0001209191-21-027014.txt : 20210416
0001209191-21-027014.hdr.sgml : 20210416
20210416172440
ACCESSION NUMBER: 0001209191-21-027014
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210414
FILED AS OF DATE: 20210416
DATE AS OF CHANGE: 20210416
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dombro Lisa
CENTRAL INDEX KEY: 0001855954
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40332
FILM NUMBER: 21832442
MAIL ADDRESS:
STREET 1: C/O AGILON HEALTH, INC.
STREET 2: 1 WORLD TRADE CENTER, SUITE 2000
CITY: LONG BEACH
STATE: CA
ZIP: 90831
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: agilon health, inc.
CENTRAL INDEX KEY: 0001831097
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090]
IRS NUMBER: 371915147
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1 WORLD TRADE CENTER
STREET 2: SUITE 2000
CITY: LONG BEACH
STATE: CA
ZIP: 90831
BUSINESS PHONE: 562-256-3800
MAIL ADDRESS:
STREET 1: 1 WORLD TRADE CENTER
STREET 2: SUITE 2000
CITY: LONG BEACH
STATE: CA
ZIP: 90831
FORMER COMPANY:
FORMER CONFORMED NAME: Agilon Health Topco, Inc.
DATE OF NAME CHANGE: 20201103
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-04-14
0
0001831097
agilon health, inc.
AGL
0001855954
Dombro Lisa
C/O AGILON HEALTH, INC.
1 WORLD TRADE CENTER, SUITE 2000
LONG BEACH
CA
90831
0
1
0
0
Exper. & Innovation Officer
Common Stock
2021-04-14
4
A
0
11956
0.00
A
11956
D
Options (Rights to Buy)
23.00
2021-04-14
4
A
0
40710
0.00
A
2031-04-14
Common Stock
40710
40710
D
Restricted stock units that vest in four equal installments on each anniversary of April 14, 2021, subject to continued employment.
Options that vest in four equal installments on each anniversary of April 14, 2021, subject to continued employment.
/s/ Lyn Amor Macaraeg, as Attorney-in-Fact
2021-04-16