Sec Form 4 Filing - Bertolini Mark T @ AETNA INC /PA/ - 2018-11-28

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Bertolini Mark T
2. Issuer Name and Ticker or Trading Symbol
AETNA INC /PA/ [ AET]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chairman and CEO
(Last) (First) (Middle)
151 FARMINGTON AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
11/28/2018
(Street)
HARTFORD, CT06156
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 11/28/2018 M 72,500 ( 1 ) A $ 0 124,037 D
Common Stock 11/28/2018 M 32,331 ( 2 ) A $ 0 156,368 D
Common Stock 11/28/2018 M 8,893 ( 3 ) A $ 0 165,261 D
Common Stock 11/28/2018 M 13,220 ( 4 ) A $ 0 178,481 D
Common Stock 11/28/2018 M 17,572 ( 5 ) A $ 0 196,053 D
Common Stock 11/28/2018 M 76,044 ( 5 ) A $ 0 272,097 D
Common Stock 11/28/2018 F 102,990 D $ 209.01 ( 6 ) 169,107 D
Common Stock 11/28/2018 D 169,107 D 0 D
Common Stock 11/28/2018 D 119,447 D 0 I By CLAT ( 8 )
Common Stock 11/28/2018 D 107,098 ( 9 ) D 0 I By 2017 GRAT ( 10 )
Common Stock 11/28/2018 D 107,576 D 0 I By 2017 GRAT II ( 11 )
Common Stock 11/28/2018 D 259,969 ( 12 ) D 0 I By 2018 GRAT ( 13 )
Common Stock 11/28/2018 D 134,649 ( 14 ) D 0 I By 2016 Trust ( 15 )
Common Stock 11/28/2018 D 14,961 ( 16 ) D 0 I By 2018 Trust ( 17 )
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
Restricted Stock Units ( 3 ) 11/28/2018 M 8,893 ( 3 ) ( 3 ) Common Stock 8,893 $ 0 ( 3 ) 0 D
Restricted Stock Units ( 4 ) 11/28/2018 M 13,220 ( 4 ) ( 4 ) Common Stock 13,220 $ 0 ( 4 ) 0 D
Restricted Stock Units ( 5 ) 11/28/2018 M 17,572 ( 5 ) ( 5 ) Common Stock 17,572 $ 0 ( 5 ) 0 D
Restricted Stock Units ( 5 ) 11/28/2018 M 76,044 ( 5 ) ( 5 ) Common Stock 76,044 $ 0 ( 5 ) 0 D
Stock Appreciation Rights $ 32.11 11/28/2018 D 299,751 ( 18 ) ( 18 ) Common Stock 299,751 ( 18 ) 0 D
Stock Appreciation Right $ 64.25 11/28/2018 D 500,000 ( 19 ) ( 19 ) Common Stock 500,000 ( 19 ) 0 D
Stock Appreciation Rights $ 72.26 11/28/2018 D 304,626 ( 20 ) ( 20 ) Common Stock 304,626 ( 20 ) 0 D
Stock Appreciation Rights $ 100.5 11/28/2018 D 253,480 ( 21 ) ( 21 ) Common Stock 253,480 ( 21 ) 0 D
Stock Appreciation Rights $ 103.45 11/28/2018 D 253,242 ( 22 ) ( 22 ) Common Stock 253,242 ( 22 ) 0 D
Stock Appreciation Rights $ 125.27 11/28/2018 D 260,037 ( 23 ) ( 23 ) Common Stock 260,037 ( 23 ) 0 D
Deferred Stock Units ( 24 ) 11/28/2018 D 74,140.1044 ( 24 ) ( 24 ) Common Stock 74,140.1044 ( 24 ) 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Bertolini Mark T
151 FARMINGTON AVENUE
HARTFORD, CT06156
X Chairman and CEO
Signatures
Mark T. Bertolini by Adam F. McAnaney, Attorney-in-Fact 11/28/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Vesting of performance stock units ("PSUs") granted under the Aetna Inc. 2010 Stock Incentive Plan (the "Plan") on February 19, 2016.
( 2 )Vesting of PSUs granted under the Plan on February 17, 2017.
( 3 )Vesting of previously reported restricted stock units ("RSUs") granted under the Plan on February 19, 2016.
( 4 )Vesting of previously reported RSUs granted under the Plan on February 17, 2017.
( 5 )Vesting of previously reported RSUs granted under the Plan on March 2, 2018.
( 6 )Represents tax withholding on accelerated vesting of PSUs and RSUs granted under the Plan.
( 7 )Converted pursuant to the merger agreement (the "Merger Agreement") between CVS Health Corporation ("CVS Health") and Aetna Inc. ("Aetna") into $145 in cash and 0.8378 shares of CVS Health Common Stock for each share of Aetna Common Stock.
( 8 )Represents shares held in Charitable Lead Annuity Trust ("CLAT") for which Reporting Person is the investment advisor.
( 9 )On August 27, 2018, 51,537 shares were voluntarily transferred from 2017 Grantor Retained Annuity Trust ("GRAT") to the Reporting Person's sole account.
( 10 )Represents shares held by 2017 GRAT for which Reporting Person is sole trustee.
( 11 )Represents shares held by 2017 GRAT II for which Reporting Person is sole trustee.
( 12 )On July 23, 2018, 145,826 shares were distributed to the Reporting Person's sole account to satisfy 2016 GRAT annuity obligation. On July 31, 2018, 259,969 shares were voluntarily transferred from Reporting Person's sole account to 2018 GRAT.
( 13 )Represents shares held by 2018 GRAT for which Reporting Person is sole trustee
( 14 )On October 24, 2018, 134,649 shares were transferred from 2016 GRAT to 2016 Trust.
( 15 )Represents shares held by a 2016 Trust for which Reporting Person is the investment advisor.
( 16 )On October 24, 2018, 14,961 shares were transferred from 2016 GRAT to 2018 Trust.
( 17 )Represents shares held by a 2018 Trust for which Reporting Person is the investment advisor.
( 18 )Represents Stock Appreciation Rights ("SARs") granted under the Plan on February 13, 2009. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount (the "SAR Amount") in cash for each SAR equal to (a) $145 plus (b) 0.8378 multiplied by the average of the volume weighted averages of the trading prices of CVS Health Common Stock on each of the five consecutive trading days ending on the trading day two trading days prior to the closing date, less (c) the exercise price.
( 19 )Represents SARs granted under the Plan on August 5, 2013. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount in cash for each SAR, equal to the SAR Amount.
( 20 )Represents SARs granted under the Plan on March 3, 2014. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount in cash for each SAR, equal to the SAR Amount.
( 21 )Represents SARs granted under the Plan on March 2, 2015. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount in cash for each SAR, equal to the SAR Amount.
( 22 )Represents SARs granted under the Plan on February 19, 2016. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount in cash for each SAR, equal to the SAR Amount.
( 23 )Represents SARs granted under the Plan on February 17, 2017. These SARs were canceled pursuant to the terms of the Merger Agreement in exchange for an amount in cash for each SAR, equal to the SAR Amount.
( 24 )Represents Deferred Stock Units ("DSUs") previously reported and accrued pursuant to the Plan. These DSUs were canceled for an amount in cash for each DSU equal to (a) $145 plus (b) 0.8378 multiplied by the average of the volume weighted averages of the trading prices of CVS Health Common Stock on each of the five consecutive trading days ending on the trading day two trading days prior to the closing date.

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