SEC Form 4 · accession 0001127602-15-010099
Elevance Health, Inc. · ELV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kenneth R Goulet
Officer — EVP, Commercial & Specialty
Period of report
Mar 2, 2015
Accepted (ET)
Mar 4, 2015 · 4:54 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 | Mar 2, 2015 | F | 12,749 | $146.93 | D | 58,316 | D | |
| Common StockF2 | Mar 2, 2015 | A | 5,530 | $0.00 | A | 63,846 | D | |
| Common StockF3 | Mar 3, 2015 | A | 26,707 | $0.00 | A | 90,553 | D | |
| Common StockF1 | Mar 3, 2015 | F | 6,272 | $145.99 | D | 84,281 | D | |
| Common Stock | holding | — | — | — | 5,963 | I | Stock Units Held In 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F4 | $146.93 | Mar 2, 2015 | A | 24,216 | A | — | Mar 2, 2025 | Common Stock | 24,216 | 24,216 | D |
Explanation of responses
- F1PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
- F2Represents restricted stock units. Restrictions lapse as follows: 1,843 each on 3/2/16 and 3/2/17; and 1,844 on 3/2/18.
- F3Represents performance based restricted stock units. Restrictions lapse as follows: 8,902 each on 3/3/15 and 3/3/16; and 8,903 on 3/3/17.
- F4The option, representing a right to purchase a total of 24,216 shares, is exercisable in six equal semi-annual installments of 4,036 shares each beginning on September 2, 2015, which is the six-month anniversary of the date on which the option was granted.