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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Tough Steven D C/O HEALTH NET, INC. 21650 OXNARD STREET WOODLAND HILLS, CA 91367 |
Pres, Govt Progrms |
/s/ Steven D. Tough | 03/11/2014 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Shares forfeited in lieu of payment of tax liability in connection with the vesting of 33-1/3% of a grant of 10,000 restricted stock units (the "RSU Vest") and 33-1/3% of a grant of 30,000 performance share units (the "PSU Vest"), each of which was made to the Reporting Person on March 7, 2013, pursuant to the Issuer's 2006 Long-Term Incentive Plan, as amended (the "2006 Plan"). |
(2) | Represents 1,253 and 3,758 shares forfeited in lieu of payment of tax liability in connection with each of the RSU Vest and PSU Vest, respectively. The number of shares forfeited by the Reporting Person in connection with each of the RSU Vest and PSU Vest was based on the closing price of the Issuer's common stock on March 7, 2014, pursuant to the terms of the 2006 Plan. |