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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
cignagroup_logo_color_pos_rgb_600ppi.jpg
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2023
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _____ to _____
Commission File Number 001-38769
The Cigna Group
(Exact name of registrant as specified in its charter)
Delaware82-4991898
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
900 Cottage Grove Road
Bloomfield, Connecticut 06002
(Address of principal executive offices) (Zip Code)
(860) 226-6000
(Registrant's telephone number, including area code)

Not Applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, Par Value $0.01CI
New York Stock Exchange, Inc.
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☐ No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☐ No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See definitions of "large accelerated filer," "accelerated filer," "smaller reporting company," and "emerging growth company" in Rule 12b-2 of the Exchange Act.

Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐ Yes No
As of October 27, 2023, 292,619,966 shares of the issuer's common stock were outstanding.



THE CIGNA GROUP
TABLE OF CONTENTS
Page
As used herein, the term "Company" refers to one or more of The Cigna Group and its consolidated subsidiaries.



Part I. FINANCIAL INFORMATION
Item 1. FINANCIAL STATEMENTS
The Cigna Group
Consolidated Statements of Income
UnauditedUnaudited
Three Months Ended September 30,Nine Months Ended September 30,
(In millions, except per share amounts)2023
2022 (1)
2023
2022 (1)
Revenues
Pharmacy revenues$34,531 $32,762 $100,639 $95,431 
Premiums10,998 9,586 33,062 30,368 
Fees and other revenues3,198 2,729 9,574 8,023 
Net investment income321 204 876 943 
TOTAL REVENUES49,048 45,281 144,151 134,765 
Benefits and expenses
Pharmacy and other service costs33,639 31,777 98,540 92,740 
Medical costs and other benefit expenses8,927 7,751 27,007 24,215 
Selling, general and administrative expenses3,788 3,151 10,760 9,690 
Amortization of acquired intangible assets454 460 1,368 1,419 
TOTAL BENEFITS AND EXPENSES46,808 43,139 137,675 128,064 
Income from operations2,240 2,142 6,476 6,701 
Interest expense and other(365)(304)(1,086)(904)
(Loss) gain on sale of businesses(21)1,735 (21)1,735 
Net realized investment losses
(14)(82)(44)(493)
Income before income taxes1,840 3,491 5,325 7,039 
TOTAL INCOME TAXES391 713 1,060 1,479 
Net income1,449 2,778 4,265 5,560 
Less: Net income attributable to noncontrolling interests41 21 130 49 
SHAREHOLDERS' NET INCOME$1,408 $2,757 $4,135 $5,511 
Shareholders' net income per share
Basic$4.79 $9.07 $14.03 $17.64 
Diluted$4.74 $8.97 $13.89 $17.46 
(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
3


The Cigna Group
Consolidated Statements of Comprehensive Income
UnauditedUnaudited
Three Months Ended September 30,Nine Months Ended September 30,
(In millions)2023
2022 (1)
2023
2022 (1)
Net income$1,449 $2,778 $4,265 $5,560 
Other comprehensive income (loss), net of tax
Net unrealized (depreciation) appreciation on securities and derivatives
(192)(150)22 (1,663)
Net long-duration insurance and contractholder liabilities measurement adjustments(28)(19)(476)446 
Net translation (losses) gains on foreign currencies
(29)175 (32)(95)
Postretirement benefits liability adjustment8 10 25 50 
Other comprehensive (loss) income, net of tax
(241)16 (461)(1,262)
Total comprehensive income1,208 2,794 3,804 4,298 
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests37 3 116 8 
Net income attributable to other noncontrolling interests4 18 14 41 
Other comprehensive loss attributable to redeemable noncontrolling interests 1  (2)
Total comprehensive income attributable to noncontrolling interests41 22 130 47 
SHAREHOLDERS' COMPREHENSIVE INCOME$1,167 $2,772 $3,674 $4,251 
(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
4



The Cigna Group
Consolidated Balance Sheets
Unaudited
As of
September 30,
As of
December 31,
(In millions)2023
2022 (1)
Assets
Cash and cash equivalents$8,497 $5,924 
Investments1,046 905 
Accounts receivable, net19,083 17,218 
Inventories4,416 4,777 
Other current assets1,476 1,298 
Total current assets34,518 30,122 
Long-term investments18,974 16,288 
Reinsurance recoverables4,920 5,416 
Property and equipment3,924 3,774 
Goodwill45,810 45,811 
Other intangible assets31,324 32,492 
Other assets3,147 2,704 
Separate account assets7,028 7,278 
TOTAL ASSETS$149,645 $143,885 
Liabilities
Current insurance and contractholder liabilities$7,352 $5,409 
Pharmacy and other service costs payable19,320 17,070 
Accounts payable7,673 7,775 
Accrued expenses and other liabilities9,668 7,978 
Short-term debt3,046 2,993 
Total current liabilities47,059 41,225 
Non-current insurance and contractholder liabilities11,286 11,976 
Deferred tax liabilities, net7,480 7,786 
Other non-current liabilities2,932 2,766 
Long-term debt28,094 28,100 
Separate account liabilities7,028 7,278 
TOTAL LIABILITIES103,879 99,131 
Contingencies — Note 16
Redeemable noncontrolling interests64 66 
Shareholders' equity
Common stock (2)
4 4 
Additional paid-in capital30,563 30,233 
Accumulated other comprehensive loss(2,119)(1,658)
Retained earnings40,982 37,940 
Less: Treasury stock, at cost(23,739)(21,844)
TOTAL SHAREHOLDERS' EQUITY45,691 44,675 
Other noncontrolling interests11 13 
Total equity45,702 44,688 
Total liabilities and equity$149,645 $143,885 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
(2)Par value per share, $0.01; shares issued, 399 million as of September 30, 2023 and 398 million as of December 31, 2022; authorized shares, 600 million.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
5


The Cigna Group
Consolidated Statements of Changes in Total Equity
Unaudited
Three Months Ended September 30, 2023
(In millions)Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive (Loss)Retained EarningsTreasury StockShareholders' EquityOther Non- controlling InterestsTotal EquityRedeemable Noncontrolling Interests
Balance at June 30, 2023$4 $30,436 $(1,878)$39,936 $(23,053)$45,445 $19 $45,464 $62 
Effects of issuing stock for employee benefits plans127 (5)122 122 
Other comprehensive loss(241)(241)(241) 
Net income1,408 1,408 4 1,412 37 
Common dividends declared (per share: $1.23)
(362)(362)(362)
Repurchase of common stock (681)(681)(681)
Other transactions impacting noncontrolling interests  (12)(12)(35)
Balance at September 30, 2023$4 $30,563 $(2,119)$40,982 $(23,739)$45,691 $11 $45,702 $64 
Three Months Ended September 30, 2022 (1)
(In millions)Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive (Loss)Retained EarningsTreasury StockShareholders' EquityOther Non- controlling InterestsTotal EquityRedeemable Noncontrolling Interests
Balance at June 30, 2022, as retrospectively restated (1)
429,930 (2,343)34,668 (16,588)45,671 30 45,701 45 
Effect of issuing stock for employee benefit plans165 (2)163 163 
Other comprehensive income15 15 15 1 
Net income2,757 2,757 18 2,775 3 
Common dividends declared (per share: $1.12)
(342)(342)(342)
Repurchase of common stock(700)(2,800)(3,500)(3,500)
Other transactions impacting noncontrolling interests  (6)(6)1 
Balance at September 30, 2022$4 $29,395 $(2,328)$37,083 $(19,390)$44,764 $42 $44,806 $50 
(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
6


The Cigna Group
Consolidated Statements of Changes in Total Equity
Unaudited
Nine Months Ended September 30, 2023
(In millions)Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive (Loss)Retained EarningsTreasury StockShareholders' EquityOther Non- controlling InterestsTotal EquityRedeemable Noncontrolling Interests
Balance at December 31, 2022, as retrospectively restated (1)
$4 $30,233 $(1,658)$37,940 $(21,844)$44,675 $13 $44,688 $66 
Effect of issuing stock for employee benefit plans332 (110)222 222 
Other comprehensive loss(461)(461)(461) 
Net income4,135 4,135 14 4,149 116 
Common dividends declared (per share: $3.69)
(1,093)(1,093)(1,093)
Repurchase of common stock (1,785)(1,785)(1,785)
Other transactions impacting noncontrolling interests(2)(2)(16)(18)(118)
Balance at September 30, 2023$4 $30,563 $(2,119)$40,982 $(23,739)$45,691 $11 $45,702 $64 
Nine Months Ended September 30, 2022 (1)
(In millions)Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive (Loss)Retained EarningsTreasury StockShareholders' EquityOther Non- controlling InterestsTotal EquityRedeemable Noncontrolling Interests
Balance at December 31, 2021, as retrospectively restated (1)
4 29,574 (1,068)32,623 (14,175)46,958 18 46,976 54 
Effect of issuing stock for employee benefit plans521 (75)446 446 
Other comprehensive loss(1,260)(1,260)(1,260)(2)
Net income5,511 5,511 41 5,552 8 
Common dividends declared (per share: $3.36)
(1,051)(1,051)(1,051)
Repurchase of common stock(700)(5,140)(5,840)(5,840)
Other transactions impacting noncontrolling interests  (17)(17)(10)
Balance at September 30, 2022$4 $29,395 $(2,328)$37,083 $(19,390)$44,764 $42 $44,806 $50 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
7


The Cigna Group
Consolidated Statements of Cash Flows
Unaudited
Nine Months Ended September 30,
(In millions)2023
2022 (1)
Cash Flows from Operating Activities
Net income$4,265 $5,560 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization2,270 2,202 
Realized investment losses, net
44 493 
Deferred income tax benefit
(303)(298)
Loss (gain) on sale of businesses
21 (1,735)
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net(1,916)(2,339)
Inventories360 (296)
Reinsurance recoverable and Other assets281 734 
Insurance liabilities1,482 408 
Pharmacy and other service costs payable2,250 1,368 
Accounts payable and Accrued expenses and other liabilities1,337 380 
Other, net255 80 
NET CASH PROVIDED BY OPERATING ACTIVITIES10,346 6,557 
Cash Flows from Investing Activities
Proceeds from investments sold:
Debt securities and equity securities757 1,406 
Investment maturities and repayments:
Debt securities and equity securities715 1,124 
Commercial mortgage loans86 73 
Other sales, maturities and repayments (primarily short-term and other long-term investments)
453 906 
Investments purchased or originated:
Debt securities and equity securities(4,005)(2,457)
Commercial mortgage loans(94)(84)
Other (primarily short-term and other long-term investments)
(891)(1,109)
Property and equipment purchases, net(1,208)(950)
Acquisitions, net of cash acquired(443) 
Divestitures, net of cash sold13 4,838 
Other, net(117)(33)
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES(4,734)3,714 
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds127 121 
Withdrawals and benefit payments from contractholder deposit funds(139)(161)
Net change in short-term debt1,484 (2,051)
Repayment of long-term debt(2,967) 
Net proceeds on issuance of long-term debt1,491  
Repurchase of common stock(1,740)(5,874)
Issuance of common stock113 317 
Common stock dividend paid(1,092)(1,050)
Other, net(321)94 
NET CASH USED IN FINANCING ACTIVITIES(3,044)(8,604)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash 2 (98)
Net increase in cash, cash equivalents and restricted cash2,570 1,569 
Cash, cash equivalents and restricted cash January 1, (2)
5,976 5,548 
Cash, cash equivalents and restricted cash, September 30, (3)
8,546 7,117 
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds$1,380 $1,346 
Interest paid$1,019 $923 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
(2)Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.
(3)Restricted cash and cash equivalents were reported in other long-term investments.
The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.
8


THE CIGNA GROUP
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
TABLE OF CONTENTS
Note NumberFootnotePage
BUSINESS AND CAPITAL STRUCTURE
INSURANCE INFORMATION
INVESTMENTS
COMPLIANCE, REGULATION AND CONTINGENCIES
RESULTS DETAILS

9


Note 1 – Description of Business
The Cigna Group, together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our"), is a global health company with a mission of helping those we serve improve their health and vitality. Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services.

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these ongoing operations, The Cigna Group also has certain run-off operations.
A full description of our segments follows:
Evernorth Health Services includes a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to health plans, employers, government organizations and health care providers.
Cigna Healthcare includes the U.S. Commercial, U.S. Government and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental and other products and services for insured and self-insured clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.
Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exited businesses. Our ongoing businesses include continuing business (corporate-owned life insurance ("COLI")) and our run-off businesses. Our run-off businesses include (i) variable annuity reinsurance business (also referred to as guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business) that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses comprised of deferred gains from the sales of these businesses. Our exited businesses include our interest in a joint venture in Türkiye, which was sold in December 2022 and the international life, accident and supplemental benefits businesses sold in July 2022 (the "Chubb transaction").
Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate financing less net investment income on investments not supporting segment and other operations), certain litigation matters, expense associated with our frozen pension plans, charitable contributions, operating severance, certain overhead and enterprise-wide project costs and eliminations for products and services sold between segments.
Note 2 – Summary of Significant Accounting Policies    
Basis of Presentation
The Consolidated Financial Statements include the accounts of The Cigna Group and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP"). Certain amounts in prior years related to the adoption of Targeted Improvements for the Accounting of Long-Duration Contracts, have been reclassified to conform to the current year presentation. See "Recent Accounting Pronouncements" below.
Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2022 Annual Report on Form 10-K ("2022 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care
10


and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.

Recent Accounting Pronouncements
The Company's 2022 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. The following information provides updates on recently adopted accounting pronouncements that have occurred since the Company filed its 2022 Form 10-K. There are no significant accounting pronouncements not yet adopted as of September 30, 2023.

Targeted Improvements to the Accounting for Long-Duration Contracts ("LDTI"), Accounting Standards Update ("ASU") 2018-12 and related amendments

The Cigna Group adopted LDTI January 1, 2023, which includes the following key provisions:

Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:
Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
Discount rate assumptions are updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed income instrument yield is interpreted to mean A-rated.
Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts are amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.
Market risk benefits ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.
Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
The transition methods applied at adoption were:
The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.
DAC followed the transition method used for future policyholder benefits.
Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in accumulated other comprehensive income.
Effects of adoption:

The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.
The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the year ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the year ended December 31, 2022 and December 31, 2021, respectively.
The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.
Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 9 to the Consolidated Financial Statements for the Company's updated accounting policies.
It is possible that our income recognition pattern could change on a prospective basis for several reasons:
11


Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.
DAC amortization is on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.

Additionally, in December 2022, the Financial Accounting Standards Board ("FASB") published ASU 2022-05, which simplified the retrospective adoption of LDTI by permitting companies to make an accounting policy election to exclude contracts that are sold and removed from the balance sheet prior to the effective date of the standard from the retrospective adoption of LDTI. The Cigna Group made this policy election for the contracts sold in the Chubb transaction and our divested interest in a joint venture in Türkiye.

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:
(In millions)September 30, 2023December 31, 2022
Noninsurance customer receivables$8,384 $6,899 
Pharmaceutical manufacturers receivables8,188 7,108 
Insurance customer receivables2,256 2,963 
Other receivables255 248 
Total$19,083 $17,218 

These accounts receivable are reported net of our allowances of $3.3 billion as of September 30, 2023 and $1.9 billion as of December 31, 2022. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain accounts receivable from third-party payors, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments.

The Company's allowance for current expected credit losses was $96 million as of September 30, 2023 and $86 million as of December 31, 2022.

Accounts Receivable Factoring Facility
In July 2023, the Company entered into an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution. The Facility's total capacity is $1.0 billion with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. The transactions under the Facility are accounted for as a sale and recorded as a reduction to accounts receivable in the Consolidated Balance Sheets because control of, and risk related to, the accounts receivable are transferred to the financial institution. Although the sale is made without recourse, we provide collection services related to the transferred assets. Amounts associated with this Facility are reflected within Net cash provided by operating activities in the Company's Consolidated Statements of Cash Flows. Factoring fees paid under this Facility are reflected in Interest expense and other in the Consolidated Statements of Income.
During the three months ended September 30, 2023 we sold $1.0 billion and factoring fees paid were not material. As of September 30, 2023, there were $253 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. There were $512 million of amounts received from manufacturers but not yet remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities on the Consolidated Balance Sheets.
Note 4 – Supplier Finance Program
The Company facilitates a voluntary supplier finance program (the "Program") that provides suppliers the opportunity to sell their accounts receivable due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require. The Cigna Group is not a party to the Program and agrees to commercial terms with its suppliers independently of their participation in the Program. Amounts due to suppliers that participate in the Program are generally paid within one month following the invoice date. A supplier's participation in the Program has no impact on the Company's payment terms and the Company has no economic interest in a supplier's decision to participate in the Program. The suppliers, at their sole discretion, determine which invoices, if any, to sell to the financial institution. No guarantees or pledged assets are provided by the Company or any of our subsidiaries under the Program.
As of September 30, 2023 and December 31, 2022, $1.6 billion and $1.3 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the Program by the financial institution and are reflected in Accounts payable in the
12


Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. As of September 30, 2023, we have been informed by the financial institution that $378 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.

Note 5 – Mergers, Acquisitions and Divestitures

A.Investment in CarepathRx Health Systems Solutions
In July 2023, Evernorth Health, Inc. acquired a minority interest in CarepathRx Health Systems Solutions ("CHSS"), a provider of integrated hospital pharmacy solutions to support patients across their complete health care journey. This equity method investment is reported in Other assets and the Company's share of CHSS' net income or loss is reported in Fees and other revenues. The purchase price has been allocated to the acquired tangible and intangible assets, including customer relationships, trade names, internal-use software and goodwill. Amortization of the acquired intangibles is included in Fees and other revenues. The Company's share of CHSS' net loss and amortization of acquired intangibles was immaterial for the three months ended September 30, 2023.

The Company guaranteed $125 million of CHSS' credit facilities through July 2026. The fair value of the guarantee is reflected in other liabilities and is not material. The acquisition also includes separate put and call options to increase our ownership which become exercisable annually beginning as early as April 2025. The net fair value of the options, determined using a Monte Carlo simulation, are not material and are included in Accrued expenses and other liabilities and Other assets, respectively.

B.Divestiture of International Businesses

In July 2022, the Company completed the sale of its life, accident and supplemental benefits businesses in six countries (Hong Kong, Indonesia, New Zealand, South Korea, Taiwan and Thailand) (the "Chubb transaction") for approximately $5.4 billion in cash and recognized a gain of $1.7 billion pre-tax ($1.4 billion after-tax), which included recognition of previously unrealized capital losses on investments sold and translation loss on foreign currencies. In 2023, we recorded immaterial adjustments to the sales price reflecting resolution of certain contractual matters. In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.
C.Integration and Transaction-related Costs
In the first nine months of 2023 and 2022, the Company incurred net costs related to the Chubb transaction and continued strategic realignment initiatives. In 2022, the Company also incurred net costs primarily related to the sale of the Group Disability and Life business and acquisition of MDLIVE, Inc. These net costs were $13 million pre-tax ($9 million after-tax) for the three months ended and $20 million pre-tax ($15 million after-tax) for the nine months ended September 30, 2023, compared with $24 million pre-tax ($23 million after-tax) for the three months ended and $112 million pre-tax ($86 million after-tax) for the nine months ended September 30, 2022. These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.
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Note 6 – Earnings Per Share

Basic and diluted earnings per share were computed as follows:
Three Months Ended
September 30, 2023September 30, 2022
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution
DilutedBasicEffect of
Dilution
Diluted
Shareholders' net income$1,408 $1,408 $2,757 $2,757 
Shares:
Weighted average294,058 294,058 303,854 303,854 
Common stock equivalents3,073 3,073 3,663 3,663 
Total shares294,058 3,073 297,131 303,854 3,663 307,517 
Earnings per share$4.79 $(0.05)$4.74 $9.07 $(0.10)$8.97 

Nine Months Ended
September 30, 2023September 30, 2022
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution
DilutedBasicEffect of
Dilution
Diluted
Shareholders' net income$4,135 $4,135 $5,511 $5,511 
Shares:
Weighted average294,752 294,752 312,434 312,434 
Common stock equivalents2,911 2,911 3,213 3,213 
Total shares294,752 2,911 297,663 312,434 3,213 315,647 
Earnings per share$14.03 $(0.14)$13.89 $17.64 $(0.18)$17.46 

Amounts reflected above for the three and nine months ended September 30, 2022 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).

The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:
Three Months Ended September 30,Nine Months Ended September 30,
(In millions)2023202220232022
Anti-dilutive options0.9  0.9 1.3 

The Company held approximately 105.7 million shares of common stock in treasury at September 30, 2023, 99.1 million shares as of December 31, 2022 and 91.8 million shares as of September 30, 2022.
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Note 7 – Debt
The outstanding amounts of debt, net of issuance costs, discounts or premiums, and finance leases were as follows:
(In millions)September 30, 2023December 31, 2022
Short-term debt
Commercial paper$1,513 $ 
$17 million, 8.300% Notes due January 2023
 17 
$63 million, 7.650% Notes due March 2023
 63 
$700 million, Floating Rate Notes due July 2023
 700 
$1,000 million, 3.000% Notes due July 2023
 994 
$1,187 million, 3.750% Notes due July 2023
 1,186 
$500 million, 0.613% Notes due March 2024
500  
$1,000 million, 3.500% Notes due June 2024
994  
Other, including finance leases39 33 
Total short-term debt$3,046 $2,993 
Long-term debt
$500 million, 0.613% Notes due March 2024
$ $499 
$1,000 million, 3.500% Notes due June 2024
 990 
$900 million, 3.250% Notes due April 2025 (1)
871