NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
NOTE 1. ORGANIZATION AND NATURE OF BUSINESS
Description of Business
Oak Street Health, Inc. was formed as a Delaware corporation on October 22, 2019 for the purpose of completing a public offering and related reorganization transactions (collectively referred to as the “IPO”) in order to carry on the business of Oak Street Health, LLC (“OSH LLC”) and its affiliates. On August 10, 2020, the Company completed its IPO. As the managing member of OSH LLC, Oak Street Health, Inc. operates and controls all of the business affairs of OSH LLC and its affiliates.
The Company operates primary care centers serving Medicare beneficiaries. The Company, through its centers and management services organization, combines an innovative care model with superior patient experience. The Company invests resources into primary care to prevent unnecessary acute events and manage chronic illnesses. The Company engages Medicare eligible patients through the use of an innovative community outreach approach. Once patients are engaged, the Company integrates population health analytics, social support services and primary care into the care model to drive improved outcomes. The Company contracts with health plans to generate medical costs savings and realize a return on its investment in primary care. As of March 31, 2023, the Company operated 172 centers.
Merger with CVS Health
As more fully described in Note 13, the Company consummated the transactions contemplated by the Merger Agreement, and pursuant to the terms and conditions set forth in the Merger Agreement, on May 2, 2023, Merger Sub merged with and into the Company, with the Company continuing as the surviving corporation and existing as an indirect wholly owned subsidiary of CVS Pharmacy.
On May 2, 2023, at the effective time of the Merger (the “Effective Time”), each share of our Common Stock, issued and outstanding immediately prior to the Effective Time was automatically cancelled, extinguished and converted into the right to receive $39.00 in cash, without interest and less any applicable withholding taxes (the “Merger Consideration”). In connection with the Merger, the NYSE filed a Form 25 with the SEC regarding the removal of shares of our Common Stock from listing and the withdrawal of the registration of our Common Stock under Section 12(b) of the Exchange Act. Shares of the Company’s Common Stock were suspended from trading on the NYSE prior to the opening of trading on May 2, 2023. The Company intends to file with the SEC a Form 15 to suspend its reporting obligations under Sections 13 and 15(d) of the Exchange Act. Accordingly, as of the Effective Time, the Company no longer existed as a standalone public company.
Other than transaction expenses and related costs associated with the Merger of $6.5 million for the three-months ended March 31, 2023, the terms of the Merger Agreement did not impact our condensed consolidated financial statements.
Basis of Presentation and Consolidation
The accompanying unaudited interim condensed consolidated financial statements and accompanying notes have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been omitted pursuant to such regulations that would substantially duplicate the disclosures contained in the Company's annual audited consolidated financial statements. These financial statements have been prepared on a basis consistent with the accounting principles applied for the fiscal year ended December 31, 2022 in the Company’s 2022 Form 10-K filed with the SEC. In the opinion of management, all adjustments (consisting of all normal and recurring adjustments) considered necessary for a fair presentation have been included. Operating results for the three-months ended March 31, 2023 are not necessarily indicative of the results that may be expected any other interim period for or for the year ending December 31, 2023.
The condensed consolidated financial statements of the Company include the financial statements of all wholly owned subsidiaries and majority-owned or controlled companies, which include the variable interest entities (“VIE”) in which OSH has an interest and is the primary beneficiary. See Note 11, “Variable Interest Entities.” For those consolidated subsidiaries where our ownership is less than 100%, the portion of the net income or loss allocable to the non-controlling
interests is reported as “Net income (loss) attributable to non-controlling interests” in the condensed consolidated statements of operations. Intercompany balances and transactions have been eliminated in consolidation.
In addition, Oak Street Health is the majority interest owner in two joint ventures: OSH-PCJ Joliet, LLC ("PCJ JV") and OSH-RI, LLC ("RI JV"), which are consolidated in the Company’s financial statements. In January 2022, the Company paid a former joint venture partner, Evangelical Services Corporation, $2.1 million to acquire its 49.9% ownership interest in OSH-ESC Joint Venture, LLC. As such, OSH owned 100% of this entity as of March 31, 2022, and the joint venture was effectively dissolved. During the three-months ended March 31, 2023, distributions were made from OSH-PCJ Joliet, LLC to Oak Street Health MSO, LLC, a subsidiary of the Company that holds 50.1% ownership interest in PCJ JV, and Primary Care Physicians of Joliet, an unaffiliated third party that holds 49.9% ownership interest in PCJ JV. Distributions made during the three-months ended March 31, 2023 and 2022 totaled $1.5 million and $0, respectively, to each owner.
There were no material related party transactions during the three-months ended March 31, 2023 and 2022 under ASC 850.
Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. The Company bases its estimates on the information available at the time, its experiences and various other assumptions believed to be reasonable under the circumstances including estimates of the impact of COVID-19. The areas where significant estimates are used in the accompanying financial statements include revenue recognition, the liability for unpaid claims, stock-based compensation, valuation and related impairment recognition of long-lived assets, including intangibles and goodwill and the valuation of stock options. Actual results could differ from those estimates.
COVID-19
Even as the COVID-19 pandemic subsides, disruptions caused by the pandemic, including labor shortages and inflationary pressures, may continue and could, in turn, have a negative impact on the Company. Further, recurring COVID-19 outbreaks, including outbreaks caused by different virus variants, could have the potential to impact the Company and its future results of operations, cash flows and financial position.
NOTE 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
The Company described its significant accounting policies in Note 2 of the notes to consolidated financial statements for the year ended December 31, 2022 included in its 2022 Form 10-K. During the three-months ended March 31, 2023, there were no significant changes to those accounting policies.
Recent Accounting Pronouncements Not Yet Adopted
In June 2022, the FASB issued ASU 2022-03, Fair Value Measurement (Topic 820) of Equity Securities Subject to Contractual Sale Restrictions. The new guidance clarifies that a contractual restriction on the sale of an equity security is not considered part of the unit of account of the equity security and, therefore, is not considered in measuring fair value. The amendments also clarify that an entity cannot, as a separate unit of account, recognize and measure a contractual sale restriction. The guidance is required to be adopted by January 1, 2024, and we do not anticipate the adoption of this will have a material impact on our consolidated financial statements or notes to the consolidated financial statements.
NOTE 3. REVENUE RECOGNITION
The Company earns revenue from our capitated arrangements with health plan payers and other revenue arrangements. Other revenue is comprised of ancillary fees earned under contracts with certain managed care organizations for the provision of certain care coordination and care management services; license subscription and fees; and fee-for- service revenue. Both our capitated and fee-for-service revenue generally relate to contracts with patients in which our performance obligation is to provide and/or manage healthcare services to the patients. Revenues are recorded during the period our obligations to provide healthcare services are satisfied as noted below within each service type.
Our care coordination services include a single performance obligation to stand ready to provide care coordination services to patients, which constitutes a series of distinct service increments. Payments received are recognized in other revenue ratably over the length of contract terms and are refundable on a pro rata basis to Humana if the Company ceases
to provide services at the centers within the length of the term specified in the contracts. Under our care management services, we have a single performance to stand ready to provide care management services, which constitutes a series of distinct service increments.
The Company additionally generates revenue by providing subscription licenses to its customers to access its eConsult platform, as well as providing integration, training and other ad-hoc services. We have identified the performance obligation to be standing ready to provide access to the eConsult platform. Subscription license revenue is recognized when the performance obligation is met over time by either the straight-line method or when services are performed over the terms of the applicable contract.
Capitated Revenue and Accounts Receivable
The Company has agreements in place with the payors listed below, and payor sources of capitated revenue for each period presented were as follows:
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Humana | 32 | % | | 32 | % | | | | |
Wellcare/Meridian | 13 | % | | 16 | % | | | | |
Other | 55 | % | | 52 | % | | | | |
Medicare Part D comprised 2% of capitated revenues for the three-months ended March 31, 2023 and March 31, 2022. Medicare Part D comprised 3% of medical claims expense for the three-months ended March 31, 2023 and 2% for the three-months ended March 31, 2022.
For the three-months ended March 31, 2023 and 2022, respectively, we estimate that we will receive an additional $69.1 million and $49.2 million for acuity-related adjustments to be received in subsequent periods. Under our capitated revenue arrangements, we receive a fixed fee per patient, per month ("PPPM") for services. In certain contracts, PPPM fees also include adjustments for items such as performance incentives or penalties based on the achievement of certain clinical quality metrics as contracted with payors. There were no material PPPM adjustments related to performance incentives/penalties for quality-related metrics for the three-months ended March 31, 2023 and March 31, 2022.
Other Revenue
The composition of other revenue for each period was as follows ($ in millions):
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Care coordination and care management services | $ | 2.5 | | | $ | 1.7 | | | | | |
License subscription and other fees | 2.6 | | | 3.1 | | | | | |
Fee for service | 3.7 | | | 2.9 | | | | | |
Total other revenue | $ | 8.8 | | | $ | 7.7 | | | | | |
As of March 31, 2023 and December 31, 2022, the Company’s contract liabilities related to the Humana care coordination payments totaled $36.3 million and $37.6 million, respectively. The short-term portion is recorded in other liabilities and the long-term portion is included in other long-term liabilities in the accompanying condensed consolidated balance sheets. As of March 31, 2023 and December 31, 2022, we recorded $7.0 million and $7.0 million of short-term contract liabilities, respectively, and $29.3 million and $30.6 million of long-term contract liabilities, respectively.
NOTE 4. FAIR VALUE MEASUREMENTS AND INVESTMENTS
Fair Value Measurements
In determining the fair value of financial assets and liabilities, the Company utilizes market data or other assumptions that it believes market participants would use in pricing the asset or liability in the principal or most advantageous market and adjusts for non-performance and/or other risks associated with the Company as well as
counterparties, as appropriate. Assets and liabilities measured at fair value are classified using the following hierarchy, which is based upon the transparency of inputs to the valuation as of the measurement date:
Level 1 – Valuations based on unadjusted quoted prices which are available in active markets for identical assets or liabilities accessible at the measurement date.
Level 2 – Valuations with inputs other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability.
Level 3 – Valuations with unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at the measurement date.
The following tables present information about the Company’s financial assets measured at fair value on a recurring basis ($ in millions):
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Fair Value Measurements as of March 31, 2023 using: | Fair Value Measurements as of December 31, 2022 using: |
| Level 1 | | Level 2 | | Level 3 | | Level 1 | | Level 2 | | Level 3 |
Marketable debt securities: | | | | | | | | | | | |
Commercial paper | $ | 75.4 | | | $ | — | | | $ | — | | | $ | 88.4 | | | $ | — | | | $ | — | |
U.S. Treasury obligations | — | | | 18.5 | | | — | | | — | | | 4.9 | | | — | |
Corporate bonds | — | | | 99.7 | | | — | | | — | | | 158.1 | | | — | |
Asset-backed securities | — | | | 3.5 | | | — | | | — | | | 14.3 | | | — | |
Other | — | | | 28.9 | | | — | | | — | | | 22.0 | | | — | |
Total financial assets | $ | 75.4 | | | $ | 150.6 | | | $ | — | | | $ | 88.4 | | | $ | 199.3 | | | $ | — | |
The Company measures the fair value of its corporate bonds, U.S. treasury obligations and asset-backed securities by taking into consideration valuations obtained from third-party pricing services. The pricing services utilize industry standard valuation models, including both income and market-based approaches, for which all significant inputs are observable, either directly or indirectly, to estimate fair value.
The fair value of the Company's Convertible Senior Notes was $906.9 million and $702.0 million as of March 31, 2023 and December 31, 2022, respectively, and classified within Level 2 of the fair value hierarchy as the valuation inputs are based on quoted prices in an inactive market on the last day in the reporting period. The carrying value of the Convertible Senior Notes was $907.0 million and $905.8 million as of March 31, 2023 and December 31, 2022, respectively, which is net of unamortized debt issuance and offering costs.
The carrying value of the Company's Term Loan was $98.2 million and $72.8 million as of March 31, 2023 and December 31, 2022, respectively, which is net of debt issuance costs, and approximates fair value as the variable interest rate re-prices frequently. The fair value of the Term Loan is classified within Level 2 of the fair value hierarchy. For more information about the Convertible Senior Notes and Term Loan, see Note 8, “Long-Term Debt.”
During the three-months ended March 31, 2023 and 2022, there were no transfers between Levels 1, 2 and 3.
Investments
As of March 31, 2023 and December 31, 2022, the Company’s marketable debt securities classified as available-for-sale were as follows ($ in millions):
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| March 31, 2023 | | December 31, 2022 |
| Amortized cost | | Gross unrealized gains (losses) | | Fair value | | Amortized cost | | Gross unrealized gains (losses) | | Fair value |
Marketable debt securities: | | | | | | | | | | | |
Commercial paper | $ | 75.4 | | | $ | — | | | $ | 75.4 | | | $ | 88.5 | | | $ | (0.1) | | | $ | 88.4 | |
U.S. Treasury obligations | 18.5 | | | — | | | 18.5 | | | 4.9 | | | 0.0 | | | 4.9 | |
Corporate bonds | 100.5 | | | (0.8) | | | 99.7 | | | 160.0 | | | (1.9) | | | 158.1 | |
Asset-backed securities | 3.5 | | | — | | | 3.5 | | | 14.4 | | | (0.1) | | | 14.3 | |
Other | 28.9 | | | — | | | 28.9 | | | 22.1 | | | (0.1) | | | 22.0 | |
Total marketable debt securities | $ | 226.8 | | | $ | (0.8) | | | $ | 226.0 | | | $ | 289.9 | | | $ | (2.2) | | | $ | 287.7 | |
These investments in marketable debt securities carry maturity dates of less than five years from the date of purchase. The net realized gains and losses were immaterial during the three-months ended March 31, 2023 and 2022. We do not intend to sell these investments, and it is not more likely than not that we will be required to sell the investments before recovery of their amortized cost basis. We did not record an allowance for credit losses as of March 31, 2023 or December 31, 2022 as no losses were determined to be caused by credit losses.
NOTE 5. BUSINESS COMBINATIONS, GOODWILL AND INTANGIBLE ASSETS
Goodwill, which represents the excess of cost over the fair value of net assets acquired, amounted to $158.0 million and $158.0 million at March 31, 2023 and December 31, 2022, respectively. All goodwill recorded in the condensed consolidated balance sheets is assigned to the Oak Street Health, Inc. reporting unit, which had a negative carrying value as of March 31, 2023 and December 31, 2022.
Intangible assets with a finite useful life continue to be amortized over their useful lives. Gross intangible assets amounted to $12.5 million and $12.5 million at March 31, 2023 and December 31, 2022, respectively. Accumulated amortization related to intangible assets amount to $3.8 million and $3.4 million at March 31, 2023 and December 31, 2022, respectively. The Company recorded amortization expense of $0.4 million and $0.4 million for the three-months ended March 31, 2023 and 2022, respectively.
The remaining weighted average amortization period of finite-lived intangible assets is 5.3 years. The remaining estimated future amortization expense by year, as of March 31, 2023, is presented in the following table:
| | | | | | | | |
| | (in millions) |
2023 | | $ | 1.7 | |
2024 | | 1.7 |
2025 | | 1.7 |
2026 | | 1.7 |
2027 | | 1.7 |
Thereafter | | 0.2 |
Estimated aggregate future intangible asset amortization | | $ | 8.7 | |
NOTE 6. LEASES
The components of lease expense for the Company’s operating leases were as follows for the three-months ended March 31, 2023 and March 31, 2022 ($ in millions):
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Operating lease cost | $ | 13.8 | | | $ | 7.0 | | | | | |
Variable lease cost | 3.7 | | | 6.0 | | | | | |
Total lease cost | $ | 17.5 | | | $ | 13.0 | | | | | |
The Company entered into operating leases that resulted in $6.7 million of right-of-use assets in exchange for operating lease obligations for the three-months ended March 31, 2023. The Company entered into operating leases that resulted in $22.7 million of right-of-use assets in exchange for operating lease obligations for the three-months ended March 31, 2022.
The weighted-average remaining lease term and discount rate for operating lease liabilities included in the condensed consolidated balance sheets are as follows:
| | | | | | | | |
| March 31, 2023 | December 31, 2022 |
Weighted-average remaining lease term (in years) | 8.6 | 8.7 |
Weighted-average discount rate | 4.73 | % | 4.59 | % |
The table below presents the future minimum lease payments under the non-cancelable operating leases as of March 31, 2023 ($ in millions):
| | | | | |
2023 | $ | 37.8 | |
2024 | 55.3 | |
2025 | 55.8 | |
2026 | 56.8 | |
2027 | 56.7 | |
2028 | 55.8 | |
Thereafter | 176.2 | |
Total lease payments | 494.4 | |
Less: imputed interest | (119.7) | |
Total operating lease liabilities | $ | 374.7 | |
Reported as: | |
Operating lease liabilities, current (1) | 24.7 | |
Operating lease liabilities, noncurrent | 350.0 | |
Total operating lease liabilities | $ | 374.7 | |
| |
(1) Included in other liabilities on the condensed consolidated balance sheet |
NOTE 7. LIABILITY FOR UNPAID CLAIMS
Activity within liabilities for unpaid claims was as follows for the three-months ended ($ in millions):
| | | | | | | | | | | |
| March 31, |
| 2023 | | 2022 |
Balance, beginning of period | $ | 850.3 | | | $ | 556.3 | |
Incurred health care costs: | | | |
Current year | 530.5 | | | 377.7 | |
Prior years | (8.3) | | | 0.8 | |
Total claims incurred | 522.2 | | | 378.5 | |
Claims paid: | | | |
Current year | (57.4) | | | (32.2) | |
Prior years | (254.0) | | | (268.0) | |
Total claims paid | (311.4) | | | (300.2) | |
Adjustments to other claims-related liabilities | 1.1 | | | 1.3 | |
Balance, end of period | $ | 1,062.2 | | | $ | 635.9 | |
We assess the profitability of our managed care capitation arrangements to identify contracts where current operating results or forecasts indicate probable future losses. If anticipated future variable costs exceed anticipated future revenues, a premium deficiency reserve is recognized. No material premium deficiency reserves were recorded as of March 31, 2023 and December 31, 2022.
NOTE 8. LONG-TERM DEBT
The following table is a summary of the Company's indebtedness as of March 31, 2023 and December 31, 2022 ($ in millions):
| | | | | | | | | | | |
| March 31, 2023 | | December 31, 2022 |
Liability component: | | | |
Convertible Senior Notes Principal | $ | 920.0 | | | $ | 920.0 | |
Term Loan Principal | 100.0 | | | 75.0 | |
Total Principal | 1,020.0 | | | 995.0 | |
Less: Convertible Senior Notes debt issuance costs, net of amortization | (13.0) | | | (14.2) | |
Less: Term Loan debt issuance costs, net of amortization | (1.8) | | | (2.2) | |
Total debt issuance costs, net of amortization | (14.8) | | | (16.4) | |
Net carrying amount | $ | 1,005.2 | | | $ | 978.6 | |
Equity component recorded at issuance: | | | |
Capped call transactions | $ | 123.6 | | | $ | 123.6 | |
See Note 13 for further discussion of impact of the Merger that was consummated on May 2,2023 on the Company's debt balances as of March 31, 2023.
Term Loan Facility
On September 30, 2022, the Company and certain of its subsidiaries entered into a Loan Agreement with Hercules Capital, Inc., as administrative and collateral agent and lender, and Silicon Valley Bank ("SVB") and the other lenders from time to time parties thereto. The Loan Agreement provides the Company with a secured term loan facility of up to $300.0 million (the "Term Loan Facility") to be funded in five committed tranches, which each tranche of term loans (collectively, the "Term Loans") available to be drawn at the Company’s option during the specified time period. As required under the Loan Agreement, at the closing of the Loan Agreement on September 30, 2022 ("the Closing"), the Company borrowed $75.0 million under Tranche A and borrowed an additional $25.0 million under Tranche A as of March 31, 2023. Under Tranche B (which became available on the Closing until December 15, 2023), the Company may borrow up to $50.0
million in $25.0 million increments. Under Tranche C (which will become available on January 1, 2024 and remain available until June 30, 2024), the Company may borrow up to $50.0 million in $25.0 million increments. Under Tranche D (which will become available on the earlier of (a) the date on which Tranche C is fully drawn and (b) July 1, 2024, and remain available until December 15, 2024), the Company may borrow up to $75.0 million in $25.0 million increments. Under Tranche E (which became available on the Closing and will remain available until June 1, 2025), the Company may borrow up to $25.0 million subject to the approval of the individual lender. If the Company does not elect to draw the entire principal amount available under the Tranche B, C or D during the applicable drawdown period, then any such undrawn portion will be added to the aggregate principal amount available under Tranche E. The Company's obligations under the Term Loan Facility are secured by a perfected security interest in substantially all of the assets of the Company, subject to certain limitations and exceptions. The Term Loan Facility is scheduled to mature on October 1, 2027, subject to a springing maturity date of September 1, 2025 if, prior to June 1, 2025, the Company’s Convertible Senior Notes have not been (i) converted into equity interests of the Company, (ii) amended such that the scheduled maturity date of the Convertible Senior Notes is at least 180 days after the initial maturity date of the tranches of the Term Loans then in effect, or (iii) fully redeemed and extinguished.
The Term Loans bear interest at a rate equal to the greater of either 7.95% or the prime rate (as defined in the Loan Agreement) plus 2.45% per annum. In addition, the principal balance of the Term Loans bear “payment-in-kind” interest at the rate of 1.00% per annum (“PIK Interest”), which PIK Interest is added to the outstanding principal balance of the Term Loans and increases the outstanding principal balance of the Term Loans on each payment date. In addition, an end-of-term charge equal to 4.95% of the aggregate original principal amount of the Term Loans, due on the earlier of the maturity date of the Term Loans or the repayment of the Term Loans, is payable by the Company. Interest payments on the Term Loans are due on the first day of each month.
Borrowings under the Term Loan Facility may be voluntarily prepaid in minimum increments of $25.0 million, subject to a prepayment fee equal to (i) 2.00% of the amount prepaid, if the prepayment occurs during the first year following the Closing, (ii) 1.00% of the amount prepaid, if the prepayment occurs during the second year following the Closing, and (iii) 0.50% of the amount prepaid, if the prepayment occurs during the third year following the Closing. There is no prepayment fee, penalty or premium applicable to voluntary prepayments made by the Company on or after the fourth year following the closing.
At March 31, 2023, the outstanding aggregate balance of the Term Loan, net of debt issuance costs was $98.2 million.
The Loan Agreement contains customary affirmative and negative covenants, including a requirement that the Company maintain all of its operating and deposit accounts with Silicon Valley Bank ("SVB"). In addition, beginning on the earlier of (i) the reporting deadline of the Company’s fourth quarter 2023 financial statements under the Loan Agreement and (ii) the date at which more than $100.0 million in aggregate principal (excluding any paid-in-kind interest) is outstanding under the Term Loan Facility, the Company is required to maintain a specified trailing twelve-month platform contribution (as defined in the Loan Agreement), with the applicable platform contribution increasing over time and as the Company’s borrowings under the Term Loan Facility increase. At March 31, 2023, the financial covenant was not yet in effect.
On March 10, 2023, the California Department of Financial Protection and Innovation took possession of and closed SVB, appointing the Federal Deposit Insurance Corporation (“FDIC”) as receiver. As receiver, the FDIC transferred all deposits and substantially all assets of the former SVB to a newly created "bridge bank" (Silicon Valley Bridge Bank, N.A.). On March 16, 2023, in light of the uncertainty surrounding SVB and its ability to continue operations, the Company transferred certain cash deposits from SVB bridge bank to other financial institutions. On April 4, 2023, the Company entered into a Default Waiver and First Amendment (the “Amendment”) to the Loan Agreement. Among other matters, the Amendment provides a waiver of any potential default under the Loan Agreement. The Company was in compliance with all of the applicable covenants under the Loan Agreement as of March 31, 2023. Refer to Note 13 for more detailed information.
Convertible Senior Notes
On March 16, 2021, the Company issued, at par value, $920.0 million aggregate principal amount of 0% Convertible Senior Notes, including $120.0 million in aggregate principal amount pursuant to the option we granted to the initial purchasers to purchase additional convertible senior notes, which was exercised in full in March 2021. Total proceeds received by the Company from the sale of the Convertible Senior Notes, net of debt issuance and offering costs of $22.1 million, were $897.9 million. The Company used $123.6 million of the net proceeds to pay for the cost of the capped call transactions (see discussion on capped call transactions further below).
The Convertible Senior Notes are governed by an indenture (“Indenture”), dated as of March 16, 2021, between the Company and U.S. Bank National Association, as trustee. Under the Indenture, the Convertible Senior Notes are general senior, unsecured obligations of the Company and will mature on March 15, 2026, unless earlier redeemed, repurchased or converted. The Convertible Senior Notes are equal in right of payment with the Company’s future senior, unsecured indebtedness and structurally subordinated to all indebtedness and liabilities of the Company’s subsidiaries.
Pursuant to the terms of the Indenture, the Convertible Senior Notes are convertible at the option of the holders, or may be called by the Company for redemption, upon the occurrence of certain circumstances. For additional information on the conversion provisions included in the Indenture, please see Note 8: Long-Term Debt, of the notes to the consolidated financial statements included in our 2022 Form 10-K. Based upon the reported sales price of our Common Stock during the last 30 consecutive trading days of the first quarter of 2023, the Convertible Senior Notes were not convertible by the holders on March 31, 2023 and will not be convertible until December 15, 2025.
The Company recognized $1.1 million and $1.1 million related to the amortization of debt issuance and offering costs in interest expense, net on the condensed consolidated statements of operations related to the Convertible Senior Notes for the three-months ended March 31, 2023 and 2022, respectively. The effective interest rate for both periods was 0.49%.
Capped Call Transactions
Concurrently with the pricing of the Convertible Senior Notes, the Company entered into convertible note hedge transactions (the “capped call transactions”) with six initial purchasers or their respective affiliates and other financial institutions (the “option counterparties”) to mitigate the impact of potential economic dilution to our Common Stock upon conversion of the Convertible Senior Notes. The capped calls were purchased for $123.6 million from the net proceeds from the issuance of the Convertible Senior Notes and have an initial strike price of approximately $79.16 per share, which corresponds to the initial conversion price of the Convertible Senior Notes. The capped call transactions cover, subject to customary adjustments, the number of shares of Common Stock initially underlying the Convertible Senior Notes. The capped call transactions are expected to offset the potential dilution to the Company’s Common Stock upon any conversion of Convertible Senior Notes, with such reduction and/or offset subject to a cap initially equal to $138.8750 per share.
The capped call transactions will expire on March 12, 2026. The capped call transactions are separate transactions and are not part of the terms of the Convertible Senior Notes.
The capped call transactions cover, subject to anti-dilution adjustments, approximately 11,622,176 shares of the Company’s Common Stock. The capped call transactions are subject to either adjustment or termination upon the occurrence of specified extraordinary and disruption events affecting the Company.
NOTE 9. STOCK-BASED COMPENSATION
2020 Omnibus Incentive Plan
On August 5, 2020, the Company’s Board of Directors adopted the 2020 Omnibus Incentive Plan (the “2020 Plan,”). Under the 2020 Plan, employees, consultants and directors of the Company and our affiliates that perform services for us are eligible to receive awards. The 2020 Plan provides for the grant of incentive stock options (“ISOs”), non-statutory stock options (“NSOs”), stock appreciation rights, restricted stock awards (“RSAs”), performance awards, other share-based awards (including restricted stock units (“RSUs”)) and other cash-based awards. The maximum number of shares available for issuance under the 2020 Plan may not exceed 62,590,091 shares (subject to annual increases as approved by the Board of Directors).
Stock Options Activity, excluding PSOs
Stock options granted by the Company generally vest over four years with 25% of the option shares vesting each year. Options generally expire ten years from the date of the grant.
The following is a summary of stock option activity, excluding PSOs, as of and for the three-months ended March 31, 2023 ($ in millions):
| | | | | | | | | | | | | | | | | | | | | | | |
| Number of Options | | Weighted-Average Exercise Price | | Weighted-Average Remaining Contractual Term (Years) | | Aggregate Intrinsic Value |
Outstanding, December 31, 2022 | 15,532,081 | | $ | 21.28 | | | 7.73 | | $ | 15.2 | |
Granted | — | | — | | | | | |
Exercised | (952,273) | | 20.92 | | | | | |
Cancelled | (117,167) | | 24.76 | | | | | |
Outstanding, March 31, 2023 | 14,462,641 | | $ | 21.27 | | | 7.55 | | $ | 249.4 | |
Options exercisable as of March 31, 2023 | 9,240,178 | | $ | 21.36 | | | 7.41 | | $ | 154.8 | |
The aggregate intrinsic value of options exercised in each of the three-months ended March 31, 2023 and 2022 was $21.0 million, and $(1.6) million, respectively. Aggregate intrinsic value represents the difference between the exercise price of the option and the closing price of the Company’s Common Stock on the date of exercise. The fair value of options granted for the three-months ended March 31, 2022 was $12.5 million. No options were granted during the three-months ended March 31, 2023.
Performance Stock Options Activity
In February 2022, the Company granted PSOs to certain of its executives, with 50% of the option shares vesting at the end of year two and the remaining 50% of the option shares vesting at the end of year three, subject in each case to the satisfaction of certain performance-based conditions. The PSOs generally expire ten years from the date of the grant. The fair value of performance stock options granted for the three-months March 31, 2022 was $25.8 million. No performance stock options were granted during the three-months ended March 31, 2023.
The following is a summary of PSO activity as of and for the three-months ended March 31, 2023 ($ in millions):
| | | | | | | | | | | | | | | | | | | | | | | |
| Number of Options | | Weighted-Average Exercise Price | | Weighted-Average Remaining Contractual Term (Years) | | Aggregate Intrinsic Value |
Outstanding, December 31, 2022 | 4,356,234 | | | $ | 17.45 | | | 8.95 | | $ | 19.0 | |
Granted | — | | | — | | | | | |
Exercised | — | | | — | | | | | |
Adjustments | 7,000 | | | — | | | | | |
Cancelled | (18,000) | | | 21.96 | | | | | |
Outstanding, March 31, 2023 | 4,345,234 | | $ | 17.43 | | | 9.1 | | $ | 92.3 | |
Options exercisable as of March 31, 2023 | — | | | $ | — | | | — | | | — | |
RSU Activity
RSUs granted generally vest ratably over four years. The following is a summary of RSU transactions as of and for the three-months ended March 31, 2023:
| | | | | | | | | | | |
| Unvested Shares | | Grant Date Fair Value |
| | | |
Unvested, December 31, 2022 | 2,528,388 | | | $ | 21.53 | |
Granted | 2,747,183 | | | 33.19 | |
Vested | (452,824) | | | 19.65 | |
Canceled and forfeited | (99,991) | | | 20.46 | |
Unvested, March 31, 2023 | 4,722,756 | | | $ | 28.48 | |
PSU Activity
The Company granted PSUs to certain of its employees during the second quarter of 2022 that vested in April 2023. The following is a summary of PSU activity as of and for the three-months ended March 31, 2023:
| | | | | | | | | | | |
| Unvested Shares | | Grant Date Fair Value |
| | | |
Unvested, December 31, 2022 | 538,213 | | | $ | 28.03 | |
Granted | 11,663 | | | — | |
Vested | (27,796) | | | 44.97 | |
Canceled and forfeited | (19,719) | | | 22.13 | |
Unvested, March 31, 2023 | 502,361 | | | $ | 44.97 | |
RSA Activity
The RSAs were granted as part of the pre-IPO conversion. The following is a summary of RSA transactions as of and for the three-months ended March 31, 2023:
| | | | | | | | | | | |
| Unvested Shares | | Grant Date Fair Value |
| | | |
Unvested, December 31, 2022 | 5,943,100 | | | $ | 13.54 | |
Granted | — | | | — | |
Vested | (801,201) | | | 2.34 | |
Canceled and forfeited | (58,011) | | | 19.97 | |
Unvested, March 31, 2023 | 5,083,888 | | | $ | 15.31 | |
Employee Stock Purchase Plan
On August 5, 2020, the Board of Directors adopted, and the OSH LLC’s and OSH MH LLC’s majority unitholders approved, the 2022 Employee Stock Purchase Plan (the “ESPP”). The ESPP is more fully described in Note 13 to the consolidated financial statements included in our 2022 Form 10-K.
During the three-months ended March 31, 2023 and 2022, 95,207 shares and 63,284 shares, respectively, were purchased under the ESPP.
Stock-Based Compensation Expense
The following table is a summary of stock-based compensation expense by function ($ in millions):
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Cost of care, excluding depreciation and amortization | $ | 2.3 | | | $ | 0.6 | | | | | |
Sales and marketing | 1.0 | | 0.6 | | | | |
Corporate, general and administrative | 21.5 | | 38.2 | | | | |
Total | $ | 24.8 | | | $ | 39.4 | | | | | |
As of March 31, 2023, the Company had approximately $152.0 million in unrecognized compensation expense related to all non-vested awards (RSAs, ISOs, PSO, PSUs and RSUs) that will be recognized over the weighted-average period of 3.07 years.
NOTE 10. COMMITMENTS AND CONTINGENCIES
Contingencies
The Company is presently, and from time to time, subject to various claims, investigations, suits and other legal proceedings arising in the ordinary course of business. The Company currently believes that the outcomes of such proceedings, individually and in the aggregate, will not have a material adverse impact on its business, cash flows, financial position or results of operations. Any legal proceedings are subject to inherent uncertainties, and the Company’s view of these matters and its potential effects may change in the future. In accordance with applicable accounting standards, the Company establishes an accrued liability for loss contingencies related to legal and regulatory matters when the loss is both probable and reasonably estimable,
Uncertainties
The healthcare industry is subject to numerous laws and regulations of federal, state and local governments. These laws and regulations include, but are not limited to, matters such as licensure, accreditation, government healthcare program participation requirements, reimbursement for patient services, and Medicare and Medicaid fraud and abuse. Recently, government activity has increased with respect to investigations and allegations concerning possible violations of fraud and abuse statues and regulations by healthcare providers. Violations of these laws and regulations could result in expulsion from government healthcare programs together with imposition of significant fines and penalties, as well as significant repayments for patient services billed.
On November 1, 2021, the Company received a civil investigative demand (“CID”) from the United States Department of Justice. According to the CID, the Department of Justice is investigating whether the Company may have violated the False Claims Act, 31 U.S.C. §§ 3729-3722. The CID requests certain documents and information related to the Company’s relationships with third-party marketing agents and related to the Company’s provision of free transportation to federal health care beneficiaries and requests information and documents related to such matters. We are continuing to cooperate with the Department of Justice in response to the CID and believe we have complied with all of the current information requests. We are currently unable to predict the outcome of this investigation. Additionally, the Company cannot reasonably estimate the possible loss or range of loss that may result from this action. Regardless of the outcome, this inquiry has the potential to have an adverse impact on us due to any related defense and settlement costs, diversion of management resources and other factors.
On January 10, 2022, Reginald T. Allison, individually and on behalf of all others similarly situated, filed a putative class action lawsuit against the Company, Michael Pykosz, our Chief Executive Officer and also a member of our Board of Directors, and Timothy Cook, our Chief Financial Officer, in the United States District Court for the Northern District of Illinois (Case No. 1:22-cv-00149). On March 25, 2022, Central Pennsylvania Teamsters Pension Fund – Defined Benefit Plan, Central Pennsylvania Teamsters Pension Fund – Retirement Income Plan 1987, and Boston Retirement System (collectively, the “Northeast Pension Funds”) were appointed as the lead plaintiffs in the case. On May 25, 2022, the Northeast Pension Funds along with an additional named plaintiff, the City of Dearborn Police & Fire Revised Retirement System, filed their consolidated amended and restated complaint (the “Amended Complaint”), adding two of the Company's largest stockholders and members of the Company's Board of Directors as defendants.
Plaintiffs allege that the Company and certain of its executive officers made false and/or misleading statements about patient acquisition tactics that purportedly violated the False Claims Act and U.S. federal Anti-Kickback Statute, and are purportedly the subject of the CID discussed above. The Amended Complaint includes two categories of claims: (1) claims under the Securities Exchange Act of 1934 based on allegedly misleading public statements throughout the class period of August 6, 2020 through November 8, 2021 (the “Exchange Act Claims”), and (2) claims under the Securities Act
of 1933 based on allegedly misleading statements in the registration statements and prospectuses accompanying the IPO and secondary public offerings (the “Securities Act Claims”). The Exchange Act claims are asserted against the Company, Michael Pykosz and Timothy Cook and also against certain stockholders of as “control persons.” The Securities Act Claims are asserted against the same defendants as well as the underwriters of the Company’s public offerings, and the members of our Board of Directors who signed the registration statements related to such public offerings. The Amended Complaint seeks damages, interest, costs, attorneys’ fees and other unspecified equitable relief.
On July 25, 2022, the defendants filed a consolidated motion to dismiss the Amended Complaint. On September 26, 2022, the plaintiffs' opposition to that motion to dismiss was filed, and the defendants reply to that opposition was filed on October 26, 2022. On February 10, 2023, the Court ruled on the motion to dismiss, granting the Company's' motions to dismiss with respect to the plaintiffs' section 12(a)(2) claim and section 11 claim based on misrepresentations from the May 2021 secondary public offering, and denying the remainder of the motion. Additionally, three stockholders, Joseph Miller, the Hialeah Employees' Retirement System and the Employees Retirement System of the City of St. Louis each filed, on November 7, 2022, January 5, 2023 and February 2, 2023, respectively, derivative actions in the Delaware Court of Chancery against certain of our officers and each of the members of our Board of Directors (collectively, “Defendants”) principally alleging breach of fiduciary duties and unjust enrichment. Generally, the complaint in each derivative action concerns those Defendants’ duties relating to certain outreach practices the Company allegedly engaged in and its patient transportation program, which are also matters that are the subject of the CID. These cases have all been consolidated and stayed.
The Company intends to continue to defend these claims vigorously. Given the uncertainty of litigation, the preliminary stage of the case, and the legal standards that must be met for success on the merits, the Company cannot reasonably estimate the possible loss or range of loss that may result from this action.
NOTE 11. VARIABLE INTEREST ENTITIES
The Physician Groups, or affiliated physician practice organizations, were established to employ healthcare providers, contract with managed care payors and to deliver healthcare services to patients in the markets that the Company serves.
The Company evaluated whether it has a variable interest in the Physician Groups, whether the Physician Groups are VIEs and whether the Company has a controlling financial interest in the Physician Groups. The Company concluded that it has variable interests in the Physician Groups on the basis of its Administrative Service Agreement (“ASA”) which provides for reimbursement of costs and a management fee payable to the Company from the Physician Groups in exchange for providing management and administrative services which creates risks and a potential return to the Company. The Physician Group’s equity at risk, as defined by U.S. GAAP, is insufficient to finance its activities without additional support, and, therefore, the Physician Groups are considered VIEs.
The tables below illustrate the VIE assets and liabilities and performance for the Physician Groups as of and for the periods ended ($ in millions):
| | | | | | | | | | | |
| March 31, 2023 | | December 31, 2022 |
Total assets | $ | 1,316.2 | | | $ | 1,002.0 | |
Total liabilities | 1,140.6 | | | 930.8 | |
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Total revenues | $ | 749.6 | | | $ | 511.4 | | | | | |
Medical claims expense | 522.1 | | | 378.5 | | | | | |
Cost of care | 68.0 | | | 47.6 | | | | | |
Total operating expenses | $ | 590.1 | | | $ | 426.1 | | | | | |
There are no restrictions on the Physician Groups’ assets or on the settlement of its liabilities. The assets of the Physician Groups can be used to settle obligations of the Company. The Physician Groups are included in the Company’s obligated group; thus, creditors of the Company have recourse to the assets owned by the Physician Groups. There are no liabilities for which creditors of the Physician Groups do not have recourse to the general credit of the Company. There are no restrictions placed on the retained earnings or net income of the Physician Groups with respect to potential dividend payments.
NOTE 12. NET LOSS PER SHARE
The following table sets forth the computation of basic and diluted net loss per common share for the three-months ended March 31, 2023 and 2022 ($ in millions).
| | | | | | | | | | | | | | | |
| Three-Months Ended March 31, | | |
| 2023 | | 2022 | | | | |
Numerator: | | | | | | | |
Net loss | $ | (44.2) | | | $ | (96.7) | | | | | |
Less: Net income/(loss) attributable to non-controlling interests | 1.3 | | | (0.2) | | | | | |
Net loss attributable to Oak Street Health, Inc. | (45.5) | | | (96.5) | | | | | |
Denominator: | | | | | | | |
Weighted average common shares outstanding - basic and diluted | 238,093,465 | | | 225,645,420 | | | | | |
Net loss per share – basic and diluted | $ | (0.19) | | | $ | (0.43) | | | | | |
The Company’s potentially dilutive securities, which included stock options (including PSOs), unvested RSUs (including PSUs), unvested RSAs, and shares issuable upon conversion of our Convertible Senior Notes, have been excluded from the computation of diluted net loss per share as the effect would reduce the net loss per share. Therefore, the weighted average number of common shares outstanding used to calculate both basic and diluted net loss per share was the same. The Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share for the periods indicated:
| | | | | | | | | | | |
| Three-Months Ended March 31, |
| 2023 | | 2022 |
Stock options | 18,807,875 | | | 19,650,785 | |
RSUs (including PSUs) | 5,225,117 | | | 2,345,372 | |
RSAs | 5,083,888 | | | 14,966,634 | |
Convertible Senior Notes | 11,622,176 | | | 11,622,176 | |
| 40,739,056 | | | 48,584,967 | |
NOTE 13. SUBSEQUENT EVENTS
Loan Amendment
On April 4, 2023, the Company entered into an Amendment to the Loan Agreement dated September 30, 2022 with Hercules Capital, Inc. as administrative and collateral agent and lender (the “Agent”), and SVB and the other lenders from time to time parties thereto (collectively with Agent in its capacity as a lender, the “Lenders”).
Among other matters, the Amendment provided a waiver of any potential default under the Loan Agreement related to the Company’s movement of certain cash deposits between financial institutions in March 2023, which were made intentionally by the Company during the recent period of uncertainty surrounding SVB and its ability to continue operations. The Amendment provides that the Company may maintain cash in certain accounts outside of SVB and its affiliates in an aggregate amount not to exceed $65.0 million. We were in compliance with terms of the Amendment as of March 31, 2023.
Delisting and Deregistration
On May 2, 2023, the Merger, as described in Note 1, was consummated. Also, on May 2, 2023, the NYSE filed a notification of removal from listing on Form 25 with the SEC with respect to the delisting and deregistration of the Company’s Common Stock. Our shares of common stock ceased trading prior to the opening of the market on May 2, 2023, and are no longer listed on the NYSE. Accordingly, the Company is no longer a publicly traded company. In addition, on May 12, 2023, the Company intends to file with the SEC a Form 15, which, upon filing, will immediately suspend the reporting obligations of the Company under Sections 13(a) and 15(d) of the Exchange Act.
Treatment of Outstanding Debt in Connection with the Merger
At the Effective Time, CVS Pharmacy repaid and discharged in full the amount outstanding under the Term Loan Facility. All commitments and obligations pursuant to such indebtedness have been terminated in full (other than indemnities and other contingent obligations expressly meant to survive termination).
On May 2, 2023, the Company entered into the first supplemental indenture to the Indenture (the “Supplemental Indenture”) pursuant to which the right to convert each $1,000 principal amount of Convertible Senior Notes into shares of Common Stock was changed to a right to convert such principal amount of Convertible Senior Notes into the Merger Consideration that a holder of a number of shares of Common Stock equal to the Conversion Rate (as defined in the Indenture) immediately prior to the Merger would have owned or been entitled to receive (the “Reference Property”), which Reference Property will be cash in an amount equal to $492.6792 per $1,000 principal amount of Convertible Senior Notes, in accordance with the Indenture, at any time from, and including, the date that the Merger became effective. In addition, the Merger constitutes a Fundamental Change (as defined in the Indenture) under the Indenture, giving the holders of the Convertible Senior Notes the right to require the Company to repurchase their Convertible Senior Notes, subject to the terms and conditions of the therein. Pursuant to the Indenture, the repurchase price for the Convertible Senior Notes will be an amount in cash equal to one hundred percent (100%) of the principal amount of the Convertible Senior Notes (or portions thereof) to be so repurchased, plus accrued and unpaid Special Interest (as defined in the Indenture) thereon to, but excluding, the Fundamental Change Repurchase Date (as defined in the Indenture). At the Effective Time, the capped call transactions were terminated pursuant to the agreements between the Company and each of the bank counterparties to the capped call transactions, with each bank counterparty paying to the Company, on or about May 2, 2023, an amount in cash as agreed between the Company and such bank counterparty.
Treatment of Outstanding Equity-Based Awards in Connection with the Merger
Each outstanding and unexercised option to purchase shares of Common Stock (for the purposes of this Note 13, an “Option”) with an exercise price per share less than $39.00 that was vested prior to the Effective Time or that, as a result of the Merger, became vested, as of the Effective Time (with any performance conditions applicable to such Option determined in accordance with the applicable award agreement as of immediately prior to the Effective Time), was, at the Effective Time, automatically cancelled and converted into the right to receive an amount in cash (without interest and subject to applicable tax withholdings) equal to the product of (i) the number of shares of Common Stock subject to such Option as of immediately prior to the Effective Time and (ii) the excess of $39.00 over the per share exercise price of such Option. At the Effective Time, each outstanding and unexercised Option with an exercise price per share equal to or greater than the $39.00, whether vested or unvested, was automatically cancelled for no consideration.
Each Option that was unvested at the Effective Time and not cancelled pursuant to the provisions described in the preceding paragraph was, at the Effective Time, automatically cancelled and converted into the contractual right to receive a payment in cash (without interest and subject to applicable tax withholdings) equal to the product of (i) the number of shares of Common Stock subject to such Option as of immediately prior to the Effective Time and (ii) the excess of $39.00 over the exercise price per share of such Option (each, a “Converted Option Cash Award”), and each Converted Option Cash Award was subject to the same terms and conditions (including applicable vesting provisions, but excluding exercise provisions) as applied to the corresponding Option immediately prior to the Effective Time and became payable in accordance with the original vesting schedule applicable to the corresponding Option, except that each Converted Option Cash Award provides that the unvested portion, if any, of such Converted Option Cash Award will immediately vest and become payable upon a termination of the holder’s employment or services without “cause” or a resignation by the holder for “good reason” that occurs within the 12-month period following the Effective Time.
Each Oak Street Health restricted stock award ("RSA") that was outstanding as of immediately prior to the Effective Time was, at the Effective Time, automatically assumed by CVS Pharmacy and converted into a corresponding CVS Health restricted stock award (each, an “Assumed RSA”) on the same terms and conditions (including applicable vesting and expiration provisions) as applied to each such RSA immediately prior to the Effective Time, except that each Assumed RSA covers a number of whole shares of CVS Health Common Stock equal to the product of (i) the number of shares of Common Stock underlying such Assumed RSA as of immediately prior to the Effective Time and (ii) the Equity Award Exchange Ratio (as defined below), and such Assumed RSA provides that the unvested portion, if any, of such Assumed RSA will immediately vest and settle upon a termination of the holder’s employment or services without “cause” or a resignation by the holder for “good reason” that occurs within the 12-month period following the Effective Time.
Each Oak Street Health restricted stock unit ("RSU") that was outstanding as of immediately prior to the Effective Time that was vested or, as a result of the Merger, became vested as of the Effective Time (in each case, with any performance conditions applicable to such RSU determined in accordance with the applicable award agreement as of immediately prior to the Effective Time), was, at the Effective Time, automatically cancelled and converted into the right to receive, an amount in cash (without interest and subject to applicable tax withholdings) equal to the product of (i) $39.00 and (ii) the number of shares of Common Stock subject to such RSU as of immediately prior to the Effective Time (a “Cash-Out RSU”).
Each RSU granted on or after February 7, 2023 that was outstanding and unvested as of the Effective Time was, at the Effective Time, automatically assumed by CVS Pharmacy and converted into a corresponding CVS Health restricted stock unit award (each, an “Assumed RSU Award”) on the same terms and conditions (including applicable vesting and expiration provisions) as applied to each such RSU immediately prior to the Effective Time, except that each Assumed RSU Award covers a number of whole shares of CVS Health Common Stock equal to the product of (i) the number of shares of Oak Street Health Common Stock underlying such RSU as of immediately prior to the Effective Time and (ii) the Equity Award Exchange Ratio.
Each RSU (other than Cash-Out RSUs and RSUs granted on or after February 7, 2023) that was outstanding and unvested as of the Effective Time was, at the Effective Time, automatically cancelled and converted into the contractual right to receive a payment in an amount of cash (without interest and subject to applicable tax withholdings) equal to the product of (i) $39.00 and (ii) the total number of shares of Common Stock subject to such RSU as of immediately prior to the Effective Time (each, a “Converted RSU Cash Award”), and each Converted RSU Cash Award is subject to the same terms and conditions (including time-based vesting) as applied to such RSU immediately prior to the Effective Time and will become payable in accordance with the original vesting schedule applicable to the corresponding RSU, except that each Converted RSU Cash Award provides that the unvested portion, if any, of such Converted RSU Cash Award will immediately vest and become payable upon a termination of the holder’s employment or services without “cause” or a resignation by the holder for “good reason” that occurs within the 12-month period following the Effective Time.
The “Equity Award Exchange Ratio” means the quotient obtained by dividing (i) $39.00 by (ii) the volume weighted average closing sale price (rounded to the nearest cent) of one share of CVS Health Common Stock as reported on the NYSE 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 10 consecutive trading days ending on (and including) the date that is two trading days immediately preceding the Effective Time (as adjusted as appropriate to reflect any stock splits, stock dividends, combinations, reorganizations, reclassifications or similar events), rounded to the nearest 0.0001.
Pursuant to the Merger Agreement, Oak Street Health took all actions necessary pursuant to the terms of the ESPP to, among other things, ensure each purchase right issued pursuant to the ESPP was fully exercised on the earlier of (x) the scheduled purchase date for such offering period and (y) the date that is no later than five business days prior to the Effective Time (with any participant payroll deductions not applied to the purchase of shares of Oak Street Health Common Stock returned to the participant). The ESPP was terminated effective immediately prior to the Effective Time.
Assumed RSAs and Assumed RSUs
Pursuant to the Merger Agreement, on May 2, 2023 CVS Health filed a registration statement on Form S-8 with respect to the issuance of the shares of CVS Health Common Stock subject to the Assumed RSAs and Assumed RSU Awards that are eligible to be registered on Form S-8.