0001209191-21-027046.txt : 20210416 0001209191-21-027046.hdr.sgml : 20210416 20210416190546 ACCESSION NUMBER: 0001209191-21-027046 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210414 FILED AS OF DATE: 20210416 DATE AS OF CHANGE: 20210416 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH MICHAEL L CENTRAL INDEX KEY: 0001194201 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40332 FILM NUMBER: 21832685 MAIL ADDRESS: STREET 1: ANTHEM INC STREET 2: 120 MONUMENT CIRCLE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: agilon health, inc. CENTRAL INDEX KEY: 0001831097 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 371915147 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 WORLD TRADE CENTER STREET 2: SUITE 2000 CITY: LONG BEACH STATE: CA ZIP: 90831 BUSINESS PHONE: 562-256-3800 MAIL ADDRESS: STREET 1: 1 WORLD TRADE CENTER STREET 2: SUITE 2000 CITY: LONG BEACH STATE: CA ZIP: 90831 FORMER COMPANY: FORMER CONFORMED NAME: Agilon Health Topco, Inc. DATE OF NAME CHANGE: 20201103 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-04-14 0 0001831097 agilon health, inc. AGL 0001194201 SMITH MICHAEL L C/O AGILON HEALTH, INC. 1 WORLD TRADE CENTER, SUITE 2000 LONG BEACH CA 90831 1 0 0 0 Common Stock 2021-04-14 4 A 0 6956 0.00 A 152056 D Common Stock 150000 I By trust Restricted stock units that vests in full on April 14, 2022, subject to continued service as a director. These shares of common stock are held in the Michael L. Smith Revised and Amended Trust Dated August 1, 2011. /s/ Lyn Amor Macaraeg, as Attorney-in-Fact 2021-04-16