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