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