0000899243-23-009923.txt : 20230329 0000899243-23-009923.hdr.sgml : 20230329 20230329085002 ACCESSION NUMBER: 0000899243-23-009923 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230329 FILED AS OF DATE: 20230329 DATE AS OF CHANGE: 20230329 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Farazi Paymon CENTRAL INDEX KEY: 0001936279 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40028 FILM NUMBER: 23771900 MAIL ADDRESS: STREET 1: C/O SIGNIFY HEALTH, INC. STREET 2: 800 CONNECTICUT AVE CITY: NORWALK STATE: CT ZIP: 06854 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Signify Health, Inc. CENTRAL INDEX KEY: 0001828182 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 CONNECTICUT AVENUE CITY: NORWALK STATE: CT ZIP: 06854 BUSINESS PHONE: (203) 541-4600 MAIL ADDRESS: STREET 1: 800 CONNECTICUT AVENUE CITY: NORWALK STATE: CT ZIP: 06854 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-03-29 1 0001828182 Signify Health, Inc. SGFY 0001936279 Farazi Paymon C/O SIGNIFY HEALTH, INC. 4055 VALLEY VIEW LN, SUITE 700 DALLAS TX 75244 0 1 0 0 Chief Product Officer 0 Class A Common Stock 2023-03-29 4 D 0 237269 D 0 D Employee Stock Options (Right to Buy) 18.47 2023-03-29 4 D 0 142125 D Class A Common Stock 142125 0 D On March 29, 2023, pursuant to that certain Agreement and Plan of Merger, dated September 2, 2022, between the Issuer, CVS Pharmacy, Inc. ("Parent") and Noah Merger Sub, Inc. (the "Merger Agreement"), as of the effective time of the merger (the "Effective Time"), each restricted stock unit with respect to shares of the Issuer's Class A Common Stock (each, an "Issuer RSU") that was not (i) outstanding immediately prior to the Effective Time to the extent vested and unsettled or (ii) outstanding immediately prior to the Effective Time and was held by any person who is a non-employee director, consultant or independent contractor engaged by the Issuer and was outstanding immediately prior to the Effective Time (each, a "Rollover RSU") was converted into a restricted stock unit, subject to substantially the same terms and conditions as were applicable under such Rollover RSU, with respect to a number of shares of common stock of CVS Health Corporation ("CVS Health Stock") (Continued from Footnote 1) equal to the number of shares of the Issuer's Class A Common Stock ("Class A Common Stock") subject to such Rollover RSU multiplied by a fraction, the numerator of which is $30.50 (the "Per Share Consideration") and the denominator of which is the volume weighted average trading price (rounded to the nearest $0.01) of one share of CVS Health Stock on the New York Stock Exchange as reported on Bloomberg L.P. under the function "VWAP" (or, if not reported therein, in another authoritative source mutually selected by the parties) for the ten (10) consecutive trading days ending on (and including) the trading day that is three (3) trading days prior to the date of the closing of the Merger (the "Exchange Ratio"). Pursuant to the Merger Agreement, each option to purchase Issuer Stock (each, an "Issuer Option") granted by Issuer under an Issuer stock plan that was not (i) outstanding as of immediately prior to the Effective Time and was vested and unexercised (but not, for the avoidance of doubt, (x) any unvested Issuer Option that was outstanding immediately prior to the Effective Time with an exercise price that is equal to or greater than $30.50 or (y) any Issuer Option that is forfeited due to failure to satisfy performance-based conditions) or (ii) outstanding immediately prior to the Effective Time and was held by a non-employee director, consultant or independent contractor of the Issuer (whether vested or unvested) and is outstanding immediately prior to the Effective Time (each, a "Rollover Stock Option") (Continued from Footnote 3) was converted into an option to acquire, on substantially the same terms and conditions as were applicable under such Rollover Stock Option, the number of shares of CVS Health Stock (rounded down to the nearest whole share), determined by multiplying (x) the number of shares of Class A Common Stock subject to such Rollover Stock Option immediately prior to the Effective Time by (y) the Exchange Ratio, at an exercise price per share of CVS Health Stock (rounded up to the nearest whole cent) equal to (A) the exercise price per share of Class A Common Stock subject to such Rollover Stock Option divided by (B) the Exchange Ratio. /s/ Adam McAnaney, as attorney-in-fact for Paymon Farazi 2023-03-29