0000950103-21-002456.txt : 20210217 0000950103-21-002456.hdr.sgml : 20210217 20210217201524 ACCESSION NUMBER: 0000950103-21-002456 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: Rothman Marc D CENTRAL INDEX KEY: 0001842819 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40028 FILM NUMBER: 21647187 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 dp146255_4-rothman.xml FORM 4 X0306 4 2021-02-12 0 0001828182 Signify Health, Inc. SGFY 0001842819 Rothman Marc D C/O SIGNIFY HEALTH, INC. 800 CONNECTICUT AVENUE NORWALK CT 06854 0 1 0 0 Chief Medical Officer Class B Common Stock 2021-02-12 4 A 0 120837 0.01 A 120837 D Class A Common Stock 2021-02-16 4 P 0 1000 24 A 1000 D LLC Units in Cure Aggregator, LLC 2021-02-12 4 A 0 120837 0 A Class A Common Stock 120837 120837 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. These securities were purchased through the Issuer's directed share program in connection with its initial public offering. The LLC Units service-vest 25% on each of the first four anniversaries of August 5, 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 Marc D. Rothman 2021-02-17