0001127602-22-011635.txt : 20220405
0001127602-22-011635.hdr.sgml : 20220405
20220405192635
ACCESSION NUMBER: 0001127602-22-011635
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220401
FILED AS OF DATE: 20220405
DATE AS OF CHANGE: 20220405
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: 22808943
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
2022-04-01
0000064803
CVS HEALTH Corp
CVS
0001900910
Shah Prem S
ONE CVS DRIVE
WOONSOCKET
RI
02895
1
EVP and Co-President of Retail
Common Stock
2022-04-01
4
F
0
18747
101.09
D
40324.24
D
Common Stock
2022-04-01
4
F
0
3731
101.09
D
46583.24
D
Common Stock (pep)
4413.0017
D
Common Stock (restricted)
18447
D
ESOP Common Stock
4538.8882
D
Common Stock (restricted)
1866
D
Stock Unit (deferred)
5672.1478
D
Stock Option
101.09
2022-04-01
4
A
0
41580
101.09
A
2023-04-01
2032-04-01
Common Stock
41580
41580
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
Surrender of shares in payment of taxes due upon the vesting and settlement of PSUs on April 1, 2022.
Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock award.
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 4/1/2023.
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
2022-04-05