SEC Form 4 · accession 0000049071-17-000003
HUMANA INC · HUM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David A Jr/ky Jones
Director
Period of report
Jan 3, 2017
Accepted (ET)
Jan 4, 2017 · 4:21 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000049071
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Humana CommonF8 | Jan 3, 2017 | A | 761 | $0.00 | A | 761 | D | |
| Humana CommonF2 | holding | — | — | — | 1,300 | I | See Footnote | |
| Humana CommonF1 | holding | — | — | — | 1,300 | I | See Footnote | |
| Humana CommonF6 | holding | — | — | — | 52,198 | I | See Footnote | |
| Humana CommonF5 | holding | — | — | — | 20,802 | I | See Footnote | |
| Humana CommonF7 | holding | — | — | — | 54,050 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF3 | — | holding | — | — | — | — | — | Humana Common | 5,892 | 5,892 | D |
| Restricted Stock UnitsF4 | — | holding | — | — | — | — | — | Humana Common | 95 | 95 | D |
Explanation of responses
- F1Shares held by spouse as custodian for daughter.
- F2Shares held by spouse as custodian for son.
- F3Annual Director's fee payable in stock units which have been deferred at the election of the reporting person until his resignation of services as a director at which time the stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule 16(b)-3(d)(1).
- F4Director's dividend payment reinvested into stock units on vested and deferred stock units, deferred in accordance with the Plan until his resignation of services as a director at which time the deferred dividend stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule16(b)-3(d).
- F5Shares held by a revocable trust account (Dec 2009), on which reporting person is the sole trustee, holding certain shares of Humana Inc. common stock.
- F6Shares held by a grantor retained annuity trust (GRAT #1) exempt from Rule 16(a)-13, on which reporting person is the sole trustee.
- F7Shares held by grantor retained annuity trust (GRAT #2) exempt from Rule 16(a)-13, on which reporting person is the sole trustee.
- F8Includes 761 restricted stock units pursuant to the annual Director's Fee Program representing a contingent right to receive one share of Humana Inc. common stock, exempt under Rule 16b-3(d)(1)&(3) under the Company's 2011 Plan of which 100% is vesting on 12/31/2017.