Statement of Changes in Beneficial Ownership (4)
March 23 2021 - 4:31PM
Edgar (US Regulatory)
FORM 4
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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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
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1. Name and Address of Reporting Person
*
Haytaian Peter D |
2. Issuer Name and Ticker or Trading Symbol
Anthem, Inc.
[
ANTM
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) EVP & President, Commercial |
(Last)
(First)
(Middle)
220 VIRGINIA AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/22/2021 |
(Street)
INDIANAPOLIS, IN 46204
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 3/22/2021 | | M | | 15593 | A | $146.93 | 59544 | D | |
Common Stock | 3/22/2021 | | M | | 22500 | A | $131.80 | 82044 | D | |
Common Stock | 3/22/2021 | | S(1) | | 300 | D | $345.59 (2) | 81744 | D | |
Common Stock | 3/22/2021 | | S(1) | | 9387 | D | $347.44 (3) | 72357 | D | |
Common Stock | 3/22/2021 | | S(1) | | 12416 | D | $348.52 (4) | 59941 | D | |
Common Stock | 3/22/2021 | | S(1) | | 26777 | D | $349.53 (5) | 33164 | D | |
Common Stock | 3/22/2021 | | S(1) | | 7891 | D | $350.21 (6) | 25273 | D | |
Common Stock | 3/22/2021 | | S(1) | | 400 | D | $351.32 (7) | 24873 | D | |
Common Stock | 3/22/2021 | | S(1) | | 2329 | D | $352.84 | 22544 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. 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 Date | 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 of Derivative Security: 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 |
Employee Stock Option (Right to Buy) | $146.93 | 3/22/2021 | | M | | | 15593 | (8) | 3/2/2025 | Common Stock | 15593.0 | $0 | 0 | D | |
Employee Stock Option (Right to Buy) | $131.8 | 3/22/2021 | | M | | | 22500 | (9) | 3/1/2026 | Common Stock | 22500.0 | $0 | 1848 | D | |
Explanation of Responses: |
(1) | The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on February, 1, 2021. |
(2) | This transaction was executed in multiple trades at prices ranging from $345.53 to $345.66. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(3) | This transaction was executed in multiple trades at prices ranging from $346.93 to $347.91. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(4) | This transaction was executed in multiple trades at prices ranging from $347.95 to $348.91. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(5) | This transaction was executed in multiple trades at prices ranging from $348.97 to $349.94. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(6) | This transaction was executed in multiple trades at prices ranging from $349.97 to $350.72. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(7) | This transaction was executed in multiple trades at prices ranging from $350.99 to $351.54. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(8) | The option represents a right to purchase a total of 22,353 shares and is exercisable in six semi-annual installments, with three installments of 3,725 shares each and three installments of 3,726 shares each beginning on September 2, 2015, which is the six-month anniversary of the date on which the option was granted |
(9) | The option represents a right to purchase a total of 24,348 shares, and is exercisable in six semi-annual installments of 4,058 shares each, beginning on September 1, 2016, which is the six-month anniversary of the option grant date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Haytaian Peter D 220 VIRGINIA AVENUE INDIANAPOLIS, IN 46204 |
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| EVP & President, Commercial |
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Signatures
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/s/ Kathleen S. Kiefer, Attorney in fact | | 3/23/2021 |
**Signature of Reporting Person | Date |
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