0001140361-15-033436.txt : 20150825 0001140361-15-033436.hdr.sgml : 20150825 20150825172602 ACCESSION NUMBER: 0001140361-15-033436 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150814 FILED AS OF DATE: 20150825 DATE AS OF CHANGE: 20150825 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Health Insurance Innovations, Inc. CENTRAL INDEX KEY: 0001561387 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 461282634 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15438 N. FLORIDA AVENUE STREET 2: SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 BUSINESS PHONE: 813-280-1289 MAIL ADDRESS: STREET 1: 15438 N. FLORIDA AVENUE STREET 2: SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Health Plan Intermediaries Sub, LLC CENTRAL INDEX KEY: 0001571685 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35811 FILM NUMBER: 151074047 BUSINESS ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 BUSINESS PHONE: (877) 376-5831 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Health Plan Intermediaires, LLC CENTRAL INDEX KEY: 0001571686 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35811 FILM NUMBER: 151074048 BUSINESS ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 BUSINESS PHONE: (877) 376-5831 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kosloske Lori CENTRAL INDEX KEY: 0001569131 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35811 FILM NUMBER: 151074049 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kosloske Michael W CENTRAL INDEX KEY: 0001569146 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35811 FILM NUMBER: 151074050 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVENUE, SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 4/A 1 doc1.xml FORM 4/A X0306 4/A 2015-08-14 2015-04-18 0 0001561387 Health Insurance Innovations, Inc. HIIQ 0001569146 Kosloske Michael W 15438 N. FLORIDA AVENUE SUITE 201 TAMPA FL 33613 1 1 1 0 Chairman, President and CEO 0001569131 Kosloske Lori 15438 N. FLORIDA AVENUE SUITE 201 TAMPA FL 33613 1 0 0 0 0001571686 Health Plan Intermediaires, LLC C/O HEALTH INSURANCE INNOVATIONS, INC. 15438 N. FLORIDA AVENUE, SUITE 201 TAMPA FL 33613 0 0 1 0 0001571685 Health Plan Intermediaries Sub, LLC C/O HEALTH INSURANCE INNOVATIONS, INC. 15438 N. FLORIDA AVENUE, SUITE 201 TAMPA FL 33613 0 0 1 0 Class A Common Stock 2015-08-14 4 P 0 3740 4.4277 A 3740 I See Footnote Class A Common Stock 2015-08-17 4 P 0 22339 4.8191 A 26079 I See Footnote This Amended Form 4 is being filed solely for the purpose of adding a footnote to this transaction to explain that the price is a weighted average price. This footnote was erroneously omitted on the Form 4 filed August 18, 2015. These shares were purchased at a range of prices from $4.40 to $4.49. The reporting person will provide upon request by the Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares purchased at each separate price. By Michael W. Kosloske 2012 Descendants Trust Agreement dated December 7, 2012, Lori Kosloske as Directing Trustee. These shares were purchased at a range of prices from $4.53 to $4.98. The reporting person will provide upon request by the Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares purchased at each separate price. /s/ Michael W. Kosloske 2015-08-20