0001127602-18-034857.txt : 20181130
0001127602-18-034857.hdr.sgml : 20181130
20181130172453
ACCESSION NUMBER: 0001127602-18-034857
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181128
FILED AS OF DATE: 20181130
DATE AS OF CHANGE: 20181130
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bertolini Mark T
CENTRAL INDEX KEY: 0001352552
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-01011
FILM NUMBER: 181212079
MAIL ADDRESS:
STREET 1: AETNA INC.
STREET 2: 151 FARMINGTON AVENUE
CITY: HARTFORD
STATE: CT
ZIP: 06156
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CVS HEALTH Corp
CENTRAL INDEX KEY: 0000064803
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912]
IRS NUMBER: 050494040
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: ONE CVS DR.
CITY: WOONSOCKET
STATE: RI
ZIP: 02895
BUSINESS PHONE: 4017651500
MAIL ADDRESS:
STREET 1: ONE CVS DR.
CITY: WOONSOCKET
STATE: RI
ZIP: 02895
FORMER COMPANY:
FORMER CONFORMED NAME: CVS CAREMARK CORP
DATE OF NAME CHANGE: 20070509
FORMER COMPANY:
FORMER CONFORMED NAME: CVS/CAREMARK CORP
DATE OF NAME CHANGE: 20070322
FORMER COMPANY:
FORMER CONFORMED NAME: CVS CORP
DATE OF NAME CHANGE: 19970128
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2018-11-28
0000064803
CVS HEALTH Corp
CVS
0001352552
Bertolini Mark T
ONE CVS DRIVE
WOONSOCKET
RI
02895
1
Common Stock
2018-11-28
4
A
0
1308
80.27
A
1308
D
Common Stock
2018-11-28
4
A
0
141677
A
142985
D
Common Stock
2018-11-28
4
A
0
100072
A
100072
I
By CLAT
Common Stock
2018-11-28
4
A
0
89726
A
89726
I
By 2017 GRAT
Common Stock
2018-11-28
4
A
0
90127
A
90127
I
By 2017 GRAT II
Common Stock
2018-11-28
4
A
0
217802
A
217802
I
By 2018 GRAT
Common Stock
2018-11-28
4
A
0
12534
A
12534
I
By 2018 Trust
Common Stock
2018-11-28
4
A
0
112808
A
112808
I
By 2016 Trust
Consists of common stock issued as a pro rata portion of the retainer payable for the reporting person's 2018-2019 Board service, pursuant to the Registrant's 2017 Incentive Compensation Plan.
Pursuant to the terms of the Agreement and Plan of Merger, dated as of December 3, 2017 (the "Merger Agreement"), by and among CVS Health Corporation ("CVS Health"), Hudson Merger Sub Corp. (the "Merger Sub"), a wholly owned subsidiary of CVS Health, and Aetna Inc. ("Aetna"), on November 28, 2018 (the "Closing Date") the Merger Sub merged with and into Aetna (the "Merger"), with Aetna continuing as the surviving company of the Merger and as a wholly owned subsidiary of CVS Health. Pursuant to the Merger Agreement, on the Closing Date each share of Aetna common stock held by the reporting person was converted into the right to receive 0.8378 of a share of common stock of CVS Health and $145.00 in cash. The closing price of CVS Health's common stock on November 28, 2018 was $80.27 per share.
Represents shares held in Charitable Lead Annuity Trust for which the reporting person is the investment advisor.
Represents shares held by 2017 Grantor Retained Annuity Trust ("GRAT") for which the reporting person is the sole trustee.
Represents shares held by 2017 GRAT II for which the reporting person is the sole trustee.
Represents shares held by 2018 GRAT for which the reporting person is the sole trustee.
Represents shares held by a 2018 Trust for which the reporting person is the investment advisor.
Represents shares held by a 2016 Trust for which the reporting person is the investment advisor.
/s/ Mark T. Bertolini
2018-11-30