0001209191-15-050558.txt : 20150605
0001209191-15-050558.hdr.sgml : 20150605
20150605160646
ACCESSION NUMBER: 0001209191-15-050558
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150605
FILED AS OF DATE: 20150605
DATE AS OF CHANGE: 20150605
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Evolent Health, Inc.
CENTRAL INDEX KEY: 0001628908
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741]
IRS NUMBER: 453084136
FISCAL YEAR END: 1214
BUSINESS ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
BUSINESS PHONE: 571-389-6000
MAIL ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WIGGINTON STEVE
CENTRAL INDEX KEY: 0001232583
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37415
FILM NUMBER: 15916039
MAIL ADDRESS:
STREET 1: 800 N. GLEBE ROAD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-06-05
0
0001628908
Evolent Health, Inc.
EVH
0001232583
WIGGINTON STEVE
C/O EVOLENT HEALTH, INC.
800 N. GLEBE ROAD, SUITE 500
ARLINGTON
VA
22203
0
1
0
0
Chief Development Officer
Class A Common Stock
59400
D
Class A Common Stock
8029
D
Non-Qualified Stock Options
3.84
2024-04-01
Class A Common Stock
447680
D
Non-Qualified Stock Options
17.00
2025-06-04
Class A Common Stock
33137
D
Represents shares of restricted stock granted to Mr. Wigginton pursuant to the Evolent Health, Inc. 2011 Equity Incentive Plan, which will automatically vest in connection with the registrant's initial public offering.
Represents restricted stock units granted to Mr. Wigginton pursuant to the Evolent Health, Inc. 2015 Omnibus Incentive Compensation Plan.
Securities vest at a rate of 25% annually beginning June 4, 2016.
Securities vest at a rate of 25% annually beginning October 15, 2014.
Securities vest at a rate of 25% annually beginning June 4, 2016.
/s/ Steve Wigginton
2015-06-05