Initial Statement of Beneficial Ownership (3)
01 Februar 2023 - 04:35PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE
COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP
OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person * Renaudin George
II |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
2/1/2023
|
3. Issuer Name and Ticker or Trading
Symbol HUMANA INC [HUM] |
(Last)
(First)
(Middle)
HUMANA INC., 500 W. MAIN STREET |
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
___X___ Officer (give title
below) _____
Other (specify below)
President, Medicare & Medicaid
/ |
(Street)
LOUISVILLE, KY 40202
(City)
(State)
(Zip)
|
5. If Amendment, Date Original
Filed(MM/DD/YYYY)
|
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) |
Humana Common |
0 |
D |
|
Humana Common |
1364 |
I |
See Footnote (1) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 4) |
2. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
3. Title and Amount of Securities Underlying
Derivative Security
(Instr. 4) |
4. Conversion or Exercise Price of Derivative
Security |
5. Ownership Form of Derivative Security: 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 |
Restricted Stock Units (2) |
(3) |
(3) |
Humana Common |
241 |
$0 |
D |
|
Restricted Stock Units (2) |
(4) |
(4) |
Humana Common |
1241 |
$0 |
D |
|
Restricted Stock Units (2) |
(5) |
(5) |
Humana Common |
459 |
$0 |
D |
|
Restricted Stock Units (2) |
(6) |
(6) |
Humana Common |
609 |
$0 |
D |
|
Phantom Stock Units (7) |
(7) |
(7) |
Humana Common |
418 |
$0 |
I |
See Footnote (7) |
Explanation of
Responses: |
(1) |
Shares held for the benefit
of reporting person as of January 23, 2023 under the Humana
Retirement Savings Plan including routine payroll deductions,
quarterly dividend allocation, and a routine disposition of shares
to fund an administrative fee assessment under a Tax-Conditioned
Plan, exempt under Rule 16b-3(c). |
(2) |
Right to receive one share
per restricted stock unit pursuant to the Company's 2019 Amended
& Restated Stock Incentive Plan. Each restricted stock unit
represents a contingent right to receive one share of Humana Inc.
common stock, exempt under Rule 16b-3(d)(1) & (3). |
(3) |
Restricted stock units
granted to reporting person on 2/22/2021, 33% of the award is
vesting on 12/15/21, 12/15/22, and 12/15/23. Amount reported is
what remains unvested. |
(4) |
Restricted stock units
granted to reporting person on 9/1/2021, 100% of the award is
vesting on 9/1/2024. |
(5) |
Restricted stock units
granted to reporting person on 2/21/2022, 33% of the award is
vesting on 12/15/22, 12/15/23, and 12/15/24. Amount reported is
what remains unvested. |
(6) |
Restricted stock units
granted to reporting person on 10/1/2022, 100% of the award is
vesting on 10/1/2025. |
(7) |
Phantom Stock Units held for
the benefit of reporting person as of January 23, 2023 based on the
value of Humana common stock on a 1-for-1 basis, under the Humana
Retirement Equalization Plan. The ending number of units reflects
normal fluctuation due to changes in stock price. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Renaudin George II
HUMANA INC.
500 W. MAIN STREET
LOUISVILLE, KY 40202 |
|
|
President, Medicare &
Medicaid |
|
Signatures
|
George Renaudin II |
|
2/1/2023 |
**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 control number. |
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