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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 | ||||||||
Stock Options (Right to Buy) | $ 31.32 | 03/01/2008(4) | 03/01/2017 | Common Stock | 2,000 | 2,000 | D | ||||||||
Stock Options (Right to Buy) | $ 32.58 | 08/15/2008(5) | 08/15/2007 | Common Stock | 1,000 | 1,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DESAI AMIR 200 OCEANGATE, SUITE 100 LONG BEACH, CA 90802 |
Chief Information Officer |
Jeff D. Barlow, by power of attorney for Amir Desai. | 03/03/2009 | |
**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) | Annual grant of restricted shares under the Molina Healthcare, Inc. 2002 Equity Incentive Plan. The shares vest in one-quarter increments on each of 3/1/2010, 3/1/2011, 3/1/2012, and 3/1/2013. |
(2) | In addition to the shares vesting as noted above, 533 shares vest on 8/25/2009; increments of 625 shares vest on each of 3/1/2010 and 3/1/2011; increments of 750 shares vest on each of 8/15/2009, 8/15/2010, and 8/15/2011; and increments of 1,400 shares vest on each of 3/1/2010, 3/1/2011, and 3/1/2012. The remainder of shares are vested. |
(3) | Represents the closing price of our common stock on Friday, 2/27/2009. In connection with the vesting of 2,025 shares of restricted stock on 3/1/2009, the reporting person surrendered 873 shares of restricted stock in payment of the taxes associated with the vested shares. |
(4) | 500 of the options are vested; increments of 500 options vest on each of 3/1/2009, 3/1/2010, and 3/1/2011. |
(5) | 250 of the options are vested; increments of 250 options vest on each of 8/15/2009, 8/15/2010, and 8/15/2011. |