0001127602-20-005082.txt : 20200212 0001127602-20-005082.hdr.sgml : 20200212 20200212164506 ACCESSION NUMBER: 0001127602-20-005082 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200210 FILED AS OF DATE: 20200212 DATE AS OF CHANGE: 20200212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Benjamin Eric CENTRAL INDEX KEY: 0001731734 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 20604838 MAIL ADDRESS: STREET 1: C/O INSULET CORPORATION STREET 2: 600 TECHNOLOGY PARK DR, 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 2020-02-10 0001145197 INSULET CORP PODD 0001731734 Benjamin Eric C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 SVP, R&D, New Prod Dev & Comm Common Stock 2020-02-10 4 A 0 925 0 A 13373 D Employee Stock Option (Right to Buy) 202.64 2020-02-10 4 A 0 2618 0 A 2030-02-10 Common Stock 2618 2618 D Annual Restricted Stock Unit ("RSU") award. RSUs vest in equal installments on each of the first, second and third anniversaries of the grant date and are settled in shares of common stock on a one-for-one basis. Includes 207 shares acquired on May 31, 2019 and 64 shares acquired on November 29, 2019 under the Insulet Corporation Employee Stock Purchase Plan. Annual Non-Qualified Stock Option ("Option") Award. The Options become exercisable in substantially equal installments on each of the first, second, third and fourth anniversaries of the grant date. /s/ John W. Kapples, attorney-in-fact 2020-02-12 EX-24 2 doc1.txt POWER OF ATTORNEY (PUBLIC): POA POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby constitutes and appoints Shacey Petrovic, John W. Kapples, Wayde D. McMillan and Keith Bilezerian, and either of them acting singly, the true and lawful attorneys-in-fact and agents, with full power of substitution and resubstitution, for the undersigned and in the undersigned's name, place and stead, in any and all capacities (until revoked in writing) to execute for and on behalf of the undersigned, in any and all of the undersigned's capacities, any and all statements on Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by Insulet Corporation (the ?Company?) in accordance with Sections 16(a) of the Securities Exchange Act of 1934, as amended (the ?Exchange Act?), and any and all regulations promulgated thereunder, and to file the same, with all exhibits thereto, and any other documents in connection therewith, with the Securities and Exchange Commission, and with any other entity when and if such is mandated by the Exchange Act or by the By-laws of the National Association of Securities Dealers, granting unto said attorneys-in-fact and agents full power and authority to do and perform each and every act and thing requisite and necessary fully to all intents and purposes as the undersigned might or could do in person thereby ratifying and confirming all that said attorneys-in-fact and agents, or their substitute or substitutes, may lawfully do or cause to be done by virtue hereof. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned?s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, this Power of Attorney has been signed as of March 26, 2019. Signature: /s/ Eric Benjamin Name: Eric Benjamin