SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Kendrick Charles Morgan JR

(Last) (First) (Middle)
220 VIRGINIA AVE

(Street)
INDIANAPOLIS IN 46204

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/05/2021
3. Issuer Name and Ticker or Trading Symbol
Anthem, Inc. [ ANTM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & President, Commercial
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 10,949(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) 03/01/2021(2) 03/01/2028 Common Stock 568 $232.04 D
Employee Stock Option (Right to Buy) (3) 03/01/2029 Common Stock 1,999 $307.68 D
Employee Stock Option (Right to Buy) (4) 03/02/2030 Common Stock 4,161 $271.27 D
Employee Stock Option (Right to Buy) (5) 03/01/2031 Common Stock 2,963 $311.48 D
Explanation of Responses:
1. Includes 1,463 restricted share units. Restrictions lapse as follows: 458 shares on 3/1/2022, 261 shares on 3/2/2022, 241 shares on 3/1/2023, 262 shares on 3/02/2023 and 241 shares on 3/1/2024
2. The option represents a right to purchase a total of 3,404 shares and is exercisable in six semi-annual installments, with four installments of 567 shares each and two installments of 568 shares each beginning on 9/01/2018, which is the six-month anniversary of the date on which the option was granted.
3. The option represents a right to purchase a total of 2,997 shares, and is exercisable in three annual installments, with one installment of 998 shares, one installment of 999 shares and one installment of 1,000 shares, beginning on 3/1/2020, which is the one-year anniversary of the option grant date.
4. The option represents a right to purchase a total of 4,161 shares and is exercisable in three annual installments of 1,387 shares each, beginning on 3/2/2021, which is the one-year anniversary of the option grant date.
5. The option represents a right to purchase a total of 2,963 shares, and is exercisable in three annual installments, with one installment of 987 shares and two installments of 988 shares each, beginning on 3/1/2022, which is the one-year anniversary of the option grant date.
Remarks:
/s/ Kathleen S. Kiefer, Attorney in fact 10/15/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.