Delaware
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7389
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52-2383166
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(State or other jurisdiction of incorporation or organization)
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(Primary Standard Industrial
Classification Code Number) 15 W. Scenic Pointe Dr. Ste. 100 Draper, Utah 84020 (801) 727 -1000 |
(I.R.S. Employer Identification Number)
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(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices
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HealthEquity, Inc. 2014 Equity Incentive Plan
(Full title of the plan) |
Large accelerated filer
x
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Accelerated filer
o
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Non-accelerated filer
o
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Smaller reporting company
o
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(Do not check if a smaller reporting company)
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Title of securities to be registered
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Amount to be registered(1)
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Proposed maximum offering price per share(2)
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Proposed maximum aggregate offering price(2)
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Amount of registration fee(3)
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Common Stock, par value $0.0001 per share
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1,731,788
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$25.05
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$43,381,289.40
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$4,368.50
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(1)
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Represents the additional shares of common stock, par value $0.0001 per share (“Common Stock”) of HealthEquity, Inc. (the “Registrant”), that were automatically added to the shares authorized for issuance under the HealthEquity, Inc. 2014 Equity Incentive Plan, as amended and restated (the “Plan”), on February 1, 2016 pursuant to an “evergreen” provision contained in the Plan. Pursuant to such provision, on February 1st of each year commencing in 2015 and ending on (and including) February 1, 2024, the number of shares of Common Stock reserved for issuance under the Plan is automatically increased by an amount equal to the lesser of: (i) 3% of the total number of shares of Common Stock outstanding on January 31st of the preceding fiscal year; and (ii) such lesser number of shares of Common Stock determined by the Registrant’s board of directors. In addition, pursuant to Rule 416(a) under the Securities Act of 1933, as amended (the “Securities Act”), this Registration Statement shall also cover any additional shares of Common Stock that become issuable under the Plan by reason of any stock dividend, stock split, recapitalization or other similar transaction.
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(2)
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Estimated solely for the purpose of calculating the amount of the registration fee pursuant to Rules 457(c) and 457(h) of the Securities Act, based on the average of the high and low sales prices of the Registrant’s Common Stock as reported on The NASDAQ Global Select Market on April 18, 2016.
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(a)
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The Registrant’s Annual Report on Form 10-K for the fiscal year ended January 31, 2016, filed on March 31, 2016 (File No. 001-36568) pursuant to the Securities Exchange Act of 1934, as amended (the “Exchange Act”); and
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(b)
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The description of the Registrant’s common stock contained in the Registrant’s registration statement on Form 8-A filed on July 25, 2014 (File No. 001-36568) under the Exchange Act, including any amendment or report filed for the purpose of updating such description.
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HEALTHEQUITY, INC.
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By:
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/s/ Jon Kessler
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Name:
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Jon Kessler
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Title:
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President and Chief Executive Officer
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Date: April 22, 2016
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By:
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/s/ Jon Kessler
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Name:
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Jon Kessler
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Title:
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President and Chief Executive Officer (Principal Executive Officer)
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Date: April 22, 2016
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By:
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/s/ Darcy Mott
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Name:
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Darcy Mott
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Title:
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Executive Vice President and Chief Financial Officer (Principal Financial and Accounting Officer)
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Date: April 22, 2016
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By:
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/s/ Frank A. Corvino
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Name:
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Frank A. Corvino
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Evelyn Dilsaver
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Name:
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Evelyn Dilsaver
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Michael O. Leavitt
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Name:
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Michael O. Leavitt
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Frank T. Medici
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Name:
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Frank T. Medici
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Stephen D. Neeleman, M.D.
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Name:
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Stephen D. Neeleman, M.D.
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Manu Rana
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Name:
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Manu Rana
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Ian Sacks
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Name:
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Ian Sacks
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Title:
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Director
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Date: April 22, 2016
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By:
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/s/ Robert W. Selander
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Name:
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Robert W. Selander
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Title:
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Chairman of the Board, Director
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Incorporated by Reference
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Exhibit No.
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Description
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Form
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File No.
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Exhibit
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Filing Date
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Filed Herewith
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4.1
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Form of Common Stock Certificate.
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S-1/A
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333-196645
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4.1
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July 16, 2014
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5.1
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Opinion of Willkie Farr & Gallagher LLP.
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X
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23.1
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Consent of Independent Registered Public Accounting Firm.
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X
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23.2
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Consent of Willkie Farr & Gallagher LLP (included in Exhibit 5.1).
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X
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24.1
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Power of Attorney (included on signature page of this Form S-8).
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X
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99.1
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HealthEquity, Inc. 2014 Equity Incentive Plan, as amended and restated, and Form of Award Agreement.
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S-1/A
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333-196645
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10.3
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July 16, 2014
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