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*
SCHAEFFER LEONARD D

(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)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/01/2004
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 12/01/2004 M 11,869 A $53.09 1,544,216 D
Common Stock 12/01/2004 F 8,239 D $101.33 1,535,977 D
Common Stock 12/01/2004 M 17,978 A $42.94 1,553,955 D
Common Stock 12/01/2004 F 11,322 D $101.33 1,542,633 D
Common Stock 12/01/2004 M 20,221 A $62.9 1,562,854 D
Common Stock 12/01/2004 F 15,294 D $101.33 1,547,560 D
Common Stock 12/01/2004 M 47,021 A $49.04 1,594,581 D
Common Stock 12/01/2004 F 31,431 D $101.33 1,563,150 D
Common Stock 12/01/2004 M 40,193 A $59.98 1,603,343 D
Common Stock 12/01/2004 F 29,655 D $101.33 1,573,688 D
Common Stock 12/01/2004 M 106,122 A $49.85 1,679,810 D
Common Stock 12/01/2004 F 71,482 D $101.33 1,608,328 D
Common Stock 12/01/2004 M 248,004 A $55.1 1,856,332 D
Common Stock 12/01/2004 F 175,306 D $101.33 1,681,026 D
Common Stock 12/01/2004 M 81,313 A $68.82 1,762,339 D
Common Stock 12/01/2004 F 64,551 D $101.33 1,697,788 D
Common Stock 12/01/2004 M 8,934 A $75.4 1,706,722 D
Common Stock 12/01/2004 F 7,465 D $101.33 1,699,257 D
Common Stock 12/01/2004 M 80,549 A $59.81 1,779,806 D
Common Stock 12/01/2004 F 59,343 D $101.33 1,720,463 D
Common Stock 12/01/2004 M 61,960 A $87.72 1,782,423 D
Common Stock 12/01/2004 F 56,613 D $101.33 1,725,810 D
Common Stock 12/01/2004 M 60,284 D $82.06 1,786,094 D
Common Stock 12/01/2004 F 52,918 D $101.33 1,733,176 D
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) $49.04 12/01/2004 M 47,021 03/01/2002 03/03/2006 Common Stock 47,021 $0 3,031,710 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 31,431 12/01/2004 03/03/2006 Common Stock 31,431 $0 3,063,141 D
Common Stock $59.98 12/01/2004 M 40,193 09/01/2002 03/03/2006 Common Stock 40,193 $0 3,022,948 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 29,655 12/01/2004 03/03/2006 Common Stock 29,655 $0 3,052,603 D
Common Stock $49.82 12/01/2004 M 106,122 02/11/2009 02/10/2009 Common Stock 106,122 $0 2,946,481 D
Common Stock $101.33 12/01/2004 A 71,482 12/01/2004 02/10/2009 Common Stock 71,482 $0 3,017,963 D
Employee Stock Option (right to buy) $55.1 12/01/2004 M 248,004 02/05/2003 02/04/2013 Common Stock 248,004 $0 2,769,959 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 175,306 12/01/2004 02/04/2013 Common Stock 175,306 $0 2,945,265 D
Employee Stock Option (right to buy) $68.82 12/01/2004 M 81,313 06/01/2003 03/03/2006 Common Stock 81,313 $0 2,863,952 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 64,551 12/01/2004 03/03/2006 Common Stock 64,551 $0 2,928,503 D
Employee Stock Option (right to buy) $75.4 12/01/2004 M 8,934 12/01/2003 03/03/2006 Common Stock 8,934 $0 2,919,569 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 7,465 12/01/2004 03/03/2006 Common Stock 7,465 $0 2,927,034 D
Employee Stock Option (right to buy) $59.81 12/01/2004 M 80,549 06/01/2002 03/03/2006 Common Stock 80,549 $0 2,846,485 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 59,343 12/01/2004 03/03/2006 Common Stock 59,343 $0 2,905,828 D
Employee Stock Option (right to buy) $87.72 12/01/2004 M 61,960 03/01/2004 03/01/2010 Common Stock 61,960 $0 2,843,868 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 56,613 12/01/2004 03/01/2010 Common Stock 56,613 $0 2,900,481 D
Employee Stock Option (right to buy) $82.06 12/01/2004 M 60,284 01/26/2004 01/25/2014 Common Stock 60,284 $0 2,840,197 D
Employee Stock Option (right to buy) $101.33 12/01/2004 A 52,918 12/01/2004 01/25/2014 Common Stock 52,918 $0 2,893,115 D
Explanation of Responses:
Remarks:
Form 2 of 2 being filed for the reporting person on the same day.
Nancy Purcell, Attorney-in-fact 12/03/2004
** 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.