SEC Form 4 · accession 0001127602-15-028655
Elevance Health, Inc. · ELV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Craig E Samitt
Officer — EVP & Chief Clinical Officer
Period of report
Oct 1, 2015
Accepted (ET)
Oct 5, 2015 · 4:11 pm EDT
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 | Oct 1, 2015 | A | 2,700 | $0.00 | A | 2,700 | 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)F2 | $138.94 | Oct 1, 2015 | A | 11,816 | A | — | Oct 1, 2025 | Common Stock | 11,816 | 11,816 | D |
Explanation of responses
- F1Represents restricted share units. Restrictions lapse as follows: 900 shares each on 10/1/2016, 10/1/2017 and 10/1/18.
- F2The option, representing a right to purchase a total of 11,816 shares, is exercisable in four equal semi-annual installments of 1,969 shares each and two equal semi-annual installments of 1,970 shares each beginning on April 1, 2016, which is the six-month anniversary of the date on which the option was granted.