0000950142-21-001590.txt : 20210513 0000950142-21-001590.hdr.sgml : 20210513 20210513172204 ACCESSION NUMBER: 0000950142-21-001590 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210326 FILED AS OF DATE: 20210513 DATE AS OF CHANGE: 20210513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KAO JOHN E CENTRAL INDEX KEY: 0001222028 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-40295 FILM NUMBER: 21920850 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Alignment Healthcare, Inc. CENTRAL INDEX KEY: 0001832466 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 465596242 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1100 W. TOWN AND COUNTRY ROAD STREET 2: SUITE 1600 CITY: ORANGE STATE: CA ZIP: 92868 BUSINESS PHONE: 844-310-2247 MAIL ADDRESS: STREET 1: 1100 W. TOWN AND COUNTRY ROAD STREET 2: SUITE 1600 CITY: ORANGE STATE: CA ZIP: 92868 3/A 1 es210151510_3a-kao.xml OWNERSHIP DOCUMENT X0206 3/A 2021-03-26 2021-03-26 0 0001832466 Alignment Healthcare, Inc. ALHC 0001222028 KAO JOHN E C/O ALIGNMENT HEALTHCARE, INC. 1100 W. TOWN & COUNTRY ROAD, SUITE 1600 ORANGE CA 92868 1 1 0 0 Chief Executive Officer Common Stock, par value $0.001 per share ("Common Stock") 4285037 I See Footnote Common Stock 311030 D Stock Option (right to buy) 18 2031-03-25 Common Stock 3916668 D Represents 2,797,642 shares of Common Stock of Alignment Healthcare, Inc. (the "Company") and 1,487,395 restricted shares of Common Stock of the Company that will vest upon a change of control of the Company or otherwise (A) if received in exchange for pre-IPO (as defined below) transaction-based incentive units, on the later of (x) the four-year anniversary of the initial vesting date, or (y) 50% on the first anniversary of Company's initial public offering (the "IPO") and 50% on the second anniversary of the IPO, in each case, subject to Mr. Kao's continued employment or service on each such vesting date and (B) if received in exchange for pre-IPO service-based incentive units according to the pre-IPO vesting schedule applicable to Mr. Kao disclosed in the "Executive Compensation - Outstanding Equity Awards at Fiscal Year End" section of the Company's registration statement on Form S-1. Represents securities held by JEK Trust, dated February 8, 2021, of which Mr. Kao is the trustee. Represents 311,030 restricted stock units, each restricted stock unit representing the right to receive one share of Common Stock of the Company, that will vest 25% on the first four anniversaries of the initial vesting date. Vest 25% on the first four anniversaries of the initial vesting date. This Form 3 amends and restates in its entirety the Form 3 filed by Mr. Kao on March 26, 2021. The purpose of this Form 3 is to correct the form of ownership of 311,030 restricted stock units and 3,916,668 stock options which were inadvertently reported as being held indirectly in the original Form 3. Such restricted stock units and stock options are held directly by Mr. Kao. This amendment does not affect Mr. Kao's aggregate beneficial ownership of non-derivative and derivative securities of the Company. /s/ Richard A. Cross, as Attorney-in-Fact, for John E. Kao 2021-05-13