0001127602-23-003336.txt : 20230203 0001127602-23-003336.hdr.sgml : 20230203 20230203163244 ACCESSION NUMBER: 0001127602-23-003336 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230202 FILED AS OF DATE: 20230203 DATE AS OF CHANGE: 20230203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PELUSO MICHELLE A CENTRAL INDEX KEY: 0001271739 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 23586515 MAIL ADDRESS: STREET 1: 3150 SABRE DRIVE CITY: SOUTHLAKE STATE: TX ZIP: 76092 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 2023-02-02 0000064803 CVS HEALTH Corp CVS 0001271739 PELUSO MICHELLE A 1 CVS DRIVE WOONSOCKET RI 02895 1 EVP and Co-President of Retail Common Stock 2023-02-02 4 A 0 192554 0 A 207465 D Common Stock (restricted) 82563 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 86386 86386 D Stock Option 101.09 2023-04-01 2032-04-01 Common Stock 57172 57172 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 2017 Incentive Compensation Plan on February 26, 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 2, 2023. Consists of Restricted Stock Unit awarded pursuant to Issuer's 2017 Incentive Compensation Plan. Restrictions lapse in four equal annual installments, commencing 02/26/2022. Option became exercisable in four equal annual installments, commencing 4/1/2022. Option becomes exercisable in four equal annual installments, commencing 4/1/2023. /s/ Michelle A. Peluso 2023-02-03