SEC Form 4 · accession 0001127602-16-044835
Elevance Health, Inc. · ELV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Peter D Haytaian
Officer — EVP & President, GBD
Period of report
Mar 1, 2016
Accepted (ET)
Mar 3, 2016 · 4:32 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 1, 2016 | A | 5,691 | $0.00 | A | 54,694 | D | |
| Common StockF2 | Mar 1, 2016 | F | 1,029 | $131.80 | D | 53,665 | D | |
| Common StockF2 | Mar 2, 2016 | F | 634 | $134.09 | D | 53,031 | 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)F3 | $131.80 | Mar 1, 2016 | A | 24,348 | A | — | Mar 1, 2026 | Common Stock | 24,348 | 24,348 | D |
Explanation of responses
- F1Represents restricted share units. Restrictions lapse as follows: 1,897 shares each on 3/1/2017, 3/1/2018 and 3/1/2019.
- F2PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
- F3The option represents a right to purchase a total of 24,348 shares, and is exercisable in six semi-annual installments of 4,058 shares each, beginning on September 1, 2016, which is the six-month anniversary of the option grant date.