0001209191-21-056202.txt : 20210915 0001209191-21-056202.hdr.sgml : 20210915 20210915171918 ACCESSION NUMBER: 0001209191-21-056202 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210914 FILED AS OF DATE: 20210915 DATE AS OF CHANGE: 20210915 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Halkias Theodore CENTRAL INDEX KEY: 0001855972 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40332 FILM NUMBER: 211256100 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 2021-09-14 0 0001831097 agilon health, inc. AGL 0001855972 Halkias Theodore C/O AGILON HEALTH, INC. 1 WORLD TRADE CENTER, SUITE 2000 LONG BEACH CA 90831 0 1 0 0 Chief Business Officer Common Stock 2021-09-14 4 M 0 58553 1.00 A 63987 D Common Stock 2021-09-14 4 S 0 58553 28.98 D 5434 D Common Stock 2021-09-14 4 S 0 100000 28.98 D 0 I By trust Options (Rights to Buy) 1.00 2021-09-14 4 M 0 58553 0.00 D 2027-04-27 Common Stock 58553 1741447 D Includes restricted stock units. These shares of common stock were held in the Halkias Irrevocable Trust. These options were granted on April 27, 2017, and fully vested on May 15, 2017. /s/ Lyn Amor Macaraeg, as Attorney-in-Fact 2021-09-15