0001127602-23-023583.txt : 20230901 0001127602-23-023583.hdr.sgml : 20230901 20230901162427 ACCESSION NUMBER: 0001127602-23-023583 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230831 FILED AS OF DATE: 20230901 DATE AS OF CHANGE: 20230901 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shah Prem S CENTRAL INDEX KEY: 0001900910 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 231232871 MAIL ADDRESS: STREET 1: ONE CVS DRIVE CITY: WOONSOCKET STATE: RI ZIP: 02895 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CVS HEALTH Corp CENTRAL INDEX KEY: 0000064803 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 050494040 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE CVS DR. CITY: WOONSOCKET STATE: RI ZIP: 02895 BUSINESS PHONE: 4017651500 MAIL ADDRESS: STREET 1: ONE CVS DR. CITY: WOONSOCKET STATE: RI ZIP: 02895 FORMER COMPANY: FORMER CONFORMED NAME: CVS CAREMARK CORP DATE OF NAME CHANGE: 20070509 FORMER COMPANY: FORMER CONFORMED NAME: CVS/CAREMARK CORP DATE OF NAME CHANGE: 20070322 FORMER COMPANY: FORMER CONFORMED NAME: CVS CORP DATE OF NAME CHANGE: 19970128 4 1 form4.xml PRIMARY DOCUMENT X0508 4 2023-08-31 0000064803 CVS HEALTH Corp CVS 0001900910 Shah Prem S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP and Co-President of Retail 0 Common Stock 2023-08-31 4 F 0 3508 65.17 D 50987.7242 D Common Stock (Restricted) 29649 D ESOP Common Stock 4667.2023 D Stock Unit (deferred) 7870.5483 D Phantom Stock Credits 1.00 Common Stock 12232.5318 12232.5318 D Stock Option 104.82 2017-04-01 2023-04-01 Common Stock 2935 2935 D Stock Option 62.21 2019-04-01 2025-04-01 Common Stock 846 846 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 9469 9469 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 28596 28596 D Stock Option 75.24 2021-08-31 2028-08-31 Common Stock 26580 26580 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 28723 28723 D Stock Option 101.09 2023-04-01 2032-04-01 Common Stock 41580 41580 D Stock Option 74.31 2024-04-01 2033-04-01 Common Stock 89073 89073 D Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock award. Consists of Stock Units awarded pursuant to Issuer's 2010 & 2017 Incentive Compensation Plans, the receipt of which the reporting person has elected to defer. Reflects year-end company-match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, at such time as has been elected by the reporting person. Reflects year-end company-match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, at such time as has been elected by the reporting person. Option became exercisable in four equal installments commencing 04/01/2017. Option became exercisable in four equal installments commencing 04/01/2019. Additional options from this award have been exercised. Option became exercisable in four equal installments commencing 04/01/2020. Additional options from this award have been exercised Option became exercisable in four equal installments commencing 04/01/2021. Additional options from this award have been exercised. Option vests in three equal installments, on 8/31/2021, 8/31/2022 and 8/31/2023. Option became exercisable in three equal installments commencing 04/01/2022. Option became exercisable in four equal installments, commencing 4/1/2023. Option becomes exercisable in four equal annual installments, commencing 4/1/2024. /s/ Prem S. Shah 2023-09-01