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*
Orozco Tomas

(Last) (First) (Middle)
8000 NORMAN CENTER DRIVE
SUITE 900

(Street)
MINNEAPOLIS MN 55437

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/03/2023
3. Issuer Name and Ticker or Trading Symbol
Bright Health Group Inc. [ BHG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, Consumer Care
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 1,696 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
Restricted Stock Units (1) (1) Common Stock 4,655 (2) D
Restricted Stock Units (3) (3) Common Stock 3,971 (2) D
Restricted Stock Units (4) (4) Common Stock 7,472 (2) D
Explanation of Responses:
1. These restricted stock units vest over three years as follows: (a) one-third of the original grant amount vested on March 7, 2023, (b) one-third of the original grant amount vests on March 7, 2024, (c) and one-third of the original grant amount vests on March 7, 2025.
2. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
3. All of these restricted stock units vest on January 3, 2025, two years from the grant date.
4. These restricted stock units vest over three years as follows: (a) one-third of the original grant amount vests on March 6, 2024, (b) one-third of the original grant amount vests on March 6, 2025, (c) and one-third of the original grant amount vests on March 6, 2026.
Remarks:
/s/ Eric Halverson for Tomas Orozco, Attorney-in-Fact 11/13/2023
** 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.
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