Filing Details
- Accession Number:
- 0001140361-17-012162
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2017-03-15 17:55:12
- Reporting Period:
- 2017-03-13
- Filing Date:
- 2017-03-15
- Accepted Time:
- 2017-03-15 17:55:12
- SEC Url:
- Form 4 Filing
Issuer
Cik | Name | Symbol | Sector (SIC) | IRS No |
---|---|---|---|---|
1561387 | Health Insurance Innovations Inc. | HIIQ | Insurance Agents, Brokers & Service (6411) | 461282634 |
Insiders
Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
---|---|---|---|---|---|---|---|
1569131 | Lori Kosloske | 15438 N. Florida Avenue Suite 201 Tampa FL 33613 | Yes | No | No | No | |
1569146 | W Michael Kosloske | 15438 N. Florida Avenue Suite 201 Tampa FL 33613 | Chief Of Product Innovation | Yes | Yes | Yes | No |
1571685 | Health Plan Intermediaries Sub, Llc | C/O Health Insurance Innovations, Inc. 15438 N. Florida Avenue, Suite 201 Tampa FL 33613 | No | No | Yes | No | |
1571686 | Health Plan Intermediaires, Llc | C/O Health Insurance Innovations, Inc. 15438 N. Florida Avenue, Suite 201 Tampa FL 33613 | No | No | Yes | No |
Reported Non-Derivative Transactions
Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|---|---|---|---|---|---|
Class A Common Stock | Disposition | 2017-03-13 | 3,000,000 | $13.16 | 3,841,667 | No | 4 | S | Indirect | See Footnote |
Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|
No | 4 | S | Indirect | See Footnote |
Reported Non-Derivative Holdings
Sec. Name | Remaning Holdings | Nature of Ownership | Explanation |
---|---|---|---|
Class A Common Stock | 100 | Direct | |
Class A Common Stock | 7,203 | Indirect | See Footnote |
Class A Common Stock | 26,079 | Indirect | See Footnote |
Reported Derivative Holdings
Sec. Name | Sec. Type | Price | Date | Expiration Date | Amount | Remaning Holdings | Nature of Ownership |
---|---|---|---|---|---|---|---|
Common Stock | Stock Appreciation Rights | $9.80 | 2023-11-19 | 106,173 | 106,173 | Direct |
Expiration Date | Amount | Remaning Holdings | Nature of Ownership |
---|---|---|---|
2023-11-19 | 106,173 | 106,173 | Direct |
Footnotes
- By Lori Kosloske. Michael Kosloske and Lori Kosloske are husband and wife.
- By Michael W. Kosloske 2012 Descendants Trust Agreement dated December 7, 2012, Lori Kosloske as Directing Trustee.
- This number of shares consists of 3,802,451 shares of Class B Common Stock held of record by Health Plan Intermediaries, LLC ("HPI") and 39,216 shares of Class B Common Stock held by Health Plan Intermediaries Sub, LLC ("HPIS"). Michael Kosloske is the sole member and primary manager of HPI, and has sole voting and dispositive power over the shares held by HPI. HPI is the sole managing member of HPIS and has sole voting and dispositive power over the shares held by HPIS. Mr. Kosloske, by virtue of his control of HPI and HPI's control of HPIS, may be deemed to beneficially own all the shares of Class B Common Stock held of record by each of HPI and HPIS. The shares of Class B Common Stock, together with the Series B Membership Interests of HPI, are exchangeable, at Mr. Kosloske's election, for equal numbers of shares of Class A Common Stock. This exchange right has no expiration date.
- These stock-settled stock appreciation rights were granted to Michael Kosloske under the Issuer's Long-Term Incentive Plan and vest 25% on each of the first and second anniversaries of grant date (11/19/2016) and 50% on the third anniversary, subject to the terms of the Long-Term Incentive Plan and an award agreement under the Long-Term Incentive Plan.