Filing Details

Accession Number:
0001209191-21-042254
Form Type:
4
Zero Holdings:
No
Publication Time:
2021-06-21 19:02:06
Reporting Period:
2021-06-17
Accepted Time:
2021-06-21 19:02:06
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1818383 Mediaalpha Inc. MAX Insurance Carriers, Nec (6399) 851854133
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1829960 Brian Mikalis C/O Mediaalpha, Inc.
700 South Flower Street, Suite 640
Los Angeles CA 90017
See Remarks No Yes No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Class A Common Stock Acquisiton 2021-06-17 8,498 $0.00 23,133 No 4 C Direct
Class A Common Stock Disposition 2021-06-21 12,924 $40.96 10,209 No 4 S Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Direct
No 4 S Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Class A Common Stock Class B-1 Units of QL Holdings LLC and Class B Common Stock Disposition 2021-06-17 8,498 $0.00 8,498 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
144,465 No 4 C Direct
Footnotes
  1. On June 17, 2021, pursuant to the Exchange Agreement, dated October 27, 2020, among the Issuer, QL Holdings LLC ("QLH"), Guilford Holdings, Inc. and the Class B-1 members of QLH, the Reporting Person exchanged 8,498 Class B-1 Units of QLH (the "Class B-1 Units"), along with 8,498 shares of Class B Common Stock (the "Class B Common Stock") for shares of Class A Common Stock on a one-for-one basis.
  2. Pursuant to the Exchange Agreement, dated October 27, 2020, among the Issuer, QL Holdings LLC (QLH), Guilford Holdings, Inc. and the Class B-1 members of QLH, each Class B-1 Unit, together with one share of Class B Common Stock, is exchangeable for one share of Class A Common Stock, subject to vesting conditions set forth in separate agreements.