0001127602-19-009055.txt : 20190228 0001127602-19-009055.hdr.sgml : 20190228 20190228203608 ACCESSION NUMBER: 0001127602-19-009055 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190226 FILED AS OF DATE: 20190228 DATE AS OF CHANGE: 20190228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Petrovic Shacey CENTRAL INDEX KEY: 0001631895 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 19646346 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK DRIVE STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 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: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2019-02-26 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 President and CEO Common Stock 2019-02-26 4 A 0 7600 0 A 97520 D Employee Stock Option (Right to Buy) 92.11 2019-02-26 4 A 0 19771 0 A 2029-02-26 Common Stock 19771 19771 D The 7,600 restricted stock units vest one-third of the total units on February 26, 2020, one-third of the total units on February 26, 2021, and one-third of the total units on February 26, 2022, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes 4,508 restricted stock units granted on February 22, 2017, which vest on February 22, 2020; 4,474 restricted stock units granted on February 14, 2018, which vest as to one-half of the total units on February 14, 2020 and one-half of the total units on February 14, 2021; and 6,809 restricted stock units granted on January 2, 2019, which vest as to one-third of the total units on January 2, 2020, and one-third of the total units on January 2, 2021, and one-third of the total units on January 2, 2022, 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 on each of the first, second, third and fourth anniversaries of the grant date , subject to continued employment. /s/ David Colleran, attorney-in-fact 2019-02-28