0001127602-22-010749.txt : 20220331 0001127602-22-010749.hdr.sgml : 20220331 20220331164958 ACCESSION NUMBER: 0001127602-22-010749 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220330 FILED AS OF DATE: 20220331 DATE AS OF CHANGE: 20220331 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shah Prem S CENTRAL INDEX KEY: 0001900910 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 22793574 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 2022-03-30 0000064803 CVS HEALTH Corp CVS 0001900910 Shah Prem S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP and Co-President of Retail Common Stock 2022-03-30 4 M 0 5346 102.26 A 64417.24 D Common Stock 2022-03-30 4 S 0 5346 104.70 D 59071.24 D Common Stock (pep) 4413.0017 D Common Stock (restricted) 1925 D Common Stock (restricted) 6393 D Common Stock (restricted) 1808 D Common Stock (restricted) 15427 D Common Stock (restricted) 2884 D ESOP Common Stock 4538.8882 D Common Stock (restricted) 1866 D Stock Unit (deferred) 5672.1478 D Stock Option 102.26 2022-03-30 4 M 0 5346 0 D 2016-04-01 2022-04-01 Common Stock 5346 0 D Stock Option 104.82 2017-04-01 2023-04-01 Common Stock 2935 2935 D Stock Option 62.2011 2019-04-01 2025-04-01 Common Stock 1691 1691 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 12626 12626 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 34315 34315 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 32826 32826 D Stock Option 75.24 2021-08-31 2028-08-31 Common Stock 26580 26580 D Phantom Stock Credits 1.00 Common Stock 11259.1952 11259.1952 D All sales were effected pursuant to a Rule 10b5-1 plan. 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 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 RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions lapse 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 on remaining RSUs lapse in two equal installments commencing on 04/01/2022. 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 04/01/2016. Option becomes exercisable in four equal installments commencing 04/01/2017. 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. Reflects year-end company-match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, at such time as has been elected by the reporting person. Reflects year-end company-match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, at such time as has been elected by the reporting person. /s/ Prem S. Shah 2022-03-31