Statement of Changes in Beneficial Ownership (4)

Date : 01/10/2020 @ 10:32PM
Source : Edgar (US Regulatory)
Stock : CVS Health Corporation (CVS)
Quote : 57.415  1.695 (3.04%) @ 2:54PM

Statement of Changes in Beneficial Ownership (4)

FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
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OMB Number: 3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

Roberts Jonathan C
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 & Chief Operating Officer
(Last)          (First)          (Middle)

ONE CVS DRIVE
3. Date of Earliest Transaction (MM/DD/YYYY)

1/8/2020
(Street)

WOONSOCKET, RI 02895-
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
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. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. 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 1/8/2020  M  68844 A$54.53 102607.6311 D  
Common Stock 1/8/2020  S(1)  57563 D$72.63 (2)45044.6311 D  
Common Stock (restricted)         41246 D  
ESOP Common Stock         5772.6789 I By ESOP 
Stock Unit         230362.6616 D  

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. 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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock Option $54.53 1/8/2020  M     68844  4/1/2014 (3)4/1/2020 Common Stock 68844 $0 0 D  
Phantom Stock Credits $1.00            (4) (4)Common Stock 1424.1494  1424.1494 D  
Stock Option $74.29           4/1/2015 (5)4/1/2021 Common Stock 73433  73433 D  
Stock Option $45.93           9/4/2015 (6)9/4/2022 Common Stock 108870  108870 D  
Stock Option $102.26           4/1/2016 (7)4/1/2022 Common Stock 68482  68482 D  
Stock Option $104.82           4/1/2017 (8)4/1/2023 Common Stock 161318  161318 D  
Stock Option $78.05           4/3/2018 (9)4/3/2024 Common Stock 200358  200358 D  
Stock Option $62.21           4/1/2019 (10)4/1/2025 Common Stock 248131  248131 D  
Stock Option $54.19           4/1/2020 (11)4/1/2029 Common Stock 303010  303010 D  

Explanation of Responses:
(1) All sales were effected pursuant to a Rule 10b5-1 plan. The transaction was a sell-to-cover exercise, with shares sold to cover the option exercise price and taxes, and the Reporting Person retaining all remaining shares.
(2) Represents weighted average sale price for this group of sales, which occurred on the same trading day. Multiple sales were executed, with sales prices ranging between $71.75 and 73.04 per share.
(3) Option became exercisable in four equal annual installments, commencing 4/1/2014.
(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 annual installments, commencing 4/1/2015.
(6) Option became exercisable in three equal annual installments, commencing 9/4/2015.
(7) Option became exercisable in four equal annual installments, commencing 4/1/2016.
(8) Option became exercisable in four equal annual installments, commencing 4/1/2017.
(9) Option became exercisable in four equal annual installments, commencing 4/3/2018.
(10) Option became exercisable in four equal annual installments, commencing 4/1/2019.
(11) Option becomes exercisable in four equal annual installments, commencing 4/1/2020.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Roberts Jonathan C
ONE CVS DRIVE
WOONSOCKET, RI 02895-


EVP & Chief Operating Officer

Signatures
Jonathan C. Roberts1/10/2020
**Signature of Reporting PersonDate

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