0001567619-20-011478.txt : 20200602 0001567619-20-011478.hdr.sgml : 20200602 20200602114014 ACCESSION NUMBER: 0001567619-20-011478 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200601 FILED AS OF DATE: 20200602 DATE AS OF CHANGE: 20200602 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ashworth Richard M CENTRAL INDEX KEY: 0001617806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19364 FILM NUMBER: 20936055 MAIL ADDRESS: STREET 1: 200 WILMOT ROAD CITY: DEERFIELD STATE: IL ZIP: 60015 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TIVITY HEALTH, INC. CENTRAL INDEX KEY: 0000704415 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 621117144 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 701 COOL SPRINGS BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 6156144929 MAIL ADDRESS: STREET 1: 701 COOL SPRINGS BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHWAYS, INC. DATE OF NAME CHANGE: 20170104 FORMER COMPANY: FORMER CONFORMED NAME: TIVITY HEALTH, INC DATE OF NAME CHANGE: 20161230 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHWAYS, INC DATE OF NAME CHANGE: 20060201 4 1 doc1.xml FORM 4 X0306 4 2020-06-01 0 0000704415 TIVITY HEALTH, INC. TVTY 0001617806 Ashworth Richard M 701 COOL SPRINGS BOULEVARD FRANKLIN TN 37067 1 1 0 0 President and CEO Common Stock 2020-06-01 4 A 0 650000 0 A 650000 D Market Stock Units 2020-06-01 4 A 0 150000 0 A Common stock 150000 150000 D Reflects restricted stock units ("RSUs") granted to the reporting person in connection with his employment as President and Chief Executive Officer of Tivity Health, Inc. effective 6/1/2020. 300,000 RSUs vest on 6/1/2021, 175,000 RSUs vest on 6/1/2022, and 175,000 RSUs vest on 6/1/2023. Reflects an award of Market Stock Units ("MSUs"). Each MSU represents a contingent right to receive one share of Tivity Health, Inc. common stock ("Common Stock"). The number of shares of Common Stock shown above represents the award at the target performance level. The actual number of shares of Common Stock that may be issued to the reporting person upon vesting of the MSUs ranges from a minimum of 0% to a maximum of 300% of the target performance level, depending on cumulative total shareholder return of the Common Stock over a three-year performance period beginning on June 1, 2020. /s/ Mary Flipse, by power of attorney for Richard M. Ashworth 2020-06-02