0001127602-19-009899.txt : 20190305
0001127602-19-009899.hdr.sgml : 20190305
20190305160817
ACCESSION NUMBER: 0001127602-19-009899
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190301
FILED AS OF DATE: 20190305
DATE AS OF CHANGE: 20190305
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gallina John E
CENTRAL INDEX KEY: 0001433032
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16751
FILM NUMBER: 19658354
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: 220 VIRGINIA AVENUE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
BUSINESS PHONE: 3174886000
MAIL ADDRESS:
STREET 1: 220 VIRGINIA AVENUE
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
2019-03-01
0001156039
Anthem, Inc.
ANTM
0001433032
Gallina John E
220 VIRGINIA AVENUE
INDIANAPOLIS
IN
46204
1
EVP & Chief Financial Officer
Common Stock
2019-03-01
4
F
0
2217
307.68
D
13442
D
Common Stock
2019-03-01
4
A
0
2940
0
A
16382
D
Common Stock
2019-03-01
4
A
0
2641
0
A
19023
D
Common Stock
2019-03-01
4
A
0
4033
0
A
23056
D
Employee Stock Option (Right to Buy)
307.68
2019-03-01
4
A
0
12187
0
A
2029-03-01
Common Stock
12187
12187
D
PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.
Represents performance based restricted share units. Restrictions lapse on 3/1/19.
Represents restricted share units. Restrictions lapse as follows: 880 shares each on 3/1/2020 and 3/1/2021, and 881 on 3/1/2022.
Represents performance based restricted share units. Restrictions lapse on 6/1/19.
The option represents a right to purchase a total of 12,187 shares, and is exercisable in three annual installments, with two installments of 4,062 shares each and one installment of 4,063 shares, beginning on 3/1/2020, which is the one-year anniversary of the option grant date.
/s/ Kathleen S. Kiefer, Attorney in fact
2019-03-05