SEC FORM
3
SEC Form 3
| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person*
| C/O EHEALTH, INC. |
| 440 EAST MIDDLEFIELD ROAD |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
10/01/2016
|
3. Issuer Name and Ticker or Trading Symbol
eHealth, Inc.
[ EHTH ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| SVP, Finance and PAO |
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
|
| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
|
3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Common Stock |
13,055 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Stock Option (right to buy) |
|
03/16/2017 |
Common Stock |
5,300 |
18.37 |
D |
|
| Stock Option (right to buy) |
|
04/19/2018 |
Common Stock |
5,300 |
12.43 |
D |
|
| Stock Option (right to buy) |
|
04/17/2019 |
Common Stock |
5,300 |
16.73 |
D |
|
| Explanation of Responses: |
|
|
|
| Remarks: |
|
|
/s/ Scott Giesler as attorney-in-fact for Jay W. Jennings |
10/05/2016 |
|
** 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
5
(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. |
POWER OF ATTORNEY
The undersigned, as a Section 16 reporting person of eHealth, Inc.
(the Corporation) under the Securities Exchange Act of 1934, as amended
(the Exchange Act), hereby constitutes and appoints Scott Giesler, SVP
and General Counsel of the Corporation, Christine Wong and Matt
Enriquez of the Corporation, and J. Randall Lewis of
Wilson Sonsini Goodrich and Rosati, P.C. (WSGR), each acting solely in
his or her capacity as an employee of the Corporation or WSGR, as
applicable, and each of them, as the undersigned's true and lawful
attorney-in-fact for the following actions (only for so long as such
individual remains an employee of the Corporation or WSGR, as applicable):
* to complete and execute Forms 3, 4 and 5 and other forms and all
amendments thereto as such attorney-in-fact shall in his discretion
determine to be required or advisable pursuant to Section 16 of the
Exchange Act and the rules and regulations promulgated thereunder, or
any successor laws and regulations, as a consequence of the undersigned's
ownership, acquisition or disposition of securities of the Corporation; and
* to do all acts necessary in order to file such forms with the Securities
and Exchange Commission, any securities exchange or national association, the
Corporation and such other person or agency as the attorney-in-fact shall deem
necessary or appropriate.
The undersigned hereby ratifies and confirms all that said
attorneys-in-fact and agents shall do or cause to be done by virtue hereof.
The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Corporation assuming, any of the undersigned's responsibilities
to comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to
the undersigned's holdings of and transactions in securities issued by the
Corporation, unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
I hereby revoke any and all powers of attorney relating to the foregoing
actions that previously have been signed by me. However, the preceding sentence
shall not have the effect of revoking any powers of attorney that are unrelated
to the foregoing actions that previously have been signed by me.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 4 day of October, 2016.
Signature: /s/ Matt Enriquez, as attorney-in-fact for Jay W. Jennings
Print Name: Jay Jennings
