0001127602-20-009415.txt : 20200304
0001127602-20-009415.hdr.sgml : 20200304
20200304163231
ACCESSION NUMBER: 0001127602-20-009415
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200302
FILED AS OF DATE: 20200304
DATE AS OF CHANGE: 20200304
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: 20687658
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
2020-03-02
0001156039
Anthem, Inc.
ANTM
0001659075
Penczek Ronald W
220 VIRGINIA AVENUE
INDIANAPOLIS
IN
46204
1
SVP, Chief Accounting Officer
Common Stock
2020-03-02
4
F
0
1424
271.27
D
527.86
D
Common Stock
2020-03-02
4
A
0
369
0
A
896.86
D
Common Stock
2020-03-02
4
A
0
4030
0
A
4926.86
D
Employee Stock Option (Right to Buy)
271.27
2020-03-02
4
A
0
1960
0
A
2030-03-02
Common Stock
1960
1960
D
PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
Represents restricted share units. Restrictions lapse as follows: 123 shares each on 3/2/2021, 3/2/2022 and 3/2/2023.
Represents performance based restricted share units. Restrictions lapse on 3/2/2020.
Balance includes 13.86 shares acquired through a dividend reinvestment plan.
The option represents a right to purchase a total of 1,960 shares, and is exercisable in three annual installments, with two installments of 653 shares each and one installment of 654 shares, beginning on 3/2/2021, which is the one-year anniversary of the option grant date.
/s/ Kathleen S. Kiefer, Attorney in fact
2020-03-04