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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) |
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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
2015 Performance Stock Units | (8) | 09/24/2018 | M | 1,546 | (9) | (9) | Common Stock | 1,546 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GUERTIN SHAWN M AETNA INC. 151 FARMINGTON AVENUE HARTFORD, CT 06156 |
Exec. Vice President, CFO |
Shawn M. Guertin, by Adam F. McAnaney, Attorney-in-fact | 09/26/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Represents vesting of previously reported Performance Stock Units (PSUs) granted under the 2010 Stock Incentive Plan (the "Plan"). |
(2) | Represents tax withholding on previously reported PSUs granted under the Plan. |
(3) | On July 24, 2018, 25,000 shares from sole account were voluntarily transferred to 2018 Charitable Remainder Unitrust ("CRUT"). |
(4) | Represents shares held in CRUT where Mr. Guertin is sole trustee. |
(5) | On July 24, 2018, 11,174 shares from sole account were voluntarily transferred to 2018 Grantor Retained Annuity Trust ("GRAT") |
(6) | Represents shares held in GRAT where Mr. Guertin is sole trustee. |
(7) | Represents the pro rata portion of the stock portion of Aetna Common Stock Fund held by reporting person on August 31, 2018 pursuant to Aetna Inc. 401(k) Plan. The information is based on information provided by the Plan Trustee as of that date. |
(8) | Each Performance Stock Unit represents a right to receive up to two shares of Aetna Inc. Common Stock net of taxes. |
(9) | Vesting of previously reported PSUs granted under the Plan on September 24, 2015. |