0001127602-21-012769.txt : 20210402 0001127602-21-012769.hdr.sgml : 20210402 20210402172005 ACCESSION NUMBER: 0001127602-21-012769 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: Lynch Karen S CENTRAL INDEX KEY: 0001333760 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 21802959 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 2021-02-01 0000064803 CVS HEALTH Corp CVS 0001333760 Lynch Karen S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP and President, Aetna Common Stock 2021-02-01 4 A 0 95302 0 A 95302 D Common Stock 2021-04-01 4 F 0 43211 74.30 D 52091 D Common Stock (By Trust) 94369 D Common Stock (restricted) 31144 D Stock Option 74.30 2021-04-01 4 A 0 224604 74.30 A 2022-04-01 2031-04-01 Common Stock 224604 224604 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 Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 211196 211196 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 Aetna Inc. 2010 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. Option becomes exercisable in four equal installments, commencing 4/1/2022. 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 vested in two substantially equal annual installments beginning on February 17, 2019. 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 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 installments, commencing 4/1/2021. /s/ Karen S. Lynch 2021-04-02