Statement of Changes in Beneficial Ownership (4)
June 30 2023 - 8:14AM
Edgar (US Regulatory)
FORM 4
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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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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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1. Name and Address of Reporting Person
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WHITE MOUNTAINS INSURANCE GROUP LTD |
2. Issuer Name and Ticker or Trading Symbol
MediaAlpha, Inc.
[
MAX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
23 SOUTH MAIN STREET, SUITE 3B |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/30/2023 |
(Street)
HANOVER, NH 03755 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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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)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock | 6/30/2023 | | P(1) | | 5916816 | A | $10.00 | 22856814 | I | See footnote (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
Explanation of Responses: |
(1) | On June 30, 2023, White Mountains Insurance Group, Ltd. ("WMIG"), through its wholly-owned, direct subsidiary, WM Hinson (Bermuda) Ltd. ("WM Hinson"), accepted for purchase shares of the class A common stock of MediaAlpha, Inc. ("Shares") through a fixed-price tender offer. |
(2) | WMIG owns 900,000 Shares directly and owns 21,956,814 Shares indirectly. Of the Shares owned indirectly by WMIG, 5,916,816 Shares are owned directly by WMIG's direct subsidiary, WM Hinson, and 16,039,998 Shares are held directly by White Mountains Investments (Luxembourg) S.a' r.l., a direct subsidiary of WM Birkdale, Ltd., a direct subsidiary of WMIG. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
WHITE MOUNTAINS INSURANCE GROUP LTD 23 SOUTH MAIN STREET SUITE 3B HANOVER, NH 03755 | X | X |
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WM Hinson (Bermuda) Ltd. 26 REID STREET SUITE 601 HAMILTON, D0 HM 11 |
| X |
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Signatures
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White Mountains Insurance Group, Ltd., by Robert L. Seelig, its EVP and General Counsel | | 6/30/2023 |
**Signature of Reporting Person | Date |
WM Hinson (Bermuda) Ltd., by John G. Sinkus, its Director | | 6/30/2023 |
**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 control number. |
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