SEC Form 4 · accession 0001122304-18-000131
AETNA INC /PA/ · AET
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shawn M Guertin
Officer — Exec. Vice President, CFO
Period of report
Sep 24, 2018
Accepted (ET)
Sep 26, 2018 · 4:12 pm EDT
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 | Jun 26, 2018 | G | 2,500 | $0.00 | D | 46,237 | D | |
| Common StockF1 | Sep 24, 2018 | M | 1,856 | $0.00 | A | 11,919 | D | |
| Common StockF2 | Sep 24, 2018 | F | 861 | $203.40 | D | 11,058 | D | |
| Common StockF3,F4 | holding | — | — | — | 25,000 | I | BY 2018 CRUT | |
| Common StockF5,F6 | holding | — | — | — | 11,174 | I | BY 2018 GRAT | |
| Common StockF7 | holding | — | — | — | 632 | I | By 401(k) Plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 2015 Performance Stock UnitsF8,F9 | — | Sep 24, 2018 | M | 1,546 | D | — | — | Common Stock | 1,546 | 0 | D |
Explanation of responses
- F1Represents vesting of previously reported Performance Stock Units (PSUs) granted under the 2010 Stock Incentive Plan (the "Plan").
- F2Represents tax withholding on previously reported PSUs granted under the Plan.
- F3On July 24, 2018, 25,000 shares from sole account were voluntarily transferred to 2018 Charitable Remainder Unitrust ("CRUT").
- F4Represents shares held in CRUT where Mr. Guertin is sole trustee.
- F5On July 24, 2018, 11,174 shares from sole account were voluntarily transferred to 2018 Grantor Retained Annuity Trust ("GRAT")
- F6Represents shares held in GRAT where Mr. Guertin is sole trustee.
- F7Represents the pro rata portion of the stock portion of Aetna Common Stock Fund held by reporting person on August 31, 2018 pursuant to Aetna Inc. 401(k) Plan. The information is based on information provided by the Plan Trustee as of that date.
- F8Each Performance Stock Unit represents a right to receive up to two shares of Aetna Inc. Common Stock net of taxes.
- F9Vesting of previously reported PSUs granted under the Plan on September 24, 2015.