0001127602-18-010108.txt : 20180305
0001127602-18-010108.hdr.sgml : 20180305
20180305164933
ACCESSION NUMBER: 0001127602-18-010108
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180301
FILED AS OF DATE: 20180305
DATE AS OF CHANGE: 20180305
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Penczek Ronald W
CENTRAL INDEX KEY: 0001659075
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16751
FILM NUMBER: 18666788
MAIL ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Anthem, Inc.
CENTRAL INDEX KEY: 0001156039
STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324]
IRS NUMBER: 352145715
STATE OF INCORPORATION: IN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
BUSINESS PHONE: 3174886000
MAIL ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
FORMER COMPANY:
FORMER CONFORMED NAME: WELLPOINT, INC
DATE OF NAME CHANGE: 20100105
FORMER COMPANY:
FORMER CONFORMED NAME: WELLPOINT INC
DATE OF NAME CHANGE: 20041130
FORMER COMPANY:
FORMER CONFORMED NAME: ANTHEM INC
DATE OF NAME CHANGE: 20010730
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2018-03-01
0001156039
Anthem, Inc.
ANTM
0001659075
Penczek Ronald W
120 MONUMENT CIRCLE
INDIANAPOLIS
IN
46204
1
SVP, Chief Accounting Officer
Common Stock
2018-03-01
4
F
0
125
232.04
D
880
D
Common Stock
2018-03-01
4
A
0
388
0
A
1268
D
Common Stock
2018-03-02
4
F
0
305
233.08
D
963
D
Common Stock
2018-03-02
4
A
0
952
0
A
1915
D
Employee Stock Option (Right to Buy)
232.04
2018-03-01
4
A
0
1634
0
A
2028-03-01
Common Stock
1634
1634
D
PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
Represents restricted share units. Restrictions lapse as follows: 129 shares each on 3/1/2019 and 3/1/2020, and 130 on 3/1/2021.
Represents performance based restricted share units. Restrictions lapsed on 3/2/18.
The option represents a right to purchase a total of 1,634 shares, and is exercisable in six semi-annual installments, with four installments of 272 shares each and two installments of 273 shares each, beginning on September 1, 2018, which is the six-month anniversary of the option grant date.
/s/ Kathleen S. Kiefer, Attorney in fact
2018-03-05