0001127602-24-005068.txt : 20240214 0001127602-24-005068.hdr.sgml : 20240214 20240214170819 ACCESSION NUMBER: 0001127602-24-005068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240212 FILED AS OF DATE: 20240214 DATE AS OF CHANGE: 20240214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lynch Karen S CENTRAL INDEX KEY: 0001333760 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 24640357 MAIL ADDRESS: STREET 1: 151 FARMINGTON AVENUE STREET 2: RW61 CITY: HARTFORD STATE: CT ZIP: 06156 FORMER NAME: FORMER CONFORMED NAME: Rohan Karen DATE OF NAME CHANGE: 20050721 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CVS HEALTH Corp CENTRAL INDEX KEY: 0000064803 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] ORGANIZATION NAME: 07 Trade & Services 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 X0508 4 2024-02-12 0000064803 CVS HEALTH Corp CVS 0001333760 Lynch Karen S ONE CVS DRIVE WOONSOCKET RI 02895 1 1 President and CEO 0 Common Stock 2024-02-12 4 A 0 136640 0 A 136640 D Common Stock (By Trust) 431392 D Stock Appreciation Rights 45.91 2019-02-17 2027-02-16 Common Stock 192741 192741 D Stock Appreciation Rights 37.91 2019-02-19 2026-02-18 Common Stock 93989 93989 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 242408 242408 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 211196 211196 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 224604 224604 D Stock Option 101.09 2023-04-01 2032-04-01 Common Stock 171517 171517 D Stock Option 74.31 2024-04-01 2033-04-01 Common Stock 244952 244952 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 April 1, 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 12, 2024. Represents Aetna Inc. Stock Appreciation Rights ("SARs") granted under the Aetna Inc. 2010 Incentive Plan (the "Aetna Plan") on February 17, 2017 that were converted into CVS Health SARs in November 2018 pursuant to the terms of the CVS/Aetna Merger Agreement. These SARs vested in two substantially equal annual installments beginning on February 17, 2019. Represents SARs granted under the Aetna Plan on February 19, 2016 that were converted into CVS Health SARs in November 2018 pursuant to the terms of the CVS/Aetna Merger Agreement. These SARs vested on February 19, 2019. Represents unvested SARs granted under the Aetna Plan on February 19, 2016 that were converted into CVS Health SARs pursuant to the terms of the CVS/Aetna Merger Agreement. These SARs vested on February 19, 2019. Option became exercisable in four equal annual installments, commencing 4/1/2020. The number of shares subject to the option were calculated using a 30-day average price. Option became exercisable in four equal installments, commencing 4/1/2021. Option became exercisable in four equal installments, commencing 4/1/2022. Option became exercisable in four equal installments, commencing 4/1/2023. Option becomes exercisable in four equal annual installments, commencing 4/1/2024. /s/ Karen S. Lynch 2024-02-14