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Delaware
(State or other jurisdiction of
incorporation or organization) |
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52-2383166
(I.R.S. Employer Identification Number)
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Large accelerated filer ☒
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Accelerated filer
☐
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Non-accelerated filer ☐
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Smaller reporting company
☐
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Emerging growth company
☐
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Title of Each Class of Securities to Be Registered
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Amount to Be
Registered |
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Proposed Maximum
Offering Price per Unit |
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Proposed Maximum
Aggregate Offering Price |
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Amount of Registration
Fee |
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| Securities to be sold by the Registrant: | | | | | | | | | | | | | | | | | |
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Common stock, par value $0.0001 per share
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(1)
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(1)
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(1)
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(2)
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Preferred stock, par value $0.0001 per share
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(1)
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(1)
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(1)
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(2)
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Warrants
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Debt securities
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(1)
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(1)
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(1)
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(2)
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Units
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| Securities to be sold by the Selling Stockholder: | | | | | | | | | | | | | | | | | |
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Common stock, par value $0.0001 per share(3)
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978,431
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$65.46(3)
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$13,690,698(3)
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$1,494(3)(4)
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| | | | | | 4 | | | |
| | | | | | 4 | | | |
| | | | | | 4 | | | |
| | | | | | 5 | | | |
| | | | | | 5 | | | |
| | | | | | 12 | | | |
| | | | | | 13 | | | |
| | | | | | 15 | | | |
| | | | | | 15 | | | |
| | | | | | 15 | | | |
| | | | | | 16 | | |
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Name
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Shares Beneficially Owned
Before the Offering |
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Number of
Shares Being Sold |
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Shares Beneficially
Owned After the Offering(1) |
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Number (#)
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Percent(2)
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Number (#)
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Percent(2)
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Stephen D. Neeleman, M.D.(3)
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| | | | 978,431 | | | | | | 1.2% | | | | | | 978,431 | | | | | | — | | | |
*
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Amount to
be Paid |
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SEC registration fee
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| | | $ | 1,494(1)(2) | | |
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Printing and engraving expenses
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(2)
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Legal fees and expenses
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(2)
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Trustee’s fees and expenses
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(2)
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Accounting fees and expenses
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(2)
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Transfer agent and registrar
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(2)
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Miscellaneous
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(2)
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TOTAL
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(2)
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Exhibit
Number |
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Incorporated by Reference
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Exhibit Description
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Form
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Date
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Number
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Filed Herewith
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1.1*
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| | Form of Underwriting Agreement | | | | | | | | | | | | | |
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3.1
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8-K
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7/6/2018
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001-36568
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3.2
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8-K
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7/6/2018
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001-36568
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4.1
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S-1/A
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7/16/2014
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333-196645
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4.2
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S-3
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9/7/2018
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333-227231
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4.3*
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| | Form of Debt Security | | | | | | | | | | | | | |
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4.4*
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| | Form of Preferred Stock Certificate | | | | | | | | | | | | | |
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4.5*
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| | Form of Certificate of Designations | | | | | | | | | | | | | |
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4.6*
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| | Form of Warrant Agreement | | | | | | | | | | | | | |
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4.7*
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| | Form of Warrant Certificate | | | | | | | | | | | | | |
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4.8*
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| | Form of Unit Agreement | | | | | | | | | | | | | |
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Exhibit
Number |
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Incorporated by Reference
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Exhibit Description
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Form
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Date
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Number
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Filed Herewith
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5.1
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X
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23.1
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X
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23.2
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X
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24.1
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X
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25.1
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| | Statement of Eligibility on Form T-1 of Wells Fargo Bank, National Association, under the Trust Indenture Act of 1939, as amended | | | | | | | | | | | |
X
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Signature
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Title
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Date
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/s/ Robert Selander
Robert Selander
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Chairman of the Board, Director
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September 9, 2021
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/s/ Jon Kessler
Jon Kessler
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President, Chief Executive
Officer, and Director (Principal Executive Officer) |
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September 9, 2021
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/s/ Tyson Murdock
Tyson Murdock
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Executive Vice President and Chief Financial Officer (Principal Financial and Accounting Officer)
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September 9, 2021
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/s/ Frank Corvino
Frank Corvino
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Director
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September 9, 2021
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/s Adrian Dillon
Adrian Dillon
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Director
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September 9, 2021
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/s/ Evelyn Dilsaver
Evelyn Dilsaver
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Director
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September 9, 2021
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/s/ Debra McCowan
Debra McCowan
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Director
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September 9, 2021
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/s/ Stephen Neeleman, M.D.
Stephen Neeleman, M.D.
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Vice Chairman and Director
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September 9, 2021
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/s/ Stuart Parker
Stuart Parker
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Director
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September 9, 2021
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/s/ Ian Sacks
Ian Sacks
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Director
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September 9, 2021
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/s/ Gayle Wellborn
Gayle Wellborn
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Director
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September 9, 2021
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