0000950103-21-002445.txt : 20210217 0000950103-21-002445.hdr.sgml : 20210217 20210217200157 ACCESSION NUMBER: 0000950103-21-002445 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210212 FILED AS OF DATE: 20210217 DATE AS OF CHANGE: 20210217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Douty Laurel CENTRAL INDEX KEY: 0001842574 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40028 FILM NUMBER: 21647126 MAIL ADDRESS: STREET 1: 800 CONNECTICUT AVENUE CITY: NORWALK STATE: CT ZIP: 06854 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Signify Health, Inc. CENTRAL INDEX KEY: 0001828182 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 CONNECTICUT AVENUE CITY: NORWALK STATE: CT ZIP: 06854 BUSINESS PHONE: (203) 541-4600 MAIL ADDRESS: STREET 1: 800 CONNECTICUT AVENUE CITY: NORWALK STATE: CT ZIP: 06854 4 1 dp146245_4-douty.xml FORM 4 X0306 4 2021-02-12 0 0001828182 Signify Health, Inc. SGFY 0001842574 Douty Laurel C/O SIGNIFY HEALTH, INC. 800 CONNECTICUT AVENUE NORWALK CT 06854 0 1 0 0 EVP, Clinic. Ops, Care Srvces Class B Common Stock 2021-02-12 4 A 0 145042 0.01 A 145042 D LLC Units in Cure Aggregator, LLC 2021-02-12 4 A 0 145042 0 A Class A Common Stock 145042 145042 D These securities were acquired through the conversion prior to the completion of the Issuer's initial public offering of historical interests held by the reporting person in Cure Aggregator, LLC. The LLC Units service-vest 25% on each of the first four anniversaries of February 17, 2020 and performance-vest based on the achievement by New Mountain Capital, LLC and its affiliates of specified cash-on-cash return thresholds. Upon vesting, each LLC Unit may be converted by the holder into an LLC Unit of Cure TopCo, LLC, which may thereafter be redeemed for, together with the cancellation of a share of Class B common stock, one share of Class A common stock or a cash payment equal to the volume weighted average market price of one share of Class A common stock for each LLC Unit redeemed. The LLC Units do not expire. /s/ Adam McAnaney as Attorney-in-Fact for Laurel Douty 2021-02-17