0001127602-17-031738.txt : 20171109
0001127602-17-031738.hdr.sgml : 20171109
20171109161848
ACCESSION NUMBER: 0001127602-17-031738
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171107
FILED AS OF DATE: 20171109
DATE AS OF CHANGE: 20171109
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Penczek Ronald W
CENTRAL INDEX KEY: 0001659075
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16751
FILM NUMBER: 171191101
MAIL ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Anthem, Inc.
CENTRAL INDEX KEY: 0001156039
STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324]
IRS NUMBER: 352145715
STATE OF INCORPORATION: IN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
BUSINESS PHONE: 3174886000
MAIL ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
FORMER COMPANY:
FORMER CONFORMED NAME: WELLPOINT, INC
DATE OF NAME CHANGE: 20100105
FORMER COMPANY:
FORMER CONFORMED NAME: WELLPOINT INC
DATE OF NAME CHANGE: 20041130
FORMER COMPANY:
FORMER CONFORMED NAME: ANTHEM INC
DATE OF NAME CHANGE: 20010730
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2017-11-07
0001156039
Anthem, Inc.
ANTM
0001659075
Penczek Ronald W
120 MONUMENT CIRCLE
INDIANAPOLIS
IN
46204
1
SVP, Chief Accounting Officer
Common Stock
2017-11-07
4
M
0
217
146.93
A
1222
D
Common Stock
2017-11-07
4
M
0
405
131.80
A
1627
D
Common Stock
2017-11-07
4
M
0
356
166.97
A
1983
D
Common Stock
2017-11-07
4
S
0
978
217.42
D
1005
D
Employee Stock Option (Right to Buy)
146.93
2017-11-07
4
M
0
217
0
D
2025-03-02
Common Stock
217
217
D
Employee Stock Option (Right to Buy)
131.80
2017-11-07
4
M
0
405
0
D
2026-03-01
Common Stock
405
1217
D
Employee Stock Option (Right to Buy)
166.97
2017-11-07
4
M
0
356
0
D
2027-03-01
Common Stock
356
1785
D
The option represents a right to purchase a total of 1,301 shares, became exercisable in six semi-annual installments, with one installment of 216 shares and five installments of 217 shares each, beginning on September 2, 2015, which was the six-month anniversary of the option grant date.
The option represents a right to purchase a total of 2,432 shares, and is exercisable in six semi-annual installments, with four installments of 405 shares each and two installments of 406 shares each, beginning on September 1, 2016, which is the six-month anniversary of the option grant date.
The option represents a right to purchase a total of 2,141 shares, and is exercisable in six semi-annual installments, with one installment of 356 shares and five installments of 357 shares each, beginning on September 1, 2017, which is the six-month anniversary of the option grant date.
/s/ Kathleen S. Kiefer, Attorney in fact
2017-11-09