SEC Form 4 · accession 0001127602-17-006904
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan C Roberts
Officer — EVP & President, CVS Caremark
Period of report
Feb 16, 2017
Accepted (ET)
Feb 17, 2017 · 4:10 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 | Feb 16, 2017 | M | 61,196 | $36.23 | A | 89,955 | D | |
| Common Stock | Feb 16, 2017 | S | 61,196 | $80.00 | D | 28,759 | D | |
| Common Stock (pep) | holding | — | — | — | 11,703 | D | ||
| Common Stock (restricted) | holding | — | — | — | 60,753 | D | ||
| ESOP Common Stock | holding | — | — | — | 5,320 | I | By ESOP | |
| Stock Unit | holding | — | — | — | 113,725 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF2 | $36.23 | Feb 16, 2017 | M | 61,196 | D | Apr 1, 2011 | Apr 1, 2017 | Common Stock | 61,196 | 0 | D |
| Phantom Stock CreditsF3 | $1.00 | holding | — | — | — | — | — | Common Stock | 1,417 | 1,417 | D |
| Stock OptionF4 | $34.96 | holding | — | — | — | Apr 1, 2012 | Apr 1, 2018 | Common Stock | 85,743 | 85,743 | D |
| Stock OptionF5 | $45.07 | holding | — | — | — | Apr 2, 2013 | Apr 2, 2019 | Common Stock | 77,639 | 77,639 | D |
| Stock OptionF6 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 68,844 | 68,844 | D |
| Stock OptionF7 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 73,433 | 73,433 | D |
| Stock OptionF8 | $45.93 | holding | — | — | — | Sep 4, 2015 | Sep 4, 2022 | Common Stock | 108,870 | 108,870 | D |
| Stock OptionF9 | $102.26 | holding | — | — | — | Apr 1, 2016 | Apr 1, 2022 | Common Stock | 68,482 | 68,482 | D |
| Stock OptionF10 | $104.82 | holding | — | — | — | Apr 1, 2017 | Apr 1, 2023 | Common Stock | 161,318 | 161,318 | D |
Explanation of responses
- F1All sales were effected pursuant to a Rule 10b5-1 plan.
- F10Option becomes exercisable in four equal annual installments, commencing 4/1/2017.
- F2Option became exercisable in three annual installments, commencing 4/1/2011.
- F3Reflects 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.
- F4Option became exercisable in four equal annual installments, commencing 4/1/2012.
- F5Option became exercisable in four equal annual installments, commencing 4/2/2013.
- F6Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F7Option became exercisable in four equal annual installments, commencing 4/1/2015.
- F8Option became exercisable in three equal annual installments, commencing 9/4/2015.
- F9Option became exercisable in four equal annual installments, commencing 4/1/2016.