SEC Form 4 · accession 0001127602-16-044839
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 1, 2016
Accepted (ET)
Mar 3, 2016 · 4:34 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 1, 2016 | A | 4,268 | $0.00 | A | 33,690 | D | |
| Common StockF3 | Mar 2, 2016 | F | 353 | $134.09 | D | 33,337 | 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)F4 | $131.80 | Mar 1, 2016 | A | 18,261 | A | — | Mar 1, 2026 | Common Stock | 18,261 | 18,261 | D |
Explanation of responses
- F1Represents restricted share units. Restrictions lapse as follows: 1,422 on 3/1/17, and 1,423 each on 3/1/18 and 3/1/19.
- F2Includes 24.3891 shares acquired under the Anthem, Inc. Employee Stock Purchase Plan, in transactions exempt under Rule 16b-3.
- F3PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
- F4The option represents a right to purchase a total of 18,261 shares, and is exercisable in six semi-annual installments, with three installments of 3,043 shares each and three installments of 3,044 shares each, beginning on September 1, 2016, which is the six-month anniversary of the option grant date.