SEC Form 4 · accession 0001127602-18-013801
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan C Roberts
Officer — EVP & Chief Operating Officer
Period of report
Apr 1, 2018
Accepted (ET)
Apr 3, 2018 · 5:16 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 Stock | holding | — | — | — | 33,763 | D | ||
| Common Stock (restricted) | holding | — | — | — | 57,867 | D | ||
| ESOP Common Stock | holding | — | — | — | 5,465 | I | By ESOP | |
| Stock Unit | holding | — | — | — | 175,824 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF1 | $62.21 | Apr 1, 2018 | A | 248,131 | A | Apr 1, 2019 | Apr 1, 2025 | Common Stock | 248,131 | 248,131 | D |
| Phantom Stock CreditsF2 | $1.00 | holding | — | — | — | — | — | Common Stock | 1,421 | 1,421 | D |
| Stock OptionF3 | $45.07 | holding | — | — | — | Apr 2, 2013 | Apr 2, 2019 | Common Stock | 77,639 | 77,639 | D |
| Stock OptionF4 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 68,844 | 68,844 | D |
| Stock OptionF5 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 73,433 | 73,433 | D |
| Stock OptionF6 | $45.93 | holding | — | — | — | Sep 4, 2015 | Sep 4, 2022 | Common Stock | 108,870 | 108,870 | D |
| Stock OptionF7 | $102.26 | holding | — | — | — | Apr 1, 2016 | Apr 1, 2022 | Common Stock | 68,482 | 68,482 | D |
| Stock OptionF8 | $104.82 | holding | — | — | — | Apr 1, 2017 | Apr 1, 2023 | Common Stock | 161,318 | 161,318 | D |
| Stock OptionF9 | $78.05 | holding | — | — | — | Apr 3, 2018 | Apr 3, 2024 | Common Stock | 200,358 | 200,358 | D |
Explanation of responses
- F1Option becomes exercisable in four equal annual installments, commencing 4/1/2019.
- F2Reflects 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.
- F3Option became exercisable in four equal annual installments, commencing 4/2/2013.
- F4Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F5Option became exercisable in four equal annual installments, commencing 4/1/2015.
- F6Option became exercisable in three equal annual installments, commencing 9/4/2015.
- F7Option became exercisable in four equal annual installments, commencing 4/1/2016.
- F8Option became exercisable in four equal annual installments, commencing 4/1/2017.
- F9Option became exercisable in four equal annual installments, commencing 4/3/2018.