0001062993-21-005923.txt : 20210624 0001062993-21-005923.hdr.sgml : 20210624 20210624142827 ACCESSION NUMBER: 0001062993-21-005923 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210622 FILED AS OF DATE: 20210624 DATE AS OF CHANGE: 20210624 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LANCE HOWARD L CENTRAL INDEX KEY: 0001220679 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38961 FILM NUMBER: 211042114 MAIL ADDRESS: STREET 1: C/O SUMMIT MATERIALS, INC. STREET 2: 1550 WYNKOOP STREET, 3RD FLOOR CITY: DENVER STATE: CO ZIP: 80202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Change Healthcare Inc. CENTRAL INDEX KEY: 0001756497 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 822152098 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 424 CHURCH STREET, SUITE 1400 CITY: NASHVILLE STATE: TN ZIP: 37219 BUSINESS PHONE: 615-932-3000 MAIL ADDRESS: STREET 1: 424 CHURCH STREET, SUITE 1400 CITY: NASHVILLE STATE: TN ZIP: 37219 FORMER COMPANY: FORMER CONFORMED NAME: HCIT Holdings, Inc. DATE OF NAME CHANGE: 20181019 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0306 4 2021-06-22 0001756497 Change Healthcare Inc. CHNG 0001220679 LANCE HOWARD L C/O CHANGE HEALTHCARE INC. 424 CHURCH STREET, SUITE 1400 NASHVILLE TN 37219 1 0 0 0 Common Stock 2021-06-22 4 A 0 7136 0.00 A 218856 D Stock Appreciation Right 8.07 2021-06-22 4 A 0 63200 0.00 A 2023-05-22 Common Stock 63200 63200 D Represents the grant of deferred stock units that vests on June 22, 2022. The shares subject to the units will be issued to the Reporting Person after the Reporting Person's separation from service from the Issuer. Reflects the vesting of shares of 2.5x stock appreciation rights that were granted in connection with the Company's JV with McKesson as replacement awards for unvested exit-vesting Legacy CHC stock options. The shares of exit-vesting stock appreciation rights vested upon achievement of certain performance criteria on June 22, 2021. These stock appreciation rights are fully vested. /s/ Carrie Ratliff, as Attorney-in-Fact 2021-06-24