4
M
0
49774
0.00
D
Common Stock
49774
0
D
Each cash-settled restricted stock unit represents the contingent right to receive the cash value of one share of the Company's Common Stock upon vesting
Pursuant to a grant on August 20, 2019, whereby (a) one-third will vest on each of August 1, 2021 and 2022; and (b) one-third will vest on August 1, 2021, unless a Qualified MCK Exit (as defined in the LLC Agreement of Change Healthcare LLC) has occurred prior to the second anniversary of the Company's initial public offering, in which case such one-third of the cash-settled restricted stock units will instead vest on the later of (x) August 20, 2020 and (y) the date that is 30 days after a Qualified MCK Exit.
Pursuant to a grant on June 17, 2020, these cash-settled restricted stock units vested in full on June 17, 2021.
The Form 4 filed on December 30, 2021, is being amended to remove the transaction reporting the acquisition of certain underlying RSUs, as such shares had already previously been reported at the time of grant of the RSUs and to correct the number of shares withheld from the shares deliverable upon vesting of the RSUs to satisfy tax withholding requirements, as well as the amount of securities beneficially owned following the reported transaction The amount of securities beneficially owned following the reported transaction reflects the current balance as of the filing date.
Exhibit List: Exhibit 24 - Power of Attorney
/s/ Robert Zachary Beasley, as Attorney-in-Fact
2022-02-25
EX-24
2
exhibit24.txt
POWER OF ATTORNEY
POWER OF ATTORNEY
Know all by these presents that the undersigned, does hereby
make, constitute and appoint each of Loretta Cecil, Robert
Zachary Beasley and Elizabeth Way, or any one of them, as a true
and lawful attorney-in-fact of the undersigned with full powers
of substitution and revocation, for and in the name, place and
stead of the undersigned (in the undersigned's individual
capacity), to execute and deliver such forms that the
undersigned may be required to file with the U.S. Securities and
Exchange Commission as a result of the undersigned's ownership
of or transactions in securities of Change Healthcare Inc. (i)
pursuant to Section 16(a) of the Securities Exchange Act of
1934, as amended, including without limitation, statements on
Form 3, Form 4 and Form 5 (including any amendments thereto) and
(ii) in connection with any applications for EDGAR access codes,
including without limitation the Form ID. The Power of Attorney
shall remain in full force and effect until the undersigned is
no longer required to file Forms 3, 4 and 5 with regard to his
or her ownership of or transactions in securities of Change
Healthcare Inc., unless earlier revoked in writing. The
undersigned acknowledges that Loretta Cecil, Robert Zachary
Beasley and Elizabeth Way are not assuming any of the
undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934, as amended.
By: /s/ Neil E. de Crescenzo
Name: Neil E. de Crescenzo
Date: February 2, 2022