0001127602-22-001262.txt : 20220110 0001127602-22-001262.hdr.sgml : 20220110 20220110171351 ACCESSION NUMBER: 0001127602-22-001262 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220101 FILED AS OF DATE: 20220110 DATE AS OF CHANGE: 20220110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shah Prem S CENTRAL INDEX KEY: 0001900910 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 22521991 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 3 1 form3.xml PRIMARY DOCUMENT X0206 3 2022-01-01 0 0000064803 CVS HEALTH Corp CVS 0001900910 Shah Prem S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP and Co-President of Retail Common Stock 11980.24 D Common Stock (restricted) 575 D Common Stock (restricted) 2884 D Common Stock (restricted) 15427 D Common Stock (restricted) 1808 D Common Stock (restricted) 1925 D Common Stock (restricted) 6393 D Common Stock (restricted) 4372.62 D Common Stock (restricted) 2798 D Stock Unit (deferred) 5625.28 D Stock Option 104.82 2017-04-01 2023-04-01 Common Stock 5870 D Stock Option 102.26 2016-04-01 2022-04-01 Common Stock 5346 D Stock Option 62.2011 2019-04-01 2025-04-01 Common Stock 1691 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 12626 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 34315 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 32826 D Stock Option 75.24 2021-08-31 2028-08-31 Common Stock 26580 D Consists of remaining Restricted Stock Units (RSUs) awarded pursuant to Issuer's Performance-Based Restricted Stock Plan, a sub-plan under its 2017 Incentive Compensation Plan (ICP). Restrictions lapse on 02/28/2022. Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in two equal installments commencing on 04/01/2022. Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in three equal installments commencing on 04/01/2022. Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions lapse on 04/01/2022. Consists of remaining RSUs awarded pursuant to Issuer's Performance-Based Restricted Stock Plan, a sub-plan under its 2017 ICP. Restrictions lapse in two equal installments commencing on 02/28/2022. Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in four equal installments commencing on 04/01/2022. Consists of Matching RSUs awarded pursuant to Issuer's Partnership Equity Program, a sub-plan under its ICP, and dividend equivalents on the Matching RSUs. Restrictions lapse on the RSUs on 08/31/2023. Consists of RSUs awarded pursuant to Issuer's Performance-Based Restricted Stock Plan under its 2017 ICP. Restrictions lapse in three equal installments commencing on 02/26/2022. Consists of Stock Units awarded pursuant to Issuer's 2010 & 2017 Incentive Compensation Plans, the receipt of which the reporting person has elected to defer. Option becomes exercisable in four equal installments commencing 04/01/2017. Option becomes exercisable in four equal installments commencing 04/01/2016. Option becomes exercisable in four equal installments commencing 04/01/2019. Additional options from this award have been exercised. Option becomes exercisable in four equal installments commencing 04/01/2020. Additional options from this award have been exercised. Option becomes exercisable in four equal installments commencing 04/01/2021. Additional options from this award have been exercised. Option becomes exercisable in three equal installments commencing 04/01/2022. Option vests in three equal installments, on 8/31/2021, 8/31/2022 and 8/31/2023. /s/ Prem S. Shah 2022-01-10