SEC Form 4 · accession 0001127602-16-048870
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
Apr 1, 2016
Accepted (ET)
Apr 5, 2016 · 5:34 pm EDT
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 StockF1 | Apr 1, 2016 | F | 17,583 | $104.82 | D | 242,134 | D | |
| Common Stock (restricted)F2 | Apr 1, 2016 | A | 38,160 | $104.82 | A | 209,398 | D | |
| Common Stock | holding | — | — | — | 353,291 | I | By Trust As Beneficiary | |
| ESOP Common Stock | holding | — | — | — | 6,513 | I | By ESOP | |
| Stock Unit | holding | — | — | — | 595,371 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF3 | $104.82 | Apr 1, 2016 | A | 286,787 | A | Apr 1, 2017 | Apr 1, 2023 | Common Stock | 286,787 | 286,787 | D |
| Phantom Stock CreditsF4,F5,F6 | $1.00 | holding | — | — | — | — | — | Common Stock | 5,131 | 5,131 | D |
| Stock OptionF7 | $36.23 | holding | — | — | — | Apr 1, 2011 | Apr 1, 2017 | Common Stock | 114,741 | 114,741 | D |
| Stock OptionF8 | $34.96 | holding | — | — | — | Apr 1, 2012 | Apr 1, 2018 | Common Stock | 241,150 | 241,150 | D |
| Stock OptionF9 | $45.07 | holding | — | — | — | Apr 2, 2013 | Apr 2, 2019 | Common Stock | 332,736 | 332,736 | D |
| Stock OptionF10 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 314,713 | 314,713 | D |
| Stock OptionF11 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 335,697 | 335,697 | D |
| Stock OptionF12 | $102.26 | holding | — | — | — | Apr 1, 2016 | Apr 1, 2022 | Common Stock | 273,929 | 273,929 | D |
Explanation of responses
- F1Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock unit award.
- F10Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F11Option became exercisable in four equal annual installments, commencing 4/1/2015.
- F12Option became exercisable in four equal annual installments, commencing 4/1/2016.
- F2Consists of restricted stock units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 50% on 4/1/2019 and 50% on 4/1/2021.
- F3Option becomes exercisable in four equal installments, commencing 4/1/2017.
- F4Each share credit is equivalent to one share; 1-for-1 conversion.
- F5Reflects 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.
- 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 4/1/2011.
- F8Option became exercisable in four equal annual installments, commencing 4/1/2012.
- F9Option became exercisable in four equal annual installments, commencing 4/2/2013.