0001156039-21-000029.txt : 20210303
0001156039-21-000029.hdr.sgml : 20210303
20210303163442
ACCESSION NUMBER: 0001156039-21-000029
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210301
FILED AS OF DATE: 20210303
DATE AS OF CHANGE: 20210303
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: 21709525
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
wf-form4_161480725900279.xml
FORM 4
X0306
4
2021-03-01
0
0001156039
Anthem, Inc.
ANTM
0001659075
Penczek Ronald W
220 VIRGINIA AVENUE
INDIANAPOLIS
IN
46204
0
1
0
0
SVP, Chief Accounting Officer
Common Stock
2021-03-01
4
F
0
818
311.48
D
2419
D
Common Stock
2021-03-01
4
A
0
322
0
A
2741
D
Common Stock
2021-03-01
4
A
0
2573
0
A
5314
D
Common Stock
2021-03-02
4
F
0
42
311.66
D
5272
D
Employee Stock Option (Right to Buy)
311.48
2021-03-01
4
A
0
1315
0
A
2031-03-01
Common Stock
1315.0
1315
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: 107 shares each on 3/1/2022 and 3/1/2023, and 108 shares on 3/1/2024.
Represents performance based restricted share units. Restrictions lapse on 3/1/2021.
Balance includes 7.89 shares acquired on December 22, 2020 through a dividend reinvestment plan.
The option represents a right to purchase a total of 1,315 shares, and is exercisable in three annual installments, with two installments of 438 shares each and one installment of 439 shares, beginning on 3/1/2022, which is the one-year anniversary of the option grant date.
/s/ Kathleen S. Kiefer, Attorney in fact
2021-03-03