# EDGAR Filing Document

**Accession Number:** 0001393584
**File Stem:** 0001209191-23-015789
**Filing Date:** 2023-3
**Character Count:** 6999
**Document Hash:** 2fd805859aec2d9858f74201492292eb
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-015789.hdr.sgml**: 20230303

**ACCESSION NUMBER**: 0001209191-23-015789

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230301

**FILED AS OF DATE**: 20230303

**DATE AS OF CHANGE**: 20230303

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Gotlib Phyllis
- **CENTRAL INDEX KEY:** 0001824038

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39515
- **FILM NUMBER:** 23705882

**MAIL ADDRESS:**
- **STREET 1:** AMERICAN WELL CORPORATION
- **STREET 2:** 75 STATE STREET, 26TH FLOOR
- **CITY:** BOSTON
- **STATE:** MA
- **ZIP:** 02109
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** American Well Corp
- **CENTRAL INDEX KEY:** 0001393584
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-BUSINESS SERVICES, NEC [7389]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 75 STATE STREET
- **STREET 2:** 26TH FLOOR
- **CITY:** Boston
- **STATE:** MA
- **ZIP:** 02109
- **BUSINESS PHONE:** 617-205-3500

**MAIL ADDRESS:**
- **STREET 1:** 75 STATE STREET
- **STREET 2:** 26TH FLOOR
- **CITY:** Boston
- **STATE:** MA
- **ZIP:** 02109

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Gotlib Phyllis<br><sub>(Last) (First) (Middle)</sub><br>C/O AMERICAN WELL CORPORATION<br>75 STATE STREET, 26TH FLOOR<br><sub>(Street)</sub><br>BOSTON, MA 02109<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-01 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_President, International_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>American Well Corp [ AMWL ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Class A Common Stock | 2023-03-01 |  | S<sup>(1)</sup> |  | 42005 | D | $2.7443 | 395982 | D |  |
| Class A Common Stock | 2023-03-01 |  | A |  | 274378<sup>(2)</sup> | A | $0.00 | 670360 | D |  |
| Class A Common Stock |  |  |  |  |  |  |  | 1463382 | I | By husband |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Performance Share Units | <sup>(3)</sup> | 2023-03-01 |  | A |  | 274378 |  | <sup>(3)</sup> | <sup>(3)</sup> | Class A Common Stock | 274378 | $0.00 | 274378 | D |  |

---

### Footnotes:

(1) The sales reported in this Form 4 were made in order to pay the tax liability arising from the vesting and settlement of restricted stock units on March 1, 2023. The sale was effected through an automatic "sell to cover" transaction that did not represent a discretionary trade by the reporting person.

(2) Represents a grant of restricted stock units, with 25% vesting upon the first anniversary of the grant date ("Initial Vesting Date"), and the remaining vesting every 3 months thereafter over a three-year period (beginning on the first calendar day of the month following the date that is three months following the Initial Vesting Date).

(3) Each Performance Share Unit represents a contingent right to receive one share of Class A Common Stock of the Issuer. The Performance Share Units are eligible to vest over a three-year performance period ending February 28, 2026, and may be earned between 0%-150% of target levels, based upon the Issuer's achievement of specified stock price performance thresholds, subject to the reporting person's continued employment through the date on which performance is certified.

**Signature:** /s/ Bradford Gay as attorney-in-fact for Phyllis Gotlib  
**Date:** 2023-03-03

### Remarks:

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 Number.**