0001127602-11-016823.txt : 20110518 0001127602-11-016823.hdr.sgml : 20110518 20110518162001 ACCESSION NUMBER: 0001127602-11-016823 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110516 FILED AS OF DATE: 20110518 DATE AS OF CHANGE: 20110518 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WELLPOINT, 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: 20041130 FORMER COMPANY: FORMER CONFORMED NAME: ANTHEM INC DATE OF NAME CHANGE: 20010730 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAKER LENOX D JR MD CENTRAL INDEX KEY: 0001201942 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16751 FILM NUMBER: 11855124 MAIL ADDRESS: STREET 1: 120 MONUMENT CIRCLE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 4 1 form4.xml PRIMARY DOCUMENT X0303 4 2011-05-16 0001156039 WELLPOINT, INC WLP 0001201942 BAKER LENOX D JR MD 120 MONUMENT CIRCLE INDIANAPOLIS 46204 1 Common Stock 2011-05-16 4 M 0 3430 A 66548 D Phantom Stock Units 2011-05-16 4 M 0 3430 D 2011-05-16 2011-05-16 Common Stock 3430 0 D Phantom Stock Units 2011-05-17 4 A 0 3125 A Common Stock 3125 3125 D Phantom stock units converted to Company common stock on a 1-for-1 basis in accordance with the terms of the WellPoint, Inc ("Company") Board of Directors Deferred Compensation Plan (the "Plan"). The phantom stock units were accrued under the Company Plan. The Conversion or Exercise Price of the Derivative Security is 1-for-1. The phantom stock units shall be payable in Company common stock upon the first to occur of (a) five years from the date of grant or (b) the date the Reporting Person ceases to be a member of the Company's board of directors, unless a later date is designated in the Reporting Person's election made under the Plan in accordance with the terms of the Plan. /s/ Kathleen S. Kiefer, Attorney in fact 2011-05-18