0001127602-18-006485.txt : 20180215 0001127602-18-006485.hdr.sgml : 20180215 20180215201125 ACCESSION NUMBER: 0001127602-18-006485 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180213 FILED AS OF DATE: 20180215 DATE AS OF CHANGE: 20180215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SULLIVAN PATRICK J CENTRAL INDEX KEY: 0001039138 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 18619426 MAIL ADDRESS: STREET 1: 85 SWANSON ROAD STREET 2: . CITY: BOXBOROUGH STATE: MA ZIP: 01719 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2018-02-13 0001145197 INSULET CORP PODD 0001039138 SULLIVAN PATRICK J C/O INSULET CORPORATION 600 TECHNOLOGY PARK DRIVE, SUITE 200 BILLERICA MA 01821 1 1 CEO and Chairman of the Board Common Stock 2018-02-13 4 A 0 102530 0 A 282107 D Common Stock 2018-02-14 4 A 0 12081 0 A 294188 D Common Stock 100000 I By Grantor Retained Annuity Trust Employee Stock Option (Right to Buy) 74.50 2018-02-14 4 A 0 31476 0 A 2028-02-14 Common Stock 31476 31476 D The 102,530 performance share units were granted on February 24, 2016, and the Compensation Committee of the Board of Directors determined on February 13, 2018 that the performance share units were earned based on the performance of the Company. The full award remains subject to time-based vesting in accordance with the following schedule: one-half of the performance share units vest on the second anniversary of the date of grant and one-half of the performance share units vest on the third anniversary of the date of grant. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes 14,550 restricted stock units granted on March 2, 2015, which vest on March 2, 2018; 15,216 performance share units granted on April 1, 2015, which vest on April 1, 2018; 28,480 restricted stock units granted on February 24, 2016, which vest one-half of the total units on February 24, 2018 and one-half of the total units on February 24, 2019; and 18,033 restricted stock units granted on February 22, 2017, which vest one-third of the total units on February 22, 2018, one-third of the total units on February 22, 2019 and one-third of the total units on February 22, 2020. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes an aggregate of 2,213 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on the following dates: 777 shares on December 31, 2015, 674 shares acquired on June 30, 2016 and 762 shares acquired on May 31, 2017. The 12,081 restricted stock units vest one-third of the total units on February 14, 2019, one-third of the total units on February 14, 2020 and one-third of the total units on February 14, 2021, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. This option is subject to a four-year vesting period with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment. /s/ David Colleran, attorney-in-fact 2018-02-15