Sec Form 4 Filing - Lotvin Alan @ CVS HEALTH Corp - 2021-06-28

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
Lotvin Alan
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&President-PharmacyServices
(Last) (First) (Middle)
ONE CVS DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
06/28/2021
(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 06/28/2021 S( 1 ) 2,781 D $ 83.67 61,047.6756 D
Common Stock 492 I By Children's Trusts
Common Stock (restricted) 6,027 D
Stock Unit 29,505.3163 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
Phantom Stock Credits $ 1 ( 2 ) ( 3 ) Common Stock 556.7643 556.7643 D
Stock Option $ 102.26 04/01/2016( 4 ) 04/01/2022 Common Stock 21,386 21,386 D
Stock Option $ 104.82 04/01/2017( 5 ) 04/01/2023 Common Stock 27,395 27,395 D
Stock Option $ 78.05 04/03/2018( 6 ) 04/03/2024 Common Stock 32,911 32,911 D
Stock Option $ 62.21 04/01/2019( 7 ) 04/01/2025 Common Stock 22,541 22,541 D
Stock Option $ 54.19 04/01/2020( 8 ) 04/01/2029 Common Stock 70,702 70,702 D
Stock Option $ 58.34 ( 9 ) 04/01/2021( 10 ) 04/01/2030 Common Stock 140,797 140,797 D
Stock Option $ 74.3 04/01/2022( 11 ) 04/01/2031 Common Stock 120,940 120,940 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Lotvin Alan
ONE CVS DRIVE
WOONSOCKET, RI02895
EVP&President-PharmacyServices
Signatures
/s/ Alan M. Lotvin 06/29/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )All sales were effected pursuant to a Rule 10b5-1 plan.
( 2 )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.
( 3 )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.
( 4 )Option became exercisable in four equal annual installments, commencing 4/1/2016.
( 5 )Option became exercisable in four equal annual installments, commencing 4/1/2017.
( 6 )Option became exercisable in four equal annual installments, commencing 4/3/2018.
( 7 )Option became exercisable in four equal annual installments, commencing 4/1/2019.
( 8 )Option became exercisable in four equal annual installments, commencing 4/1/2020.
( 9 )The number of shares subject to the option were calculated using a 30-day average price.
( 10 )Option became exercisable in four equal annual installments, commencing 4/1/2021.
( 11 )Option becomes exercisable in four equal annual installments, commencing 4/1/2022.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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