SEC Form 4 · accession 0001127602-17-014072
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andrew Sussman
Officer — EVP, Clinical Services
Period of report
Apr 1, 2017
Accepted (ET)
Apr 4, 2017 · 5:48 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, 2017 | F | 1,129 | $78.50 | D | 13,252 | D | |
| Common Stock | Apr 2, 2017 | F | 1,596 | $78.50 | D | 11,656 | D | |
| Common Stock (restricted)F2 | Apr 3, 2017 | A | 4,804 | $78.05 | A | 16,433 | D | |
| Stock Unit | holding | — | — | — | 10,145 | 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 | $78.05 | Apr 3, 2017 | A | 37,567 | A | Apr 3, 2018 | Apr 3, 2024 | Common Stock | 37,567 | 37,567 | D |
| Stock OptionF4 | $36.96 | holding | — | — | — | Sep 1, 2012 | Sep 1, 2019 | Common Stock | 0 | 0 | D |
| Stock OptionF5 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 11,802 | 11,802 | D |
| Stock OptionF6 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 29,373 | 29,373 | D |
| Stock OptionF7 | $102.26 | holding | — | — | — | Apr 1, 2016 | Apr 1, 2022 | Common Stock | 23,968 | 23,968 | D |
| Stock OptionF8 | $104.82 | holding | — | — | — | Apr 1, 2017 | Apr 1, 2023 | Common Stock | 23,301 | 23,301 | D |
Explanation of responses
- F1Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock unit award.
- F2Consists of restricted stock units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 50% on 4/3/2020 and 50% on 4/3/2022.
- F3Option becomes exercisable in four equal annual installments, commencing 4/3/2018.
- F4Option became exercisable in three equal annual installments, commencing 9/1/2012.
- F5Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F6Option became exercisable in four equal annual installments, commencing 4/1/2015.
- F7Option became exercisable in four equal annual installments, commencing 4/1/2016.
- F8Option became exercisable in four equal annual installments, commencing 4/1/2017.