Sec Form 4/A Filing - Joyner J. David @ CVS HEALTH Corp - 2024-11-30

Insider filing report for Changes in Beneficial Ownership
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FORM 4/A
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
Joyner J. David
2. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President and CEO
(Last) (First) (Middle)
ONE CVS DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
11/30/2024
(Street)
WOONSOCKET, RI02895
4. If Amendment, Date Original Filed (MM/DD/YY)
12/03/2024
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 40,681 D
Common Stock (Restricted) 44,241 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
Premium Stock Option ( 1 ) $ 71.82 11/30/2024 A 1,000,000 11/30/2025 11/30/2031 Common Stock 1,000,000 $ 71.82 1,000,000 D
Premium Stock Appreciation Right ( 1 ) $ 71.82 11/30/2024 A 492,537 11/30/2025 11/30/2031 Common Stock 492,537 $ 71.82 492,537 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Joyner J. David
ONE CVS DRIVE
WOONSOCKET, RI02895
X President and CEO
Signatures
/s/ J. David Joyner 12/24/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On December 20, 2024, the Issuer made certain administrative modifications to the Reporting Person's November 30, 2024 grant agreement, confirming that the Reporting Person was granted a stock option to acquire 1,000,000 shares of Issuer common stock and a stock-settled stock appreciation right ("SAR") with respect to 492,537 shares of Issuer common stock, each at a premium exercise or grant price, as applicable, of $71.82. Both the option and the SAR become exercisable in three equal annual installments, with the first installment vesting on November 30, 2025. No change was made to the aggregate grant date value of the award, as reflected in the original Form 4 filed by the Reporting Person on December 3, 2024.

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