You can access the original SEC filing by clicking here.
Ownership Summary Table
Name | Sole Voting Power | Shared Voting Power | Sole Dispositive Power | Shared Dispositive Power | Aggregate Amount Owned Power | Percent of Class |
---|---|---|---|---|---|---|
Michael W. Kosloske | 100 | 3,841,667 | 100 | 3,841,667 | 3,841,767 | 24.38% |
Health Plan Intermediaries | 3,841,667 | 3,841,667 | 3,841,667 | 24.38% | ||
Health Plan Intermediaries Sub | 3,841,667 | 3,841,667 | 3,841,667 | 24.38% |
Page 1 of 9 – SEC Filing
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D/A Under the Securities Exchange Act of 1934 (Amendment No. 2)* | |||
Health Insurance Innovations, Inc. | |||
(Name of Issuer) | |||
Class A Common Stock, par value $0.001 per share | |||
(Title of Class of Securities) | |||
42225K106 | |||
(CUSIP Number) | |||
Michael W. Kosloske c/o Health Insurance Innovations, Inc. 15438 N. Florida Avenue, Suite 201 Tampa, Florida 33613 (877) 376-5831 | |||
(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) | |||
March 13, 2017 | |||
(Date of Event Which Requires Filing of this Statement) |
* | The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. |
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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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Page 3 of 9 – SEC Filing
1 | NAMES OF REPORTING PERSONS Health Plan Intermediaries, LLC | ||
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 Florida | ||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER None | |
8 | SHARED VOTING POWER 3,841,667 | ||
9 | SOLE DISPOSITIVE POWER None | ||
10 | SHARED DISPOSITIVE POWER 3,841,667 | ||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,841,667 | ||
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 OO |
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Page 4 of 9 – SEC Filing
1 | NAMES OF REPORTING PERSONS Health Plan Intermediaries Sub, LLC | ||
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 Delaware | ||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER None | |
8 | SHARED VOTING POWER 3,841,667 | ||
9 | SOLE DISPOSITIVE POWER None | ||
10 | SHARED DISPOSITIVE POWER 3,841,667 | ||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,841,667 | ||
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 OO |
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Page 5 of 9 – SEC Filing
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Page 7 of 9 – SEC Filing
(a) | Kosloske directly owns 100 shares of Class A common stock of the Issuer. These shares represent less than 1% of the total number of shares of Class A common stock outstanding. |
(b) | Kosloske has the sole power to vote and dispose of the 100 shares of Class A common stock that he directly owns. |
(c) | Other than as described above, to the best knowledge of the Reporting Persons, none of the Reporting Persons has effected a transaction in membership interests in HPIH or shares of Class A common stock or Class B common stock during the past 60 days. |
(d) | Other than the Reporting Persons, no other person is known to have the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, the Reporting Persons’ securities. |
(e) | Not applicable. |
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Page 8 of 9 – SEC Filing
EXHIBIT | DOCUMENT |
1 | Joint Filing Agreement dated February 22, 2013 among the Reporting Persons.* |
2 | Exchange Agreement dated as of February 13, 2013 (incorporated by reference to Exhibit 10.3 to Current Report on Form 8-K filed by the Issuer with the Securities and Exchange Commission on February 13, 2013). |
3 | Registration Rights Agreement dated as of February 13, 2013 (incorporated by reference to Exhibit 4.1 to Current Report on Form 8-K filed by the Issuer with the Securities and Exchange Commission on February 13, 2013). |
* Previously filed.
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Page 9 of 9 – SEC Filing
Date: March 16, 2017 | MICHAEL W. KOSLOSKE By: /s/ Michael W. Kosloske Name: Michael W. Kosloske |
HEALTH PLAN INTERMEDIARIES, LLC By: /s/ Michael W. Kosloske Name: Michael W. Kosloske Title: Authorized Signatory | |
HEALTH PLAN INTERMEDIARIES SUB, LLC By: /s/ Michael W. Kosloske Name: Michael W. Kosloske Title: Authorized Signatory | |