# EDGAR Filing Document

**Accession Number:** 0001608538
**File Stem:** 0001156039-23-000026
**Filing Date:** 2023-3
**Character Count:** 6695
**Document Hash:** 6b811a2e51bf7eca2bb9c7ee97657b89
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001156039-23-000026.hdr.sgml**: 20230303

**ACCESSION NUMBER**: 0001156039-23-000026

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230301

**FILED AS OF DATE**: 20230303

**DATE AS OF CHANGE**: 20230303

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Haytaian Peter D
- **CENTRAL INDEX KEY:** 0001608538

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-16751
- **FILM NUMBER:** 23704225

**MAIL ADDRESS:**
- **STREET 1:** 220 VIRGINIA AVE
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46204
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Elevance Health, Inc.
- **CENTRAL INDEX KEY:** 0001156039
- **STANDARD INDUSTRIAL CLASSIFICATION:** HOSPITAL & MEDICAL SERVICE PLANS [6324]
- **IRS NUMBER:** 352145715
- **STATE OF INCORPORATION:** IN
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 220 VIRGINIA AVENUE
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46204
- **BUSINESS PHONE:** 8003311476

**MAIL ADDRESS:**
- **STREET 1:** 220 VIRGINIA AVENUE
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46204

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Anthem, Inc.
- **DATE OF NAME CHANGE:** 20141202

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** WELLPOINT, INC
- **DATE OF NAME CHANGE:** 20100105

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** WELLPOINT INC
- **DATE OF NAME CHANGE:** 20041130

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

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] 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>Haytaian Peter D<br><sub>(Last) (First) (Middle)</sub><br>220 VIRGINIA AVENUE<br><sub>(Street)</sub><br>INDIANAPOLIS, IN 46204<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-01 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_EVP & Pres Carelon & CarelonRx_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Elevance Health, Inc. [ ELV ] | **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 |
| Common Stock | 2023-03-01 |  | F |  | 607<sup>(1)</sup> | D | $469.03 | 11354 | D |  |
| Common Stock | 2023-03-01 |  | A |  | 2292<sup>(2)</sup> | A | $0 | 13646 | D |  |
| Common Stock | 2023-03-01 |  | A |  | 9716<sup>(3)</sup> | A | $0 | 23362 | D |  |
| Common Stock | 2023-03-02 |  | F |  | 5469<sup>(1)</sup> | D | $468.78 | 17893 | D |  |

---

## 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 |
| Employee Stock Option (Right to Buy) | $469.03 | 2023-03-01 |  | A |  | 8812 |  | <sup>(4)</sup> | 2033-03-01 | Common Stock | 8812.0 | $0 | 8812 | D |  |

---

### Footnotes:

(1) PAYMENT OF TAX LIABILITY BY WITHHOLDING STOCK INCIDENT TO THE VESTING OF PREVIOUSLY GRANTED RESTRICTED STOCK.

(2) Represents restricted share units. Restrictions lapse as follows: 764 shares each on 3/1/2024, 3/1/2025 and 3/1/2026.

(3) Represents performance based restricted share units. Restrictions lapse on 3/2/2023.

(4) The option represents a right to purchase a total of 8,812 shares, and is exercisable in two installments of 2,937 shares each and one installment of 2,938 shares, beginning on 3/1/2024 which is the one-year anniversary of the option grant date.

**Signature:** /s/ Kathleen S. Kiefer, Attorney in fact  
**Date:** 2023-03-03

### 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.**