SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Clark James David

(Last)

(First)

(Middle)

ONE CVS DRIVE

(Street)

WOONSOCKET

02895

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
11/19/2018

3. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	SVP, Cont & Chief Acct Officer

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	8,040.2554	D
Common Stock (restricted)	858⁽¹⁾	D
Common Stock (restricted)	537⁽²⁾	D
Common Stock (restricted)	831⁽³⁾	D
Common Stock (restricted)	2,214⁽⁴⁾	D
Common Stock (restricted)	274⁽⁵⁾	D
Common Stock (restricted)	2,009⁽⁶⁾	D
Common Stock (restricted)	1,057⁽⁷⁾	D
Common Stock (restricted)	790⁽⁸⁾	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Stock Option	04/02/2013⁽⁹⁾	04/02/2019	Common Stock	1,664	$45.07	D
Stock Option	04/01/2014⁽¹⁰⁾	04/01/2020	Common Stock	3,030	$54.53	D
Stock Option	04/01/2015⁽¹¹⁾	04/01/2021	Common Stock	5,350	$74.29	D
Stock Option	04/01/2016⁽¹²⁾	04/01/2022	Common Stock	6,059	$102.26	D
Stock Option	04/01/2017⁽¹³⁾	04/01/2023	Common Stock	7,044	$104.82	D
Stock Option	04/03/2018⁽¹⁴⁾	04/03/2024	Common Stock	9,050	$78.05	D
Stock Option	04/01/2019⁽¹⁵⁾	04/01/2025	Common Stock	7,513	$62.21	D

Explanation of Responses:

1. Consists of Restricted Stock Units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 4/1/2020.

2. Consists of Restricted Stock Units (RSUs) awarded pursuant to Issuer's Performance-Based Restricted Stock Unit Plan, a sub-plan under its 2010 Incentive Compensation Plan. Restrictions on remaining RSUs lapse in two equal installments on 2/28/2019 and 2/28/2020.

3. Consists of Restricted Stock Units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 4/1/2019.

4. Consists of Restricted Stock Units awarded pursuant to Issuer's 2017 Incentive Compensation Plan. Restrictions lapse 2/28/2021.

5. Consists of Restricted Stock Units (RSUs) awarded pursuant to Issuer's Performance-Based Restricted Stock Unit Plan, a sub-plan under its 2010 Incentive Compensation Plan. Restrictions on remaining RSUs lapse 2/28/2019.

6. Consists of Restricted Stock Units awarded pursuant to Issuer's 2017 Incentive Compensation Plan. Restrictions lapse 4/1/2022.

7. Consists of Restricted Stock Units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 4/3/2021.

8. Consists of Restricted Stock Units awarded pursuant to Issuer's Performance-Based Restricted Stock Unit Plan, a sub-plan under its 2017 Incentive Compensation Plan. Restrictions lapse in three equal installments, commencing 2/28/2019.

9. Remaining Options became exercisable in four equal annual installments beginning on 4/2/2013.

10. Remaining Options became exercisable in four equal annual installments beginning on 4/1/2014.

11. Remaining Options became exercisable in four equal annual installments beginning on 4/1/2015.

12. Options became exercisable in four equal annual installments beginning on 4/1/2016.

13. Options became exercisable in four equal annual installments beginning on 4/1/2017.

14. Options became exercisable in four equal annual installments beginning on 4/3/2018.

15. Options become exercisable in four equal annual installments, commencing 4/1/2019.

	/s/ James D. Clark	11/20/2018
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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