Healthextras Inc - Statement of Changes in Beneficial Ownership (4)
2008年8月6日 - 8:33AM
Edgar (US Regulatory)
FORM 4
[
X
]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
FARAH THOMAS M
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2. Issuer Name
and
Ticker or Trading Symbol
HEALTHEXTRAS INC
[
HLEX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
_____ Officer (give title below)
__
X
__ Other (specify below)
GC& Secretary through 07/06/08
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(Last)
(First)
(Middle)
800 KING FARM BOULEVARD, 4TH FLOOR
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3. Date of Earliest Transaction
(MM/DD/YYYY)
8/1/2008
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(Street)
ROCKVILLE, MD 20850
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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8/1/2008
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M
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500
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A
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$2.42
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38140
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D
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Common Stock
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8/1/2008
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S
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500
(3)
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D
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$31.00
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37640
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Employee Stock Option (right to buy)
(1)
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$2.42
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8/1/2008
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M
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500
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4/1/2005
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4/1/2012
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Common Stock
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500
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$0
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35500
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D
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Employee Stock Option (right to buy)
(2)
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$4.00
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(2)
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12/10/2012
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Common Stock
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25000
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25000
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D
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Explanation of Responses:
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(
1)
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A total of 100,000 options were granted on April 1, 2002 pursuant to the HealthExtras, Inc. 1999 Stock Option Plan. These options vest in four equal, annual installments beginning on the first anniversary of the date of grant; however, all options not yet vested as of December 31, 2005 became vested and exercisable as of that date.
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(
2)
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A total of 25,000 options were granted on December 10, 2002 pursuant to the HealthExtras, Inc. 1999 Stock Option Plan. These options vest in four equal, annual installments beginning on the first anniversary of the date of grant; however, all options not yet vested as of December 31, 2005 became vested and exercisable as of that date.
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(
3)
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Sale is pursuant to a 10b5-1 Plan.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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FARAH THOMAS M
800 KING FARM BOULEVARD
4TH FLOOR
ROCKVILLE, MD 20850
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GC& Secretary through 07/06/08
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Signatures
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Thomas M. Farah
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8/5/2008
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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