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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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*
Goulet Kenneth R

(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, Commercial & Specialty
3. Date of Earliest Transaction (Month/Day/Year)
08/06/2013
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 08/06/2013 M 20,000 A $63.36 110,332 D
Common Stock 08/06/2013 M 6,681 A $44.9 117,013 D
Common Stock 08/06/2013 M 18,102 A $44.9 135,115 D
Common Stock 08/06/2013 S 62,643 D $87.36(1) 72,472 D
Common Stock 5,858.96(2)(3) I Stock Units Held In 401(k) Plan
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) $63.36 08/06/2013 M 20,000 (4) 04/04/2015 Common Stock 20,000 $0 14,662 D
Employee Stock Option (Right to Buy) $44.9 08/06/2013 M 6,681 (5) 06/27/2014 Common Stock 6,681 $0 0 D
Employee Stock Option (Right to Buy) $44.9 08/06/2013 M 18,102 (6) 06/27/2014 Common Stock 18,102 $0 0 D
Explanation of Responses:
1. This transaction was executed in multiple trades at prices ranging from $87.28 to $87.47. 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.
2. The information in this report is based on the plan trustees calculation of stock units held as of August 6, 2013.
3. Includes units acquired under WLP's Qualified 401(k) Plan (which represent 61.02 shares of WLP common stock) since the date of the reporting person's last ownership report.
4. The option, representing a right to purchase a total of 34,662 shares, became exercisable in six equal semi-annual installments of 5,777 shares each beginning on October 4, 2005, which was the six-month anniversary of the date on which the option was granted.
5. The option, representing a right to purchase a total of 8,908 shares, became exercisable in one semi-annual installment of 2,227 shares and three annual installments of 2,227 shares each beginning on December 28, 2004, which was the six-month anniversary of the date on which the option was granted.
6. The option, representing a right to purchase a total of 40,692 shares, became exercisable in three equal semi-annual installments of 6,040 shares each, a semi-annual installment of 8,266 shares, a semi-annual installment of 6,038 shares and a semi-annual installment of 8,268 shares beginning on December 28, 2004, which was the six-month anniversary of the date on which the option was granted.
Mary M. Kleiman, Attorney-in-fact 08/08/2013
** 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.