# EDGAR Filing Document

**Accession Number:** 0000049071
**File Stem:** 0001062993-23-005464
**Filing Date:** 2023-3
**Character Count:** 7574
**Document Hash:** 94ab4af9256c2666926c63937f939565
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001062993-23-005464.hdr.sgml**: 20230302

**ACCESSION NUMBER**: 0001062993-23-005464

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230228

**FILED AS OF DATE**: 20230302

**DATE AS OF CHANGE**: 20230302

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** JONES DAVID A JR/KY
- **CENTRAL INDEX KEY:** 0001025393
- **STATE OF INCORPORATION:** KY

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-05975
- **FILM NUMBER:** 23696726

**MAIL ADDRESS:**
- **STREET 1:** C/O HUMANA INC
- **STREET 2:** 500 WEST MAIN STREET
- **CITY:** LOUISVILLE
- **STATE:** KY
- **ZIP:** 40202
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** HUMANA INC
- **CENTRAL INDEX KEY:** 0000049071
- **STANDARD INDUSTRIAL CLASSIFICATION:** HOSPITAL & MEDICAL SERVICE PLANS [6324]
- **IRS NUMBER:** 610647538
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 500 W MAIN ST
- **CITY:** LOUISVILLE
- **STATE:** KY
- **ZIP:** 40202
- **BUSINESS PHONE:** 5025801000

**MAIL ADDRESS:**
- **STREET 1:** 500 W. MAIN ST
- **CITY:** LOUISVILLE
- **STATE:** KY
- **ZIP:** 40202

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** EXTENDICARE INC
- **DATE OF NAME CHANGE:** 19740404

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** HERITAGE HOUSE OF AMERICA INC
- **DATE OF NAME CHANGE:** 19671129

### 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>JONES DAVID A JR/KY<br><sub>(Last) (First) (Middle)</sub><br>CHRYSALIS VENTURES, INC.<br>101 S. FIFTH STREET, SUITE 1650<br><sub>(Street)</sub><br>LOUISVILLE, KY 40202<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-28 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>HUMANA INC [ HUM ] | **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 |
| Humana Common |  |  |  |  |  |  |  | 380<sup>(5)</sup> | D |  |
| Humana Common |  |  |  |  |  |  |  | 800 | I | See Footnote<sup>(1)</sup> |
| Humana Common | 2023-02-28 |  | G |  | 10000<sup>(6)</sup> | D | $0 | 32440 | I | See Footnote<sup>(4)</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 |
| Restricted Stock Units<sup>(2)</sup> | <sup>(2)</sup> |  |  |  |  |  |  | <sup>(2)</sup> | <sup>(2)</sup> | Humana Common | 5892 |  | 5892 | D |  |
| Restricted Stock Units<sup>(3)</sup> | <sup>(3)</sup> |  |  |  |  |  |  | <sup>(3)</sup> | <sup>(3)</sup> | Humana Common | 95 |  | 95 | D |  |

---

### Footnotes:

(1) Shares held in two trusts for the benefit of reporting person's son/daughter, respectively, in each case where the reporting person is the sole trustee.

(2) Annual Director's fee payable in stock units which have been deferred at the election of the reporting person until his resignation of services as a director at which time the stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule 16(b)-3(d)(1).

(3) Director's dividend payment reinvested into stock units on vested and deferred stock units, deferred in accordance with the Plan until his resignation of services as a director at which time the deferred dividend stock units will be payable in Humana Inc. common stock on a 1-for-1 basis, exempt pursuant to Rule16(b)-3(d).

(4) Shares held by a revocable trust account (Dec 2009), on which reporting person is the sole trustee, holding certain shares of Humana Inc. common stock.

(5) Includes 380 restricted stock units pursuant to the annual Director's Fee Program representing a contingent right to receive one share of Humana Inc. common stock, exempt under Rule 16b-3(d)(1)&(3) under the Company's 2019 Amended & Restated Plan of which 100% is vesting on 12/31/23. Total shares received will be pro-rated based on number of months served on the Board prior to separation.

(6) Shares disposed of represent a gift/charitable donation, effective February 28, 2023, in which no value was received in return.

**Signature:** David A. Jones, Jr.  
**Date:** 2023-03-02

### 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.**