SEC Form 4 · accession 0001127602-15-010097
Elevance Health, Inc. · ELV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jose D. Tomas
Officer — EVP & Chief HR Officer
Period of report
Mar 2, 2015
Accepted (ET)
Mar 4, 2015 · 4:51 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001156039
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Mar 2, 2015 | A | 3,829 | $0.00 | A | 16,225 | D | |
| Common StockF3 | Mar 3, 2015 | A | 16,436 | $0.00 | A | 32,661 | D | |
| Common StockF4 | Mar 3, 2015 | F | 2,338 | $145.99 | D | 30,323 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F5 | $146.93 | Mar 2, 2015 | A | 16,762 | A | — | Mar 2, 2025 | Common Stock | 16,762 | 16,762 | D |
Explanation of responses
- F1Represents restricted stock units. Restrictions lapse as follows: 1,276 each on 3/2/16 and 3/2/17; and 1,277 on 3/2/18.
- F2Includes 21.2627 shares acquired under the Anthem, Inc. Employee Stock Purchase Plan, in transactions exempt under Rule 16b-3.
- F3Represents performance based restricted stock units. Restrictions lapse as follows: 5,478 on 3/3/15; and 5,479 each on 3/3/16 and 3/3/17.
- F4PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
- F5The option, representing a right to purchase a total of 16,762 shares, is exercisable in two equal semi-annual installments of 2,793 shares each and four equal semi-annual installments of 2,794 shares each beginning on September 2, 2015, which is the six-month anniversary of the date on which the option was granted.