0001127602-24-005070.txt : 20240214 0001127602-24-005070.hdr.sgml : 20240214 20240214171223 ACCESSION NUMBER: 0001127602-24-005070 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240212 FILED AS OF DATE: 20240214 DATE AS OF CHANGE: 20240214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shah Prem S CENTRAL INDEX KEY: 0001900910 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 24640473 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] ORGANIZATION NAME: 07 Trade & Services 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 2024-02-12 0000064803 CVS HEALTH Corp CVS 0001900910 Shah Prem S ONE CVS DRIVE WOONSOCKET RI 02895 1 EVP and Pres-Pharm, Consumer W 0 Common Stock 2024-02-12 4 A 0 13313 0 A 69237.7624 D Common Stock (Restricted) 29649 D ESOP Common Stock 4788.9422 D Stock Unit (deferred) 3350.3557 D Phantom Stock Credits 1.00 Common Stock 33754.62 33754.62 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 Represents shares earned by the reporting person pursuant to certain performance stock units (the "PSUs"), which were granted to the reporting person under the Issuer's 2017 Incentive Compensation Plan on April 1, 2021. The PSUs were earned based on the attainment of certain performance metrics, which performance metrics were certified by the Management and Planning Committee of the Board of Directors of the Issuer on February 12, 2024. 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 04/01/2019. 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 became exercisable in three equal installments, commencing on 8/31/2021. 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 2024-02-14