Sec Form 4 Filing - Bisaccia Lisa @ CVS HEALTH Corp - 2020-04-01

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
Bisaccia Lisa
2. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
EVP and Chief HR Officer
(Last) (First) (Middle)
ONE CVS DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
04/01/2020
(Street)
WOONSOCKET, RI02895
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 04/01/2020 F 1,109 ( 1 ) D $ 58.34 44,663 D
Common Stock (restricted) 9,670 D
ESOP Common Stock 970.084 I Direct
Stock Unit 31,582.8936 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 (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
Stock Option $ 58.61 ( 2 ) 04/01/2020 A 98,558 04/01/2021( 3 ) 04/01/2030 Common Stock 98,558 $ 58.61 98,558 D
Phantom Stock Credits $ 1 ( 4 ) ( 5 ) Common Stock 468.9237 468.9237 D
Stock Option $ 74.29 04/01/2015( 6 ) 04/01/2021 Common Stock 25,177 25,177 D
Stock Option $ 102.26 04/01/2016( 7 ) 04/01/2022 Common Stock 34,241 34,241 D
Stock Option $ 104.82 04/01/2017( 8 ) 04/01/2023 Common Stock 39,433 39,433 D
Stock Option $ 78.05 04/03/2018( 9 ) 04/03/2024 Common Stock 55,098 55,098 D
Stock Option $ 62.21 04/01/2019( 10 ) 04/01/2025 Common Stock 64,222 64,222 D
Stock Option $ 54.19 04/01/2020( 11 ) 04/01/2029 Common Stock 141,405 141,405 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Bisaccia Lisa
ONE CVS DRIVE
WOONSOCKET, RI02895
EVP and Chief HR Officer
Signatures
Lisa G. Bisaccia 04/03/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock award.
( 2 )The number of shares subject to the option were calculated using a 30-day average price.
( 3 )Option becomes exercisable in four equal annual installments, commencing 4/1/2021.
( 4 )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.
( 5 )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.
( 6 )Option became exercisable in four equal annual installments, commencing 4/1/2015.
( 7 )Option became exercisable in four equal annual installments, commencing 4/1/2016.
( 8 )Option became exercisable in four equal annual installments, commencing 4/1/2017.
( 9 )Option became exercisable in four equal annual installments, commencing 4/3/2018.
( 10 )Option became exercisable in four equal annual installments, commencing 4/1/2019.
( 11 )Option became exercisable in four equal annual installments, commencing 4/1/2020.

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