SEC Form 4 · accession 0001122304-17-000010
AETNA INC /PA/ · AET
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark T Bertolini
Officer — Chairman and CEO · Director
Period of report
Feb 3, 2017
Accepted (ET)
Feb 7, 2017 · 4:27 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001122304
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 7, 2016 | G | 28,517 | $0.00 | D | 363,670 | D | |
| Common StockF1 | Nov 23, 2016 | G | 120,000 | $0.00 | D | 243,670 | D | |
| Common Stock | Feb 3, 2017 | M | 148,138 | $42.57 | A | 391,808 | D | |
| Common StockF2 | Feb 3, 2017 | F | 96,632 | $122.56 | D | 295,176 | D | |
| Common StockF3 | holding | — | — | — | 120,000 | I | by Charitable Lead Annuity Trust (CLAT) | |
| Common StockF4 | holding | — | — | — | 454,071 | I | by Grantor Retained Annuity Trust (GRAT) |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Appreciation Right | $42.57 | Feb 3, 2017 | M | 148,138 | D | Feb 9, 2008 | Feb 8, 2017 | Common Stock | 148,138 | 0 | D |
Explanation of responses
- F1Gift to Charitable Lead Annuity Trust ("CLAT").
- F2Stock Appreciation Right is net settled; amount represents withholding of shares by the Company to pay exercise price and taxes.
- F3Represents shares held in CLAT where Mr. Bertolini is investment advisor.
- F4Represents shares held in a Grantor Retained Annuity Trust ("GRAT") where Mr. Bertolini is sole trustee.