0001127602-22-016899.txt : 20220606
0001127602-22-016899.hdr.sgml : 20220606
20220606170532
ACCESSION NUMBER: 0001127602-22-016899
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220531
FILED AS OF DATE: 20220606
DATE AS OF CHANGE: 20220606
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: 22998808
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
2022-05-31
0000064803
CVS HEALTH Corp
CVS
0001900910
Shah Prem S
ONE CVS DRIVE
WOONSOCKET
RI
02895
1
EVP and Co-President of Retail
Common Stock (RSU)
2022-05-31
4
A
0
20671
0
A
20671
D
Common Stock
43453.24
D
Common Stock (pep)
4413.0017
D
Common Stock (restricted)
16522
D
ESOP Common Stock
4538.8882
D
Common Stock (restricted)
2829
D
Stock Unit (deferred)
6634.1478
D
Stock Option
104.82
2017-04-01
2023-04-01
Common Stock
2935
2935
D
Stock Option
62.21
2019-04-01
2025-04-01
Common Stock
846
846
D
Stock Option
54.19
2020-04-01
2029-04-01
Common Stock
9469
9469
D
Stock Option
58.34
2021-04-01
2030-04-01
Common Stock
28596
28596
D
Stock Option
74.30
2022-04-01
2031-04-01
Common Stock
28723
28723
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
Stock Option
101.09
2023-04-01
2032-04-01
Common Stock
41580
41580
D
Consists of RSUs awarded pursuant to the Issuer's 2017 Incentive Compensation Plan. Restrictions lapse in three equal installments beginning 5/31/2023.
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 Incentive Compensation Plan. Restrictions on the 2018 grant lapse in three equal installments commencing on 02/26/2022; restrictions on the 2020 grant lapse in two equal installments commencing on 2/28/22.
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 04/01/2019. 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.
Option becomes exercisable in four equal installments, commencing 4/1/2023.
/s/ Prem S. Shah
2022-06-06