Jonathan C. Roberts - Nov 3, 2021 Form 4 Insider Report for CVS HEALTH Corp (CVS)

Role: EVP & Chief Operating Officer
Signature: Jonathan C. Roberts
Stock symbol: CVS
Transactions as of: Nov 3, 2021
Transactions value $: -$5,342,251
Form type: 4
Date filed: 11/5/2021, 04:35 PM
Next filing: Jan 28, 2022
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	CVS	Common Stock	Options Exercise	$5M	+109K	+101.64%	$45.93	216K	Nov 3, 2021	Direct
transaction	CVS	Common Stock	Sale	-$10.3M	-109K	-50.41%	$95.00	107K	Nov 3, 2021	Direct	F1
holding	CVS	Common Stock						34.7K	Nov 3, 2021	By GRAT
holding	CVS	Common Stock (restricted)						12.8K	Nov 3, 2021	Direct
holding	CVS	ESOP Common Stock						6.05K	Nov 3, 2021	By ESOP
holding	CVS	Stock Unit						338K	Nov 3, 2021	Direct

Showing 1 to 6 of 6 entries

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	CVS	Stock Option	Options Exercise	$0	-109K	-100%	$0.00^*	0	Nov 3, 2021	Common Stock	109K	$45.93	Direct	F2
holding	CVS	Phantom Stock Credits						1.42K	Nov 3, 2021	Common Stock	1.42K	$1.00	Direct	F3
holding	CVS	Stock Option						68.5K	Nov 3, 2021	Common Stock	68.5K	$102.26	Direct	F4
holding	CVS	Stock Option						161K	Nov 3, 2021	Common Stock	161K	$104.82	Direct	F5
holding	CVS	Stock Option						200K	Nov 3, 2021	Common Stock	200K	$78.05	Direct	F6
holding	CVS	Stock Option						248K	Nov 3, 2021	Common Stock	248K	$62.21	Direct	F7
holding	CVS	Stock Option						303K	Nov 3, 2021	Common Stock	303K	$54.19	Direct	F8
holding	CVS	Stock Option						239K	Nov 3, 2021	Common Stock	239K	$58.34	Direct	F9, F10
holding	CVS	Stock Option						173K	Nov 3, 2021	Common Stock	173K	$74.30	Direct	F11

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	All sales were effected pursuant to a Rule 10b5-1 plan.
F2	Option became exercisable in three equal annual installments, commencing 9/4/2015.
F3	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.
F4	Option became exercisable in four equal annual installments, commencing 4/1/2016.
F5	Option became exercisable in four equal annual installments, commencing 4/1/2017.
F6	Option became exercisable in four equal annual installments, commencing 4/3/2018.
F7	Option became exercisable in four equal annual installments, commencing 4/1/2019.
F8	Option became exercisable in four equal annual installments, commencing 4/1/2020.
F9	The number of shares subject to the option were calculated using a 30-day average price.
F10	Options became exercisable in four equal installments, commencing 4/1/2021.
F11	Option becomes exercisable in four equal installments, commencing 4/1/2022.