SEC Form 4
| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol HMS HOLDINGS CORP [ HMSY ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 06/09/2017 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock | 06/09/2017 | A | 23,634(1) | A | $0.0000 | 89,380 | D | |||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Nonqualified Stock Option (Right to Buy) | $19.04 | 06/09/2017 | A | 58,215 | (2) | 06/09/2027 | Common Stock | 58,215 | $0.0000 | 58,215 | D | ||||
| Explanation of Responses: |
| 1. Represents restricted stock units (RSUs), 50% of which vest in 3 equal installments on the 1st, 2nd and 3rd anniversaries of March 3, 2017 (Measurement Date or MD). The remaining 50% (PRSUs) will vest only if the Issuer's average closing price/share in any consecutive 30 calendar day period preceding the 1st, 2nd and/or 3rd anniversaries of March 3, 2017 is at least 25% higher than the closing price/share on the grant date (the Performance Goal or PG). If the PG is met prior to the 1st anniversary of the MD, 1/3 of the PRSUs will vest on each anniversary of the MD; if the PG is met after the 1st anniversary of the MD but prior to the 2nd, 2/3 of the PRSUs will vest on the 2nd anniversary of the MD and 1/3 will vest on the 3rd anniversary of the MD; if the PG is met after the 2nd anniversary of the MD but prior to the 3rd, 100% of the PRSUs will vest on the 3rd anniversary of the MD. If the PG is not achieved by the 3rd anniversary of the MD, the PRSUs shall be forfeited. |
| 2. 50% of the option vests in 3 equal installments on the 1st, 2nd and 3rd anniversaries of March 3, 2017 (Measurement Date or MD). The remaining 50% (Performance Option or PO) will vest only if the Issuer's average closing price/share in any consecutive 30 calendar day period preceding the 1st, 2nd and/or 3rd anniversaries of March 3, 2017 is at least 25% higher than the option Exercise Price (the Performance Goal or PG). If the PG is met prior to the 1st anniversary of the MD, 1/3 of the PO will vest on each anniversary of the MD; if the PG is met after the 1st anniversary of the MD but prior to the 2nd, 2/3 of the PO will vest on the 2nd anniversary of the MD and 1/3 will vest on the 3rd anniversary of the MD; if the PG is met after the 2nd anniversary of the MD but prior to the 3rd, 100% of the PO will vest on the 3rd anniversary of the MD. If the PG is not achieved by the 3rd anniversary of the MD, the PO shall be forfeited. |
| Kimberly J. Day, as Attorney-in-Fact for Teresa South | 06/13/2017 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||