0001127602-19-034257.txt : 20191204 0001127602-19-034257.hdr.sgml : 20191204 20191204170111 ACCESSION NUMBER: 0001127602-19-034257 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191202 FILED AS OF DATE: 20191204 DATE AS OF CHANGE: 20191204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lynch Karen S CENTRAL INDEX KEY: 0001333760 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 191268748 MAIL ADDRESS: STREET 1: 151 FARMINGTON AVENUE STREET 2: RW61 CITY: HARTFORD STATE: CT ZIP: 06156 FORMER NAME: FORMER CONFORMED NAME: Rohan Karen DATE OF NAME CHANGE: 20050721 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 2019-12-02 0000064803 CVS HEALTH Corp CVS 0001333760 Lynch Karen S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP & Pres, Aetna Bus Unit Common Stock 2019-12-02 4 F 0 12778 75.55 D 57235 D Common Stock (restricted) 95273 D Stock Appreciation Rights 45.91 2019-02-17 2027-02-16 Common Stock 192741 192741 D Stock Appreciation Rights 37.91 2019-02-19 2026-02-18 Common Stock 93989 93989 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 242408 242408 D Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock award. Represents unvested Aetna Inc. Stock Appreciation Rights ("SARs") granted under the Aetna Inc. 2010 Stock Incentive Plan (the "Aetna Plan") on February 17, 2017 that were converted into CVS Health SARs pursuant to the terms of the CVS/Aetna Merger Agreement. These SARs vest in two substantally equal annual installments beginning on February 17, 2019. RemoveClose Represents unvested SARs granted under the Aetna Plan on February 19, 2016 that were converted into CVS Health SARs pursuant to the terms of the CVS/Aetna Merger Agreement. These SARs vested on February 19, 2019. Option becomes exercisable in four equal annual installments, commencing 4/1/2020. /s/ Karen S. Lynch 2019-12-04