SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
 Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
Shah Prem S
(Last) (First) (Middle)
ONE CVS DRIVE
(Street)
WOONSOCKET RI 02895
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS ] 		5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP and Pres-Pharm, Consumer W
3. Date of Earliest Transaction (Month/Day/Year)
02/12/2024
4. If Amendment, Date of Original Filed (Month/Day/Year)
 6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/12/2024 A 13,313(1) A $0 69,237.7624 D
Common Stock (Restricted) 29,649 D
ESOP Common Stock 4,788.9422 D
Stock Unit (deferred)(2) 3,350.3557 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Phantom Stock Credits $1 (3) (4) Common Stock 33,754.62 33,754.62 D
Stock Option(5) $62.21 04/01/2019 04/01/2025 Common Stock 846 846 D
Stock Option(6) $54.19 04/01/2020 04/01/2029 Common Stock 9,469 9,469 D
Stock Option(7) $58.34 04/01/2021 04/01/2030 Common Stock 28,596 28,596 D
Stock Option(8) $75.24 08/31/2021 08/31/2028 Common Stock 26,580 26,580 D
Stock Option(9) $74.3 04/01/2022 04/01/2031 Common Stock 28,723 28,723 D
Stock Option(10) $101.09 04/01/2023 04/01/2032 Common Stock 41,580 41,580 D
Stock Option(11) $74.31 04/01/2024 04/01/2033 Common Stock 89,073 89,073 D
Explanation of Responses:
1. 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.
2. 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.
3. 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.
4. 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.
5. Option became exercisable in four equal installments commencing 04/01/2019. Additional options from this award have been exercised.
6. Option became exercisable in four equal installments commencing 04/01/2020. Additional options from this award have been exercised
7. Option became exercisable in four equal installments commencing 04/01/2021. Additional options from this award have been exercised.
8. Option became exercisable in three equal installments, commencing on 8/31/2021.
9. Option became exercisable in three equal installments commencing 04/01/2022.
10. Option became exercisable in four equal installments, commencing 4/1/2023.
11. Option becomes exercisable in four equal annual installments, commencing 4/1/2024.
/s/ Prem S. Shah 02/14/2024
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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