SEC Form 4 · accession 0001127602-15-001235
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Larry J Merlo
Officer — President and CEO · Director
Period of report
Jan 5, 2015
Accepted (ET)
Jan 6, 2015 · 5:33 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000064803
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | May 12, 2014 | G | 10,000 | $76.82 | D | 107,048 | D | |
| Common Stock | Aug 8, 2014 | G | 30,966 | $77.81 | D | 76,082 | D | |
| Common Stock | Jan 5, 2015 | M | 144,144 | $41.17 | A | 220,273 | D | |
| Common StockF3 | Jan 5, 2015 | S | 144,144 | $94.30 | D | 76,129 | D | |
| Common Stock | holding | — | — | — | 345,854 | I | By Trust As Beneficiary | |
| Common Stock (restricted) | holding | — | — | — | 263,284 | D | ||
| ESOP Common Stock | holding | — | — | — | 9,900 | I | By ESOP | |
| Stock Unit | holding | — | — | — | 533,999 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF4 | $41.17 | Jan 5, 2015 | M | 144,144 | D | Apr 1, 2009 | Apr 1, 2015 | Common Stock | 144,144 | 0 | D |
| Phantom Stock CreditsF5,F6 | $1.00 | holding | — | — | — | — | — | Common Stock | 5,156 | 5,156 | D |
| Stock OptionF7 | $28.10 | holding | — | — | — | Apr 1, 2010 | Apr 1, 2016 | Common Stock | 92,786 | 92,786 | D |
| Stock OptionF8 | $36.23 | holding | — | — | — | Apr 1, 2011 | Apr 1, 2017 | Common Stock | 152,988 | 152,988 | D |
| Stock OptionF9 | $34.96 | holding | — | — | — | Apr 1, 2012 | Apr 1, 2018 | Common Stock | 241,150 | 241,150 | D |
| Stock OptionF10 | $45.07 | holding | — | — | — | Apr 2, 2013 | Apr 2, 2019 | Common Stock | 332,736 | 332,736 | D |
| Stock OptionF11 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 314,713 | 314,713 | D |
| Stock OptionF12 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 335,697 | 335,697 | D |
Explanation of responses
- F1Gift was to an Irrevocable Life Insurance Trust ("ILIT"). The reporting person is not a trustee of the ILIT and disclaims any beneficial ownership or investment control over the ILIT.
- F10Option became exercisable in four equal annual installments, commencing 4/2/2013.
- F11Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F12Option becomes exercisable in four equal annual installments, commencing 4/1/2015.
- F2All sales were effected pursuant to a Rule 10b5-1 plan.
- F3Represents weighted average sale price for this trading day. Multiple sales were executed, with sales prices ranging between $93.88 and $94.86 per share.
- F4Option became exercisable in three equal annual installments, commencing 4/1/2009.
- F5Each share credit is equivalent to one share; 1-for-1 conversion.
- F6Reflects year end company match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, at such time as has been elected by the reporting person.
- F7Option became exercisable in three equal annual installments, commencing 4/1/2010.
- F8Option became exercisable in three equal annual installments, commencing 4/1/2011.
- F9Option became exercisable in four equal annual installments, commencing 4/1/2012.