0001062993-22-024440.txt : 20221223 0001062993-22-024440.hdr.sgml : 20221223 20221223101811 ACCESSION NUMBER: 0001062993-22-024440 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221221 FILED AS OF DATE: 20221223 DATE AS OF CHANGE: 20221223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JONES DAVID A JR/KY CENTRAL INDEX KEY: 0001025393 STATE OF INCORPORATION: KY FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05975 FILM NUMBER: 221483767 MAIL ADDRESS: STREET 1: C/O HUMANA INC STREET 2: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HUMANA INC CENTRAL INDEX KEY: 0000049071 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 610647538 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 W MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025801000 MAIL ADDRESS: STREET 1: 500 W. MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 FORMER COMPANY: FORMER CONFORMED NAME: EXTENDICARE INC DATE OF NAME CHANGE: 19740404 FORMER COMPANY: FORMER CONFORMED NAME: HERITAGE HOUSE OF AMERICA INC DATE OF NAME CHANGE: 19671129 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0306 4 2022-12-21 0000049071 HUMANA INC HUM 0001025393 JONES DAVID A JR/KY CHRYSALIS VENTURES, INC. 101 S. FIFTH STREET, SUITE 1650 LOUISVILLE KY 40202 1 0 0 0 Humana Common 412 D Humana Common 800 I See Footnote Humana Common 2022-04-28 4 G 0 11300 0 D 57028 I See Footnote Humana Common 2022-12-21 4 S 0 15000 501.72 D 42028 I See Footnote Restricted Stock Units Humana Common 5892 5892 D Restricted Stock Units Humana Common 95 95 D Shares held in two trusts for the benefit of reporting person's son/daughter, respectively, in each case where the reporting person is the sole trustee. Annual Director's fee payable in stock units which have been deferred at the election of the reporting person until his resignation of services as a director at which time the stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule 16(b)-3(d)(1). Director's dividend payment reinvested into stock units on vested and deferred stock units, deferred in accordance with the Plan until his resignation of services as a director at which time the deferred dividend stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule16(b)-3(d). Shares held by a revocable trust account (Dec 2009), on which reporting person is the sole trustee, holding certain shares of Humana Inc. common stock. Includes 412 restricted stock units pursuant to the annual Director's Fee Program representing a contingent right to receive one share of Humana Inc. common stock, exempt under Rule 16b-3(d)(1)&(3) under the Company's 2019 Amended & Restated Plan of which 100% is vesting on 12/31/22. Shares disposed of represent gift/charitable donation effective April 28, 2022, in which no value was received in return. Shares contributed by the David Jones Jr Revocable Trust to an exchange fund in return for shares of the exchange fund. The Humana Inc. common stock was valued at $501.72 per share, using close of business prices on the day prior to the exchange date, for purposes of determining the number of shares of the exchange fund issued to the Revocable Trust. David A. Jones, Jr. 2022-12-23