SEC Form 4 · accession 0001127602-15-010102
Elevance Health, Inc. · ELV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Peter D Haytaian
Officer — EVP & Pres., Govt. Bus. Div.
Period of report
Mar 2, 2015
Accepted (ET)
Mar 4, 2015 · 4:56 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 | 1,033 | $146.93 | D | 35,570 | D | |
| Common StockF2 | Mar 2, 2015 | A | 5,105 | $0.00 | A | 40,675 | D | |
| Common StockF1 | Mar 3, 2015 | F | 1,378 | $145.99 | D | 39,297 | D | |
| Common StockF3 | Mar 3, 2015 | A | 8,217 | $0.00 | A | 47,514 | D | |
| Common StockF4 | Mar 3, 2015 | A | 7,294 | $0.00 | A | 54,808 | 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 | 22,353 | A | — | Mar 2, 2025 | Common Stock | 22,353 | 22,353 | 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: 1,701 on 3/2/16; and 1,702 each on 3/2/17 and 3/2/18
- F3Represents performance based restricted stock units. Restrictions lapse as follows: 2,739 each on 3/3/15, 3/3/16 and 3/3/17.
- F4Represents performance based restricted stock units. Restrictions lapse as follows: 2,431 each on 5/1/15 and 5/1/16; and 2,432 on 5/1/17.
- F5The option, representing a right to purchase a total of 22,353 shares, is exercisable in three equal semi-annual installments of 3,725 shares each and three equal semi-annual installments of 3,726 shares each beginning on September 2, 2015, which is the six-month anniversary of the date on which the option was granted.