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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 | ||||||||
Non-Qualified Stock Option (Right to Buy) | $ 58.17 | 12/20/2018 | D | 27,234 | (2) | 03/06/2020 | Express Scripts Holding Company Common Shares | 27,234 | $ 0 (3) | 0 | D | ||||
Non-Qualified Stock Option (Right to Buy) | $ 77.15 | 12/20/2018 | D | 23,996 | (2) | 03/05/2021 | Express Scripts Holding Company Common Shares | 23,996 | $ 0 (3) | 0 | D | ||||
Non-Qualified Stock Option (Right to Buy) | $ 84.83 | 12/20/2018 | D | 24,019 | (2) | 03/04/2025 | Express Scripts Holding Company Common Shares | 24,019 | $ 0 (3) | 0 | D | ||||
Non-Qualified Stock Option (Right to Buy) | $ 69.57 | 12/20/2018 | D | 31,678 | (2) | 03/09/2026 | Express Scripts Holding Company Common Shares | 31,678 | $ 0 (3) | 0 | D | ||||
Non-Qualified Stock Option (Right to Buy) | $ 67.62 | 12/20/2018 | D | 30,715 | (2) | 03/08/2027 | Express Scripts Holding Company Common Shares | 30,715 | $ 0 (3) | 0 | D | ||||
Phantom Stock Units (4) | $ 0 (5) | 12/20/2018 | D(6) | 1,500.5715 | (7) | (7) | Express Scripts Holding Company Common Shares | 1,500.5715 | (5) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Stettin Glen D. C/O EXPRESS SCRIPTS HOLDING COMPANY ONE EXPRESS WAY ST. LOUIS, MO 63121 |
Sr. VP, Clin. Res. & New Sol. |
/s/ Nick H. Varsam, as Attorney-in-Fact for Glen D. Stettin | 12/21/2018 | |
**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) | Pursuant to the agreement and plan of merger ("Merger Agreement") between the Issuer and Cigna Corporation, Halfmoon Parent, Inc., Halfmoon I, Inc. and Halfmoon II, Inc., upon closing of the merger of Halfmoon II, Inc. with and into the Issuer (the "Merger"), each common share of the Issuer was converted into the right to receive 0.2434 shares of Halfmoon Parent, Inc. common stock and $48.75 in cash. Each restricted stock unit was converted into a unit with respect to common stock of Halfmoon Parent, Inc. in accordance with the exchange ratio set forth in the Merger Agreement. |
(2) | The options vest on varying dates pursuant to the terms of the plans and/or agreements under which they were granted. |
(3) | Pursuant to the Merger Agreement, upon closing of the Merger, the option was converted into an option to purchase common shares of Halfmoon Parent, Inc. in accordance with the exchange ratio set forth in the Merger Agreement. |
(4) | Phantom Stock Unit credited under the Company's Executive Deferred Compensation Plan. |
(5) | Upon distribution, each phantom stock unit would have converted into one share of the Issuer's common stock. |
(6) | Pursuant to the Merger Agreement, upon closing of the Merger, each phantom stock unit was converted into a stock unit relating to the common stock of Halfmoon Parent, Inc. in accordance with the exchange ratio set forth in the Merger Agreement. |
(7) | Basic Company Credit by the Issuer to Reporting Person's Account in the Executive Deferred Compensation Plan; shares vest 3 (three) years after the plan year to which such credit relates. |