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