0001062993-21-013685.txt : 20211230 0001062993-21-013685.hdr.sgml : 20211230 20211230180334 ACCESSION NUMBER: 0001062993-21-013685 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211228 FILED AS OF DATE: 20211230 DATE AS OF CHANGE: 20211230 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Eliasson Fredrik J CENTRAL INDEX KEY: 0001540752 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38961 FILM NUMBER: 211533918 MAIL ADDRESS: STREET 1: 500 WATER STREET CITY: JACKSONVILLE STATE: FL ZIP: 32202 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 2021-12-28 0001756497 Change Healthcare Inc. CHNG 0001540752 Eliasson Fredrik J C/O CHANGE HEALTHCARE INC. 424 CHURCH STREET, SUITE 1400 NASHVILLE TN 37219 0 1 0 0 EVP & CFO Common Stock 2021-12-28 4 A 0 92180 0.00 A 490899 D Common Stock 2021-12-28 4 F 0 36274 21.44 D 454625 D Common Stock 140000 I See Footnote In connection with the anticipated transactions contemplated by the Agreement and Plan of Merger whereby the Issuer will be acquired by UnitedHealth Group Incorporated, the Compensation Committee of the Board of Directors of the Issuer accelerated the payment of certain restricted stock unit ("RSU") awards granted on (i) August 20, 2019, (ii) June 17, 2020, and (iii) April 1, 2021 in connection with certain tax-planning actions to mitigate adverse tax consequences of Section 280G and Section 4999 of the Internal Revenue Code of 1986 (as amended). The shares reported were withheld from the shares deliverable upon vesting of the RSUs to satisfy tax withholding requirements. Reflects securities held by a trust, of which the Reporting Person and his spouse are trustees. /s/ Carrie Ratliff, as Attorney-in-Fact 2021-12-30