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