0001127602-21-012695.txt : 20210402 0001127602-21-012695.hdr.sgml : 20210402 20210402170055 ACCESSION NUMBER: 0001127602-21-012695 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210201 FILED AS OF DATE: 20210402 DATE AS OF CHANGE: 20210402 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boratto Eva C CENTRAL INDEX KEY: 0001580827 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 21802692 MAIL ADDRESS: STREET 1: ONE CVS DRIVE CITY: WOONSOCKET STATE: RI ZIP: 02895 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 2021-02-01 0000064803 CVS HEALTH Corp CVS 0001580827 Boratto Eva C ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP & CFO Common Stock 2021-02-01 4 A 0 88500 0 A 159582.0445 D Common Stock 2021-04-01 4 F 0 40128 74.30 D 119454.0445 D Common Stock 2021-04-01 4 F 0 649 74.30 D 120236.0445 D Common Stock (restricted) 2242 D Stock Option 74.30 2021-04-01 4 A 0 103663 74.30 A 2022-04-01 2031-04-01 Common Stock 103663 103663 D Stock Option 102.26 2016-04-01 2022-04-01 Common Stock 27392 27392 D Stock Option 104.82 2017-04-01 2023-04-01 Common Stock 21509 21509 D Stock Option 78.05 2018-04-03 2024-04-03 Common Stock 35062 35062 D Stock Option 62.21 2019-04-01 2025-04-01 Common Stock 35030 35030 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 202007 202007 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 168956 168956 D Represents shares earned by the reporting person pursuant to certain performance stock units (the "PSUs"), which were granted to the reporting person under the Issuer's 2017 Incentive Compensation Plan on February 1, 2021. The PSUs were earned based on the attainment of certain performance metrics, which performance metrics were certified by the Management and Planning Committee of the Board of Directors of the Issuer on February 1, 2021. The PSUs vested and settled on April 1, 2021. Surrender of shares in payment of taxes due upon the vesting and settlement of the PSUs on April 1, 2021. Surrender of shares in payment of taxes due upon the vesting and settlement of a restricted stock unit award on April 1, 2021. Option becomes exercisable in four equal annual installments, commencing 4/1/2022. Option became exercisable in four equal annual installments, commencing 4/1/2016. Option becomes exercisable in four equal annual installments, commencing 4/1/2017. Option became exercisable in four equal annual installments, commencing 4/3/2018. Option became exercisable in four equal annual installments, commencing 4/1/2019. Option became exercisable in four equal annual installments, commencing 4/1/2020. The number of shares subject to the option were calculated using a 30-day average price. Options became exercisable in four equal annual installments, commencing 4/1/2021. /s/ Eva C. Boratto 2021-04-02