0001567619-18-005091.txt : 20181105 0001567619-18-005091.hdr.sgml : 20181105 20181105170122 ACCESSION NUMBER: 0001567619-18-005091 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181101 FILED AS OF DATE: 20181105 DATE AS OF CHANGE: 20181105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flipse Mary CENTRAL INDEX KEY: 0001554321 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19364 FILM NUMBER: 181160600 MAIL ADDRESS: STREET 1: 701 COOL SPRINGS BLVD CITY: FRANKLIN STATE: TN ZIP: 37067 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TIVITY HEALTH, INC. CENTRAL INDEX KEY: 0000704415 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 621117144 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 701 COOL SPRINGS BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 6156144929 MAIL ADDRESS: STREET 1: 701 COOL SPRINGS BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHWAYS, INC. DATE OF NAME CHANGE: 20170104 FORMER COMPANY: FORMER CONFORMED NAME: TIVITY HEALTH, INC DATE OF NAME CHANGE: 20161230 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHWAYS, INC DATE OF NAME CHANGE: 20060201 4 1 doc1.xml FORM 4 X0306 4 2018-11-01 0 0000704415 TIVITY HEALTH, INC. TVTY 0001554321 Flipse Mary 701 COOL SPRINGS BLVD FRANKLIN TN 37067 0 1 0 0 Chief Legal and Admin Officer Common Stock 2018-11-01 4 M 0 33000 0 A 73574 D Common Stock 2018-11-01 4 A 0 54294 0 A 94868 D Common Stock 2018-11-01 4 F 0 20934 34.80 D 73934 D Common Stock 347 I Held in 401(k) plan Market Stock Units 2018-11-01 4 M 0 33000 0 D Common Stock 33000 0 D Reflects the vesting (33,000) and payout (54,294) of the Market Stock Units granted on September 24, 2015 at a payout factor of 164.5281%, and such payout includes 21,294 shares of common stock that were above the target number of shares originally reported. Reflects 20,934 shares of common stock withheld to cover the payment of taxes following vesting of 54,294 Market Stock Units granted on September 24, 2015. Each Market Stock Unit converts into shares of common stock on a 1-for-1 basis but the number of common stock that may be issued to the reporting person upon vesting of the Market Stock Units ranges from a minimum of 0% to a maximum of 180% of the "target" performance level, depending on annualized shareholder return of the common stock over a three-year performance period beginning on November 1, 2015. /s/ Mary Flipse 2018-11-05