SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Gertsch Timothy

(Last) (First) (Middle)
C/O AGILON HEALTH, INC.
6210 E HWY, SUITE 450

(Street)
AUSTIN TX 78723

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/16/2023
3. Issuer Name and Ticker or Trading Symbol
agilon health, inc. [ AGL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Accounting Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 11,518(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Options (Right to buy) (2) 07/29/2030 Common Stock 17,500 $4.5 D
Options (Right to buy) (3) 07/29/2030 Common Stock 26,250 $8.99 D
Options (Right to buy) (4) 04/14/2031 Common Stock 2,035 $23 D
Options (Right to buy) (5) 04/14/2032 Common Stock 2,854 $23.07 D
Options (Right to buy) (6) 05/24/2032 Common Stock 4,326 $18.8 D
Explanation of Responses:
1. Includes 10,396 restricted stock units that vest in four equal installments on each anniversary of April 14, 2021, April 14, 2022, May 24, 2022 or April 14, 2023, subject to continued employment.
2. These options were granted on July 29, 2020, and vest in four equal installments on each anniversary of June 29, 2020, subject to continued employment.
3. These options were granted on July 29, 2020, and vest in four equal installments on each of September 14, 2021, June 29, 2022, June 29, 2023, and June 29, 2024, subject to continued employment.
4. These options were granted on April 14, 2021, and vest in four equal installments on each anniversary of April 14, 2021, subject to continued employment.
5. These options were granted on April 14, 2022, and vest in four equal installments on each anniversary of April 14, 2022, subject to continued employment.
6. These options were granted on May 24, 2022, and vest in four equal installments on each anniversary of May 24, 2022, subject to continued employment.
Remarks:
Exhibit List: Ex.24 - Power of Attorney
/s/ Steve Meetre, as Attorney-in-Fact 08/18/2023
** 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 5 (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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.