13D Filing: Kosloske Michael W and Health Insurance Innovations Inc. (NASDAQ:HIIQ)

Page 2 of 9 – SEC Filing

1
NAMES OF REPORTING PERSONS
Michael W. Kosloske
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(a)   S
(b)   £
3
SEC USE ONLY
4
SOURCE OF FUNDS
OO
5
CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e)
£
6
CITIZENSHIP OR PLACE OF ORGANIZATION
United States
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
7
SOLE VOTING POWER
100
8
SHARED VOTING POWER
3,841,667
9
SOLE DISPOSITIVE POWER
100
10
SHARED DISPOSITIVE POWER
3,841,667
11
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
3,841,767
12
CHECK IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
£
13
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
24.38%
14
TYPE OF REPORTING PERSON
IN

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