SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
GRIFFIN BRIAN T

(Last) (First) (Middle)
120 MONUMENT CIRCLE

(Street)
INDIANAPOLIS IN 46204

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2015
3. Issuer Name and Ticker or Trading Symbol
Anthem, Inc. [ ANTM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & President, CSBD
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 34,457(1) D
Common Stock 2,008 I 2014 GRAT Trust
Common Stock 17,917 I 2015 GRAT Trust
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) (2) 03/01/2020 Common Stock 9,756 $61.88 D
Employee Stock Option (Right to Buy) (3) 03/03/2021 Common Stock 14,830 $89.44 D
Employee Stock Option (Right to Buy) (4) 03/02/2025 Common Stock 7,489 $146.93 D
Employee Stock Option (Right to Buy) (5) 08/03/2025 Common Stock 5,374 $152.78 D
Explanation of Responses:
1. Restricted shares which vest on various dates between February 1, 2016 and August 3, 2018.
2. The option, representing a right to purchase a total of 9,756 shares, became exercisable in six equal semi-annual installments of 1,626 shares each beginning on September 1, 2013, which was the six-month anniversary of the date on which the option was granted.
3. The option, representing a right to purchase a total of 14,830 shares, became exercisable in two equal semi-annual installments of 2,471 shares each and four semi-annual installments of 2,472 shares beginning on September 3, 2014, which was the six-month anniversary of the date on which the option was granted.
4. The option, representing a right to purchase a total of 7,489 shares, is exercisable in five equal semi-annual installments of 1,248 shares each and one semi-annual installment of 1,249 shares beginning on September 2, 2014, which is the six-month anniversary of the date on which the option was granted.
5. The option, representing a right to purchase a total of 5,374 shares, is exercisable in two equal semi-annual installments of 895 shares each and four semi-annual installments of 896 shares each beginning on February 3, 2016, which is the six-month anniversary of the date on which the option was granted.
Remarks:
Exhibit List: Exhibit 24-Power of Attorney
/s/ Kathleen S. Kiefer, Attorney in fact 09/11/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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