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).
1. Name and Address of Reporting Person*
HERMAN JOAN E

(Last) (First) (Middle)
120 MONUMENT CIRCLE

(Street)
INDIANAPOLIS IN 46204

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
WELLPOINT INC [ WLP ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP
3. Date of Earliest Transaction (Month/Day/Year)
12/02/2004
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 12/02/2004 M 536 A $29.28 25,536 D
Common Stock 12/02/2004 M 2,349 A $29.28 27,885 D
Common Stock 12/02/2004 M 432 A $29.39 28,317 D
Common STock 12/02/2004 M 367 A $34.81 28,684 D
Common Stock 12/02/2004 M 59,520 A $34.92 88,204 D
Common Stock 12/02/2004 M 6,148 A $35 94,352 D
Common Stock 12/02/2004 M 80,114 A $38.9 174,466 D
Common Stock 12/02/2004 M 5 A $39.86 174,471 D
Common Stock 12/02/2004 M 3,519 A $39.86 177,990 D
Common Stock 12/02/2004 M 992 A $43.47 178,982 D
Common Stock 12/02/2004 M 2,755 A $43.47 181,737 D
Common Stock 12/02/2004 S 536 D $105.73 181,201 D
Common Stock 12/02/2004 S 2,349 D $105.73 178,852 D
Common Stock 12/02/2004 S 432 D $105.73 178,420 D
Common Stock 12/02/2004 S 367 D $105.73 178,053 D
Common Stock 12/02/2004 S 59,520 D $105.73 118,533 D
Common Stock 12/02/2004 S 6,148 D $105.73 115,904 D
Common Stock 12/02/2004 S 80,114 D $105.73 32,271 D
Common Stock 12/02/2004 S 5 D $105.73 32,266 D
Common Stock 12/02/2004 S 3,519 D $105.73 28,747 D
Common Stock 12/02/2004 S 992 D $105.73 27,755 D
Common Stock 12/02/2004 S 2,755 D $105.73 25,000 D
Common Stock 114 I 401(k)
Common Stock 46,319 I The Herman-Rasiej Family Trust Account
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
Employee Stock Option (right to buy) $29.28 12/02/2004 M 536 06/01/2001 06/01/2008 Common Stock 536 $0 0 D
Employee Stock Option (right to buy) $29.28 12/02/2004 M 2,349 06/01/2001 06/01/2008 Common Stock 2,349 $0 0 D
Employee Stock Option $29.39 12/02/2004 M 432 09/01/2000 06/04/2008 Common Stock 432 $0 0 D
Employee Stock Option (right to buy) $34.81 12/02/2004 M 367 09/01/2001 06/04/2008 Common Stock 367 $0 0 D
Employee Stock Option (right to buy) $34.92 12/02/2004 M 59,520 06/04/2002 06/03/2011 Common Stock 59,520 $0 0 D
Employee Stock Option (right to buy) $35 12/02/2004 M 6,148 06/01/2002 06/04/2008 Common Stock 6,148 $0 0 D
Employee Stock Option (rght to buy) $38.9 12/02/2004 M 80,114 02/01/2002 01/31/2011 Common Stock 80,114 $0 0 D
Employee Stock Option (right to buy) $39.86 12/02/2004 M 5 03/01/2002 06/04/2008 Common Stock 5 $0 0 D
Employee Stock Option (right to buy) $39.86 12/02/2004 M 3,519 03/01/2002 02/11/2009 Common Stock 3,519 $0 0 D
Employee Stock Option (right to buy) $43.47 12/02/2004 M 992 12/01/2001 06/04/2008 Common Stock 992 $0 0 D
Employee Stock Option (right to buy) $43.47 12/02/2004 M 2,755 12/01/2001 06/04/2008 Common Stock 2,755 $0 0 D
Explanation of Responses:
Remarks:
Nancy Purcell, Attorney-in-fact 12/06/2004
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.