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*
CCP III Cayman GP Ltd.

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/15/2020
3. Issuer Name and Ticker or Trading Symbol
GoHealth, Inc. [ GOCO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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)
Class A Common Stock 40,682,961 I See Footnotes(1)(2)
Class B Common Stock 90,365,387 I See Footnotes(2)(4)
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
LLC Interests (3) (3) Class A Common Stock 90,365,387 (3) I See Footnotes(2)(4)
1. Name and Address of Reporting Person*
CCP III Cayman GP Ltd.

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
CCP III AIV VII Holdings, L.P.

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
CB Blizzard Co-Invest Holdings, L.P.

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Centerbridge Associates III, L.P.

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Blizzard Aggregator, LLC

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Aronson Jeffrey

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Gallogly Mark T

(Last) (First) (Middle)
375 PARK AVENUE, 11TH FLOOR

(Street)
NEW YORK NY 10152

(City) (State) (Zip)
Explanation of Responses:
1. Consists of 23,129,333 Class A shares held of record by CCP III AIV VII Holdings, L.P. ("CCP III") and 17,553,628 Class A shares held of record by CB Blizzard Co-Invest Holdings, L.P. ("CB Blizzard").
2. CCP III Cayman GP Ltd. ("CCP GP") is the general partner of Centerbridge Associates III, L.P. ("Centerbridge Associates"), which is the general partner of each of CCP III and CB Blizzard and may be deemed to share beneficial ownership over the shares held of record by CCP III and CB Blizzard. CCP GP is the sole manager of Blizzard Aggregator, LLC ("Blizzard Aggregator") and may be deemed to share beneficial ownership over the shares held of record by Blizzard Aggregator. As the directors of CCP GP, Jeffrey H. Aronson and Mark T. Gallogly may be deemed to share beneficial ownership with respect to the shares held by each of CCP III, CB Blizzard and Blizzard Aggregator. Such persons and entities disclaim beneficial ownership of the shares held by each of CCP III, CB Blizzard and Blizzard Aggregator, except to the extent of any proportionate pecuniary interest therein.
3. The LLC Interests may be redeemed by a Reporting Person at any time on or following the closing of the Initial Public Offering for shares of Class A Common Stock on a 1-to-1 basis.
4. Consists entirely of LLC Interests held of record by Blizzard Aggregator.
Remarks:
CCP III AIV VII HOLDINGS, L.P., By: CENTERBRIDGE ASSOCIATES III, L.P., its general partner, By: CCP III CAYMAN GP LTD., its general partner, By: /s/ Susanne V. Clark, Authorized Signatory 07/15/2020
CB BLIZZARD CO-INVEST HOLDINGS, L.P., By: CENTERBRIDGE ASSOCIATES III, L.P., its general partner, By: CCP III CAYMAN GP LTD., its general partner, By: /s/ Susanne V. Clark, Authorized Signatory 07/15/2020
CENTERBRIDGE ASSOCIATES III, L.P., By: CCP III CAYMAN GP LTD., its general partner, By: /s/ Susanne V. Clark, Authorized Signatory 07/15/2020
CCP III CAYMAN GP LTD., By: /s/ Susanne V. Clark, Authorized Signatory 07/15/2020
BLIZZARD AGGREGATOR, LLC, By: CCP III CAYMAN GP LTD., its sole manager, By: /s/ Susanne V. Clark, Authorized Signatory 07/15/2020
JEFFREY H. ARONSON, By: /s/ Jeffrey H. Aronson 07/15/2020
MARK T. GALLOGLY, By: /s/ Mark T. Gallogly 07/15/2020
** 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.