# EDGAR Filing Document

**Accession Number:** 0001828182
**File Stem:** 0000899243-23-009946
**Filing Date:** 2023-3
**Character Count:** 12576
**Document Hash:** 1b0863a1e64c1e3afa156470d48d8857
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000899243-23-009946.hdr.sgml**: 20230329

**ACCESSION NUMBER**: 0000899243-23-009946

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230329

**FILED AS OF DATE**: 20230329

**DATE AS OF CHANGE**: 20230329

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Armbrester Bradford Kyle
- **CENTRAL INDEX KEY:** 0001653708

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-40028
- **FILM NUMBER:** 23771997

**MAIL ADDRESS:**
- **STREET 1:** 311 ARSENAL STREET
- **CITY:** WATERTOWN
- **STATE:** MA
- **ZIP:** 02472
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Signify Health, Inc.
- **CENTRAL INDEX KEY:** 0001828182
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-HOME HEALTH CARE SERVICES [8082]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 800 CONNECTICUT AVENUE
- **CITY:** NORWALK
- **STATE:** CT
- **ZIP:** 06854
- **BUSINESS PHONE:** (203) 541-4600

**MAIL ADDRESS:**
- **STREET 1:** 800 CONNECTICUT AVENUE
- **CITY:** NORWALK
- **STATE:** CT
- **ZIP:** 06854

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[x] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Armbrester Bradford Kyle<br><sub>(Last) (First) (Middle)</sub><br>C/O SIGNIFY HEALTH, INC.<br>4055 VALLEY VIEW LN, SUITE 700<br><sub>(Street)</sub><br>DALLAS, TX 75244<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-29 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Signify Health, Inc. [ SGFY ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Class A Common Stock | 2023-03-29 |  | C<sup>(1)</sup> |  | 3686599 | A | <sup>(1)</sup> | 4068165 | D |  |
| Class A Common Stock | 2023-03-29 |  | C<sup>(1)</sup> |  | 1043854 | A | <sup>(1)</sup> | 1043854 | I | By KA Family Investments, LLC<sup>(9)</sup> |
| Class A Common Stock | 2023-03-29 |  | C<sup>(1)</sup> |  | 1260625 | A | <sup>(1)</sup> | 1260625 | I | By PA Family Enterprises, LLC<sup>(9)</sup> |
| Class A Common Stock | 2023-03-29 |  | D<sup>(2)(3)</sup> |  | 348097 | D | <sup>(2)(3)</sup> | 3720068 | D |  |
| Class B Common Stock | 2023-03-29 |  | D<sup>(4)</sup> |  | 3686599 | D | <sup>(4)</sup> | 0 | D |  |
| Class B Common Stock | 2023-03-29 |  | D<sup>(4)</sup> |  | 1043854 | D | <sup>(4)</sup> | 0 | I | By KA Family Investments, LLC<sup>(9)</sup> |
| Class B Common Stock | 2023-03-29 |  | D<sup>(4)</sup> |  | 1260625 | D | <sup>(4)</sup> | 0 | I | By PA Family Enterprises, LLC<sup>(9)</sup> |
| Class A Common Stock | 2023-03-29 |  | D<sup>(5)</sup> |  | 3720068 | D | <sup>(5)</sup> | 0 | D |  |
| Class A Common Stock | 2023-03-29 |  | D<sup>(5)</sup> |  | 1043854 | D | <sup>(5)</sup> | 0 | I | By KA Family Investments, LLC<sup>(9)</sup> |
| Class A Common Stock | 2023-03-29 |  | D<sup>(5)</sup> |  | 1260625 | D | <sup>(5)</sup> | 0 | I | By PA Family Enterprises, LLC<sup>(9)</sup> |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| LLC Units in Cure Aggregator, LLC | <sup>(1)</sup> | 2023-03-29 |  | C |  |  | 3686599 | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 3686599 | <sup>(1)</sup> | 0 | D |  |
| LLC Units in Cure Aggregator, LLC | <sup>(1)</sup> | 2023-03-29 |  | C |  |  | 1043854 | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 1043854 | <sup>(1)</sup> | 0 | I | By KA Family Investments, LLC<sup>(9)</sup> |
| LLC Units in Cure Aggregator, LLC | <sup>(1)</sup> | 2023-03-29 |  | C |  |  | 1260625 | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 1260625 | <sup>(1)</sup> | 0 | I | By PA Family Enterprises, LLC<sup>(9)</sup> |
| Employee Stock Options (Right to Buy) | $14.19 | 2023-03-29 |  | D |  |  | 634257 | <sup>(6)(7)(8)</sup> | <sup>(6)(7)(8)</sup> | Class A Common Stock | 634257 | <sup>(6)(7)(8)</sup> | 0 | D |  |

---

### Footnotes:

(1) On March 29, 2023, pursuant to that certain Agreement and Plan of Merger, dated September 2, 2022, between the Issuer, CVS Pharmacy, Inc. ("Parent") and Noah Merger Sub, Inc. (the "Merger Agreement"), the Reporting Person directly received 3,686,599 shares of the Issuer's Class A Common Stock ("Class A Common Stock") and entities affiliated with the Reporting Person received 1,043,854 and 1,260,625 shares of Class A Common Stock, respectively, pursuant to the exchange by Cure Aggregator, LLC of LLC Units of Cure TopCo, LLC ("LLC Units") for the Issuer's Class A Common Stock on a one-for one basis (and the corresponding cancellation of an equal number of shares of the Issuer's Class B Common Stock ("Class B Common Stock")), and the subsequent distribution by Cure Aggregator, LLC to the Reporting Person of such shares of Class A Common Stock.

(2) Pursuant to the Merger Agreement, as of the effective time of the merger (the "Effective Time"), each restricted stock unit with respect to shares of the Issuer's Class A Common Stock (each, an "Issuer RSU") that was not (i) outstanding immediately prior to the Effective Time to the extent vested and unsettled or (ii) outstanding immediately prior to the Effective Time and was held by any person who is a non-employee director, consultant or independent contractor engaged by the Issuer and was outstanding immediately prior to the Effective Time (each, a "Rollover RSU") was converted into a restricted stock unit, subject to substantially the same terms and conditions as were applicable under such Rollover RSU, with respect to a number of shares of common stock of CVS Health Corporation ("CVS Health Stock") equal to the number of shares of Class A Common Stock subject to such Rollover RSU multiplied by a fraction,

(3) (Continued from Footnote 2)  the numerator of which is the Per Share Consideration and the denominator of which is the volume weighted average trading price (rounded to the nearest $0.01) of one share of CVS Health Stock on the New York Stock Exchange as reported on Bloomberg L.P. under the function "VWAP" (or, if not reported therein, in another authoritative source mutually selected by the parties) for the ten (10) consecutive trading days ending on (and including) the trading day that is three (3) trading days prior to the date of the closing of the Merger (the "Exchange Ratio").

(4) Pursuant to the Merger Agreement, each share of Class B Common Stock outstanding and held by the Reporting Person immediately prior to the Effective Time, was cancelled.

(5) Pursuant to the Merger Agreement, each share of Class A Common Stock outstanding and held by the Reporting Person immediately prior to the Effective Time, was cancelled and converted into the right to receive an amount in cash equal to $30.50 (the "Per Share Consideration").

(6) Pursuant to the Merger Agreement, each option to purchase a share of Class A Common Stock (each, an "Issuer Option") granted by Issuer under an Issuer stock plan that was (i) outstanding as of immediately prior to the Effective Time and was vested and unexercised (but not, for the avoidance of doubt, (x) any unvested Issuer Option that was outstanding immediately prior to the Effective Time with an exercise price that is equal to or greater than $30.50 or (y) any Issuer Option that is forfeited due to failure to satisfy performance-based conditions) or (ii) outstanding immediately prior to the Effective Time and was held by a non-employee director, consultant or independent contractor of the Issuer (whether vested or unvested) (each, a "Cash-Out Option"),

(7) (Continued from Footnote 6) was cancelled and converted into the right to receive an amount in cash equal to the product of (1) the excess, if any, of the Per Share Consideration over the per-share exercise price of such Cash-Out Option, multiplied by (2) the number of shares of Class A Common Stock then subject to such Cash-Out Option as of immediately prior to the Effective Time.

(8) Pursuant to the Merger Agreement, each Issuer Option that is not a Cash-Out Option and is outstanding immediately prior to the Effective Time (each, a "Rollover Stock Option") was converted into an option to acquire, on substantially the same terms and conditions as were applicable under such Rollover Stock Option, the number of shares of CVS Health Stock (rounded down to the nearest whole share), determined by multiplying (x) the number of shares of Class A Common Stock subject to such Rollover Stock Option immediately prior to the Effective Time by (y) the Exchange Ratio, at an exercise price per share of CVS Health Stock (rounded up to the nearest whole cent) equal to (A) the exercise price per share of Class A Common Stock subject to such Rollover Stock Option divided by (B) the Exchange Ratio.

(9) The Reporting Person serves as sole manager of the LLCs, the membership interests of which are held through family trusts, the beneficiaries of which are the Reporting Person or his immediate family members.

**Signature:** /s/ Adam McAnaney, as attorney-in-fact for Kyle Bradford Armbrester  
**Date:** 2023-03-29

### Remarks:

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 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).

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.**