SEC Form 4 · accession 0000899243-18-011182

UNIVERSAL HEALTH SERVICES INC · UHS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Alan B Miller

Officer — Chairman and CEO · Director · 10% Owner

Period of report

Apr 30, 2018

Accepted (ET)

May 2, 2018 · 8:00 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000352915

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class B Common Stock	Apr 30, 2018	J	22,259	$0.00	D	0	I	AMK 2014 LLC held by The Abby Miller King 2015 GRAT
Class B Common Stock	Apr 30, 2018	J	20,369	$0.00	A	1,125,432	D
Class B Common Stock	Apr 30, 2018	J	1,890	$0.00	A	16,748	I	AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class B Common Stock	Apr 30, 2018	J	22,259	$0.00	D	0	I	MDM 2014 LLC held by The Marc Daniel Miller 2015 GRAT
Class B Common Stock	Apr 30, 2018	J	20,369	$0.00	A	1,145,801	D
Class B Common Stock^F8	Apr 30, 2018	J	1,890	$0.00	A	24,007	I	MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class B Common Stock	Apr 30, 2018	J	22,259	$0.00	D	0	I	MS 2014 LLC held by The Marni Spencer 2015 GRAT
Class B Common Stock	Apr 30, 2018	J	20,369	$0.00	A	1,166,170	D
Class B Common Stock	Apr 30, 2018	J	1,890	$0.00	A	16,748	I	MS 2014 LLC held by The Marni Spencer 2002 Trust
Class B Common Stock	Apr 30, 2018	J	31,564	$0.00	D	31,319	I	AMK 2014 LLC held by The Abby Miller King 2017 GRAT
Class B Common Stock	Apr 30, 2018	J	31,564	$0.00	A	1,197,734	D
Class B Common Stock^F8	Apr 30, 2018	J	31,562	$0.00	D	44,896	I	MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT
Class B Common Stock	Apr 30, 2018	J	31,562	$0.00	A	1,229,296	D
Class B Common Stock	Apr 30, 2018	J	31,564	$0.00	D	31,319	I	MS 2014 LLC held by The Marni Spencer 2017 GRAT
Class B Common Stock	Apr 30, 2018	J	31,564	$0.00	A	1,260,860	D
Class B Common Stock	Apr 30, 2018	J	51,933	$0.00	D	1,208,927	D
Class B Common Stock	Apr 30, 2018	J	51,933	$0.00	A	51,933	I	AMK 2014 LLC held by The Abby Miller King 2018 GRAT
Class B Common Stock	Apr 30, 2018	J	51,931	$0.00	D	1,156,996	D
Class B Common Stock	Apr 30, 2018	J	100,000	$114.49	D	1,056,996	D
Class B Common Stock	Apr 30, 2018	J	100,000	$114.49	A	200,000	I	MDM 2014 LLC
Class B Common Stock	Apr 30, 2018	J	131,097	$0.00	A	131,097	I	MDM 2014 LLC held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock	Apr 30, 2018	J	51,933	$0.00	D	1,005,063	D
Class B Common Stock	Apr 30, 2018	J	51,933	$0.00	A	51,933	I	MS 2014 LLC held by The Marni Spencer 2018 GRAT

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class A Common Stock^F4,F6,F7	—	Apr 30, 2018	J	22,259	D	—	—	Class B Common Stock	22,259	0	I
Class A Common Stock^F4,F6,F7	—	Apr 30, 2018	J	20,369	A	—	—	Class B Common Stock	20,369	4,175,624	D
Class A Common Stock^F1,F2,F6,F7	—	Apr 30, 2018	J	1,890	A	—	—	Class B Common Stock	1,890	16,748	I
Class A Common Stock^F4,F6,F7	—	Apr 30, 2018	J	33,388	D	—	—	Class B Common Stock	33,388	0	I
Class A Common Stock^F4,F6,F7	—	Apr 30, 2018	J	30,553	A	—	—	Class B Common Stock	30,553	4,206,177	D
Class A Common Stock^{F8,F1,F2,F6,F7}	—	Apr 30, 2018	J	2,835	A	—	—	Class B Common Stock	2,835	18,005	I
Class A Common Stock^F4,F6,F7	—	Apr 30, 2018	J	22,259	D	—	—	Class B Common Stock	22,259	0	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	20,369	A	—	—	Class B Common Stock	20,369	4,226,546	D
Class A Common Stock^F1,F2,F6,F7	—	Apr 30, 2018	J	1,890	A	—	—	Class B Common Stock	1,890	16,748	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	31,564	D	—	—	Class B Common Stock	31,564	31,320	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	31,564	A	—	—	Class B Common Stock	31,564	4,258,110	D
Class A Common Stock^F8,F5,F6,F7	—	Apr 30, 2018	J	47,343	D	—	—	Class B Common Stock	47,343	33,671	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	47,343	A	—	—	Class B Common Stock	47,343	4,305,453	D
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	31,564	D	—	—	Class B Common Stock	31,564	31,320	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	31,564	A	—	—	Class B Common Stock	31,564	4,337,017	D
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	51,933	D	—	—	Class B Common Stock	51,933	4,285,084	D
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	51,933	A	—	—	Class B Common Stock	51,933	51,933	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	77,896	D	—	—	Class B Common Stock	77,896	4,207,188	D
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	98,324	A	—	—	Class B Common Stock	98,324	98,324	I
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	51,933	D	—	—	Class B Common Stock	51,933	4,155,255	D
Class A Common Stock^F5,F6,F7	—	Apr 30, 2018	J	51,933	A	—	—	Class B Common Stock	51,933	51,933	I
Class A Common Stock^F5,F6,F7	—	holding	—	—	—	—	—	Class B Common Stock	400,000	400,000	I
Class A Common Stock^F5,F6,F7	—	holding	—	—	—	—	—	Class B Common Stock	258,630	258,630	I

Explanation of responses

F1On April 30, 2018, The Marc Daniel Miller 2015 GRAT distributed a 20.36850% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2015 GRAT distributed a 20.36904% interest in AMK 2014 LLC to Alan B. Miller and The Marni Spencer 2015 GRAT distributed a 20.369.04% interest of MS 2014 LLC to Alan B. Miller The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. Mr. Miller's pecuniary interest in these shares is unchanged. In addition, The Marc Daniel Miller 2015 GRAT distributed a 1.89002% interest in MDM 2014 LLC to The Marc Daniel Miller 2002 Trust, The Abby Miller King 2015 GRAT distributed a 1,88952% interest in AMK 2014 LLC to The Abby Danielle Miller 2002 Trust and The Marni Spencer 2015 GRAT distributed a 1.88952% interest in MS 2014 LLC to The Marni Spencer 2002 Trust.
F2(Continued From footnote 1) All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2015 GRAT. Each 2015 GRAT has now terminated.
F3On April 30, 2018, The Marc Daniel Miller 2017 GRAT distributed a 31.56209% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2017 GRAT distributed a 31.56356% interest in AMK 2014 LLC to Alan B. Miller and The Marni Spencer 2017 GRAT distributed a 31.56356% interest in MS 2014 LLC to Alan B. Miller (the distributions were made pursuant to the terms of the Trust Agreement creating each 2017 GRAT). The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. Mr. Miller's pecuniary interest in these shares is unchanged.
F4On April 30, 2018, Alan B. Miller contributed a 65.54866% interest in MDM 2014 LLC to The Marc Daniel Miller 2018 GRAT, a 51.93260% interest in AMK 2014 LLC to The Abby Miller King 2018 GRAT and a 51.93260% interest in MS 2014 LLC to The Marni Spencer 2018 GRAT. The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests contributed. Mr. Miller's pecuniary interest in these shares is unchanged.
F5The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
F6Immediately
F7Not Applicable
F8The percentage interest in the 2014 MDM LLC, owned by the Marc Daniel Miller 2017 GRAT and the Marc Daniel Miller 2002 Trust was reduced and the interest of Alan B. Miller was increased as a result of the contribution of an additional 100,000 shares of Class B Common Stock to the MDM 2014 LLC by Alan B. Miller. The shares reflected represent the amount of shares represented by the LLC interest held by the Marc Daniel Miller 2017 GRAT and the Marc Daniel Miller 2002 Trust, respectively.
F9On April 30, 2018 Alan B. Miller contributed 100,000 Class B Shares to the MDM 2014 LLC. Marc Miller is the special manager of the MDM 2014 LLC.