0001127602-19-009916.txt : 20190305 0001127602-19-009916.hdr.sgml : 20190305 20190305161438 ACCESSION NUMBER: 0001127602-19-009916 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190301 FILED AS OF DATE: 20190305 DATE AS OF CHANGE: 20190305 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: 19658487 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: 220 VIRGINIA AVENUE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 BUSINESS PHONE: 3174886000 MAIL ADDRESS: STREET 1: 220 VIRGINIA AVENUE 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 2019-03-01 0001156039 Anthem, Inc. ANTM 0001659075 Penczek Ronald W 220 VIRGINIA AVENUE INDIANAPOLIS IN 46204 1 SVP, Chief Accounting Officer Common Stock 2019-03-01 4 F 0 512 307.68 D 416 D Common Stock 2019-03-01 4 A 0 1217 0 A 1633 D Common Stock 2019-03-01 4 A 0 305 0 A 1938 D Employee Stock Option (Right to Buy) 307.68 2019-03-01 4 A 0 1403 0 A 2029-03-01 Common Stock 1403 1403 D PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK. Represents performance based restricted share units. Restrictions lapse on 3/1/19. Represents restricted share units. Restrictions lapse as follows: 101 shares on 3/1/2020, and 102 shares each on 3/1/2021 and 3/1/2022. The option represents a right to purchase a total of 1,403 shares, and is exercisable in three annual installments, with one installment of 467 shares and two installments of 468 shares each, beginning on 3/1/2020, which is the one-year anniversary of the option grant date. /s/ Kathleen S. Kiefer, Attorney in fact 2019-03-05