10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2024

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)

Delaware	82-4991898
(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 class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock, Par Value $0.01	CI	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 filer	☒	Accelerated filer	☐
Non-accelerated filer	☐	Smaller 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 April 30, 2024, 284,074,001 shares of the issuer's common stock were outstanding.

THE CIGNA GROUP

TABLE OF CONTENTS

		Page
PART I	FINANCIAL INFORMATION
	Item 1. Financial Statements (Unaudited)	3
	Consolidated Statements of Income	3
	Consolidated Statements of Comprehensive Income	4
	Consolidated Balance Sheets	5
	Consolidated Statements of Changes in Total Equity	6
	Consolidated Statements of Cash Flows	7
	Notes to the Consolidated Financial Statements	8
	Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations	33
	Item 3. Quantitative and Qualitative Disclosures About Market Risk	48
	Item 4. Controls and Procedures	48
PART II	OTHER INFORMATION
	Item 1. Legal Proceedings	50
	Item 1A. Risk Factors	50
	Item 2. Unregistered Sales of Equity Securities and Use of Proceeds	50
	Item 5. Other Information	50
	Item 6. Exhibits	52
SIGNATURE		53

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
	Unaudited
	Three Months Ended March 31,
(In millions, except per share amounts)	2024		2023
Revenues
Pharmacy revenues	$	42,036	$	32,144
Premiums	11,603		11,025
Fees and other revenues	3,326		3,071
Net investment income	290		277
TOTAL REVENUES	57,255		46,517
Benefits and expenses
Pharmacy and other service costs	41,431		31,459
Medical costs and other benefit expenses	9,440		9,046
Selling, general and administrative expenses	3,705		3,538
Amortization of acquired intangible assets	423		459
TOTAL BENEFITS AND EXPENSES	54,999		44,502
Income from operations	2,256		2,015
Interest expense and other	(322)		(358)
Loss on sale of businesses	(19)		—
Net realized investment losses	(1,836)		(56)
Income before income taxes	79		1,601
TOTAL INCOME TAXES	291		295
Net (loss) income	(212)		1,306
Less: Net income attributable to noncontrolling interests	65		39
SHAREHOLDERS' NET (LOSS) INCOME	$	(277)	$	1,267
Shareholders' net (loss) income per share
Basic	$	(0.97)	$	4.28
Diluted	$	(0.97)	$	4.24

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
	Unaudited
	Three Months Ended March 31,
(In millions)	2024		2023
Net (loss) income	$	(212)	$	1,306
Other comprehensive income (loss), net of tax
Net unrealized appreciation on securities and derivatives	121		194
Net long-duration insurance and contractholder liabilities measurement adjustments	(560)		(331)
Net translation (losses) gains on foreign currencies	(26)		16
Postretirement benefits liability adjustment	5		10
Other comprehensive loss, net of tax	(460)		(111)
Total comprehensive (loss) income	(672)		1,195
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests	—		34
Net income attributable to other noncontrolling interests	65		5
Total comprehensive income attributable to noncontrolling interests	65		39
SHAREHOLDERS' COMPREHENSIVE (LOSS) INCOME	$	(737)	$	1,156

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 March 31,		As of December 31,
(In millions)	2024		2023
Assets
Cash and cash equivalents	$	8,439	$	7,822
Investments	1,108		925
Accounts receivable, net	20,563		17,722
Inventories	4,630		5,645
Other current assets	2,263		2,169
Assets of businesses held for sale	6,354		3,068
Total current assets	43,357		37,351
Long-term investments	16,025		17,985
Reinsurance recoverables	4,672		4,835
Property and equipment	3,607		3,695
Goodwill	44,258		44,259
Other intangible assets	30,491		30,863
Other assets	3,293		3,421
Separate account assets	7,416		7,430
Assets of businesses held for sale, non-current	—		2,922
TOTAL ASSETS	$	153,119	$	152,761
Liabilities
Current insurance and contractholder liabilities	$	5,788	$	5,514
Pharmacy and other service costs payable	24,284		19,815
Accounts payable	8,118		8,553
Accrued expenses and other liabilities	8,857		9,955
Short-term debt	1,715		2,775
Liabilities of businesses held for sale	3,215		2,104
Total current liabilities	51,977		48,716
Non-current insurance and contractholder liabilities	10,641		10,904
Deferred tax liabilities, net	7,029		7,173
Other non-current liabilities	3,653		3,441
Long-term debt	31,053		28,155
Separate account liabilities	7,416		7,430
Liabilities of businesses held for sale, non-current	—		591
TOTAL LIABILITIES	111,769		106,410
Contingencies — Note 16
Redeemable noncontrolling interests	—		107
Shareholders' equity
Common stock (1)	4		4
Additional paid-in capital	30,292		30,669
Accumulated other comprehensive loss	(2,324)		(1,864)
Retained earnings	40,978		41,652
Less: Treasury stock, at cost	(27,769)		(24,238)
TOTAL SHAREHOLDERS' EQUITY	41,181		46,223
Other noncontrolling interests	169		21
Total equity	41,350		46,244
Total liabilities and equity	$	153,119	$	152,761

(1)Par value per share, $0.01; shares issued, 402 million as of March 31, 2024 and 400 million as of December 31, 2023; 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 March 31, 2024
(In millions)	Common Stock		Additional Paid-in Capital		Accumulated Other Comprehensive (Loss)		Retained Earnings		Treasury Stock		Shareholders' Equity		Other Non- controlling Interests		Total Equity		Redeemable Noncontrolling Interests
Balance at December 31, 2023	$	4	$	30,669	$	(1,864)	$	41,652	$	(24,238)	$	46,223	$	21	$	46,244	$	107
Effects of issuing stock for employee benefits plans			263						(114)		149				149
Other comprehensive loss					(460)						(460)				(460)		—
Net (loss) income							(277)				(277)		65		(212)		—
Common dividends declared (per share: $1.40)							(397)				(397)				(397)
Repurchase of common stock			(640)						(3,417)		(4,057)				(4,057)
Other transactions impacting noncontrolling interests			—								—		83		83		(107)
Balance at March 31, 2024	$	4	$	30,292	$	(2,324)	$	40,978	$	(27,769)	$	41,181	$	169	$	41,350	$	—
Three Months Ended March 31, 2023
(In millions)	Common Stock		Additional Paid-in Capital		Accumulated Other Comprehensive (Loss)		Retained Earnings		Treasury Stock		Shareholders' Equity		Other Non- controlling Interests		Total Equity		Redeemable Noncontrolling Interests
Balance at December 31, 2022	$	4	$	30,233	$	(1,658)	$	37,940	$	(21,844)	$	44,675	$	13	$	44,688	$	66
Effect of issuing stock for employee benefit plans			99						(104)		(5)				(5)
Other comprehensive loss					(111)						(111)				(111)		—
Net income							1,267				1,267		5		1,272		34
Common dividends declared (per share: $1.23)							(366)				(366)				(366)
Repurchase of common stock			—						(958)		(958)				(958)
Other transactions impacting noncontrolling interests			—								—		(2)		(2)		(22)
Balance at March 31, 2023	$	4	$	30,332	$	(1,769)	$	38,841	$	(22,906)	$	44,502	$	16	$	44,518	$	78

The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements.

6

The Cigna Group

Consolidated Statements of Cash Flows

	Unaudited
	Three Months Ended March 31,
(In millions)	2024		2023
Cash Flows from Operating Activities
Net (loss) income	$	(212)	$	1,306
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	741		749
Realized investment losses, net	1,836		56
Deferred income tax benefit	(102)		(108)
Loss on sale of businesses	19		—
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net	(2,687)		(479)
Inventories	1,015		566
Reinsurance recoverable and Other assets	68		72
Insurance liabilities	532		1,533
Pharmacy and other service costs payable	4,637		539
Accounts payable and Accrued expenses and other liabilities	(1,068)		690
Other, net	61		104
NET CASH PROVIDED BY OPERATING ACTIVITIES	4,840		5,028
Cash Flows from Investing Activities
Proceeds from investments sold:
Debt securities and equity securities	268		196
Investment maturities and repayments:
Debt securities and equity securities	179		257
Commercial mortgage loans	4		4
Other sales, maturities and repayments (primarily short-term and other long-term investments)	272		160
Investments purchased or originated:
Debt securities and equity securities	(180)		(2,794)
Commercial mortgage loans	(32)		—
Other (primarily short-term and other long-term investments)	(594)		(377)
Property and equipment purchases, net	(300)		(408)
Divestitures, net of cash sold	—		22
Other, net	(112)		(43)
NET CASH USED IN INVESTING ACTIVITIES	(495)		(2,983)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds	43		45
Withdrawals and benefit payments from contractholder deposit funds	(65)		(48)
Net change in short-term debt	(364)		(9)
Repayment of long-term debt	(2,210)		(80)
Net proceeds on issuance of long-term debt	4,462		1,491
Repurchase of common stock	(4,022)		(962)
Issuance of common stock	181		30
Common stock dividend paid	(401)		(368)
Other, net	(153)		(136)
NET CASH USED IN FINANCING ACTIVITIES	(2,529)		(37)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash	(9)		5
Net increase in cash, cash equivalents and restricted cash	1,807		2,013
Cash, cash equivalents and restricted cash January 1,	8,337		5,976
Cash, cash equivalents and restricted cash, March 31, (1)	10,144		7,989
Cash and cash equivalents reclassified to assets of businesses held for sale	(1,660)		—
Cash, cash equivalents and restricted cash March 31, per Consolidated Balance Sheets (1)	$	8,484	$	7,989
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds	$	110	$	77
Interest paid	$	336	$	322

(1)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.

7

THE CIGNA GROUP

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

TABLE OF CONTENTS

Note Number	Footnote	Page
BUSINESS AND CAPITAL STRUCTURE
1	Description of Business	9
2	Summary of Significant Accounting Policies	9
3	Accounts Receivable, Net	10
4	Supplier Finance Program	10
5	Assets and Liabilities of Businesses Held for Sale	11
6	Earnings Per Share	11
7	Debt	12
8	Common and Preferred Stock	14
INSURANCE INFORMATION
9	Insurance and Contractholder Liabilities	15
10	Reinsurance	19
INVESTMENTS
11	Investments	20
12	Fair Value Measurements	23
13	Variable Interest Entities	27
14	Accumulated Other Comprehensive Income (Loss)	27
COMPLIANCE, REGULATION AND CONTINGENCIES
15	Income Taxes	28
16	Contingencies and Other Matters	29
RESULTS DETAILS
17	Segment Information	30

8

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 committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. Powered by our people and our brands, we advance our mission to improve the health and vitality of those we serve.

Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services. The majority of these products and services are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

The Evernorth Health Services reportable segment now presents the Pharmacy Benefit Services and the Specialty and Care Services operating segments, which partner with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.

Pharmacy Benefit Services drives high-quality, cost-effective pharmacy care through various services such as drug claim adjudication, retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and access to our home delivery pharmacy. Specialty and Care Services provides specialty drugs for the treatment of complex and rare diseases, specialty distribution of pharmaceuticals and medical supplies, as well as clinical programs to help our clients drive better whole-person health outcomes through Care Delivery and Management Solutions. The Company's reporting units remain aligned with its operating segments and goodwill was allocated on a relative fair value basis.

The Cigna Healthcare reportable segment includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Healthcare provides medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Stand-Alone Prescription Drug Plans for seniors and individual health insurance plans. International Health provides health care solutions in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC") for approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction"). See Note 5 to the Consolidated Financial Statements for further information.

Other Operations comprises the remainder of our business operations, which includes our continuing business (corporate-owned life insurance ("COLI")) and our run-off and other non-strategic businesses. Our run-off businesses include (i) variable annuity reinsurance 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 which were sold through reinsurance agreements.

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").

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout

9

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 2023 Annual Report on Form 10-K ("2023 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 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 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2024		December 31, 2023
Noninsurance customer receivables	$	9,735	$	8,044
Pharmaceutical manufacturers receivables	9,512		8,169
Insurance customer receivables	2,045		2,359
Other receivables	230		272
Total	$	21,522	$	18,844
Accounts receivable, net classified as assets of businesses held for sale	(959)		(1,122)
Total	$	20,563	$	17,722

These accounts receivable are reported net of our allowances of $4.5 billion as of March 31, 2024 and $3.7 billion as of December 31, 2023. 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 $91 million as of March 31, 2024 and $90 million as of December 31, 2023.

Accounts Receivable Factoring Facility

The Company maintains 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 and began in July 2023 with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.

For the three months ended March 31, 2024, we sold $1.9 billion of accounts receivable under the Facility and factoring fees paid were not material. As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in 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. Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K.

10

As of March 31, 2024 and December 31, 2023, $1.6 billion and $1.5 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 Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. As of March 31, 2024, we have been informed by the financial institution that $327 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 – Assets and Liabilities of Businesses Held for Sale

In January 2024, the Company entered into the HCSC transaction for a total purchase price of approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025.

The assets and liabilities of businesses held for sale were as follows:

(In millions)	March 31, 2024		December 31, 2023
Cash and cash equivalents	$	1,660	$	467
Investments	1,341		1,438
Accounts receivable, net	959		1,122
Other assets, including Goodwill (1)	2,394		2,963
Total assets of businesses held for sale	6,354		5,990
Insurance and contractholder liabilities	2,081		1,636
All other liabilities	1,134		1,059
Total liabilities of businesses held for sale	$	3,215	$	2,695

(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.

Integration and Transaction-related Costs

In 2024, the Company incurred costs related to the HCSC transaction. In 2023, the Company incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). 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. These costs were $37 million pre-tax ($29 million after-tax) for the three months ended March 31, 2024 and $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023.

Note 6 – Earnings Per Share

Basic and diluted earnings per share were computed as follows:

	Three Months Ended
	March 31, 2024						March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net (loss) income	$	(277)			$	(277)	$	1,267			$	1,267
Shares:
Weighted average	286,465				286,465		295,706				295,706
Common stock equivalents			—		—				3,293		3,293
Total shares	286,465		—		286,465		295,706		3,293		298,999
Earnings per share	$	(0.97)	$	—	$	(0.97)	$	4.28	$	(0.04)	$	4.24

Due to the Shareholders' net loss for the three months ended March 31, 2024, 8.2 million outstanding employee stock options, unvested restricted stock grants and units and strategic performance shares were excluded in the computation of diluted earnings per share because their effect was anti-dilutive. For the three months ended March 31, 2023, 0.9 million outstanding employee stock options were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.

The Company held approximately 117.8 million shares of common stock in treasury at March 31, 2024, 107.4 million shares as of December 31, 2023 and 102.7 million shares as of March 31, 2023.

11

The increase in Treasury stock as of March 31, 2024 and the reduction in weighted average shares outstanding for the three months ended March 31, 2024 was driven in part by 7.6 million shares of our common stock repurchased in February 2024 under the accelerated share repurchase agreements (the "ASR agreements"). Additionally, we expect final settlement of the ASR agreements to occur in the second quarter of 2024. See Note 8 for additional information.

Note 7 – Debt

The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:

(In millions)	March 31, 2024		December 31, 2023
Short-term debt
Commercial paper	$	884	$	1,237
$500 million, 0.613% Notes due March 2024	—		500
$790 million, 3.500% Notes due June 2024 (1)	789		996
Other, including finance leases	42		42
Total short-term debt	$	1,715	$	2,775
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)	881		882
$1,216 million, 4.125% Notes due November 2025 (1)	1,214		2,197
$1,284 million, 4.500% Notes due February 2026 (1)	1,285		1,502
$550 million, 1.250% Notes due March 2026 (1)	549		798
$700 million, 5.685% Notes due March 2026	698		698
$1,500 million, 3.400% Notes due March 2027	1,454		1,450
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	598		597
$3,800 million, 4.375% Notes due October 2028	3,788		3,787
$1,000 million, 5.000% Notes due May 2029	994		—
$1,400 million, 2.400% Notes due March 2030 (1)	1,394		1,493
$1,500 million, 2.375% Notes due March 2031 (2)	1,382		1,397
$750 million, 5.125% Notes due May 2031	745		—
$45 million, 8.080% Step Down Notes due January 2033 (3)	45		45
$800 million, 5.400% Notes due March 2033	794		794
$1,250 million, 5.250% Notes due February 2034	1,242		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,193		2,193
$750 million, 3.200% Notes due March 2040	744		744
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	487		487
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,467		1,467
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,970		2,970
$1,250 million, 3.400% Notes due March 2050	1,237		1,237
$1,500 million, 3.400% Notes due March 2051	1,479		1,479
$1,500 million, 5.600% Notes due February 2054	1,482		—
Other, including finance leases	59		66
Total long-term debt	$	31,053	$	28,155

(1)Included in the February 2024 debt tender offers discussed below.

(2)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.

(3)Interest rate step down to 8.080% effective January 15, 2023.

Short-term and Credit Facilities Debt

Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including providing liquidity support if necessary under our commercial paper program discussed below. As of March 31, 2024, there were no outstanding balances under these revolving credit agreements.

12

In April 2024, The Cigna Group replaced our existing $4.0 billion five-year revolving credit and letter of credit agreement maturing in April 2028 and a $1.0 billion 364-day revolving credit agreement maturing in April 2024 by entering into the following revolving credit agreements (the "Credit Agreements"):

•a $5.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2029 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $5.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.

•a $1.5 billion 364-day revolving credit agreement that will mature in April 2025. The Company can borrow up to $1.5 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.

The increase in the aggregate size of our revolving credit agreements from $5.0 billion to $6.5 billion will provide enhanced liquidity to support the continued growth of our business.

Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $1.5 billion across both facilities for a maximum total commitment of $8.0 billion. The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the two facilities is diversified among 22 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of March 31, 2024. Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60% subject to certain exceptions upon the consummation of an acquisition.

Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The weighted average interest rate of our commercial paper was 5.54% at March 31, 2024.

Long-term debt

Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$1,000 million (1)	May 15, 2029	5.000%	$995 million
$750 million (2)	May 15, 2031	5.125%	$746 million
$1,250 million (3)	February 15, 2034	5.250%	$1,244 million
$1,500 million (4)	February 15, 2054	5.600%	$1,485 million

(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.

(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.

(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.

(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.

In the first quarter of 2024, the Company completed the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes that were tendered to the Company pursuant to cash tender offers.

Interest Expense

Interest expense on long-term and short-term debt was $369 million for the three months ended March 31, 2024 and $345 million for the three months ended March 31, 2023.

13

Debt Covenants

The Company was in compliance with its debt covenants as of March 31, 2024.

Note 8 – Common and Preferred Stock

Dividends

In the first quarter of 2024, The Cigna Group declared quarterly cash dividends of $1.40 per share of the Company's common stock. In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock.

The following table provides details of the Company's dividend payments:

Record Date	Payment Date	Amount per Share	Total Amount Paid (in millions)
2024
March 6, 2024	March 21, 2024	$1.40	$401
2023
March 8, 2023	March 23, 2023	$1.23	$368

On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 2024. The Company currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of The Cigna Group and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board may deem relevant.

Accelerated Share Repurchase Agreements

In February 2024, as part of our share repurchase program, we entered into separate accelerated share repurchase agreements with Deutsche Bank AG and Bank of America, N.A. (collectively, the "Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024, representing $2.6 billion of the total remitted. The final number of shares to be received under the ASR agreements will be determined based on the daily volume-weighted average share price ("VWAP") of our common stock over the term of the agreements, less a discount and subject to adjustments pursuant to the terms and conditions of the ASR agreements.

We recorded the payment to the Counterparties as a reduction to Total shareholders' equity, consisting of a $2.6 billion increase in Treasury stock, which reflects the value of the initial 7.6 million shares received, and a $640 million decrease in Additional paid-in capital, which reflects the value of the stock hold-back by the Counterparties pending final settlement of the ASR agreements. The $640 million recorded in Additional paid-in capital will be reclassified to Treasury stock upon settlement of the ASR agreements in the second quarter of 2024. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted earnings per share.

14

Note 9 – Insurance and Contractholder Liabilities

A.Account Balances – Insurance and Contractholder Liabilities

The Company's insurance and contractholder liabilities were comprised of the following:

	March 31, 2024						December 31, 2023						March 31, 2023
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	5,786	$	77	$	5,863	$	5,017	$	75	$	5,092	$	4,959
Other Operations	99		161		260		99		154		253		272
Future policy benefits
Cigna Healthcare	92		515		607		97		518		615		601
Other Operations	163		3,297		3,460		163		3,375		3,538		3,631
Contractholder deposit funds
Cigna Healthcare	11		130		141		12		133		145		163
Other Operations	365		6,087		6,452		362		6,178		6,540		6,670
Market risk benefits	26		865		891		37		966		1,003		1,220
Unearned premiums	815		21		836		846		22		868		1,440
Total	7,357		11,153		18,510		6,633		11,421		18,054
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)	(1,569)		(512)		(2,081)		(1,119)		(517)		(1,636)
Total insurance and contractholder liabilities	$	5,788	$	10,641	$	16,429	$	5,514	$	10,904	$	16,418	$	18,956

(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.

Insurance and contractholder liabilities expected to be paid within one year are classified as current.

B.Unpaid Claims and Claim Expenses – Cigna Healthcare

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

The total of incurred but not reported liabilities plus expected development on reported claims and reported claims in process was $5.4 billion at March 31, 2024 and $4.6 billion at March 31, 2023. This increase was primarily due to claim submission and payment process disruptions related to a third-party cyber incident.

15

Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Beginning balance	$	5,092	$	4,176
Less: Reinsurance and other amounts recoverable	236		221
Beginning balance, net	4,856		3,955
Incurred costs related to:
Current year	9,452		9,041
Prior years	(226)		(144)
Total incurred	9,226		8,897
Paid costs related to:
Current year	5,072		5,316
Prior years	3,352		2,795
Total paid	8,424		8,111
Ending balance, net	5,658		4,741
Add: Reinsurance and other amounts recoverable	205		218
Ending balance	$	5,863	$	4,959

(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.

Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance.

Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:

	Three Months Ended March 31,
	2024				2023
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	76	0.2	%	$	1	—	%
Medical cost trend	150		0.4		143		0.5
Total favorable variance	$	226	0.6	%	$	144	0.5	%

(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.

Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions.

C.Future Policy Benefits

Cigna Healthcare

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	2.56	%	2.59	%
Current discount rate	5.11	%	5.29	%
Weighted average duration	7.8 years		8.1 years

16

The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses. The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Present value of expected net premiums
Beginning balance	$	9,233	$	8,557
Reversal of effect of beginning of period discount rate assumptions	1,154		1,537
Issuances and lapses	446		306
Net premiums collected	(350)		(326)
Interest and other (2)	73		56
Ending balance at original discount rate	10,556		10,130
Effect of end of period discount rate assumptions	(1,309)		(1,312)
Ending balance (3)	$	9,247	$	8,818
Present value of expected policy benefits
Beginning balance	$	9,633	$	8,945
Reversal of effect of discount rate assumptions	1,220		1,611
Issuances and lapses	457		307
Benefit payments	(362)		(326)
Interest and other (2)	71		58
Ending balance at original discount rate	11,019		10,595
Effect of discount rate assumptions	(1,381)		(1,378)
Ending balance (4)	$	9,638	$	9,217
Liability for future policy benefits	$	391	$	399
Other (5)	216		202
Total liability for future policy benefits (6)(7)	$	607	$	601

(1)Includes future policy benefits amounts classified as liabilities of businesses held for sale.

(2)Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.

(3)As of March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.

(4)As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 billion, respectively.

(5)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.

(6)$72 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

(7)Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

Other Operations

The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	5.64	%	5.64	%
Current discount rate	5.16	%	4.95	%
Weighted average duration	11.3 years		11.7 years

Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations' traditional insurance contracts, which are in run-off, have no premium remaining to be collected; therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.

Future policy benefits for Other Operations includes deferred profit liability of $379 million as of March 31, 2024 and $392 million as of March 31, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of March 31, 2024 and $3.2 billion as

17

of each of December 31, 2023, March 31, 2023, and December 31, 2022. The change in future policy benefits reserves year-to-date was primarily driven by benefit payments, as well as changes in the current discount rate. Undiscounted expected future policy benefits were $4.4 billion as of March 31, 2024 and $4.6 billion as of March 31, 2023. As of both March 31, 2024 and March 31, 2023, $1.0 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

D.Contractholder Deposit Funds

Contractholder deposit fund liabilities within Other Operations were $6.5 billion as of March 31, 2024 and December 31, 2023 and $6.7 billion as of March 31, 2023 and December 31, 2022. Approximately 38% of the balance is reinsured externally. Activity in these liabilities is presented net of reinsurance in the Consolidated Statements of Cash Flows. The net year-to-date decrease in contractholder deposit fund liabilities generally relates to withdrawals and benefit payments from contractholder deposit funds, partially offset by deposits and interest credited to contractholder deposit funds.

As of March 31, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.33%, $3.0 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2023 were 3.25%, $3.2 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of March 31, 2024 and the $4.1 billion liability as of March 31, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.2 billion represented contracts with policies at the guarantee. At both of these same period ends, $1.2 billion was 50-150 basis points ("bps") above the guarantee and the remaining $1.6 billion as of March 31, 2024 and $1.7 billion as of March 31, 2023 represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. More than 90% of these contracts have actual cash values of at least 110% of the guaranteed cash value.

E.Market Risk Benefits

Liabilities for market risk benefits consist of variable annuity reinsurance contracts in Other Operations. These liabilities arise under annuities and riders to annuities written by ceding companies that guarantee the benefit received at death and, for a subset of policies, also provide contractholders the option, within 30 days of a policy anniversary after the appropriate waiting period, to elect minimum income payments. The Company's capital market risk exposure on variable annuity reinsurance contracts arises when the reinsured guaranteed minimum benefit exceeds the contractholder's account value in the related underlying mutual funds at the time the insurance benefit is payable under the respective contract. The Company receives and pays premium periodically based on the terms of the reinsurance agreements.

Market risk benefits activity was as follows:

	Three Months Ended March 31,
(Dollars in millions)	2024		2023
Balance, beginning of year	$	1,003	$	1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,085		1,379
Changes due to expected run-off	(3)		(6)
Changes due to capital markets versus expected	(113)		(41)
Changes due to policyholder behavior versus expected	(14)		6
Assumption changes	—		(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	955		1,305
Nonperformance risk (own credit risk), end of period	(64)		(85)
Balance, end of period	$	891	$	1,220
Reinsured market risk benefit, end of period	$	951	$	1,301

The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.

(Dollars in millions, excludes impact of reinsurance ceded)	March 31, 2024		March 31, 2023
Net amount at risk	$	1,441	$	2,183
Average attained age of contractholders (weighted by exposure)	77.7 years		75.4 years

18

Note 10 – Reinsurance

The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.

A.Reinsurance Recoverables

The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.

The Company's reinsurance recoverables as of March 31, 2024 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:

(In millions)	Fair value of collateral contractually required to meet or exceed carrying value of recoverable		Collateral provisions exist that may mitigate risk of credit loss (1)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (2)	$	—	$	—	$	85	$	85
BBB- to BBB+ equivalent current credit ratings (2)	—		—		60		60
Not rated	145		7		188		340
Total recoverables related to ongoing operations	145		7		333		485
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,619		—		2,619
Empower Annuity Insurance Company	—		—		128		128
Prudential Insurance Company of America	351		—		—		351
Life Insurance Company of North America	—		334		—		334
Other	167		23		14		204
Not rated	—		6		4		10
Total recoverables related to acquisition, disposition or run-off activities	518		2,982		146		3,646
Total reinsurance recoverables before market risk benefits	$	663	$	2,989	$	479	$	4,131
Allowance for uncollectible reinsurance							(35)
Market risk benefits							951
Total reinsurance recoverables (3)							$	5,047

(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.

(2)Certified by an NRSRO.

(3)Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 million of reinsurance recoverables classified as assets of businesses held for sale.

Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.

B.Effective Exit of Variable Annuity Reinsurance Business

The Company entered into an agreement with Berkshire to effectively exit the variable annuity reinsurance business via a reinsurance transaction in 2013. Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 9 to the Consolidated Financial Statements. Berkshire reinsured 100% of the Company's future cash flows in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall

19

limit with approximately $3.1 billion remaining at March 31, 2024. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)	March 31, 2024		December 31, 2023		Collateral and Other Terms at March 31, 2024
Berkshire	$	777	$	873	100% were secured by assets in a trust.
Sun Life Assurance Company of Canada	79		92
Liberty Re (Bermuda) Ltd.	91		104		100% were secured by assets in a trust.
SCOR SE	27		31		75% were secured by a letter of credit.
Market risk benefits (2)	$	974	$	1,100

(1)All reinsurers are rated A- equivalent and higher by an NRSRO.

(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three months ended March 31, 2024 and March 31, 2023.

Note 11 – Investments

The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 to the Consolidated Financial Statements for information about the valuation of the Company's investment portfolio. Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the Company's investments by category and current or long-term classification:

	March 31, 2024						December 31, 2023
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	604	$	8,876	$	9,480	$	590	$	9,265	$	9,855
Equity securities	18		1,553		1,571		31		3,331		3,362
Commercial mortgage loans	197		1,365		1,562		182		1,351		1,533
Policy loans	—		1,186		1,186		—		1,211		1,211
Other long-term investments	—		4,301		4,301		—		4,181		4,181
Short-term investments	374		—		374		206		—		206
Total	$	1,193	$	17,281	$	18,474	$	1,009	$	19,339	$	20,348
Investments classified as assets of businesses held for sale (1)	(85)		(1,256)		(1,341)		(84)		(1,354)		(1,438)
Investments per Consolidated Balance Sheets	$	1,108	$	16,025	$	17,133	$	925	$	17,985	$	18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

20

A.Investment Portfolio

Debt Securities

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	633	$	619
Due after one year through five years	3,768		3,587
Due after five years through ten years	3,144		2,921
Due after ten years	2,186		2,000
Mortgage and other asset-backed securities	389		353
Total	$	10,120	$	9,480

Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties.

Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:

(In millions)	Amortized Cost		Allowance for Credit Loss		Unrealized Appreciation		Unrealized Depreciation		Fair Value
March 31, 2024
Federal government and agency	$	289	$	—	$	21	$	(10)	$	300
State and local government	37		—		2		(1)		38
Foreign government	354		—		8		(14)		348
Corporate	9,051		(50)		122		(682)		8,441
Mortgage and other asset-backed	389		—		—		(36)		353
Total	$	10,120	$	(50)	$	153	$	(743)	$	9,480
December 31, 2023
Federal government and agency	$	251	$	—	$	24	$	(8)	$	267
State and local government	37		—		2		(1)		38
Foreign government	355		—		10		(13)		352
Corporate	9,338		(33)		158		(630)		8,833
Mortgage and other asset-backed	398		—		1		(34)		365
Total	$	10,379	$	(33)	$	195	$	(686)	$	9,855

Review of declines in fair value. Management reviews debt securities in an unrealized loss position to determine whether a credit loss allowance is needed based on criteria that include:

•severity of decline;

•financial health and specific prospects of the issuer; and

•changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

21

The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.

	March 31, 2024							December 31, 2023
(Dollars in millions)	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues
One year or less
Investment grade	$	562	$	576	$	(14)	232	$	330	$	338	$	(8)	142
Below investment grade	133		137		(4)		253	161		170		(9)		135
More than one year
Investment grade	5,284		5,946		(662)		1,561	5,441		6,036		(595)		1,590
Below investment grade	598		661		(63)		367	701		775		(74)		486
Total	$	6,577	$	7,320	$	(743)	2,413	$	6,633	$	7,319	$	(686)	2,353

Equity Securities

The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:

	March 31, 2024				December 31, 2023
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	647	$	39	$	656	$	51
Equity securities with no readily determinable fair value	3,281		1,532		3,248		3,311
Total	$	3,928	$	1,571	$	3,904	$	3,362

We are a minority owner in VillageMD, a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in equity securities with no readily determinable fair value in the above table. As of March 31, 2024, we determined our investment in VillageMD was impaired and wrote down the carrying value to an estimated fair value of $0.9 billion, resulting in a $1.8 billion loss recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 90% of our investments in equity securities are in the health care sector.

Commercial Mortgage Loans

Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties.

The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:

(Dollars in millions)	March 31, 2024					December 31, 2023
Loan-to-Value Ratio	Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio		Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio
Below 60%	$	810	2.12			$	802	2.13
60% to 79%	594		1.75			574		1.77
80% to 100%	158		0.63			157		0.65
Total	$	1,562	1.81	64	%	$	1,533	1.82	64	%

22

Other Long-Term Investments

Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments:

	Carrying Value as of
(In millions)	March 31, 2024		December 31, 2023
Real estate investments	$	1,696	$	1,606
Securities partnerships	2,423		2,400
Other	182		175
Total	$	4,301	$	4,181

B.Derivative Financial Instruments

The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt.

As of March 31, 2024, there have been no material changes to the Company's derivative financial instruments. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

C.Realized Investment Gains and Losses

Net realized investment losses, before income taxes were $1,836 million for the three months ended March 31, 2024 and $56 million for the three months ended March 31, 2023. This increase was primarily driven by the impairment of equity securities in 2024. These amounts exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders.

Note 12 – Fair Value Measurements

The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.

Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.

The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).

23

For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.

A.Financial Assets and Financial Liabilities Carried at Fair Value

The following table provides information about the Company's financial assets and liabilities carried at fair value. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 9E to the Consolidated Financial Statements. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:

(In millions)	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency	$	165	$	130	$	135	$	137	$	—	$	—	$	300	$	267
State and local government	—		—		38		38		—		—		38		38
Foreign government	—		—		348		352		—		—		348		352
Corporate	—		—		8,072		8,432		369		401		8,441		8,833
Mortgage and other asset-backed	—		—		300		319		53		46		353		365
Total debt securities	165		130		8,893		9,278		422		447		9,480		9,855
Equity securities (1)	2		4		37		47		—		—		39		51
Short-term investments	—		—		374		206		—		—		374		206
Derivative assets	—		—		147		131		—		1		147		132
Financial liabilities at fair value
Derivative liabilities	$	—	$	—	$	4	$	4	$	—	$	—	$	4	$	4

(1)Excludes certain equity securities that have no readily determinable fair value.

Level 3 Financial Assets and Financial Liabilities

Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. Additionally, as discussed in Note 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.

24

Quantitative Information about Unobservable Inputs

The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.

The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.

	Fair Value as of					Unobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)	March 31, 2024		December 31, 2023		Unobservable Input March 31, 2024	March 31, 2024		December 31, 2023
Debt securities
Corporate	$	369	$	401	Liquidity	55 - 1230 (280)	bps	70 - 1235 (310)	bps
Mortgage and other asset-backed securities	53		46		Liquidity	110 - 605 (280)	bps	95 - 640 (310)	bps
Total Level 3 debt securities	$	422	$	447

An increase in liquidity spread adjustments would result in a lower fair value measurement, while a decrease would result in a higher fair value measurement.

Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value

The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.

	Three Months Ended March 31,
(In millions)	2024		2023
Debt and Equity Securities
Beginning balance	$	447	$	447
(Losses) gains included in Shareholders' net (loss) income	(21)		1
(Losses) gains included in Other comprehensive loss	(3)		5
Purchases, sales and settlements
Purchases	—		4
Settlements	(14)		(9)
Total purchases, sales and settlements	(14)		(5)
Transfers into/(out of) Level 3
Transfers into Level 3	16		39
Transfers out of Level 3	(3)		(16)
Total transfers into/(out of) Level 3	13		23
Ending balance	$	422	$	471
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date	$	(21)	$	1
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	(4)	$	5

Total gains and losses included in Shareholders' net (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income.

Gains and losses included in Other comprehensive loss, net of tax in the tables above are reflected in Net unrealized appreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2024 and 2023 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. See discussion under Quantitative Information about Unobservable Inputs above for more information.

25

Separate Accounts

The investment income and fair value gains and losses of Separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. The separate account activity for the three months ended March 31, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments.

Fair values of Separate account assets were as follows:

	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
(In millions)	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Guaranteed separate accounts (See Note 16)	$	230	$	226	$	339	$	352	$	—	$	—	$	569	$	578
Non-guaranteed separate accounts (1)	158		158		5,794		5,797		229		217		6,181		6,172
Subtotal	$	388	$	384	$	6,133	$	6,149	$	229	$	217	6,750		6,750
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													666		680
Total													$	7,416	$	7,430

(1)Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.

Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three months ended March 31, 2024 or 2023.

Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments:

	Fair Value as of				Unfunded Commitment as of March 31, 2024		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2024		December 31, 2023
Securities partnerships	$	412	$	419	$	252	Not applicable	Not applicable
Real estate funds	251		258		—		Quarterly	30 - 90 days
Hedge funds	3		3		—		Up to annually, varying by fund	30 - 90 days
Total	$	666	$	680	$	252

As of March 31, 2024, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception.

B.Assets and Liabilities Measured at Fair Value under Certain Conditions

Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.

For the three months ended March 31, 2024, our equity investment in VillageMD was written down to an estimated fair value of $0.9 billion resulting in an investment loss of $1.8 billion recorded in Net realized investment losses in the Company's Consolidated Statements of Income. For the three months ended March 31, 2023, impairments recognized requiring these assets to be measured at fair value were not material. Observable price changes for other equity securities with no readily determinable fair value were not material for the three months ended March 31, 2024 and March 31, 2023.

26

C.Fair Value Disclosures for Financial Instruments Not Carried at Fair Value

The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:

	Classification in Fair Value Hierarchy	March 31, 2024				December 31, 2023
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,451	$	1,562	$	1,430	$	1,533
Long-term debt, including current maturities, excluding finance leases	Level 2	$	29,806	$	31,783	$	28,033	$	29,585

Note 13 – Variable Interest Entities

We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined that it was not a primary beneficiary in any material variable interest entity as of March 31, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure.

Note 14 – Accumulated Other Comprehensive Income (Loss)

Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive loss, net of tax, for the three months ended March 31, 2024 and March 31, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method.

Changes in the components of AOCI were as follows:

	Three Months Ended March 31,
(In millions)	2024		2023
Securities and Derivatives
Beginning balance	$	171	$	(332)
Unrealized appreciation on securities and derivatives	143		252
Tax (expense)	(39)		(54)
Net unrealized appreciation on securities and derivatives	104		198
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)	22		(5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income	(5)		1
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income	17		(4)
Other comprehensive income, net of tax	121		194
Ending balance	$	292	$	(138)

27

	Three Months Ended March 31,
(In millions)	2024		2023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance	$	(971)	$	(256)
Current period change in discount rate for certain long-duration liabilities	(732)		(411)
Tax benefit	186		101
Net current period change in discount rate for certain long-duration liabilities	(546)		(310)
Current period change in instrument-specific credit risk for market risk benefits	(18)		(26)
Tax benefit	4		5
Net current period change in instrument-specific credit risk for market risk benefits	(14)		(21)
Other comprehensive (loss), net of tax	(560)		(331)
Ending balance	$	(1,531)	$	(587)

	Three Months Ended March 31,
(In millions)	2024		2023
Translation of foreign currencies
Beginning balance	$	(149)	$	(154)
Translation of foreign currencies	(24)		15
Tax (expense) benefit	(2)		1
Other comprehensive (loss) income, net of tax	(26)		16
Ending balance	$	(175)	$	(138)

	Three Months Ended March 31,
(In millions)	2024		2023
Postretirement benefits liability
Beginning balance	$	(915)	$	(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)	8		13
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income	(3)		(3)
Other comprehensive income, net of tax	5		10
Ending balance	$	(910)	$	(906)

	Three Months Ended March 31,
(In millions)	2024		2023
Total Accumulated other comprehensive loss
Beginning balance	$	(1,864)	$	(1,658)
Shareholders' other comprehensive (loss), net of tax	(460)		(111)
Ending balance	$	(2,324)	$	(1,769)

Note 15 – Income Taxes

Income Tax Expense

The effective tax rate for the three months ended March 31, 2024 increased due to a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution. The 368.4% effective tax rate for the three months ended March 31, 2024 was higher than the 18.4% rate for the three months ended March 31, 2023.

As of March 31, 2024, we had approximately $664 million in deferred tax assets ("DTAs") associated with the impairment of equity securities, as well as unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $427 million, which drove the higher effective tax rate, was established in the three months ended March 31, 2024, almost entirely related to the impairment of equity securities. For the remainder of the DTAs, we have determined that a valuation allowance is not currently required based on the Company's ability to carry back losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any additional valuation allowance.

28

Note 16 – Contingencies and Other Matters

The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business.

A.Financial Guarantees: Retiree and Life Insurance Benefits

The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of March 31, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $410 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of March 31, 2024. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.

The Company does not expect that these financial guarantees will have a material effect on the Company's consolidated results of operations, liquidity or financial condition.

B.Certain Other Guarantees

The Company had indemnification obligations as of March 31, 2024 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with laws or regulations or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a stated dollar amount or a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no recorded liabilities for these indemnification obligations as of March 31, 2024.

C.Guaranty Fund Assessments

The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.

There were no material charges or credits resulting from existing or new guaranty fund assessments for the three months ended March 31, 2024.

D.Legal and Regulatory Matters

The Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator's filing of a complaint under court seal, and other legal matters arising, for the most part, in the ordinary course of managing a global health services business. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions.

Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company's accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in this ongoing litigation matter or any future claims or litigation.

29

Litigation Matters

Express Scripts Litigation with Elevance. In March 2016, Elevance filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Elevance also requested that the court enter declaratory judgment that Express Scripts is required to provide Elevance competitive benchmark pricing, that Elevance can terminate the agreement and that Express Scripts is required to provide Elevance with post-termination services at competitive benchmark pricing for one year following any termination by Elevance. Elevance claimed it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Elevance and $150 million damages for service issues ("Elevance's Allegations"). On April 19, 2016, in response to Elevance's complaint, Express Scripts filed its answer denying Elevance's Allegations in their entirety and asserting affirmative defenses and counterclaims against Elevance. The court subsequently granted Elevance's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Elevance completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. On March 31, 2022, the court granted summary judgment in favor of Express Scripts on all of Elevance's pricing claims for damages totaling $14.8 billion and on most of Elevance's claims relating to service issues. Elevance's only remaining service claims relate to the review or processing of prior authorizations, with alleged damages over $100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retains the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retains the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance filed its opening appellate brief on April 24, 2024.

Note 17 – Segment Information

See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments.

The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income (loss) from operations as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets, and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.

The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.

The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

30

The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:

	Three Months Ended March 31,
	2024				2023
(In millions)	Pre-tax		After-tax		Pre-tax		After-tax
Integration and transaction-related costs  (Selling, general and administrative expenses)	$	37	$	29	$	1	$	1
Loss (gain) on sale of businesses	19		(43)		—		—
Deferred tax expenses, net  (Income taxes, less amount attributable to noncontrolling interests)	—		17		—		—
Total impact from special items	$	56	$	3	$	1	$	1

Summarized segment financial information was as follows:

(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2024
Revenues from external customers	$	44,886	$	12,012	$	66	$	1	$	56,965
Intersegment revenues	1,281		1,124		25		(2,430)
Net investment income	59		149		75		7		290
Total revenues	46,226		13,285		166		(2,422)		57,255
Net realized investment results from certain equity method investments	—		(8)		—		—		(8)
Adjusted revenues	$	46,226	$	13,277	$	166	$	(2,422)	$	57,247
(Loss) income before income taxes	$	(436)	$	943	$	18	$	(446)	$	79
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(77)		—		—		—		(77)
Net realized investment losses (1)	1,456		372		—		—		1,828
Amortization of acquired intangible assets	417		6		—		—		423
Special items
Integration and transaction-related costs	—		—		—		37		37
Loss on sale of businesses	—		19		—		—		19
Pre-tax adjusted income (loss) from operations	$	1,360	$	1,340	$	18	$	(409)	$	2,309
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2023
Revenues from external customers	$	34,511	$	11,650	$	79	$	—	$	46,240
Intersegment revenues	1,618		963		—		(2,581)
Net investment income	50		143		78		6		277
Total revenues	36,179		12,756		157		(2,575)		46,517
Net realized investment results from certain equity method investments	—		(38)		—		—		(38)
Adjusted revenues	$	36,179	$	12,718	$	157	$	(2,575)	$	46,479
Income (loss) before income taxes	$	918	$	1,077	$	21	$	(415)	$	1,601
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(42)		(1)		—		—		(43)
Net realized investment losses (gains) (1)	—		24		(6)		—		18
Amortization of acquired intangible assets	444		15		—		—		459
Special items
Integration and transaction-related costs	—		—		—		1		1
Pre-tax adjusted income (loss) from operations	$	1,320	$	1,115	$	15	$	(414)	$	2,036

(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

31

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:

	Three Months Ended March 31,
(In millions)	2024		2023
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	24,166	$	15,748
Home delivery and specialty revenues	16,458		16,025
Other revenues	2,546		1,867
Total Evernorth Health Services	43,170		33,640
Total Other Operations	17		—
Intercompany eliminations	(1,151)		(1,496)
Total Pharmacy revenues	42,036		32,144
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured	4,393		4,080
Medicare Advantage	2,287		2,236
Stop loss	1,668		1,503
Individual and Family Plans	1,040		1,208
Other	1,258		1,117
U.S. Healthcare	10,646		10,144
International Health	885		786
Total Cigna Healthcare	11,531		10,930
Other	48		79
Intercompany eliminations	24		16
Total Premiums	11,603		11,025
Services (Fees) (ASC 606)
Evernorth Health Services	2,943		2,499
Cigna Healthcare	1,571		1,606
Other Operations	25		1
Other revenues	90		66
Intercompany eliminations	(1,303)		(1,101)
Total Fees and other revenues	3,326		3,071
Total revenues from external customers	$	56,965	$	46,240

(1)Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.

Financial and performance guarantees. Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $1.9 billion as of March 31, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 15% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 13% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.

32

Item 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

	PAGE
Executive Overview	35
Liquidity and Capital Resources	38
Critical Accounting Estimates	41
Segment Reporting	42
Evernorth Health Services	42
Cigna Healthcare	44
Other Operations	45
Corporate	46
Investment Assets	46

Management's Discussion and Analysis of Financial Condition and Results of Operations ("MD&A") is intended to provide information to assist you in better understanding and evaluating our financial condition as of March 31, 2024, compared with December 31, 2023 and our results of operations for the three months ended March 31, 2024, compared with the same period last year and is intended to help you understand the ongoing trends in our business. We encourage you to read this MD&A in conjunction with our Consolidated Financial Statements included in Part I, Item 1 of this Form 10-Q and our Annual Report on Form 10-K for the year ended December 31, 2023 ("2023 Form 10-K"). In particular, we encourage you to refer to the "Risk Factors" contained in Part I, Item 1A of our 2023 Form 10-K.

Unless otherwise indicated, financial information in this MD&A is presented in accordance with accounting principles generally accepted in the United States of America ("GAAP"). See Note 2 to the Consolidated Financial Statements in our 2023 Form 10-K for additional information regarding the Company's significant accounting policies and see Note 2 to the Consolidated Financial Statements in this Form 10-Q for updates to those policies resulting from adopting new accounting guidance, if any. The preparation of interim consolidated financial statements necessarily relies heavily on estimates. This and certain other factors call for caution in estimating full-year results based on interim results of operations. In some of our financial tables in this MD&A, we present either percentage changes or "N/M" when those changes are so large as to become not meaningful. Changes in percentages are expressed in basis points ("bps").

In this MD&A, our consolidated measures "adjusted income from operations," earnings per share on that same basis and "adjusted revenues" are not determined in accordance with GAAP and should not be viewed as substitutes for the most directly comparable GAAP measures of "shareholders' net income (loss)," "earnings per share" and "total revenues." We also use pre-tax adjusted income (loss) from operations and adjusted revenues to measure the results of our segments.

The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define adjusted income from operations as shareholders' net income (loss) (or income (loss) before income taxes less pre-tax income (loss) attributable to noncontrolling interests for the segment metric) excluding net realized investment results, amortization of acquired intangible assets, and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results. Consolidated adjusted income (loss) from operations is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, shareholders' net income (loss). See the below Financial Highlights section for a reconciliation of consolidated adjusted income from operations to shareholders' net income (loss).

The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business. Adjusted revenues is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, total revenues. See the below Financial Highlights section for a reconciliation of consolidated adjusted revenues to total revenues.

33

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

This report contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are based on The Cigna Group's current expectations and projections about future trends, events and uncertainties. These statements are not historical facts. Forward-looking statements may include, among others, statements concerning future financial or operating performance, including our ability to improve the health and vitality of those we serve; future growth, business strategy, and strategic or operational initiatives; economic, regulatory or competitive environments, particularly with respect to the pace and extent of change in these areas and the impact of developing inflationary and interest rate pressures; financing or capital deployment plans and amounts available for future deployment; our prospects for growth in the coming years; strategic transactions; expectations related to our Medicare Advantage Capitation Rates; and other statements regarding The Cigna Group's future beliefs, expectations, plans, intentions, liquidity, cash flows, financial condition or performance. You may identify forward-looking statements by the use of words such as "believe," "expect," "project," "plan," "intend," "anticipate," "estimate," "predict," "potential," "may," "should," "will" or other words or expressions of similar meaning, although not all forward-looking statements contain such terms.

Forward-looking statements are subject to risks and uncertainties, both known and unknown, that could cause actual results to differ materially from those expressed or implied in forward-looking statements. Such risks and uncertainties include, but are not limited to: our ability to achieve our strategic and operational initiatives; our ability to adapt to changes in an evolving and rapidly changing industry; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition, inflation and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of a potential cyberattack or other privacy or data security incident; risks related to our use of artificial intelligence and machine learning; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; risks related to strategic transactions and realization of the expected benefits of such transactions, as well as integration or separation difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits and investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions, the risk of a recession or other economic downturn and resulting impact on employment metrics, stock market or changes in interest rates and risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; credit risk related to our reinsurers; as well as more specific risks and uncertainties discussed in Part I, Item 1A – Risk Factors in our 2023 Form 10-K, Part II, Item 7 – Management's Discussion and Analysis of Financial Condition and Results of Operations in our 2023 Form 10-K, and as described from time to time in our future reports filed with the Securities and Exchange Commission.

You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. The Cigna Group undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law.

34

EXECUTIVE OVERVIEW

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. For further information on our business and strategy, see Part 1, Item 1, "Business" of our 2023 Form 10-K.

Financial Highlights

See Note 1 to the Consolidated Financial Statements for a description of our segments.

Summarized below are certain key measures of our performance by segment:

Financial highlights by segment
	Three Months Ended March 31,
(Dollars in millions, except per share amounts)	2024		2023		Change
Revenues
Adjusted revenues by segment
Evernorth Health Services	$	46,226	$	36,179	28	%
Cigna Healthcare	13,277		12,718		4
Other Operations	166		157		6
Corporate, net of eliminations	(2,422)		(2,575)		(6)
Adjusted revenues	57,247		46,479		23
Net realized investment results from certain equity method investments	8		38		(79)
Total revenues	$	57,255	$	46,517	23	%
Shareholders' net (loss) income	$	(277)	$	1,267	N/M	%
Adjusted income from operations	$	1,875	$	1,618	16	%
Earnings per share (diluted)
Shareholders' net (loss) income	$	(0.97)	$	4.24	N/M	%
Adjusted income from operations	$	6.47	$	5.41	20	%
Pre-tax adjusted income (loss) from operations by segment
Evernorth Health Services	$	1,360	$	1,320	3	%
Cigna Healthcare	1,340		1,115		20
Other Operations	18		15		20
Corporate, net of eliminations	(409)		(414)		(1)
Consolidated pre-tax adjusted income from operations	2,309		2,036		13
Income attributable to noncontrolling interests	77		43		79
Net realized investment (losses) (1)	(1,828)		(18)		N/M
Amortization of acquired intangible assets	(423)		(459)		(8)
Special items	(56)		(1)		N/M
Income before income taxes	$	79	$	1,601	(95)	%

(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

For further analysis and explanation of each segment's results, see the "Segment Reporting" section of this MD&A.

35

Consolidated Results of Operations (GAAP basis)
	Three Months Ended March 31,
(Dollars in millions)	2024			2023			Change
Pharmacy revenues	$	42,036		$	32,144		31	%
Premiums	11,603			11,025			5
Fees and other revenues	3,326			3,071			8
Net investment income	290			277			5
Total revenues	57,255			46,517			23
Pharmacy and other service costs	41,431			31,459			32
Medical costs and other benefit expenses	9,440			9,046			4
Selling, general and administrative expenses	3,705			3,538			5
Amortization of acquired intangible assets	423			459			(8)
Total benefits and expenses	54,999			44,502			24
Income from operations	2,256			2,015			12
Interest expense and other	(322)			(358)			(10)
(Loss) on sale of businesses	(19)			—			N/M
Net realized investment losses	(1,836)			(56)			N/M
Income before income taxes	79			1,601			(95)
Total income taxes	291			295			(1)
Net (loss) income	(212)			1,306			N/M
Less: Net income attributable to noncontrolling interests	65			39			67
Shareholders' net (loss) income	$	(277)		$	1,267		N/M	%
Consolidated effective tax rate	368.4		%	18.4		%	N/M	bps
Medical customers (in thousands)	19,184			19,473			(1)	%

Reconciliation of Shareholders' Net Income (Loss) (GAAP) to Adjusted Income from Operations
	Three Months Ended March 31,
	2024				2023
(In millions)	Pre-tax		After-tax		Pre-tax		After-tax
Shareholders' net (loss) income			$	(277)			$	1,267
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (1)	$	1,828	1,827		$	18	6
Amortization of acquired intangible assets	423		322		459		344
Special items
Integration and transaction-related costs	37		29		1		1
Loss (gain) on sale of businesses	19		(43)		—		—
Deferred tax expenses, net	—		17		—		—
Total special items	$	56	3		$	1	1
Adjusted income from operations			$	1,875			$	1,618

(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

36

Reconciliation of Shareholders' Net Income (Loss) (GAAP) to Adjusted Income from Operations
	Three Months Ended March 31,
	2024				2023
(Diluted Earnings Per Share)	Pre-tax		After-tax		Pre-tax		After-tax
Shareholders' net (loss) income (1)			$	(0.97)			$	4.24
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (2)	$	6.31	6.31		$	0.06	0.02
Amortization of acquired intangible assets	1.46		1.10		1.54		1.15
Special items
Integration and transaction-related costs	0.12		0.10		—		—
Loss (gain) on sale of businesses	0.07		(0.15)		—		—
Deferred tax expenses, net	—		0.06		—		—
Total special items	$	0.19	0.01		$	—	—
Adjusted income from operations (3)			$	6.47			$	5.41

(1)For the three months ended March 31, 2024, due to the anti-dilutive effect resulting from the Shareholders' net loss for the period, the impact of potentially dilutive securities has been excluded from the calculation of weighted average shares for the calculation of diluted Shareholders’ net loss per share. Weighted average common shares outstanding used to calculate diluted Shareholders’ net loss per share for the three months ended March 31, 2024 were 286,465 thousand.

(2)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

(3)For the three months ended March 31, 2024, due to the adjusted income from operations, the number of weighted average shares used to calculate Adjusted income from operations per share reflects the dilution caused by outstanding stock options, unvested restricted stock grants and units and strategic performance shares. Weighted average common shares outstanding used to calculate Adjusted income from operations per share for the three months ended March 31, 2024 were 289,717 thousand.

Commentary: Three Months Ended March 31, 2024 versus Three Months Ended March 31, 2023

The commentary presented below, and in the segment discussions that follow, compare results for the three months ended March 31, 2024 with results for the three months ended March 31, 2023.

Shareholders' net loss for the three months ended March 31, 2024 was driven by the impairment of equity securities (see Note 11 to the Consolidated Financial Statements for further discussion), offset by adjusted income from operations.

Adjusted income from operations increased 16%, primarily driven by higher earnings in our Cigna Healthcare and Evernorth Health Services segments.

Medical customers decreased 1%, primarily reflecting a decline in fee-based and Individual and Family Plans customers. See the "Segment Reporting - Cigna Healthcare Segment" section of this MD&A for further discussion.

Pharmacy revenues increased 31%, primarily reflecting the onboarding of Centene Corporation ("Centene") at the beginning of 2024. See the "Segment Reporting - Evernorth Health Services Segment" section of this MD&A for further discussion.

Premiums increased 5% reflecting higher premium rates in Cigna Healthcare due to anticipated underlying medical costs and business mix. See the "Segment Reporting - Cigna Healthcare Segment" section of this MD&A for further discussion.

Fees and other revenues increased 8%, primarily reflecting client growth from our continued affordability services within Evernorth Health Services.

Net investment income increased 5%, primarily due to growth in average assets. See the "Investment Assets" section of this MD&A for further discussion.

Pharmacy and other service costs increased 32%, primarily reflecting the onboarding of Centene at the beginning of 2024.

Medical costs and other benefit expenses increased 4%, primarily reflecting medical cost trend in Cigna Healthcare.

Selling, general and administrative expenses increased 5%, primarily driven by planned investments related to the onboarding costs of new clients and continued advancement of our digital capabilities and care solutions in Evernorth Health Services.

Interest expense and other decreased 10%, primarily reflecting lower pension costs.

37

Realized investment results for the three months ended March 31, 2024 primarily reflects the impairment of equity securities. See Note 11 to the Consolidated Financial Statements for further discussion.

The effective tax rate increased substantially driven by a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution.

Developments

Sale of Medicare Advantage and Related Businesses

In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC"), subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025 and provide approximately $3.7 billion in transaction value, which consists primarily of cash. See Note 5 to the Consolidated Financial Statements for further information.

Medicare Advantage Rates

On April 1, 2024, Centers for Medicare and Medicaid Services ("CMS") released the final Calendar Year 2025 Medicare Advantage Program and Part D Payment Policies (the "2025 Final Notice"). The Final Notice reflects no change from the January 31, 2024 advance notice. We do not expect the final rates to have a material impact on our consolidated results of operations in 2025.

LIQUIDITY AND CAPITAL RESOURCES

Liquidity

We maintain liquidity at two levels: the subsidiary level and the parent company level.

Cash requirements at the subsidiary level generally consist of:

•pharmacy, medical costs and other benefit payments;

•expense requirements, primarily for employee compensation and benefits, information technology and facilities costs;

•income taxes; and

•debt service.

Our subsidiaries normally meet their liquidity requirements by:

•maintaining appropriate levels of cash, cash equivalents and short-term investments;

•using cash flows from operating activities;

•matching investment durations to those estimated for the related insurance and contractholder liabilities;

•selling investments; and

•borrowing from affiliates, subject to applicable regulatory limits.

Cash requirements at the parent company level generally consist of:

•debt service;

•payment of declared dividends to shareholders;

•lending to subsidiaries as needed; and

•pension plan funding.

The parent company normally meets its liquidity requirements by:

•maintaining appropriate levels of cash and various types of marketable investments;

•collecting dividends from its subsidiaries;

•using proceeds from issuing debt and common stock; and

•borrowing from its subsidiaries, subject to applicable regulatory limits.

Dividends from our insurance, Health Maintenance Organization ("HMO") and certain foreign subsidiaries are subject to regulatory restrictions. See Note 22 to the Consolidated Financial Statements in our 2023 Form 10-K for additional information regarding these

38

restrictions. Most of the Evernorth Health Services segment operations are not subject to regulatory restrictions regarding dividends and therefore provide significant financial flexibility to The Cigna Group.

With respect to our investment portfolio, we support the liquidity needs of our businesses by managing the duration of assets to be consistent with the duration of liabilities. We manage the portfolio to both optimize returns in the current economic environment and meet our liquidity needs.

Cash flows for the three months ended March 31 were as follows:

	Three Months Ended March 31,
(In millions)	2024		2023
Operating activities	$	4,840	$	5,028
Investing activities	$	(495)	$	(2,983)
Financing activities	$	(2,529)	$	(37)

The following discussion explains variances in the various categories of cash flows for the three months ended March 31, 2024 compared with the same period in 2023.

Operating activities

Cash flows from operating activities consist principally of cash receipts and disbursements for pharmacy revenues and costs, premiums, fees, investment income, taxes, benefit costs and other expenses.

Operating cash flows decreased for the three months ended March 31, 2024 due to the absence of an early CMS payment received in March 2023 and the timing of payments for accrued liabilities. This decrease is partially offset by the favorable net cash flow impacts of onboarding new clients.

Investing activities

The decrease in cash used in investing activities during the three months ended March 31, 2024 was due to lower investments in equity securities.

Financing activities

The Company had higher share repurchases including from the ASR Agreements (described below), partially offset by net debt inflows. These factors resulted in an increase in cash used in financing activities in 2024.

Capital Resources

Our capital resources consist primarily of cash, cash equivalents and investments maintained at regulated subsidiaries required to underwrite insurance risks, cash flows from operating activities, our commercial paper program, credit agreements and the issuance of long-term debt and equity securities. Our businesses generate significant cash flows from operations, some of which is subject to regulatory restrictions relative to the amount and timing of dividend payments to the parent company. Dividends received from U.S. regulated subsidiaries were $0.6 billion for the three months ended March 31, 2024 and $0.3 billion for the three months ended March 31, 2023. Non-regulated subsidiaries also generate significant cash flows from operating activities, which is typically available immediately to the parent company for general corporate purposes.

We prioritize our use of capital resources to:

•invest in capital expenditures, primarily related to technology to support innovative solutions for our clients and customers, provide the capital necessary to maintain or improve the financial strength ratings of subsidiaries and to repay debt and fund pension obligations if necessary;

•pay dividends to shareholders;

•consider acquisitions and investments that are strategically and economically advantageous; and

•return capital to shareholders through share repurchases.

Funds Available

Commercial Paper Program. The Cigna Group maintains a commercial paper program and may issue short-term, unsecured commercial paper notes privately placed on a discount basis through certain broker-dealers at any time not to exceed an aggregate

39

amount of $5.0 billion. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The commercial paper program had approximately $884 million outstanding at March 31, 2024.

Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including for the purpose of providing liquidity support if necessary under our commercial paper program discussed above.

As of March 31, 2024, The Cigna Group's revolving credit agreements include: a $4.0 billion five-year revolving credit and letter of credit agreement that expires in April 2028; and a $1.0 billion 364-day revolving credit agreement that expires in April 2024.

As of March 31, 2024, we had $5.0 billion of undrawn committed capacity under our revolving credit agreements (these amounts are available for general corporate purposes, including providing liquidity support for our commercial paper program), $4.1 billion of remaining capacity under our commercial paper program and $8.8 billion in cash and short-term investments, approximately $1.4 billion of which was held by the parent company or certain non-regulated subsidiaries.

In April 2024, The Cigna Group replaced our existing revolving credit agreements, discussed above, and entered into the following revolving credit agreements: a $5.0 billion five-year revolving credit and letter of credit agreements that expire in April 2029; and a $1.5 billion 364-day revolving credit agreement that expires in April 2025. The increase in the aggregate size of our revolving credit agreements from $5.0 billion to $6.5 billion will provide enhanced liquidity to support the continued growth of our business.

See Note 7 to the Consolidated Financial Statements for further information on our credit agreements and commercial paper program.

Our debt-to-capitalization ratio was 44.3% at March 31, 2024 and 40.1% at December 31, 2023 primarily reflecting timing of debt issuance, in part due to the Accelerated Share Repurchase ("ASR") agreements.

We actively monitor our debt obligations and engage in issuance or redemption activities as needed in accordance with our capital management strategy.

Subsidiary Borrowings. In addition to the sources of liquidity discussed above, the parent company can borrow an additional $1.6 billion from its subsidiaries without further approvals as of March 31, 2024.

Use of Capital Resources

Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes. The proceeds from this debt were used to complete the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes tendered to the Company pursuant to cash tender offers. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, which may include repayment of indebtedness and repurchases of shares of our common stock.

Capital Expenditures. Capital expenditures for property, equipment and computer software were $0.3 billion in the three months ended March 31, 2024 compared to $0.4 billion in the three months ended March 31, 2023. Anticipated capital expenditures will be funded primarily from operating cash flows.

Dividends. The Cigna Group declared and paid quarterly cash dividends of $1.40 per share of its common stock during the first quarter of 2024, compared to quarterly cash dividends of $1.23 per share during the first quarter of 2023. See Note 8 to the Consolidated Financial Statements for further information on our dividend payments. On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 2024. The Cigna Group currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of the Company and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board may deem relevant.

Share Repurchases. We maintain a share repurchase program authorized by our Board of Directors, under which we may repurchase shares of our common stock from time to time. The timing and actual number of shares repurchased will depend on a variety of factors including price, general business and market conditions and alternate uses of capital. The share repurchase program may be effected through open market purchases in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), including through Rule 10b5-1 trading plans or privately negotiated transactions. The program may be suspended or discontinued at any time.

40

We repurchased 10.1 million shares for approximately $3.4 billion during the three months ended March 31, 2024, compared to 3.2 million shares for approximately $1.0 billion during the three months ended March 31, 2023. During the three months ended March 31, 2024, $640 million was also paid related to the ASR stock hold-back which will settle in the second quarter of 2024. See further discussion of ASR below. We expect to repurchase $5.0 billion of common stock in the first half of 2024, which includes shares repurchased under the ASR.

In February 2024, as part of our share repurchase program, we entered into separate ASR agreements ("ASR agreements") with Deutsche Bank AG and Bank of America, N.A. (collectively, the "Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024, representing $2.6 billion of the total remitted. We expect final settlement under the ASR agreements to occur in the second quarter of 2024. See Note 8 to the Consolidated Financial Statements for further information on our ASR agreements.

Other Sources of Funds and Uses of Capital Resources

Divestiture. In January 2024, we entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to HCSC, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025 and provide approximately $3.7 billion in transaction value, which consists primarily of cash. Following the completion of the sale, we anticipate use of the proceeds in alignment with our capital deployment priorities, with the majority allocated to share repurchases.

Risks to Liquidity and Capital Resources

Risks to our liquidity and capital resources outlook include cash projections that may not be realized and the demand for funds could exceed available cash if our ongoing businesses experience unexpected shortfalls in earnings or we experience material adverse effects from one or more risks or uncertainties described more fully in the "Risk Factors" section of our 2023 Form 10-K. Though we believe we have adequate sources of liquidity, significant disruption or volatility in the capital and credit markets could affect our ability to access those markets for additional borrowings or increase costs.

Guarantees and Contractual Obligations

We are contingently liable for various contractual obligations and financial and other guarantees entered into in the ordinary course of business. See Note 16 to the Consolidated Financial Statements for discussion of various guarantees.

Due to the issuance and repurchase of certain senior notes in the three months ended March 31, 2024, we have updated long-term debt obligations as of March 31, 2024 compared to those previously provided in our 2023 Form 10-K. See Note 7 to the Consolidated Financial Statements for discussion of these debt activities. There have been no material changes to other information presented in our guarantees and contractual obligations set forth in our 2023 Form 10-K.

On balance sheet:

•Long-term debt

◦Total scheduled payments on long-term debt are $50.3 billion through February 2054, which include scheduled interest payments and maturities of long-term debt.

◦We expect $1.8 billion of long-term debt payments (including scheduled interest payments) to be paid for the remainder of 2024.

CRITICAL ACCOUNTING ESTIMATES

The preparation of Consolidated Financial Statements in accordance with GAAP requires management to make estimates and assumptions that affect reported amounts and related disclosures in the Consolidated Financial Statements. Management considers an accounting estimate to be critical if:

•it requires assumptions to be made that were uncertain at the time the estimate was made; and

•changes in the estimate or different estimates that could have been selected could have a material effect on our consolidated results of operations or financial condition.

Management has discussed how critical accounting estimates are developed and selected with the Audit Committee of our Board of Directors and the Audit Committee has reviewed the disclosures presented in our 2023 Form 10-K. We regularly evaluate items that may impact critical accounting estimates.

41

Our most critical accounting estimates, as well as the effect of hypothetical changes in material assumptions used to develop each estimate, are described in our 2023 Form 10-K. As of March 31, 2024, there were no significant changes to the critical accounting estimates from what was reported in our 2023 Form 10-K.

SEGMENT REPORTING

The following section of this MD&A discusses the results of each of our segments.

See Note 1 to the Consolidated Financial Statements for further description of our segments.

In segment discussions, we present "adjusted revenues" and "pre-tax adjusted income (loss) from operations," defined as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Ratios presented in this segment discussion exclude the same items as adjusted revenues and pre-tax adjusted income (loss) from operations. See Note 17 to the Consolidated Financial Statements for additional discussion of these metrics and a reconciliation of income (loss) before income taxes to pre-tax adjusted income (loss) from operations, as well as a reconciliation of Total revenues to adjusted revenues. Note 17 to the Consolidated Financial Statements also explains that segment revenues include both external revenues and sales between segments that are eliminated in Corporate.

In these segment discussions, we also present "pre-tax adjusted margin," defined as pre-tax adjusted income (loss) from operations divided by adjusted revenues.

Evernorth Health Services Segment

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, within our Pharmacy Benefit Services and Specialty and Care Services operating segments. See Note 1 to our Consolidated Financial Statements for further discussion of these two operating segments. As described in the introduction to Segment Reporting, Evernorth Health Services' performance is measured using adjusted revenues and pre-tax adjusted income (loss) from operations.

The key factors that impact Evernorth Health Services' Pharmacy Benefit Services and Specialty and Care Services revenues and income from operations are volume, mix of claims, price, contract affordability services, specialty distribution customer growth and client growth. These key factors are discussed further below. Certain of the key factors impact both operating segments as services are offered through an integrated client contract. See Note 2 to the Consolidated Financial Statements included in our 2023 Form 10-K for additional information on revenue and cost recognition policies for this segment.

Pharmacy Benefit Services and Specialty and Care Services key factors:

•Pharmacy claim volume relates to processing prescription claims filled by retail pharmacies in our network and from dispensing prescription claims from our home delivery and specialty pharmacies and other claims. As our clients' prescriptions claim volumes increase or decrease, our results correspondingly increase or decrease.

•The mix of claims generally considers the type of drug and distribution method used for dispensing and fulfilling. In addition to the types of drugs, the mix of generic claims also impacts our results. Generally, a higher mix of generic drugs reduces revenues, as generic drugs are typically priced lower than the branded drugs they replace. However, as ingredient cost paid to pharmacies on generic drugs is incrementally lower than the price charged to our clients, a higher mix of generic drugs generally has a favorable impact on our income from operations.

•Pharmaceutical manufacturer inflation also impacts our pricing because most of our contracts provide that we bill clients and pay pharmacies based on a generally recognized price index for pharmaceuticals. Therefore, the rate of inflation for prescription drugs and our efforts to manage this inflation for our clients continues to be a significant driver of our revenues and cost of revenues in the current environment.

•Our client contract pricing is impacted by our ongoing ability to negotiate favorable contracts for pharmacy network, pharmaceutical and wholesaler purchasing and manufacturer rebates on our clients' behalf. Through these affordability services, we seek to improve the effectiveness of our integrated solutions for the benefit of our clients by continuously innovating, improving affordability and implementing drug purchasing contract initiatives.

Specialty and Care Services key factors:

•Customer growth and higher volume in our specialty distribution services where we deliver pharmaceuticals and medical supplies directly to health care providers, clinics and hospitals, primarily to physicians who regularly order costly specialty

42

pharmaceuticals. This business provides competitive pricing on pharmaceuticals and medical supplies and leverages our distribution platform to improve our results.

•Client growth in our Care Delivery and Management Solutions, through our virtual care, in-home care, physical primary care, benefits management, and behavioral health services, as we expand our businesses and build upon our cross-enterprise leverage.

In this MD&A, we present revenues and gross profit, as well as adjusted revenues, adjusted gross profit and pre-tax adjusted income from operations, consistent with our segment reporting metrics, which exclude special items.

Results of Operations

Financial Summary
	Three Months Ended March 31,
(Dollars in millions)	2024			2023			Change
Total revenues	$	46,226		$	36,179			28	%
Adjusted revenues (1)	$	46,226		$	36,179			28	%
Pharmacy and other service costs	$	43,838		$	33,973			29	%
Gross profit (2)	$	2,388		$	2,206			8	%
Adjusted gross profit (1),(2)	$	2,388		$	2,206			8	%
Pre-tax adjusted income from operations	$	1,360		$	1,320			3	%
Pre-tax adjusted margin	2.9		%	3.6		%		(70)	bps
Adjusted expense ratio (3)	2.1		%	2.3		%		(20)	bps

(1)Total revenues and gross profit were equal to adjusted revenues and adjusted gross profit as there were no special items in the periods presented.

(2)Gross profit and adjusted gross profit are calculated as total revenues or adjusted revenues less pharmacy and other service costs.

(3)Adjusted expense ratio is calculated as selling, general and administrative expenses as a percentage of adjusted revenues.

In this selected financial information, we present adjusted revenues and pre-tax income from operations by our two operating segments, Pharmacy Benefit Services and Specialty and Care Services.

Selected Financial Information
	Three Months Ended March 31,				Change
(Dollars and adjusted scripts in millions)	2024		2023
Total adjusted revenues
Pharmacy Benefit Services	$	26,095	$	18,209	43	%
Specialty and Care Services	20,072		17,920		12
Net investment income	59		50		18
Total adjusted revenues	$	46,226	$	36,179	28	%
Pre-tax adjusted income from operations
Pharmacy Benefit Services	$	513	$	512	—	%
Specialty and Care Services	788		758		4
Net investment income	59		50		18
Total pre-tax adjusted income from operations	$	1,360	$	1,320	3	%
Pharmacy claim volume (1)	513		381		35	%

(1)Non-specialty network prescriptions filled through 90-day programs and home delivery prescriptions are counted as three claims. All other network and specialty prescriptions are counted as one claim.

Three Months Ended March 31, 2024 versus Three Months Ended March 31, 2023

Adjusted revenues increased 28%, reflecting higher claims volume, primarily due to our collaboration with Centene beginning January 1, 2024; inflation on branded drugs; and higher volume from Specialty and Care Services, primarily our Curascript Specialty Distribution business. This increase was partially offset by claims mix.

Gross profit increased 8%, reflecting continued affordability improvements and growth in Specialty and Care Services businesses.

43

Pre-tax adjusted income from operations increased 3%, reflecting growth in Specialty and Care Services businesses and continued affordability improvements. This increase was partially offset by planned investments related to the onboarding costs of new clients, including Centene, and continued advancement of our digital capabilities and care solutions.

The adjusted expense ratio decreased 20 bps, reflecting higher revenues, partially offset by planned investments related to the onboarding costs of new clients, including Centene, and continued advancement of our digital capabilities and care solutions.

Cigna Healthcare Segment

Cigna Healthcare includes the U.S. Healthcare and International Health businesses, which provide comprehensive medical and coordinated solutions to clients and customers. As described in the introduction to Segment Reporting, performance of the Cigna Healthcare segment is measured using adjusted revenues and pre-tax adjusted income from operations. Key factors affecting results for this segment include:

•customer growth;

•revenue growth;

•percentage of Medicare Advantage customers in plans eligible for quality bonus payments;

•medical costs as a percentage of premiums (medical care ratio or "MCR") for our insured businesses; and

•selling, general and administrative expenses as a percentage of adjusted revenues (adjusted expense ratio).

In January 2024, we entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation, subject to applicable regulatory approvals and other customary closing conditions. See Note 5 to the Consolidated Financial Statements for further information.

Results of Operations

Financial Summary
	Three Months Ended March 31,						Change
(Dollars in millions)	2024			2023
Adjusted revenues	$	13,277		$	12,718		4	%
Pre-tax adjusted income from operations	$	1,340		$	1,115		20	%
Pre-tax adjusted margin	10.1		%	8.8		%	130	bps
Medical care ratio	79.9		%	81.3		%	(140)	bps
Adjusted expense ratio	20.5		%	21.4		%	(90)	bps

Three Months Ended March 31, 2024 versus Three Months Ended March 31, 2023

Adjusted revenues increased 4%, primarily reflecting higher premium rates due to expected increases in underlying medical costs and business mix.

Pre-tax adjusted income from operations increased 20%, primarily due to a lower medical care ratio and a lower adjusted expense ratio.

The medical care ratio decreased 140 bps, primarily due to a lower U.S. Healthcare medical care ratio, reflecting effective pricing execution and affordability initiatives, as well as business mix within the Individual and Family Plans business.

The adjusted expense ratio decreased 90 bps, primarily due to revenue growth outpacing volume-related expenses as well as efficiencies from disciplined expense management.

44

Medical Customers

A medical customer is defined as a person meeting any one of the following criteria:

•is covered under a medical insurance policy, managed care arrangement or administrative services agreement issued by us;

•has access to our provider network for covered services under their medical plan; or

•has medical claims that are administered by us.

Cigna Healthcare Medical Customers
	As of March 31,
(In thousands)	2024	2023	Change
U.S. Healthcare	3,947	4,055	(3)
International Health (1)	1,189	1,150	3
Insured	5,136	5,205	(1)	%
U.S. Healthcare	13,615	13,814	(1)
International Health (1)	433	454	(5)
Administrative services only	14,048	14,268	(2)
Total	19,184	19,473	(1)	%

(1)International Health excludes medical customers served by less than 100% owned subsidiaries, as well as certain customers served by our third-party administrator.

Total medical customers decreased 1%, primarily driven by a decrease in National Accounts, Individual and Family Plans and Middle Market segment customers, partially offset by customer growth within the Select market segment.

See Part I, Item 1 of our 2023 Form 10-K for definitions of Cigna Healthcare's market segments. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Medical Customer information presented as of March 31, 2023 has been restated to conform to the new operating segment presentation.

Unpaid Claims and Claim Expenses

	As of March 31,		As of December 31,
(In millions)	2024		2023		Change
Unpaid claims and claim expenses – Cigna Healthcare	$	5,863	$	5,092	15	%

Our unpaid claims and claim expenses liability increased 15%, driven by claim submission and payment process disruptions related to a third-party cyber incident and stop loss seasonality, partially offset by a decrease in Individual and Family Plans customers.

Other Operations

Other Operations includes corporate owned life insurance ("COLI"), the Company's run-off operations and other non-strategic businesses. See Note 1 to the Consolidated Financial Statements for additional information regarding these operations. As described in the introduction of Segment Reporting, performance of Other Operations is measured using adjusted revenues and pre-tax adjusted income from operations.

Results of Operations

Financial Summary	Three Months Ended March 31,						Change
(Dollars in millions)	2024			2023
Adjusted revenues	$	166		$	157		6	%
Pre-tax adjusted income from operations	$	18		$	15		20	%
Pre-tax adjusted margin	10.8		%	9.6		%	120	bps

45

Corporate

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.

Financial Summary	Three Months Ended March 31,				Change
(In millions)	2024		2023
Pre-tax adjusted loss from operations	$	(409)	$	(414)	(1)	%

Three Months Ended March 31, 2024 versus Three Months Ended March 31, 2023

Pre-tax adjusted loss from operations decreased primarily due to lower pension costs.

INVESTMENT ASSETS

The following table presents our investment asset portfolio excluding separate account assets. Additional information regarding our investment assets is included in Notes 11, 12, 13 and 14 to the Consolidated Financial Statements.

(In millions)	March 31, 2024		December 31, 2023
Debt securities	$	9,480	$	9,855
Equity securities	1,571		3,362
Commercial mortgage loans	1,562		1,533
Policy loans	1,186		1,211
Other long-term investments	4,301		4,181
Short-term investments	374		206
Total	$	18,474	$	20,348
Investments classified as assets of businesses held for sale (1)	(1,341)		(1,438)
Investments per Consolidated Balance Sheets	$	17,133	$	18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024 and December 31, 2023. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

Investment Outlook

Although portfolio impact has been limited to date, we continue to actively monitor geopolitical events and economic conditions and their potential impact on the investment portfolio, including expectations for a longer period of higher inflation and interest rates, the potential for a recession, and ongoing conflict in Europe and the Middle East. Future realized and unrealized investment results will be driven largely by market conditions and these future conditions are not reasonably predictable. We believe that the vast majority of our investments will continue to perform under their contractual terms. We manage the portfolio for long-term economics and therefore we expect to hold a significant portion of these assets for the long term. The following discussion addresses the strategies and risks associated with our various classes of investment assets. Although future declines in investment fair values remain possible due to interest rate movements and credit deterioration due to both investment-specific uncertainties and global economic uncertainties as discussed below, we do not expect these losses to have a material unfavorable effect on our financial condition or liquidity.

Debt Securities

Investments in debt securities include publicly traded and privately placed bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor. These investments are classified as available for sale and are carried at fair value in our Consolidated Balance Sheets. Additional information regarding valuation methodologies, key inputs and controls is included in Note 12 to the Consolidated Financial Statements.

46

The following table reflects our portfolio of debt securities by type of issuer:

(In millions)	March 31, 2024		December 31, 2023
Federal government and agency	$	300	$	267
State and local government	38		38
Foreign government	348		352
Corporate	8,441		8,833
Mortgage and other asset-backed	353		365
Total	$	9,480	$	9,855

The carrying value of our debt securities portfolio decreased during the three months ended March 31, 2024, reflecting net sales activity and a valuation decrease due to rising market interest rates. Our portfolio remains in a net unrealized depreciation position due to generally increasing interest rates over the last several quarters. More detailed information about debt securities by type of issuer, maturity dates and net unrealized position is included in Note 11 to the Consolidated Financial Statements.

As of March 31, 2024, $8.1 billion, or 85%, of the debt securities in our investment portfolio were investment grade (Baa and above, or equivalent) and the remaining $1.4 billion were below investment grade. The majority of the bonds that are below investment grade were rated at the higher end of the non-investment grade spectrum. These quality characteristics have not materially changed since the prior year and remain consistent with our investment strategy.

Debt securities include private placement assets of $3.9 billion. These investments are generally less marketable than publicly traded bonds; however, yields on these investments tend to be higher than yields on publicly traded bonds with comparable credit risk. We perform a credit analysis of each issuer and require financial and other covenants that allow us to monitor issuers for deteriorating financial strength and pursue remedial actions, if warranted.

Investments in debt securities are diversified by issuer, geography and industry. On an aggregate basis, the debt securities portfolio continues to perform according to original expectations, which includes a long-term economic investment strategy. Primary risks facing many of the issuers in our portfolio include on-going geopolitical events and economic conditions, including expectations for a longer period of higher inflation and interest rates. To date, most issuers have been successful in managing these issues without a meaningful change in credit quality. We continue to monitor the economic environment and its effect on our portfolio and consider the impact of various factors in determining the allowance for credit losses on debt securities, which is discussed in Note 11 to the Consolidated Financial Statements.

Commercial Mortgage Loans

As of March 31, 2024, our $1.6 billion commercial mortgage loan portfolio consisted of approximately 50 fixed-rate loans, diversified by property type, location and borrower. These loans are carried in our Consolidated Balance Sheets at their unpaid principal balance, net of an allowance for expected credit losses. As a result of increasing market interest rates since the majority of these loans were made, the carrying value exceeds the market value of these loans as of March 31, 2024. See Note 12 to the Consolidated Financial Statements for further details. Given the quality and diversity of the underlying real estate, positive debt service coverage and significant borrower cash invested in the property generally ranging between 30 and 40%, we remain confident that the vast majority of borrowers will continue to perform as expected under their contract terms. For further discussion of the results and changes in key loan metrics, see Note 11 to the Consolidated Financial Statements.

Loans are secured by high quality commercial properties, located in strong institutional markets and are generally made at approximately 60% of the property's value at origination of the loan. Property value, debt service coverage, quality, building tenancy and stability of cash flows are all important financial underwriting considerations. We hold no direct residential mortgage loans and do not originate or service securitized mortgage loans.

We assess the credit quality of our commercial mortgage loan portfolio annually, generally in the second quarter by reviewing each holding's most recent financial statements, rent rolls, budgets and relevant market reports. The review performed in the second quarter of 2023 confirmed ongoing strong overall credit quality in line with the previous year's results. See Note 11 to the Consolidated Financial Statements for further information regarding our key credit quality indicators for commercial mortgage loans.

Office sector fundamentals have been and continue to be weak and values are experiencing stress due to multiple headwinds: expanded work from home flexibility, shorter term leases, elevated tenant improvement allowances and corporate migration to lower cost states. Additionally, the current macroeconomic headwinds are impacting capital markets and reducing investor appetite for capital intensive assets (e.g., offices and regional shopping malls). Our commercial mortgage loan portfolio has no exposure to

47

regional shopping malls and less than 30% exposure to office properties. Although future losses remain possible due to further credit deterioration, we do not expect these losses to have a material unfavorable effect on our financial condition or liquidity.

Other Long-term Investments

Other long-term investments of $4.3 billion as of March 31, 2024 included investments in securities limited partnerships and real estate limited partnerships, direct investments in real estate joint ventures and other deposit activity that is required to support various insurance and health services businesses. Accounting policies for these investments are discussed in Note 11 to the Consolidated Financial Statements. These limited partnership entities typically invest in mezzanine debt or equity of privately-held companies and equity real estate. Given our subordinate position in the capital structure of these underlying entities, we assume a higher level of risk for higher expected returns. To mitigate risk, these investments are diversified across approximately 200 separate partnerships and 100 general partners who manage one or more of these partnerships. Also, the underlying investments are diversified by industry sector or property type and geographic region. No single partnership investment exceeded 4% of our securities and real estate limited partnership portfolio.

Income from our limited partnership investments is generally reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments. We expect continued volatility in private equity and real estate fund performance going forward as fair market valuations are adjusted to reflect market and portfolio transactions. Less than 4% of our other long-term investments are exposed to real estate in the office sector.

We participate in an insurance joint venture in China with a 50% ownership interest. We account for this joint venture under the equity method of accounting. Following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023, changes in discount rates have resulted in accumulated other comprehensive losses and a corresponding decline in the investment reported in our Consolidated Balance Sheets. Our 50% share of the investment portfolio supporting the joint venture's liabilities is approximately $12.7 billion as of March 31, 2024. These investments were comprised of approximately 75% debt securities, including government and corporate debt diversified by issuer, industry and geography; 15% equities, including mutual funds, equity securities and private equity partnerships; and 10% long-term deposits and policy loans. We continuously review the joint venture's investment strategy and its execution. There were no investments with a material unrealized loss as of March 31, 2024.

MARKET RISK

Financial Instruments

Our assets and liabilities include financial instruments subject to the risk of potential losses from adverse changes in market rates and prices. Our primary market risk exposures are interest rate risk and equity price risk. We encourage you to read this in conjunction with "Market Risk – Financial Instruments" included in the MD&A section of our 2023 Form 10-K.

As of March 31, 2024, there was an increase in our interest rate risk due to an increase in the fair value of our long-term debt since December 31, 2023. In the event of a 100 basis point increase in interest rates, the fair value of the Company's long-term debt would decrease approximately $2.0 billion at March 31, 2024 compared to approximately $1.8 billion at December 31, 2023.

As of March 31, 2024, there was a decline in our equity price risk exposure due to the impairment of equity securities. If the market price for all equity securities declined by 10%, the fair value of the Company's equity securities would decrease by approximately $0.2 billion as of March 31, 2024, compared to approximately $0.3 billion at December 31, 2023. See Note 11 to the Consolidated Financial Statements for more information regarding the impairment in equity securities.

Item 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

Information responsive to this item is contained under the caption "Market Risk" in Item 2 above, Management's Discussion and Analysis of Financial Condition and Results of Operations and is incorporated herein by reference.

Item 4. CONTROLS AND PROCEDURES

Based on an evaluation of the effectiveness of The Cigna Group's disclosure controls and procedures conducted under the supervision and with the participation of The Cigna Group's management (including The Cigna Group's Chief Executive Officer and Chief Financial Officer), The Cigna Group's Chief Executive Officer and Chief Financial Officer concluded that, as of the end of the period covered by this report, The Cigna Group's disclosure controls and procedures are effective to ensure that information required to be disclosed by The Cigna Group in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the Securities and Exchange Commission's rules and forms and is accumulated and

48

communicated to The Cigna Group's management (including The Cigna Group's Chief Executive Officer and Chief Financial Officer) as appropriate to allow timely decisions regarding required disclosure.

Change in Internal Control over Financial Reporting

There have been no changes in our internal control over financial reporting during the quarter ended March 31, 2024 that have materially affected, or are reasonably likely to materially affect, The Cigna Group's internal control over financial reporting.

49

Part II. OTHER INFORMATION

Item 1. LEGAL PROCEEDINGS

The information contained under "Legal and Regulatory Matters" in Note 16 to the Consolidated Financial Statements is incorporated herein by reference.

Item 1A. RISK FACTORS

For information regarding factors that could affect the Company's results of operations, financial condition and liquidity, see the risk factors discussed in Part I, Item 1A. "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 2023.

Item 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

Issuer Purchases of Equity Securities

The following table provides information about The Cigna Group's share repurchase activity for the quarter ended March 31, 2024:

Period	Total # of shares purchased (1)	Average price paid per share (1)		Total # of shares purchased as part of publicly announced program (2)	Approximate dollar value of shares that may yet be purchased as part of publicly announced program (3) (in millions)
January 1-31, 2024	253,716	$	303.91	253,748	$	11,229
February 1-29, 2024	9,832,165	(1)		9,828,122	$	7,284
March 1-31, 2024	336,493	$	336.19	—	$	7,284
Total	10,422,374	(1)		10,081,870	N/A

(1)Includes shares tendered by employees under the Company's equity compensation plans as follows: 1) payment of taxes on vesting of restricted stock (grants and units) and strategic performance shares and 2) payment of the exercise price and taxes for certain stock options exercised. Employees tendered (32) shares in January, 4,043 shares in February and 336,493 shares in March 2024. Amount purchased in February 2024 also reflects the initial delivery of 7.6 million shares pursuant to the ASR agreements discussed in the Liquidity and Capital Resources section of Management's Discussion and Analysis of Financial Condition and Results of Operations in Part 1, Item 2. Such repurchase was made pursuant to the Company's share repurchase program described in note (2) below. Average price paid per share for the period February 1-29, 2024 for shares not purchased pursuant to the accelerated share repurchase agreements ("ASR agreements") was $331.54.

(2)Additionally, the Company maintains a share repurchase program authorized by the Board. Under this program, the Company may repurchase shares from time to time, depending on market conditions and alternate uses of capital. The timing and actual number of shares repurchased will depend on a variety of factors, including price, general business and market conditions and alternate uses of capital. The share repurchase program may be effected through Rule 10b5-1 plans, open market purchases, each in compliance with Rule 10b-18 under the Exchange Act, or privately negotiated transactions. The program may be suspended or discontinued at any time and does not have an expiration date. In February 2024, as part of our share repurchase program, we entered into ASR agreements to repurchase $3.2 billion of common stock in aggregate. In February 2024, we received an initial delivery of approximately 7.6 million shares of our common stock representing $2.6 billion of the total $3.2 billion remitted. Remaining share repurchase authority was $7.3 billion as of May 1, 2024. See Note 8 to the Consolidated Financial Statements for further information on our ASR agreements.

(3)Approximate dollar value of shares is as of the last date of the applicable month and excludes the impact of excise tax.

Item 5. OTHER INFORMATION

Rule 10b5-1 Plan Elections

During the quarter ended March 31, 2024, the following 10b5-1 director and officer trading plan arrangement changes occurred:

1.On February 9, 2024, Noelle Eder, Executive Vice President, Global Chief Information Officer of The Cigna Group, adopted a 10b5-1 plan. Ms. Eder's plan provides for the sale of up to 8,179 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 6,408 shares of The Cigna Group common stock through February 28, 2025.

2.On February 15, 2024, Brian Evanko, Executive Vice President, Chief Financial Officer of The Cigna Group and President and Chief Executive Officer, Cigna Healthcare, adopted a 10b5-1 plan. Mr. Evanko's plan provides for the exercise of vested stock options and the associated sale of up to 17,924 shares of The Cigna Group common stock through February 10, 2025.

3.On February 16, 2024, Eric Palmer, Executive Vice President, Enterprise Strategy of The Cigna Group and President and Chief Executive Officer, Evernorth Health Services, adopted a 10b5-1 plan. Mr. Palmer's plan provides for the sale of up to 4,993 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 17,530 shares of The Cigna Group common stock through February 10, 2025.

50

4.On March 13, 2024, Elder Granger, Director, adopted a 10b5-1 plan. Mr. Granger's plan provides for the exercise of vested stock options and the associated sale of up to 1,547 shares of The Cigna Group common stock through September 16, 2024.

These trading plans were entered into during an open insider trading window and are intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934 and the Company's policies regarding insider transactions.

51

Item 6. EXHIBITS

INDEX TO EXHIBITS

Number	Description	Method of Filing
3.1	Restated Certificate of Incorporation of The Cigna Group	Filed by the registrant as Exhibit 3.1 to the Quarterly Report on Form 10-Q for the period ended June 30, 2023 and incorporated herein by reference.
3.2	Amended and Restated By-laws of The Cigna Group	Filed by the registrant as Exhibit 3.3 to the Current Report on Form 8-K on February 13, 2023 and incorporated herein by reference.
4.1	Supplemental Indenture No. 7, dated as of February 13, 2024, between The Cigna Group and U.S. Bank Trust Company, National Association, as trustee	Filed by the registrant as Exhibit 4.1 to the Current Report on Form 8-K on February 13, 2024 and incorporated herein by reference.
10.1	Offer Letter for Eric P. Palmer dated January 16, 2024	Filed by the registrant as Exhibit 10.23 to the Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference.
10.2	Offer letter for Brian Evanko dated January 16, 2024	Filed by the registrant as Exhibit 10.26 to the Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference.
31.1	Certification of Chief Executive Officer of The Cigna Group pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934	Filed herewith.
31.2	Certification of Chief Financial Officer of The Cigna Group pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934	Filed herewith.
32.1	Certification of Chief Executive Officer of The Cigna Group pursuant to Rule 13a-14(b) or Rule 15d-14(b) and 18 U.S.C. Section 1350	Furnished herewith.
32.2	Certification of Chief Financial Officer of The Cigna Group pursuant to Rule 13a-14(b) or Rule 15d-14(b) and 18 U.S.C. Section 1350	Furnished herewith.
101	The following materials from The Cigna Group's Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, formatted in Inline XBRL (eXtensible Business Reporting Language): (i) the Consolidated Statements of Income; (ii) the Consolidated Statements of Comprehensive Income; (iii) the Consolidated Balance Sheets; (iv) the Consolidated Statements of Total Equity; (v) the Consolidated Statements of Cash Flows; and (vi) the Notes to the Consolidated Financial Statements	Filed herewith.
104	Cover Page Interactive Data File (formatted in Inline XBRL and contained in Exhibit 101)	Filed herewith.

52

SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

Date: May 2, 2024

THE CIGNA GROUP
	/s/ Brian C. Evanko
	Brian C. Evanko
	Executive Vice President, Chief Financial Officer, The Cigna Group, and President and Chief Executive Officer, Cigna Healthcare
	(Principal Financial Officer and Authorized Signatory)

53

EX-31.1

Exhibit 31.1

CERTIFICATION

I, DAVID M. CORDANI, certify that:

1.I have reviewed this Quarterly Report on Form 10-Qof The Cigna Group;

2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a)designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b)designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d)disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b)any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date:  May 2, 2024	/s/ David M. Cordani
	Chairman and Chief Executive Officer

EX-31.2

Exhibit 31.2

CERTIFICATION

I, BRIAN C. EVANKO, certify that:

1.I have reviewed this Quarterly Report on Form 10-Q of The Cigna Group;

2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a)designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b)designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d)disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b)any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date:  May 2, 2024	/s/ Brian C. Evanko
	Executive Vice President, Chief Financial Officer, The Cigna Group, and President and Chief Executive Officer, Cigna Healthcare

EX-32.1

Exhibit 32.1

Certification of Chief Executive Officer of

The Cigna Group pursuant to 18 U.S.C. Section 1350

I certify that, to the best of my knowledge and belief, the Quarterly Report on Form 10-Q of The Cigna Group for the fiscal period ending March 31, 2024 (the “Report”):

(1)complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2)the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of The Cigna Group.

/s/ David M. Cordani

David M. Cordani

Chairman and Chief Executive Officer

May 2, 2024

EX-32.2

Exhibit 32.2

Certification of Chief Financial Officer of

The Cigna Group pursuant to 18 U.S.C. Section 1350

I certify that, to the best of my knowledge and belief, the Quarterly Report on Form 10-Q of The Cigna Group for the fiscal period ending March 31, 2024 (the “Report”):

(1)complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2)the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of The Cigna Group.

/s/ Brian C. Evanko

Brian C. Evanko

Executive Vice President, Chief Financial Officer, The Cigna Group, and President and Chief Executive Officer, Cigna Healthcare

May 2, 2024

XML

Cover Page - shares	3 Months Ended
	Mar. 31, 2024	Apr. 30, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Entity File Number	001-38769
Entity Registrant Name	The Cigna Group
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-4991898
Entity Address, Address Line One	900 Cottage Grove Road
Entity Address, City or Town	Bloomfield
Entity Address, State or Province	CT
Entity Address, Postal Zip Code	06002
City Area Code	860
Local Phone Number	226-6000
Title of 12(b) Security	Common Stock, Par Value $0.01
Trading Symbol	CI
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		284,074,001
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2024
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Entity Central Index Key	0001739940
Document Period End Date	Mar. 31, 2024

XML

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenues
Premiums	$ 11,603	$ 11,025
Net investment income	290	277
TOTAL REVENUES	57,255	46,517
Benefits and expenses
Pharmacy and other service costs	41,431	31,459
Medical costs and other benefit expenses	9,440	9,046
Selling, general and administrative expenses	3,705	3,538
Amortization of acquired intangible assets	423	459
TOTAL BENEFITS AND EXPENSES	54,999	44,502
Income from operations	2,256	2,015
Interest expense and other	(322)	(358)
Loss on sale of businesses	(19)	0
Net realized investment losses	(1,836)	(56)
Income before income taxes	79	1,601
TOTAL INCOME TAXES	291	295
Net (loss) income	(212)	1,306
Less: Net income attributable to noncontrolling interests	65	39
SHAREHOLDERS' NET (LOSS) INCOME	$ (277)	$ 1,267
Shareholders' net (loss) income per share
Basic (in dollars per share)	$ (0.97)	$ 4.28
Diluted (in dollars per share)	$ (0.97)	$ 4.24
Pharmacy revenues
Revenues
Revenues	$ 42,036	$ 32,144
Fees and other revenues
Revenues
Revenues	$ 3,326	$ 3,071

XML

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ (212)	$ 1,306
Other comprehensive income (loss), net of tax
Net unrealized appreciation on securities and derivatives	121	194
Net long-duration insurance and contractholder liabilities measurement adjustments	(560)	(331)
Net translation (losses) gains on foreign currencies	(26)	16
Postretirement benefits liability adjustment	5	10
Other comprehensive loss, net of tax	(460)	(111)
Total comprehensive (loss) income	(672)	1,195
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests	0	34
Net income attributable to other noncontrolling interests	65	5
Other comprehensive loss attributable to redeemable noncontrolling interests	0	0
Total comprehensive income attributable to noncontrolling interests	65	39
SHAREHOLDERS' COMPREHENSIVE (LOSS) INCOME	$ (737)	$ 1,156

XML

Consolidated Balance Sheets - USD ($) $ in Millions		Mar. 31, 2024	Dec. 31, 2023
Assets
Cash and cash equivalents		$ 8,439	$ 7,822
Investments		1,108	925
Accounts receivable, net		20,563	17,722
Inventories		4,630	5,645
Other current assets		2,263	2,169
Assets of businesses held for sale		6,354	3,068
Total current assets		43,357	37,351
Long-term investments		16,025	17,985
Reinsurance recoverables		4,672	4,835
Property and equipment		3,607	3,695
Goodwill		44,258	44,259
Other intangible assets		30,491	30,863
Other assets		3,293	3,421
Separate account assets		7,416	7,430
Assets of businesses held for sale, non-current		0	2,922
TOTAL ASSETS		153,119	152,761
Liabilities
Current insurance and contractholder liabilities		5,788	5,514
Pharmacy and other service costs payable		24,284	19,815
Accounts payable		8,118	8,553
Accrued expenses and other liabilities		8,857	9,955
Short-term debt		1,715	2,775
Liabilities of businesses held for sale		3,215	2,104
Total current liabilities		51,977	48,716
Non-current insurance and contractholder liabilities		10,641	10,904
Deferred tax liabilities, net		7,029	7,173
Other non-current liabilities		3,653	3,441
Long-term debt		31,053	28,155
Separate account liabilities		7,416	7,430
Liabilities of businesses held for sale, non-current		0	591
TOTAL LIABILITIES		111,769	106,410
Contingencies — Note 16
Redeemable noncontrolling interests		0	107
Shareholders' equity
Common stock	[1]	4	4
Additional paid-in capital		30,292	30,669
Accumulated other comprehensive loss		(2,324)	(1,864)
Retained earnings		40,978	41,652
Less: Treasury stock, at cost		(27,769)	(24,238)
TOTAL SHAREHOLDERS' EQUITY		41,181	46,223
Other noncontrolling interests		169	21
Total equity		41,350	46,244
Total liabilities and equity		$ 153,119	$ 152,761

[1] Par value per share, $0.01; shares issued, 402 million as of March 31, 2024 and 400 million as of December 31, 2023; authorized shares, 600 million.

XML

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	402,000,000	400,000,000
Common stock, shares authorized (in shares)	600,000,000	600,000,000

XML

Consolidated Statements of Changes in Total Equity - USD ($) $ in Millions	Total	Shareholders' Equity	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive (Loss)	Retained Earnings	Treasury Stock	Other Non- controlling Interests
Balance at Dec. 31, 2022	$ 44,688	$ 44,675	$ 4	$ 30,233	$ (1,658)	$ 37,940	$ (21,844)	$ 13
Changes in Total Equity
Effect of issuing stock for employee benefit plans	(5)	(5)		99			(104)
Other comprehensive income (loss)	(111)	(111)			(111)
Net (loss) income	1,272	1,267				1,267		5
Common dividends declared	(366)	(366)				(366)
Stock repurchased	958	958		0			958
Other transactions impacting noncontrolling interests	(2)	0		0				(2)
Balance at Mar. 31, 2023	44,518	44,502	4	30,332	(1,769)	38,841	(22,906)	16
Balance at Dec. 31, 2022	66
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	0
Net income	34
Other transactions impacting noncontrolling interests	(22)
Balance at Mar. 31, 2023	78
Balance at Dec. 31, 2023	46,244	46,223	4	30,669	(1,864)	41,652	(24,238)	21
Changes in Total Equity
Effect of issuing stock for employee benefit plans	149	149		263			(114)
Other comprehensive income (loss)	(460)	(460)			(460)
Net (loss) income	(212)	(277)				(277)		65
Common dividends declared	(397)	(397)				(397)
Stock repurchased	4,057	4,057		640			3,417
Other transactions impacting noncontrolling interests	83	0		0				83
Balance at Mar. 31, 2024	41,350	$ 41,181	$ 4	$ 30,292	$ (2,324)	$ 40,978	$ (27,769)	$ 169
Balance at Dec. 31, 2023	107
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	0
Net income	0
Other transactions impacting noncontrolling interests	(107)
Balance at Mar. 31, 2024	$ 0

XML

Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 1.40	$ 1.23

XML

Consolidated Statements of Cash Flows - USD ($) $ in Millions		3 Months Ended
		Mar. 31, 2024	Mar. 31, 2023
Cash Flows from Operating Activities
Net income		$ (212)	$ 1,306
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization		741	749
Realized investment losses, net		1,836	56
Deferred income tax benefit		(102)	(108)
Loss on sale of businesses		19	0
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net		(2,687)	(479)
Inventories		1,015	566
Reinsurance recoverable and Other assets		68	72
Insurance liabilities		532	1,533
Pharmacy and other service costs payable		4,637	539
Accounts payable and Accrued expenses and other liabilities		(1,068)	690
Other, net		61	104
NET CASH PROVIDED BY OPERATING ACTIVITIES		4,840	5,028
Proceeds from investments sold:
Debt securities and equity securities		268	196
Investment maturities and repayments:
Debt securities and equity securities		179	257
Commercial mortgage loans		4	4
Other sales, maturities and repayments (primarily short-term and other long-term investments)		272	160
Investments purchased or originated:
Debt securities and equity securities		(180)	(2,794)
Commercial mortgage loans		(32)	0
Other (primarily short-term and other long-term investments)		(594)	(377)
Property and equipment purchases, net		(300)	(408)
Divestitures, net of cash sold		0	22
Other, net		(112)	(43)
NET CASH USED IN INVESTING ACTIVITIES		(495)	(2,983)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		43	45
Withdrawals and benefit payments from contractholder deposit funds		(65)	(48)
Net change in short-term debt		(364)	(9)
Repayment of long-term debt		(2,210)	(80)
Net proceeds on issuance of long-term debt		4,462	1,491
Repurchase of common stock		(4,022)	(962)
Issuance of common stock		181	30
Common stock dividend paid		(401)	(368)
Other, net		(153)	(136)
NET CASH USED IN FINANCING ACTIVITIES		(2,529)	(37)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		(9)	5
Net increase in cash, cash equivalents and restricted cash		1,807	2,013
Cash, cash equivalents and restricted cash January 1, including held for sale assets		8,337	5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets	[1]	10,144	7,989
Cash and cash equivalents reclassified to assets of businesses held for sale		(1,660)	0
Cash, cash equivalents and restricted cash and cash equivalents December 31,	[1]	8,484	7,989
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		110	77
Interest paid		$ 336	$ 322

[1] Restricted cash and cash equivalents were reported in other long-term investments.

XML

Description of Business

3 Months Ended

Mar. 31, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Description of Business

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 committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. Powered by our people and our brands, we advance our mission to improve the health and vitality of those we serve.

Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services. The majority of these products and services are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

The Evernorth Health Services reportable segment now presents the Pharmacy Benefit Services and the Specialty and Care Services operating segments, which partner with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.

Pharmacy Benefit Services drives high-quality, cost-effective pharmacy care through various services such as drug claim adjudication, retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and access to our home delivery pharmacy. Specialty and Care Services provides specialty drugs for the treatment of complex and rare diseases, specialty distribution of pharmaceuticals and medical supplies, as well as clinical programs to help our clients drive better whole-person health outcomes through Care Delivery and Management Solutions. The Company's reporting units remain aligned with its operating segments and goodwill was allocated on a relative fair value basis.

The Cigna Healthcare reportable segment includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Healthcare provides medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Stand-Alone Prescription Drug Plans for seniors and individual health insurance plans. International Health provides health care solutions in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC") for approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction"). See Note 5 to the Consolidated Financial Statements for further information.

Other Operations comprises the remainder of our business operations, which includes our continuing business (corporate-owned life insurance ("COLI")) and our run-off and other non-strategic businesses. Our run-off businesses include (i) variable annuity reinsurance 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 which were sold through reinsurance agreements.

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.

XML

Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2024

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

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").

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax 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 2023 Annual Report on Form 10-K ("2023 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 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 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.

XML

Accounts Receivable, Net

3 Months Ended

Mar. 31, 2024

Receivables [Abstract]

Accounts Receivable, Net

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2024		December 31, 2023
Noninsurance customer receivables	$	9,735	$	8,044
Pharmaceutical manufacturers receivables	9,512		8,169
Insurance customer receivables	2,045		2,359
Other receivables	230		272
Total	$	21,522	$	18,844
Accounts receivable, net classified as assets of businesses held for sale	(959)		(1,122)
Total	$	20,563	$	17,722

These accounts receivable are reported net of our allowances of $4.5 billion as of March 31, 2024 and $3.7 billion as of December 31, 2023. 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 $91 million as of March 31, 2024 and $90 million as of December 31, 2023.

Accounts Receivable Factoring Facility

The Company maintains 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 and began in July 2023 with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.

For the three months ended March 31, 2024, we sold $1.9 billion of accounts receivable under the Facility and factoring fees paid were not material. As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.

XML

Supplier Finance Program

3 Months Ended

Mar. 31, 2024

Payables and Accruals [Abstract]

Supplier Finance Program

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. Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K.

As of March 31, 2024 and December 31, 2023, $1.6 billion and $1.5 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 Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. As of March 31, 2024, we have been informed by the financial institution that $327 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.

XML

Assets and Liabilities of Businesses Held for Sale

3 Months Ended

Mar. 31, 2024

Discontinued Operations and Disposal Groups [Abstract]

Assets and Liabilities of Business Held for Sale

Note 5 – Assets and Liabilities of Businesses Held for Sale

In January 2024, the Company entered into the HCSC transaction for a total purchase price of approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025.

The assets and liabilities of businesses held for sale were as follows:

(In millions)	March 31, 2024		December 31, 2023
Cash and cash equivalents	$	1,660	$	467
Investments	1,341		1,438
Accounts receivable, net	959		1,122
Other assets, including Goodwill (1)	2,394		2,963
Total assets of businesses held for sale	6,354		5,990
Insurance and contractholder liabilities	2,081		1,636
All other liabilities	1,134		1,059
Total liabilities of businesses held for sale	$	3,215	$	2,695

(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.

Integration and Transaction-related Costs

In 2024, the Company incurred costs related to the HCSC transaction. In 2023, the Company incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). 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. These costs were $37 million pre-tax ($29 million after-tax) for the three months ended March 31, 2024 and $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023.

XML

Earnings Per Share

3 Months Ended

Mar. 31, 2024

Earnings Per Share [Abstract]

Earnings Per Share

Note 6 – Earnings Per Share

Basic and diluted earnings per share were computed as follows:

	Three Months Ended
	March 31, 2024						March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net (loss) income	$	(277)			$	(277)	$	1,267			$	1,267
Shares:
Weighted average	286,465				286,465		295,706				295,706
Common stock equivalents			—		—				3,293		3,293
Total shares	286,465		—		286,465		295,706		3,293		298,999
Earnings per share	$	(0.97)	$	—	$	(0.97)	$	4.28	$	(0.04)	$	4.24

Due to the Shareholders' net loss for the three months ended March 31, 2024, 8.2 million outstanding employee stock options, unvested restricted stock grants and units and strategic performance shares were excluded in the computation of diluted earnings per share because their effect was anti-dilutive. For the three months ended March 31, 2023, 0.9 million outstanding employee stock options were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.

The Company held approximately 117.8 million shares of common stock in treasury at March 31, 2024, 107.4 million shares as of December 31, 2023 and 102.7 million shares as of March 31, 2023.

The increase in Treasury stock as of March 31, 2024 and the reduction in weighted average shares outstanding for the three months ended March 31, 2024 was driven in part by 7.6 million shares of our common stock repurchased in February 2024 under the accelerated share repurchase agreements (the "ASR agreements"). Additionally, we expect final settlement of the ASR agreements to occur in the second quarter of 2024. See Note 8 for additional information.

XML

Debt

3 Months Ended

Mar. 31, 2024

Debt Disclosure [Abstract]

Debt

Note 7 – Debt

The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:

(In millions)	March 31, 2024		December 31, 2023
Short-term debt
Commercial paper	$	884	$	1,237
$500 million, 0.613% Notes due March 2024	—		500
$790 million, 3.500% Notes due June 2024 (1)	789		996
Other, including finance leases	42		42
Total short-term debt	$	1,715	$	2,775
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)	881		882
$1,216 million, 4.125% Notes due November 2025 (1)	1,214		2,197
$1,284 million, 4.500% Notes due February 2026 (1)	1,285		1,502
$550 million, 1.250% Notes due March 2026 (1)	549		798
$700 million, 5.685% Notes due March 2026	698		698
$1,500 million, 3.400% Notes due March 2027	1,454		1,450
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	598		597
$3,800 million, 4.375% Notes due October 2028	3,788		3,787
$1,000 million, 5.000% Notes due May 2029	994		—
$1,400 million, 2.400% Notes due March 2030 (1)	1,394		1,493
$1,500 million, 2.375% Notes due March 2031 (2)	1,382		1,397
$750 million, 5.125% Notes due May 2031	745		—
$45 million, 8.080% Step Down Notes due January 2033 (3)	45		45
$800 million, 5.400% Notes due March 2033	794		794
$1,250 million, 5.250% Notes due February 2034	1,242		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,193		2,193
$750 million, 3.200% Notes due March 2040	744		744
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	487		487
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,467		1,467
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,970		2,970
$1,250 million, 3.400% Notes due March 2050	1,237		1,237
$1,500 million, 3.400% Notes due March 2051	1,479		1,479
$1,500 million, 5.600% Notes due February 2054	1,482		—
Other, including finance leases	59		66
Total long-term debt	$	31,053	$	28,155

(1)Included in the February 2024 debt tender offers discussed below.

(2)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.

(3)Interest rate step down to 8.080% effective January 15, 2023.

Short-term and Credit Facilities Debt

Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including providing liquidity support if necessary under our commercial paper program discussed below. As of March 31, 2024, there were no outstanding balances under these revolving credit agreements.

In April 2024, The Cigna Group replaced our existing $4.0 billion five-year revolving credit and letter of credit agreement maturing in April 2028 and a $1.0 billion 364-day revolving credit agreement maturing in April 2024 by entering into the following revolving credit agreements (the "Credit Agreements"):

•a $5.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2029 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $5.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.

•a $1.5 billion 364-day revolving credit agreement that will mature in April 2025. The Company can borrow up to $1.5 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.

The increase in the aggregate size of our revolving credit agreements from $5.0 billion to $6.5 billion will provide enhanced liquidity to support the continued growth of our business.

Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $1.5 billion across both facilities for a maximum total commitment of $8.0 billion. The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the two facilities is diversified among 22 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of March 31, 2024. Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60% subject to certain exceptions upon the consummation of an acquisition.

Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The weighted average interest rate of our commercial paper was 5.54% at March 31, 2024.

Long-term debt

Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$1,000 million (1)	May 15, 2029	5.000%	$995 million
$750 million (2)	May 15, 2031	5.125%	$746 million
$1,250 million (3)	February 15, 2034	5.250%	$1,244 million
$1,500 million (4)	February 15, 2054	5.600%	$1,485 million

(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.

(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.

(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.

(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.

In the first quarter of 2024, the Company completed the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes that were tendered to the Company pursuant to cash tender offers.

Interest Expense

Interest expense on long-term and short-term debt was $369 million for the three months ended March 31, 2024 and $345 million for the three months ended March 31, 2023.

Debt Covenants

The Company was in compliance with its debt covenants as of March 31, 2024.

XML

Common and Preferred Stock

3 Months Ended

Mar. 31, 2024

Equity [Abstract]

Common and Preferred Stock

Note 8 – Common and Preferred Stock

Dividends

In the first quarter of 2024, The Cigna Group declared quarterly cash dividends of $1.40 per share of the Company's common stock. In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock.

The following table provides details of the Company's dividend payments:

Record Date	Payment Date	Amount per Share	Total Amount Paid (in millions)
2024
March 6, 2024	March 21, 2024	$1.40	$401
2023
March 8, 2023	March 23, 2023	$1.23	$368

On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 2024. The Company currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of The Cigna Group and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board may deem relevant.

Accelerated Share Repurchase Agreements

In February 2024, as part of our share repurchase program, we entered into separate accelerated share repurchase agreements with Deutsche Bank AG and Bank of America, N.A. (collectively, the "Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024, representing $2.6 billion of the total remitted. The final number of shares to be received under the ASR agreements will be determined based on the daily volume-weighted average share price ("VWAP") of our common stock over the term of the agreements, less a discount and subject to adjustments pursuant to the terms and conditions of the ASR agreements.

We recorded the payment to the Counterparties as a reduction to Total shareholders' equity, consisting of a $2.6 billion increase in Treasury stock, which reflects the value of the initial 7.6 million shares received, and a $640 million decrease in Additional paid-in capital, which reflects the value of the stock hold-back by the Counterparties pending final settlement of the ASR agreements. The $640 million recorded in Additional paid-in capital will be reclassified to Treasury stock upon settlement of the ASR agreements in the second quarter of 2024. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted earnings per share.

XML

Insurance and Contractholder Liabilities

3 Months Ended

Mar. 31, 2024

Insurance Loss Reserves [Abstract]

Insurance and Contractholder Liabilities

Insurance and Contractholder Liabilities

A.Account Balances – Insurance and Contractholder Liabilities

The Company's insurance and contractholder liabilities were comprised of the following:

	March 31, 2024						December 31, 2023						March 31, 2023
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	5,786	$	77	$	5,863	$	5,017	$	75	$	5,092	$	4,959
Other Operations	99		161		260		99		154		253		272
Future policy benefits
Cigna Healthcare	92		515		607		97		518		615		601
Other Operations	163		3,297		3,460		163		3,375		3,538		3,631
Contractholder deposit funds
Cigna Healthcare	11		130		141		12		133		145		163
Other Operations	365		6,087		6,452		362		6,178		6,540		6,670
Market risk benefits	26		865		891		37		966		1,003		1,220
Unearned premiums	815		21		836		846		22		868		1,440
Total	7,357		11,153		18,510		6,633		11,421		18,054
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)	(1,569)		(512)		(2,081)		(1,119)		(517)		(1,636)
Total insurance and contractholder liabilities	$	5,788	$	10,641	$	16,429	$	5,514	$	10,904	$	16,418	$	18,956

(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.

Insurance and contractholder liabilities expected to be paid within one year are classified as current.

Unpaid Claims and Claim Expenses – Cigna Healthcare

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

The total of incurred but not reported liabilities plus expected development on reported claims and reported claims in process was $5.4 billion at March 31, 2024 and $4.6 billion at March 31, 2023. This increase was primarily due to claim submission and payment process disruptions related to a third-party cyber incident.

Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Beginning balance	$	5,092	$	4,176
Less: Reinsurance and other amounts recoverable	236		221
Beginning balance, net	4,856		3,955
Incurred costs related to:
Current year	9,452		9,041
Prior years	(226)		(144)
Total incurred	9,226		8,897
Paid costs related to:
Current year	5,072		5,316
Prior years	3,352		2,795
Total paid	8,424		8,111
Ending balance, net	5,658		4,741
Add: Reinsurance and other amounts recoverable	205		218
Ending balance	$	5,863	$	4,959

(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.

Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance.

Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:

	Three Months Ended March 31,
	2024				2023
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	76	0.2	%	$	1	—	%
Medical cost trend	150		0.4		143		0.5
Total favorable variance	$	226	0.6	%	$	144	0.5	%

(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.

Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions.

Future Policy Benefits

Cigna Healthcare

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	2.56	%	2.59	%
Current discount rate	5.11	%	5.29	%
Weighted average duration	7.8 years		8.1 years

The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses. The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Present value of expected net premiums
Beginning balance	$	9,233	$	8,557
Reversal of effect of beginning of period discount rate assumptions	1,154		1,537
Issuances and lapses	446		306
Net premiums collected	(350)		(326)
Interest and other (2)	73		56
Ending balance at original discount rate	10,556		10,130
Effect of end of period discount rate assumptions	(1,309)		(1,312)
Ending balance (3)	$	9,247	$	8,818
Present value of expected policy benefits
Beginning balance	$	9,633	$	8,945
Reversal of effect of discount rate assumptions	1,220		1,611
Issuances and lapses	457		307
Benefit payments	(362)		(326)
Interest and other (2)	71		58
Ending balance at original discount rate	11,019		10,595
Effect of discount rate assumptions	(1,381)		(1,378)
Ending balance (4)	$	9,638	$	9,217
Liability for future policy benefits	$	391	$	399
Other (5)	216		202
Total liability for future policy benefits (6)(7)	$	607	$	601

(1)Includes future policy benefits amounts classified as liabilities of businesses held for sale.

(2)Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.

(3)As of March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.

(4)As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 billion, respectively.

(5)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.

(6)$72 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

(7)Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

Other Operations

The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	5.64	%	5.64	%
Current discount rate	5.16	%	4.95	%
Weighted average duration	11.3 years		11.7 years

Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations' traditional insurance contracts, which are in run-off, have no premium remaining to be collected; therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.

Future policy benefits for Other Operations includes deferred profit liability of $379 million as of March 31, 2024 and $392 million as of March 31, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of March 31, 2024 and $3.2 billion as

of each of December 31, 2023, March 31, 2023, and December 31, 2022. The change in future policy benefits reserves year-to-date was primarily driven by benefit payments, as well as changes in the current discount rate. Undiscounted expected future policy benefits were $4.4 billion as of March 31, 2024 and $4.6 billion as of March 31, 2023. As of both March 31, 2024 and March 31, 2023, $1.0 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

Contractholder Deposit Funds

Contractholder deposit fund liabilities within Other Operations were $6.5 billion as of March 31, 2024 and December 31, 2023 and $6.7 billion as of March 31, 2023 and December 31, 2022. Approximately 38% of the balance is reinsured externally. Activity in these liabilities is presented net of reinsurance in the Consolidated Statements of Cash Flows. The net year-to-date decrease in contractholder deposit fund liabilities generally relates to withdrawals and benefit payments from contractholder deposit funds, partially offset by deposits and interest credited to contractholder deposit funds.

As of March 31, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.33%, $3.0 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2023 were 3.25%, $3.2 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of March 31, 2024 and the $4.1 billion liability as of March 31, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.2 billion represented contracts with policies at the guarantee. At both of these same period ends, $1.2 billion was 50-150 basis points ("bps") above the guarantee and the remaining $1.6 billion as of March 31, 2024 and $1.7 billion as of March 31, 2023 represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. More than 90% of these contracts have actual cash values of at least 110% of the guaranteed cash value.

Market Risk Benefits

Liabilities for market risk benefits consist of variable annuity reinsurance contracts in Other Operations. These liabilities arise under annuities and riders to annuities written by ceding companies that guarantee the benefit received at death and, for a subset of policies, also provide contractholders the option, within 30 days of a policy anniversary after the appropriate waiting period, to elect minimum income payments. The Company's capital market risk exposure on variable annuity reinsurance contracts arises when the reinsured guaranteed minimum benefit exceeds the contractholder's account value in the related underlying mutual funds at the time the insurance benefit is payable under the respective contract. The Company receives and pays premium periodically based on the terms of the reinsurance agreements.

Market risk benefits activity was as follows:

	Three Months Ended March 31,
(Dollars in millions)	2024		2023
Balance, beginning of year	$	1,003	$	1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,085		1,379
Changes due to expected run-off	(3)		(6)
Changes due to capital markets versus expected	(113)		(41)
Changes due to policyholder behavior versus expected	(14)		6
Assumption changes	—		(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	955		1,305
Nonperformance risk (own credit risk), end of period	(64)		(85)
Balance, end of period	$	891	$	1,220
Reinsured market risk benefit, end of period	$	951	$	1,301

The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.

(Dollars in millions, excludes impact of reinsurance ceded)	March 31, 2024		March 31, 2023
Net amount at risk	$	1,441	$	2,183
Average attained age of contractholders (weighted by exposure)	77.7 years		75.4 years

XML

Reinsurance

3 Months Ended

Mar. 31, 2024

Reinsurance Disclosures [Abstract]

Reinsurance

Note 10 – Reinsurance

The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.

Reinsurance Recoverables

The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.

The Company's reinsurance recoverables as of March 31, 2024 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:

(In millions)	Fair value of collateral contractually required to meet or exceed carrying value of recoverable		Collateral provisions exist that may mitigate risk of credit loss (1)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (2)	$	—	$	—	$	85	$	85
BBB- to BBB+ equivalent current credit ratings (2)	—		—		60		60
Not rated	145		7		188		340
Total recoverables related to ongoing operations	145		7		333		485
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,619		—		2,619
Empower Annuity Insurance Company	—		—		128		128
Prudential Insurance Company of America	351		—		—		351
Life Insurance Company of North America	—		334		—		334
Other	167		23		14		204
Not rated	—		6		4		10
Total recoverables related to acquisition, disposition or run-off activities	518		2,982		146		3,646
Total reinsurance recoverables before market risk benefits	$	663	$	2,989	$	479	$	4,131
Allowance for uncollectible reinsurance							(35)
Market risk benefits							951
Total reinsurance recoverables (3)							$	5,047

(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.

(2)Certified by an NRSRO.

(3)Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 million of reinsurance recoverables classified as assets of businesses held for sale.

Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.

Effective Exit of Variable Annuity Reinsurance Business

The Company entered into an agreement with Berkshire to effectively exit the variable annuity reinsurance business via a reinsurance transaction in 2013. Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 9 to the Consolidated Financial Statements. Berkshire reinsured 100% of the Company's future cash flows in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall

limit with approximately $3.1 billion remaining at March 31, 2024. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)	March 31, 2024		December 31, 2023		Collateral and Other Terms at March 31, 2024
Berkshire	$	777	$	873	100% were secured by assets in a trust.
Sun Life Assurance Company of Canada	79		92
Liberty Re (Bermuda) Ltd.	91		104		100% were secured by assets in a trust.
SCOR SE	27		31		75% were secured by a letter of credit.
Market risk benefits (2)	$	974	$	1,100

(1)All reinsurers are rated A- equivalent and higher by an NRSRO.

(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three months ended March 31, 2024 and March 31, 2023.

XML

Investments

3 Months Ended

Mar. 31, 2024

Investments [Abstract]

Investments

Note 11 – Investments

The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 to the Consolidated Financial Statements for information about the valuation of the Company's investment portfolio. Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the Company's investments by category and current or long-term classification:

	March 31, 2024						December 31, 2023
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	604	$	8,876	$	9,480	$	590	$	9,265	$	9,855
Equity securities	18		1,553		1,571		31		3,331		3,362
Commercial mortgage loans	197		1,365		1,562		182		1,351		1,533
Policy loans	—		1,186		1,186		—		1,211		1,211
Other long-term investments	—		4,301		4,301		—		4,181		4,181
Short-term investments	374		—		374		206		—		206
Total	$	1,193	$	17,281	$	18,474	$	1,009	$	19,339	$	20,348
Investments classified as assets of businesses held for sale (1)	(85)		(1,256)		(1,341)		(84)		(1,354)		(1,438)
Investments per Consolidated Balance Sheets	$	1,108	$	16,025	$	17,133	$	925	$	17,985	$	18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

Investment Portfolio

Debt Securities

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	633	$	619
Due after one year through five years	3,768		3,587
Due after five years through ten years	3,144		2,921
Due after ten years	2,186		2,000
Mortgage and other asset-backed securities	389		353
Total	$	10,120	$	9,480

Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties.

Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:

(In millions)	Amortized Cost		Allowance for Credit Loss		Unrealized Appreciation		Unrealized Depreciation		Fair Value
March 31, 2024
Federal government and agency	$	289	$	—	$	21	$	(10)	$	300
State and local government	37		—		2		(1)		38
Foreign government	354		—		8		(14)		348
Corporate	9,051		(50)		122		(682)		8,441
Mortgage and other asset-backed	389		—		—		(36)		353
Total	$	10,120	$	(50)	$	153	$	(743)	$	9,480
December 31, 2023
Federal government and agency	$	251	$	—	$	24	$	(8)	$	267
State and local government	37		—		2		(1)		38
Foreign government	355		—		10		(13)		352
Corporate	9,338		(33)		158		(630)		8,833
Mortgage and other asset-backed	398		—		1		(34)		365
Total	$	10,379	$	(33)	$	195	$	(686)	$	9,855

Review of declines in fair value. Management reviews debt securities in an unrealized loss position to determine whether a credit loss allowance is needed based on criteria that include:

•severity of decline;

•financial health and specific prospects of the issuer; and

•changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.

	March 31, 2024							December 31, 2023
(Dollars in millions)	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues
One year or less
Investment grade	$	562	$	576	$	(14)	232	$	330	$	338	$	(8)	142
Below investment grade	133		137		(4)		253	161		170		(9)		135
More than one year
Investment grade	5,284		5,946		(662)		1,561	5,441		6,036		(595)		1,590
Below investment grade	598		661		(63)		367	701		775		(74)		486
Total	$	6,577	$	7,320	$	(743)	2,413	$	6,633	$	7,319	$	(686)	2,353

Equity Securities

The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:

	March 31, 2024				December 31, 2023
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	647	$	39	$	656	$	51
Equity securities with no readily determinable fair value	3,281		1,532		3,248		3,311
Total	$	3,928	$	1,571	$	3,904	$	3,362

We are a minority owner in VillageMD, a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in equity securities with no readily determinable fair value in the above table. As of March 31, 2024, we determined our investment in VillageMD was impaired and wrote down the carrying value to an estimated fair value of $0.9 billion, resulting in a $1.8 billion loss recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 90% of our investments in equity securities are in the health care sector.

Commercial Mortgage Loans

Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties.

The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:

(Dollars in millions)	March 31, 2024					December 31, 2023
Loan-to-Value Ratio	Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio		Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio
Below 60%	$	810	2.12			$	802	2.13
60% to 79%	594		1.75			574		1.77
80% to 100%	158		0.63			157		0.65
Total	$	1,562	1.81	64	%	$	1,533	1.82	64	%

Other Long-Term Investments

Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments:

	Carrying Value as of
(In millions)	March 31, 2024		December 31, 2023
Real estate investments	$	1,696	$	1,606
Securities partnerships	2,423		2,400
Other	182		175
Total	$	4,301	$	4,181

Derivative Financial Instruments

The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt.

As of March 31, 2024, there have been no material changes to the Company's derivative financial instruments. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

Realized Investment Gains and LossesNet realized investment losses, before income taxes were $1,836 million for the three months ended March 31, 2024 and $56 million for the three months ended March 31, 2023. This increase was primarily driven by the impairment of equity securities in 2024. These amounts exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders.

XML

Fair Value Measurements

3 Months Ended

Mar. 31, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurements

Note 12 – Fair Value Measurements

The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.

Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.

The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).

For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.

Financial Assets and Financial Liabilities Carried at Fair Value

The following table provides information about the Company's financial assets and liabilities carried at fair value. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 9E to the Consolidated Financial Statements. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:

(In millions)	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency	$	165	$	130	$	135	$	137	$	—	$	—	$	300	$	267
State and local government	—		—		38		38		—		—		38		38
Foreign government	—		—		348		352		—		—		348		352
Corporate	—		—		8,072		8,432		369		401		8,441		8,833
Mortgage and other asset-backed	—		—		300		319		53		46		353		365
Total debt securities	165		130		8,893		9,278		422		447		9,480		9,855
Equity securities (1)	2		4		37		47		—		—		39		51
Short-term investments	—		—		374		206		—		—		374		206
Derivative assets	—		—		147		131		—		1		147		132
Financial liabilities at fair value
Derivative liabilities	$	—	$	—	$	4	$	4	$	—	$	—	$	4	$	4

(1)Excludes certain equity securities that have no readily determinable fair value.

Level 3 Financial Assets and Financial Liabilities

Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. Additionally, as discussed in Note 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.

Quantitative Information about Unobservable Inputs

The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.

The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.

	Fair Value as of					Unobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)	March 31, 2024		December 31, 2023		Unobservable Input March 31, 2024	March 31, 2024		December 31, 2023
Debt securities
Corporate	$	369	$	401	Liquidity	55 - 1230 (280)	bps	70 - 1235 (310)	bps
Mortgage and other asset-backed securities	53		46		Liquidity	110 - 605 (280)	bps	95 - 640 (310)	bps
Total Level 3 debt securities	$	422	$	447

An increase in liquidity spread adjustments would result in a lower fair value measurement, while a decrease would result in a higher fair value measurement.

Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value

The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.

	Three Months Ended March 31,
(In millions)	2024		2023
Debt and Equity Securities
Beginning balance	$	447	$	447
(Losses) gains included in Shareholders' net (loss) income	(21)		1
(Losses) gains included in Other comprehensive loss	(3)		5
Purchases, sales and settlements
Purchases	—		4
Settlements	(14)		(9)
Total purchases, sales and settlements	(14)		(5)
Transfers into/(out of) Level 3
Transfers into Level 3	16		39
Transfers out of Level 3	(3)		(16)
Total transfers into/(out of) Level 3	13		23
Ending balance	$	422	$	471
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date	$	(21)	$	1
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	(4)	$	5

Total gains and losses included in Shareholders' net (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income.

Gains and losses included in Other comprehensive loss, net of tax in the tables above are reflected in Net unrealized appreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2024 and 2023 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. See discussion under Quantitative Information about Unobservable Inputs above for more information.

Separate Accounts

The investment income and fair value gains and losses of Separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. The separate account activity for the three months ended March 31, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments.

Fair values of Separate account assets were as follows:

	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
(In millions)	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Guaranteed separate accounts (See Note 16)	$	230	$	226	$	339	$	352	$	—	$	—	$	569	$	578
Non-guaranteed separate accounts (1)	158		158		5,794		5,797		229		217		6,181		6,172
Subtotal	$	388	$	384	$	6,133	$	6,149	$	229	$	217	6,750		6,750
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													666		680
Total													$	7,416	$	7,430

(1)Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.

Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three months ended March 31, 2024 or 2023.

Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments:

	Fair Value as of				Unfunded Commitment as of March 31, 2024		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2024		December 31, 2023
Securities partnerships	$	412	$	419	$	252	Not applicable	Not applicable
Real estate funds	251		258		—		Quarterly	30 - 90 days
Hedge funds	3		3		—		Up to annually, varying by fund	30 - 90 days
Total	$	666	$	680	$	252

As of March 31, 2024, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception.

Assets and Liabilities Measured at Fair Value under Certain Conditions

Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.

For the three months ended March 31, 2024, our equity investment in VillageMD was written down to an estimated fair value of $0.9 billion resulting in an investment loss of $1.8 billion recorded in Net realized investment losses in the Company's Consolidated Statements of Income. For the three months ended March 31, 2023, impairments recognized requiring these assets to be measured at fair value were not material. Observable price changes for other equity securities with no readily determinable fair value were not material for the three months ended March 31, 2024 and March 31, 2023.

Fair Value Disclosures for Financial Instruments Not Carried at Fair Value

The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:

	Classification in Fair Value Hierarchy	March 31, 2024				December 31, 2023
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,451	$	1,562	$	1,430	$	1,533
Long-term debt, including current maturities, excluding finance leases	Level 2	$	29,806	$	31,783	$	28,033	$	29,585

XML

Variable Interest Entities

3 Months Ended

Mar. 31, 2024

Variable Interest Entities [Abstract]

Variable Interest Entities

Note 13 – Variable Interest Entities

We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined that it was not a primary beneficiary in any material variable interest entity as of March 31, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure.

XML

Accumulated Other Comprehensive Income (Loss)

3 Months Ended

Mar. 31, 2024

Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]

Accumulated Other Comprehensive Income (Loss)

Note 14 – Accumulated Other Comprehensive Income (Loss)

Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive loss, net of tax, for the three months ended March 31, 2024 and March 31, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method.

Changes in the components of AOCI were as follows:

	Three Months Ended March 31,
(In millions)	2024		2023
Securities and Derivatives
Beginning balance	$	171	$	(332)
Unrealized appreciation on securities and derivatives	143		252
Tax (expense)	(39)		(54)
Net unrealized appreciation on securities and derivatives	104		198
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)	22		(5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income	(5)		1
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income	17		(4)
Other comprehensive income, net of tax	121		194
Ending balance	$	292	$	(138)

	Three Months Ended March 31,
(In millions)	2024		2023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance	$	(971)	$	(256)
Current period change in discount rate for certain long-duration liabilities	(732)		(411)
Tax benefit	186		101
Net current period change in discount rate for certain long-duration liabilities	(546)		(310)
Current period change in instrument-specific credit risk for market risk benefits	(18)		(26)
Tax benefit	4		5
Net current period change in instrument-specific credit risk for market risk benefits	(14)		(21)
Other comprehensive (loss), net of tax	(560)		(331)
Ending balance	$	(1,531)	$	(587)

	Three Months Ended March 31,
(In millions)	2024		2023
Translation of foreign currencies
Beginning balance	$	(149)	$	(154)
Translation of foreign currencies	(24)		15
Tax (expense) benefit	(2)		1
Other comprehensive (loss) income, net of tax	(26)		16
Ending balance	$	(175)	$	(138)

	Three Months Ended March 31,
(In millions)	2024		2023
Postretirement benefits liability
Beginning balance	$	(915)	$	(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)	8		13
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income	(3)		(3)
Other comprehensive income, net of tax	5		10
Ending balance	$	(910)	$	(906)

	Three Months Ended March 31,
(In millions)	2024		2023
Total Accumulated other comprehensive loss
Beginning balance	$	(1,864)	$	(1,658)
Shareholders' other comprehensive (loss), net of tax	(460)		(111)
Ending balance	$	(2,324)	$	(1,769)

XML

Income Taxes

3 Months Ended

Mar. 31, 2024

Income Tax Disclosure [Abstract]

Income Taxes

Note 15 – Income Taxes

Income Tax Expense

The effective tax rate for the three months ended March 31, 2024 increased due to a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution. The 368.4% effective tax rate for the three months ended March 31, 2024 was higher than the 18.4% rate for the three months ended March 31, 2023.

As of March 31, 2024, we had approximately $664 million in deferred tax assets ("DTAs") associated with the impairment of equity securities, as well as unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $427 million, which drove the higher effective tax rate, was established in the three months ended March 31, 2024, almost entirely related to the impairment of equity securities. For the remainder of the DTAs, we have determined that a valuation allowance is not currently required based on the Company's ability to carry back losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any additional valuation allowance.

XML

Contingencies and Other Matters

3 Months Ended

Mar. 31, 2024

Commitments and Contingencies Disclosure [Abstract]

Contingencies and Other Matters

Note 16 – Contingencies and Other Matters

The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business.

A.Financial Guarantees: Retiree and Life Insurance Benefits

The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of March 31, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $410 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of March 31, 2024. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.

The Company does not expect that these financial guarantees will have a material effect on the Company's consolidated results of operations, liquidity or financial condition.

B.Certain Other Guarantees

The Company had indemnification obligations as of March 31, 2024 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with laws or regulations or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a stated dollar amount or a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no recorded liabilities for these indemnification obligations as of March 31, 2024.

C.Guaranty Fund Assessments

The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.

There were no material charges or credits resulting from existing or new guaranty fund assessments for the three months ended March 31, 2024.

Legal and Regulatory Matters

The Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator's filing of a complaint under court seal, and other legal matters arising, for the most part, in the ordinary course of managing a global health services business. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions.

Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company's accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in this ongoing litigation matter or any future claims or litigation.

Litigation Matters

Express Scripts Litigation with Elevance. In March 2016, Elevance filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Elevance also requested that the court enter declaratory judgment that Express Scripts is required to provide Elevance competitive benchmark pricing, that Elevance can terminate the agreement and that Express Scripts is required to provide Elevance with post-termination services at competitive benchmark pricing for one year following any termination by Elevance. Elevance claimed it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Elevance and $150 million damages for service issues ("Elevance's Allegations"). On April 19, 2016, in response to Elevance's complaint, Express Scripts filed its answer denying Elevance's Allegations in their entirety and asserting affirmative defenses and counterclaims against Elevance. The court subsequently granted Elevance's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Elevance completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. On March 31, 2022, the court granted summary judgment in favor of Express Scripts on all of Elevance's pricing claims for damages totaling $14.8 billion and on most of Elevance's claims relating to service issues. Elevance's only remaining service claims relate to the review or processing of prior authorizations, with alleged damages over $100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retains the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retains the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance filed its opening appellate brief on April 24, 2024.

XML

Segment Information

3 Months Ended

Mar. 31, 2024

Segment Reporting [Abstract]

Segment Information

Note 17 – Segment Information

See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments.

The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income (loss) from operations as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets, and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.

The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.

The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:

	Three Months Ended March 31,
	2024				2023
(In millions)	Pre-tax		After-tax		Pre-tax		After-tax
Integration and transaction-related costs  (Selling, general and administrative expenses)	$	37	$	29	$	1	$	1
Loss (gain) on sale of businesses	19		(43)		—		—
Deferred tax expenses, net  (Income taxes, less amount attributable to noncontrolling interests)	—		17		—		—
Total impact from special items	$	56	$	3	$	1	$	1

Summarized segment financial information was as follows:

(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2024
Revenues from external customers	$	44,886	$	12,012	$	66	$	1	$	56,965
Intersegment revenues	1,281		1,124		25		(2,430)
Net investment income	59		149		75		7		290
Total revenues	46,226		13,285		166		(2,422)		57,255
Net realized investment results from certain equity method investments	—		(8)		—		—		(8)
Adjusted revenues	$	46,226	$	13,277	$	166	$	(2,422)	$	57,247
(Loss) income before income taxes	$	(436)	$	943	$	18	$	(446)	$	79
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(77)		—		—		—		(77)
Net realized investment losses (1)	1,456		372		—		—		1,828
Amortization of acquired intangible assets	417		6		—		—		423
Special items
Integration and transaction-related costs	—		—		—		37		37
Loss on sale of businesses	—		19		—		—		19
Pre-tax adjusted income (loss) from operations	$	1,360	$	1,340	$	18	$	(409)	$	2,309
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2023
Revenues from external customers	$	34,511	$	11,650	$	79	$	—	$	46,240
Intersegment revenues	1,618		963		—		(2,581)
Net investment income	50		143		78		6		277
Total revenues	36,179		12,756		157		(2,575)		46,517
Net realized investment results from certain equity method investments	—		(38)		—		—		(38)
Adjusted revenues	$	36,179	$	12,718	$	157	$	(2,575)	$	46,479
Income (loss) before income taxes	$	918	$	1,077	$	21	$	(415)	$	1,601
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(42)		(1)		—		—		(43)
Net realized investment losses (gains) (1)	—		24		(6)		—		18
Amortization of acquired intangible assets	444		15		—		—		459
Special items
Integration and transaction-related costs	—		—		—		1		1
Pre-tax adjusted income (loss) from operations	$	1,320	$	1,115	$	15	$	(414)	$	2,036

(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:

	Three Months Ended March 31,
(In millions)	2024		2023
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	24,166	$	15,748
Home delivery and specialty revenues	16,458		16,025
Other revenues	2,546		1,867
Total Evernorth Health Services	43,170		33,640
Total Other Operations	17		—
Intercompany eliminations	(1,151)		(1,496)
Total Pharmacy revenues	42,036		32,144
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured	4,393		4,080
Medicare Advantage	2,287		2,236
Stop loss	1,668		1,503
Individual and Family Plans	1,040		1,208
Other	1,258		1,117
U.S. Healthcare	10,646		10,144
International Health	885		786
Total Cigna Healthcare	11,531		10,930
Other	48		79
Intercompany eliminations	24		16
Total Premiums	11,603		11,025
Services (Fees) (ASC 606)
Evernorth Health Services	2,943		2,499
Cigna Healthcare	1,571		1,606
Other Operations	25		1
Other revenues	90		66
Intercompany eliminations	(1,303)		(1,101)
Total Fees and other revenues	3,326		3,071
Total revenues from external customers	$	56,965	$	46,240

(1)Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.

Financial and performance guarantees. Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $1.9 billion as of March 31, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 15% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 13% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.

XML

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024 shares
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Noelle Eder [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 9, 2024, Noelle Eder, Executive Vice President, Global Chief Information Officer of The Cigna Group, adopted a 10b5-1 plan. Ms. Eder's plan provides for the sale of up to 8,179 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 6,408 shares of The Cigna Group common stock through February 28, 2025.
Name	Noelle Eder
Title	Executive Vice President, Global Chief Information Officer of The Cigna Group
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 9, 2024
Arrangement Duration	385 days
Brian Evanko [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 15, 2024, Brian Evanko, Executive Vice President, Chief Financial Officer of The Cigna Group and President and Chief Executive Officer, Cigna Healthcare, adopted a 10b5-1 plan. Mr. Evanko's plan provides for the exercise of vested stock options and the associated sale of up to 17,924 shares of The Cigna Group common stock through February 10, 2025.
Name	Brian Evanko
Title	Executive Vice President, Chief Financial Officer of The Cigna Group and President and Chief Executive Officer, Cigna Healthcare
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 15, 2024
Arrangement Duration	361 days
Aggregate Available	17,924
Eric Palmer [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 16, 2024, Eric Palmer, Executive Vice President, Enterprise Strategy of The Cigna Group and President and Chief Executive Officer, Evernorth Health Services, adopted a 10b5-1 plan. Mr. Palmer's plan provides for the sale of up to 4,993 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 17,530 shares of The Cigna Group common stock through February 10, 2025.
Name	Eric Palmer
Title	Executive Vice President, Enterprise Strategy of The Cigna Group and President and Chief Executive Officer, Evernorth Health Services
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 16, 2024
Arrangement Duration	360 days
Elder Granger [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On March 13, 2024, Elder Granger, Director, adopted a 10b5-1 plan. Mr. Granger's plan provides for the exercise of vested stock options and the associated sale of up to 1,547 shares of The Cigna Group common stock through September 16, 2024.
Name	Elder Granger
Title	Director
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	March 13, 2024
Arrangement Duration	187 days
Aggregate Available	1,547
Noelle Eder Trading Arrangement, Common Stock [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	8,179
Noelle Eder Trading Arrangement, Stock Options [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	6,408
Eric Palmer Trading Arrangement, Common Stock [Member] | Eric Palmer [Member]
Trading Arrangements, by Individual
Aggregate Available	4,993
Eric PalmerTrading Arrangement, Stock Options [Member] | Eric Palmer [Member]
Trading Arrangements, by Individual
Aggregate Available	17,530

XML

Summary of Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2024

Accounting Policies [Abstract]

Basis of Presentation

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").

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax 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 2023 Annual Report on Form 10-K ("2023 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 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, Recently Adopted Accounting Guidance and Accounting Guidance Not Yet Adopted

Recent Accounting Pronouncements

The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.

Revenue Recognition

Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period.

Accounts Receivable

The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution.As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.

Unpaid Claims and Claims Expenses

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

Future Policy Benefits

The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses.

Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations' traditional insurance contracts, which are in run-off, have no premium remaining to be collected; therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.

Reinsurance

Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance.

The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.

The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.

Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.

Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 9 to the Consolidated Financial Statements.

Investments

Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.

Review of declines in fair value. Management reviews debt securities in an unrealized loss position to determine whether a credit loss allowance is needed based on criteria that include:

•severity of decline;

•financial health and specific prospects of the issuer; and

•changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other.

Derivative Financial Instruments

Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies.

Fair Value Measurements

The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.

Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.

The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).

For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.

Level 3 Financial Assets and Financial Liabilities

Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. Additionally, as discussed in Note 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.

Quantitative Information about Unobservable Inputs

The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.

Total gains and losses included in Shareholders' net (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income.

Gains and losses included in Other comprehensive loss, net of tax in the tables above are reflected in Net unrealized appreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreadsAssets and Liabilities Measured at Fair Value under Certain Conditions

Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.

Separate Accounts

Separate Accounts

The investment income and fair value gains and losses of Separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. The separate account activity for the three months ended March 31, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments.

Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans.Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments

Variable Interest Entities

For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K.

AOCI

Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Guarantees

Financial Guarantees: Retiree and Life Insurance BenefitsThe Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments.An additional liability is established if management believes that the Company will be required to make payments under the guarantees;Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.Certain Other GuaranteesThe Company had indemnification obligations as of March 31, 2024 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with laws or regulations or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a stated dollar amount or a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation.Guaranty Fund Assessments

The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.

Segment Information

Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments.

The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income (loss) from operations as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets, and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.

The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.

XML

Receivables, Loans, Notes Receivable, and Others (Policies)	3 Months Ended
	Mar. 31, 2024
Receivables [Abstract]
Accounts Receivable	The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution.As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.

XML

Investments, Debt and Equity Securities (Policies)

3 Months Ended

Mar. 31, 2024

Investments, Debt and Equity Securities [Abstract]

Investments

Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.

Review of declines in fair value. Management reviews debt securities in an unrealized loss position to determine whether a credit loss allowance is needed based on criteria that include:

•severity of decline;

•financial health and specific prospects of the issuer; and

•changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other.

XML

Accounts Receivable, Net (Tables)

3 Months Ended

Mar. 31, 2024

Receivables [Abstract]

Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2024		December 31, 2023
Noninsurance customer receivables	$	9,735	$	8,044
Pharmaceutical manufacturers receivables	9,512		8,169
Insurance customer receivables	2,045		2,359
Other receivables	230		272
Total	$	21,522	$	18,844
Accounts receivable, net classified as assets of businesses held for sale	(959)		(1,122)
Total	$	20,563	$	17,722

XML

Assets and Liabilities of Businesses Held for Sale (Tables)

3 Months Ended

Mar. 31, 2024

Discontinued Operations and Disposal Groups [Abstract]

Assets and Liabilities of Business Held for Sale

The assets and liabilities of businesses held for sale were as follows:

(In millions)	March 31, 2024		December 31, 2023
Cash and cash equivalents	$	1,660	$	467
Investments	1,341		1,438
Accounts receivable, net	959		1,122
Other assets, including Goodwill (1)	2,394		2,963
Total assets of businesses held for sale	6,354		5,990
Insurance and contractholder liabilities	2,081		1,636
All other liabilities	1,134		1,059
Total liabilities of businesses held for sale	$	3,215	$	2,695

(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.

XML

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2024

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

Basic and diluted earnings per share were computed as follows:

	Three Months Ended
	March 31, 2024						March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net (loss) income	$	(277)			$	(277)	$	1,267			$	1,267
Shares:
Weighted average	286,465				286,465		295,706				295,706
Common stock equivalents			—		—				3,293		3,293
Total shares	286,465		—		286,465		295,706		3,293		298,999
Earnings per share	$	(0.97)	$	—	$	(0.97)	$	4.28	$	(0.04)	$	4.24

XML

Debt (Tables)

3 Months Ended

Mar. 31, 2024

Debt Disclosure [Abstract]

Outstanding Amounts of Debt and Finance Leases

The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:

(In millions)	March 31, 2024		December 31, 2023
Short-term debt
Commercial paper	$	884	$	1,237
$500 million, 0.613% Notes due March 2024	—		500
$790 million, 3.500% Notes due June 2024 (1)	789		996
Other, including finance leases	42		42
Total short-term debt	$	1,715	$	2,775
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)	881		882
$1,216 million, 4.125% Notes due November 2025 (1)	1,214		2,197
$1,284 million, 4.500% Notes due February 2026 (1)	1,285		1,502
$550 million, 1.250% Notes due March 2026 (1)	549		798
$700 million, 5.685% Notes due March 2026	698		698
$1,500 million, 3.400% Notes due March 2027	1,454		1,450
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	598		597
$3,800 million, 4.375% Notes due October 2028	3,788		3,787
$1,000 million, 5.000% Notes due May 2029	994		—
$1,400 million, 2.400% Notes due March 2030 (1)	1,394		1,493
$1,500 million, 2.375% Notes due March 2031 (2)	1,382		1,397
$750 million, 5.125% Notes due May 2031	745		—
$45 million, 8.080% Step Down Notes due January 2033 (3)	45		45
$800 million, 5.400% Notes due March 2033	794		794
$1,250 million, 5.250% Notes due February 2034	1,242		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,193		2,193
$750 million, 3.200% Notes due March 2040	744		744
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	487		487
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,467		1,467
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,970		2,970
$1,250 million, 3.400% Notes due March 2050	1,237		1,237
$1,500 million, 3.400% Notes due March 2051	1,479		1,479
$1,500 million, 5.600% Notes due February 2054	1,482		—
Other, including finance leases	59		66
Total long-term debt	$	31,053	$	28,155

(1)Included in the February 2024 debt tender offers discussed below.

(2)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.

(3)Interest rate step down to 8.080% effective January 15, 2023.

Summary of Debt Issuances

Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$1,000 million (1)	May 15, 2029	5.000%	$995 million
$750 million (2)	May 15, 2031	5.125%	$746 million
$1,250 million (3)	February 15, 2034	5.250%	$1,244 million
$1,500 million (4)	February 15, 2054	5.600%	$1,485 million

(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.

(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.

(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.

(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.

XML

Common and Preferred Stock (Tables)

3 Months Ended

Mar. 31, 2024

Equity [Abstract]

Dividend Payments

The following table provides details of the Company's dividend payments:

Record Date	Payment Date	Amount per Share	Total Amount Paid (in millions)
2024
March 6, 2024	March 21, 2024	$1.40	$401
2023
March 8, 2023	March 23, 2023	$1.23	$368

XML

Insurance and Contractholder Liabilities (Tables)

3 Months Ended

Mar. 31, 2024

Insurance Loss Reserves [Abstract]

Summary of Insurance and Contractholder Liabilities, Activity in the Unpaid Claims Liability and Liability Details for Unpaid Claims and Claim Expenses

The Company's insurance and contractholder liabilities were comprised of the following:

	March 31, 2024						December 31, 2023						March 31, 2023
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	5,786	$	77	$	5,863	$	5,017	$	75	$	5,092	$	4,959
Other Operations	99		161		260		99		154		253		272
Future policy benefits
Cigna Healthcare	92		515		607		97		518		615		601
Other Operations	163		3,297		3,460		163		3,375		3,538		3,631
Contractholder deposit funds
Cigna Healthcare	11		130		141		12		133		145		163
Other Operations	365		6,087		6,452		362		6,178		6,540		6,670
Market risk benefits	26		865		891		37		966		1,003		1,220
Unearned premiums	815		21		836		846		22		868		1,440
Total	7,357		11,153		18,510		6,633		11,421		18,054
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)	(1,569)		(512)		(2,081)		(1,119)		(517)		(1,636)
Total insurance and contractholder liabilities	$	5,788	$	10,641	$	16,429	$	5,514	$	10,904	$	16,418	$	18,956

(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.

Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Beginning balance	$	5,092	$	4,176
Less: Reinsurance and other amounts recoverable	236		221
Beginning balance, net	4,856		3,955
Incurred costs related to:
Current year	9,452		9,041
Prior years	(226)		(144)
Total incurred	9,226		8,897
Paid costs related to:
Current year	5,072		5,316
Prior years	3,352		2,795
Total paid	8,424		8,111
Ending balance, net	5,658		4,741
Add: Reinsurance and other amounts recoverable	205		218
Ending balance	$	5,863	$	4,959

(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.

Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses

Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:

	Three Months Ended March 31,
	2024				2023
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	76	0.2	%	$	1	—	%
Medical cost trend	150		0.4		143		0.5
Total favorable variance	$	226	0.6	%	$	144	0.5	%

(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.

Future Policy Benefit Activity

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	2.56	%	2.59	%
Current discount rate	5.11	%	5.29	%
Weighted average duration	7.8 years		8.1 years

The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows:

	Three Months Ended March 31,
(In millions)	2024 (1)		2023
Present value of expected net premiums
Beginning balance	$	9,233	$	8,557
Reversal of effect of beginning of period discount rate assumptions	1,154		1,537
Issuances and lapses	446		306
Net premiums collected	(350)		(326)
Interest and other (2)	73		56
Ending balance at original discount rate	10,556		10,130
Effect of end of period discount rate assumptions	(1,309)		(1,312)
Ending balance (3)	$	9,247	$	8,818
Present value of expected policy benefits
Beginning balance	$	9,633	$	8,945
Reversal of effect of discount rate assumptions	1,220		1,611
Issuances and lapses	457		307
Benefit payments	(362)		(326)
Interest and other (2)	71		58
Ending balance at original discount rate	11,019		10,595
Effect of discount rate assumptions	(1,381)		(1,378)
Ending balance (4)	$	9,638	$	9,217
Liability for future policy benefits	$	391	$	399
Other (5)	216		202
Total liability for future policy benefits (6)(7)	$	607	$	601

(1)Includes future policy benefits amounts classified as liabilities of businesses held for sale.

(2)Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.

(3)As of March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.

(4)As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 billion, respectively.

(5)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.

(6)$72 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

(7)Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:

	As of
	March 31, 2024		March 31, 2023
Interest accretion rate	5.64	%	5.64	%
Current discount rate	5.16	%	4.95	%
Weighted average duration	11.3 years		11.7 years

Summary of Market Risk Benefit

Market risk benefits activity was as follows:

	Three Months Ended March 31,
(Dollars in millions)	2024		2023
Balance, beginning of year	$	1,003	$	1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,085		1,379
Changes due to expected run-off	(3)		(6)
Changes due to capital markets versus expected	(113)		(41)
Changes due to policyholder behavior versus expected	(14)		6
Assumption changes	—		(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	955		1,305
Nonperformance risk (own credit risk), end of period	(64)		(85)
Balance, end of period	$	891	$	1,220
Reinsured market risk benefit, end of period	$	951	$	1,301

(In millions)
Reinsurer (1)	March 31, 2024		December 31, 2023		Collateral and Other Terms at March 31, 2024
Berkshire	$	777	$	873	100% were secured by assets in a trust.
Sun Life Assurance Company of Canada	79		92
Liberty Re (Bermuda) Ltd.	91		104		100% were secured by assets in a trust.
SCOR SE	27		31		75% were secured by a letter of credit.
Market risk benefits (2)	$	974	$	1,100

(1)All reinsurers are rated A- equivalent and higher by an NRSRO.

(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

Account Value, Net Amount at Risk and the Number of Contractholders for Guarantees Assumed in the Event of Death

The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.

(Dollars in millions, excludes impact of reinsurance ceded)	March 31, 2024		March 31, 2023
Net amount at risk	$	1,441	$	2,183
Average attained age of contractholders (weighted by exposure)	77.7 years		75.4 years

XML

Reinsurance (Tables)

3 Months Ended

Mar. 31, 2024

Reinsurance Disclosures [Abstract]

Reinsurance Recoverables by Range of External Credit Rating and Collateral Level

The Company's reinsurance recoverables as of March 31, 2024 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:

(In millions)	Fair value of collateral contractually required to meet or exceed carrying value of recoverable		Collateral provisions exist that may mitigate risk of credit loss (1)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (2)	$	—	$	—	$	85	$	85
BBB- to BBB+ equivalent current credit ratings (2)	—		—		60		60
Not rated	145		7		188		340
Total recoverables related to ongoing operations	145		7		333		485
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,619		—		2,619
Empower Annuity Insurance Company	—		—		128		128
Prudential Insurance Company of America	351		—		—		351
Life Insurance Company of North America	—		334		—		334
Other	167		23		14		204
Not rated	—		6		4		10
Total recoverables related to acquisition, disposition or run-off activities	518		2,982		146		3,646
Total reinsurance recoverables before market risk benefits	$	663	$	2,989	$	479	$	4,131
Allowance for uncollectible reinsurance							(35)
Market risk benefits							951
Total reinsurance recoverables (3)							$	5,047

(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.

(2)Certified by an NRSRO.

(3)Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 million of reinsurance recoverables classified as assets of businesses held for sale.

Reinsurance Recoverables for Variable Annuity Business

Market risk benefits activity was as follows:

	Three Months Ended March 31,
(Dollars in millions)	2024		2023
Balance, beginning of year	$	1,003	$	1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,085		1,379
Changes due to expected run-off	(3)		(6)
Changes due to capital markets versus expected	(113)		(41)
Changes due to policyholder behavior versus expected	(14)		6
Assumption changes	—		(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	955		1,305
Nonperformance risk (own credit risk), end of period	(64)		(85)
Balance, end of period	$	891	$	1,220
Reinsured market risk benefit, end of period	$	951	$	1,301

(In millions)
Reinsurer (1)	March 31, 2024		December 31, 2023		Collateral and Other Terms at March 31, 2024
Berkshire	$	777	$	873	100% were secured by assets in a trust.
Sun Life Assurance Company of Canada	79		92
Liberty Re (Bermuda) Ltd.	91		104		100% were secured by assets in a trust.
SCOR SE	27		31		75% were secured by a letter of credit.
Market risk benefits (2)	$	974	$	1,100

(1)All reinsurers are rated A- equivalent and higher by an NRSRO.

(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

XML

Investments (Tables)

3 Months Ended

Mar. 31, 2024

Investments [Abstract]

Investments by category and current or long-term classification

The following table summarizes the Company's investments by category and current or long-term classification:

	March 31, 2024						December 31, 2023
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	604	$	8,876	$	9,480	$	590	$	9,265	$	9,855
Equity securities	18		1,553		1,571		31		3,331		3,362
Commercial mortgage loans	197		1,365		1,562		182		1,351		1,533
Policy loans	—		1,186		1,186		—		1,211		1,211
Other long-term investments	—		4,301		4,301		—		4,181		4,181
Short-term investments	374		—		374		206		—		206
Total	$	1,193	$	17,281	$	18,474	$	1,009	$	19,339	$	20,348
Investments classified as assets of businesses held for sale (1)	(85)		(1,256)		(1,341)		(84)		(1,354)		(1,438)
Investments per Consolidated Balance Sheets	$	1,108	$	16,025	$	17,133	$	925	$	17,985	$	18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

Debt Securities by Contractual Maturity

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	633	$	619
Due after one year through five years	3,768		3,587
Due after five years through ten years	3,144		2,921
Due after ten years	2,186		2,000
Mortgage and other asset-backed securities	389		353
Total	$	10,120	$	9,480

Gross Unrealized Appreciation (Depreciation) on Debt Securities

Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:

(In millions)	Amortized Cost		Allowance for Credit Loss		Unrealized Appreciation		Unrealized Depreciation		Fair Value
March 31, 2024
Federal government and agency	$	289	$	—	$	21	$	(10)	$	300
State and local government	37		—		2		(1)		38
Foreign government	354		—		8		(14)		348
Corporate	9,051		(50)		122		(682)		8,441
Mortgage and other asset-backed	389		—		—		(36)		353
Total	$	10,120	$	(50)	$	153	$	(743)	$	9,480
December 31, 2023
Federal government and agency	$	251	$	—	$	24	$	(8)	$	267
State and local government	37		—		2		(1)		38
Foreign government	355		—		10		(13)		352
Corporate	9,338		(33)		158		(630)		8,833
Mortgage and other asset-backed	398		—		1		(34)		365
Total	$	10,379	$	(33)	$	195	$	(686)	$	9,855

Summary of Debt Securities with a Decline in Fair Value

The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.

	March 31, 2024							December 31, 2023
(Dollars in millions)	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues	Fair Value		Amortized Cost		Unrealized Depreciation		Number of Issues
One year or less
Investment grade	$	562	$	576	$	(14)	232	$	330	$	338	$	(8)	142
Below investment grade	133		137		(4)		253	161		170		(9)		135
More than one year
Investment grade	5,284		5,946		(662)		1,561	5,441		6,036		(595)		1,590
Below investment grade	598		661		(63)		367	701		775		(74)		486
Total	$	6,577	$	7,320	$	(743)	2,413	$	6,633	$	7,319	$	(686)	2,353

Equity Security Investments

The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:

	March 31, 2024				December 31, 2023
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	647	$	39	$	656	$	51
Equity securities with no readily determinable fair value	3,281		1,532		3,248		3,311
Total	$	3,928	$	1,571	$	3,904	$	3,362

Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:

(Dollars in millions)	March 31, 2024					December 31, 2023
Loan-to-Value Ratio	Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio		Carrying Value		Average Debt Service Coverage Ratio	Average Loan-to-Value Ratio
Below 60%	$	810	2.12			$	802	2.13
60% to 79%	594		1.75			574		1.77
80% to 100%	158		0.63			157		0.65
Total	$	1,562	1.81	64	%	$	1,533	1.82	64	%

Carrying Value Information for Other Long-Term Investments

The following table provides the carrying value information for these investments:

	Carrying Value as of
(In millions)	March 31, 2024		December 31, 2023
Real estate investments	$	1,696	$	1,606
Securities partnerships	2,423		2,400
Other	182		175
Total	$	4,301	$	4,181

XML

Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2024

Fair Value Disclosures [Abstract]

Financial Assets and Financial Liabilities Carried at Fair Value

The following table provides information about the Company's financial assets and liabilities carried at fair value. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 9E to the Consolidated Financial Statements. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:

(In millions)	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency	$	165	$	130	$	135	$	137	$	—	$	—	$	300	$	267
State and local government	—		—		38		38		—		—		38		38
Foreign government	—		—		348		352		—		—		348		352
Corporate	—		—		8,072		8,432		369		401		8,441		8,833
Mortgage and other asset-backed	—		—		300		319		53		46		353		365
Total debt securities	165		130		8,893		9,278		422		447		9,480		9,855
Equity securities (1)	2		4		37		47		—		—		39		51
Short-term investments	—		—		374		206		—		—		374		206
Derivative assets	—		—		147		131		—		1		147		132
Financial liabilities at fair value
Derivative liabilities	$	—	$	—	$	4	$	4	$	—	$	—	$	4	$	4

(1)Excludes certain equity securities that have no readily determinable fair value.

Fair Value and Significant Unobservable Inputs Used in Pricing Debt Securities

The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.

	Fair Value as of					Unobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)	March 31, 2024		December 31, 2023		Unobservable Input March 31, 2024	March 31, 2024		December 31, 2023
Debt securities
Corporate	$	369	$	401	Liquidity	55 - 1230 (280)	bps	70 - 1235 (310)	bps
Mortgage and other asset-backed securities	53		46		Liquidity	110 - 605 (280)	bps	95 - 640 (310)	bps
Total Level 3 debt securities	$	422	$	447

Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value

The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.

	Three Months Ended March 31,
(In millions)	2024		2023
Debt and Equity Securities
Beginning balance	$	447	$	447
(Losses) gains included in Shareholders' net (loss) income	(21)		1
(Losses) gains included in Other comprehensive loss	(3)		5
Purchases, sales and settlements
Purchases	—		4
Settlements	(14)		(9)
Total purchases, sales and settlements	(14)		(5)
Transfers into/(out of) Level 3
Transfers into Level 3	16		39
Transfers out of Level 3	(3)		(16)
Total transfers into/(out of) Level 3	13		23
Ending balance	$	422	$	471
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date	$	(21)	$	1
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	(4)	$	5

Fair Values of Separate Account Assets

Fair values of Separate account assets were as follows:

	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
(In millions)	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Guaranteed separate accounts (See Note 16)	$	230	$	226	$	339	$	352	$	—	$	—	$	569	$	578
Non-guaranteed separate accounts (1)	158		158		5,794		5,797		229		217		6,181		6,172
Subtotal	$	388	$	384	$	6,133	$	6,149	$	229	$	217	6,750		6,750
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													666		680
Total													$	7,416	$	7,430

(1)Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.

Additional Information on Separate Account Assets Priced at NAV

Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments:

	Fair Value as of				Unfunded Commitment as of March 31, 2024		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2024		December 31, 2023
Securities partnerships	$	412	$	419	$	252	Not applicable	Not applicable
Real estate funds	251		258		—		Quarterly	30 - 90 days
Hedge funds	3		3		—		Up to annually, varying by fund	30 - 90 days
Total	$	666	$	680	$	252

Fair Value Disclosures for Financial Instruments Not Carried at Fair Value

The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:

	Classification in Fair Value Hierarchy	March 31, 2024				December 31, 2023
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,451	$	1,562	$	1,430	$	1,533
Long-term debt, including current maturities, excluding finance leases	Level 2	$	29,806	$	31,783	$	28,033	$	29,585

XML

Accumulated Other Comprehensive Income (Loss) (Tables)

3 Months Ended

Mar. 31, 2024

Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]

Changes in the Components of AOCI

Changes in the components of AOCI were as follows:

	Three Months Ended March 31,
(In millions)	2024		2023
Securities and Derivatives
Beginning balance	$	171	$	(332)
Unrealized appreciation on securities and derivatives	143		252
Tax (expense)	(39)		(54)
Net unrealized appreciation on securities and derivatives	104		198
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)	22		(5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income	(5)		1
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income	17		(4)
Other comprehensive income, net of tax	121		194
Ending balance	$	292	$	(138)

	Three Months Ended March 31,
(In millions)	2024		2023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance	$	(971)	$	(256)
Current period change in discount rate for certain long-duration liabilities	(732)		(411)
Tax benefit	186		101
Net current period change in discount rate for certain long-duration liabilities	(546)		(310)
Current period change in instrument-specific credit risk for market risk benefits	(18)		(26)
Tax benefit	4		5
Net current period change in instrument-specific credit risk for market risk benefits	(14)		(21)
Other comprehensive (loss), net of tax	(560)		(331)
Ending balance	$	(1,531)	$	(587)

	Three Months Ended March 31,
(In millions)	2024		2023
Translation of foreign currencies
Beginning balance	$	(149)	$	(154)
Translation of foreign currencies	(24)		15
Tax (expense) benefit	(2)		1
Other comprehensive (loss) income, net of tax	(26)		16
Ending balance	$	(175)	$	(138)

	Three Months Ended March 31,
(In millions)	2024		2023
Postretirement benefits liability
Beginning balance	$	(915)	$	(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)	8		13
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income	(3)		(3)
Other comprehensive income, net of tax	5		10
Ending balance	$	(910)	$	(906)

	Three Months Ended March 31,
(In millions)	2024		2023
Total Accumulated other comprehensive loss
Beginning balance	$	(1,864)	$	(1,658)
Shareholders' other comprehensive (loss), net of tax	(460)		(111)
Ending balance	$	(2,324)	$	(1,769)

XML

Segment Information (Tables)

3 Months Ended

Mar. 31, 2024

Segment Reporting [Abstract]

Summary of Special Items

The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:

	Three Months Ended March 31,
	2024				2023
(In millions)	Pre-tax		After-tax		Pre-tax		After-tax
Integration and transaction-related costs  (Selling, general and administrative expenses)	$	37	$	29	$	1	$	1
Loss (gain) on sale of businesses	19		(43)		—		—
Deferred tax expenses, net  (Income taxes, less amount attributable to noncontrolling interests)	—		17		—		—
Total impact from special items	$	56	$	3	$	1	$	1

Summarized Segment Financial Information

Summarized segment financial information was as follows:

(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2024
Revenues from external customers	$	44,886	$	12,012	$	66	$	1	$	56,965
Intersegment revenues	1,281		1,124		25		(2,430)
Net investment income	59		149		75		7		290
Total revenues	46,226		13,285		166		(2,422)		57,255
Net realized investment results from certain equity method investments	—		(8)		—		—		(8)
Adjusted revenues	$	46,226	$	13,277	$	166	$	(2,422)	$	57,247
(Loss) income before income taxes	$	(436)	$	943	$	18	$	(446)	$	79
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(77)		—		—		—		(77)
Net realized investment losses (1)	1,456		372		—		—		1,828
Amortization of acquired intangible assets	417		6		—		—		423
Special items
Integration and transaction-related costs	—		—		—		37		37
Loss on sale of businesses	—		19		—		—		19
Pre-tax adjusted income (loss) from operations	$	1,360	$	1,340	$	18	$	(409)	$	2,309
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2023
Revenues from external customers	$	34,511	$	11,650	$	79	$	—	$	46,240
Intersegment revenues	1,618		963		—		(2,581)
Net investment income	50		143		78		6		277
Total revenues	36,179		12,756		157		(2,575)		46,517
Net realized investment results from certain equity method investments	—		(38)		—		—		(38)
Adjusted revenues	$	36,179	$	12,718	$	157	$	(2,575)	$	46,479
Income (loss) before income taxes	$	918	$	1,077	$	21	$	(415)	$	1,601
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(42)		(1)		—		—		(43)
Net realized investment losses (gains) (1)	—		24		(6)		—		18
Amortization of acquired intangible assets	444		15		—		—		459
Special items
Integration and transaction-related costs	—		—		—		1		1
Pre-tax adjusted income (loss) from operations	$	1,320	$	1,115	$	15	$	(414)	$	2,036

(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

Revenue from External Customers

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:

	Three Months Ended March 31,
(In millions)	2024		2023
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	24,166	$	15,748
Home delivery and specialty revenues	16,458		16,025
Other revenues	2,546		1,867
Total Evernorth Health Services	43,170		33,640
Total Other Operations	17		—
Intercompany eliminations	(1,151)		(1,496)
Total Pharmacy revenues	42,036		32,144
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured	4,393		4,080
Medicare Advantage	2,287		2,236
Stop loss	1,668		1,503
Individual and Family Plans	1,040		1,208
Other	1,258		1,117
U.S. Healthcare	10,646		10,144
International Health	885		786
Total Cigna Healthcare	11,531		10,930
Other	48		79
Intercompany eliminations	24		16
Total Premiums	11,603		11,025
Services (Fees) (ASC 606)
Evernorth Health Services	2,943		2,499
Cigna Healthcare	1,571		1,606
Other Operations	25		1
Other revenues	90		66
Intercompany eliminations	(1,303)		(1,101)
Total Fees and other revenues	3,326		3,071
Total revenues from external customers	$	56,965	$	46,240

(1)Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.

XML

Description of Business (Details) - Medicare Advantage and related Cigna Healthcare businesses - Held-for-Sale $ in Billions	1 Months Ended
	Jan. 31, 2024 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Disposal Group, Not Discontinued Operation, Name of Segment [Extensible Enumeration]	Cigna Healthcare
Health Care Service Corporation (HCSC)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price	$ 3.3

XML

Summary of Significant Accounting Policies (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023	Dec. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Decrease to shareholders' equity	$ (41,350)	$ (44,518)	$ (46,244)	$ (44,688)
Increase to shareholders' net income	$ (277)	$ 1,267
Increase to diluted earnings per share (in dollars per share)	$ (0.97)	$ 4.24
Pharmacy Benefits Management Services | Guarantees
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Performance guarantee liability	$ 1,900		$ 1,600

XML

Accounts Receivable, Net - Amounts Included in Accounts Receivable, Net (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Accounts, Notes, Loans and Financing Receivable [Line Items]
Noninsurance customer receivables, including held for sale assets	$ 9,735	$ 8,044
Pharmaceutical manufacturers receivable, including held for sale assets	9,512	8,169
Insurance customer receivables, including held for sale assets	2,045	2,359
Other receivables, including held for sale assets	230	272
Total	21,522	18,844
Accounts receivable, net	20,563	17,722
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable, net classified as assets of businesses held for sale	$ (959)	$ (1,122)

XML

Accounts Receivable, Net - Narrative (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Jul. 31, 2023	Mar. 31, 2024	Dec. 31, 2023
Receivables [Abstract]
Allowance for receivables, current		$ 4,500	$ 3,700
Allowance for current expected credit losses on accounts receivable		91	90
Total capacity, uncommitted factoring facility	$ 1,000
Initial term, uncommitted factoring facility (in years)	2 years
Automatic renewal term, uncommitted factoring facility (in years)	1 year
Accounts receivable sold, uncommitted factoring facility		1,900
Accounts receivable sold that remain outstanding, uncommitted factoring facility		93
Accounts receivable received but not remitted, uncommitted factoring facility		$ 722	$ 515

XML

Supplier Finance Program (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Outstanding payment obligations, current	$ 1,600	$ 1,500
Outstanding payment obligations, current, voluntarily elected by suppliers to be sold to the financial institution	$ 327
Supplier Finance Program, Obligation, Current, Statement of Financial Position [Extensible Enumeration]	Accounts payable	Accounts payable

XML

Assets and Liabilities of Businesses Held for Sale (Details) - Medicare Advantage and related Cigna Healthcare businesses - Held-for-Sale - USD ($) $ in Millions	Mar. 31, 2024	Jan. 31, 2024	Dec. 31, 2023
Disposal Group, Including Discontinued Operation, Balance Sheet Disclosures [Abstract]
Cash and cash equivalents	$ 1,660		$ 467
Investments	1,341		1,438
Accounts receivable, net	959		1,122
Other assets, including Goodwill	2,394		2,963
Goodwill classified as Assets of businesses held for sale	396		396
Total assets of businesses held for sale	6,354		5,990
Insurance and contractholder liabilities	2,081		1,636
All other liabilities	1,134		1,059
Total liabilities of businesses held for sale	$ 3,215		$ 2,695
Health Care Service Corporation (HCSC)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price		$ 3,300

XML

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Shareholders' net income	$ (277)	$ 1,267
Shares:
Weighted average (in shares)	286,465	295,706
Common stock equivalents (in shares)	0	3,293
Total shares (in shares)	286,465	298,999
EPS, basic (in dollars per share)	$ (0.97)	$ 4.28
EPS, effect of dilution (in dollars per share)	0	(0.04)
EPS, diluted (in dollars per share)	$ (0.97)	$ 4.24

XML

Earnings Per Share - Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)	8.2
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)		0.9

XML

Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares shares in Millions	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023
Earnings Per Share [Abstract]
Shares of common stock held in treasury	117.8	107.4	102.7

XML

Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023	Jan. 15, 2023
Short-term debt
Commercial paper	$ 884,000,000	$ 1,237,000,000
Other, including finance leases	42,000,000	42,000,000
Total short-term debt	1,715,000,000	2,775,000,000
Long-term debt
Other, including finance leases	59,000,000	66,000,000
Total long-term debt	31,053,000,000	28,155,000,000
$500 million, 0.613% Notes due March 2024
Short-term debt
Current maturities	0	500,000,000
Long-term debt
Gross value	$ 500,000,000
Interest Rate	0.613%
$790 million, 3.500% Notes due June 2024
Short-term debt
Current maturities	$ 789,000,000	996,000,000
Long-term debt
Gross value	$ 790,000,000
Interest Rate	3.50%
$900 million, 3.250% Notes due April 2025 (2)
Long-term debt
Long-term debt	$ 881,000,000	882,000,000
Gross value	$ 900,000,000
Interest Rate	3.25%
$1,216 million, 4.125% Notes due November 2025 (1)
Long-term debt
Long-term debt	$ 1,214,000,000	2,197,000,000
Gross value	$ 1,216,000,000
Interest Rate	4.125%
$1,284 million, 4.500% Notes due February 2026 (1)
Long-term debt
Long-term debt	$ 1,285,000,000	1,502,000,000
Gross value	$ 1,284,000,000
Interest Rate	4.50%
$550 million, 1.250% Notes due March 2026 (1)
Long-term debt
Long-term debt	$ 549,000,000	798,000,000
Gross value	$ 550,000,000
Interest Rate	1.25%
$700 million, 5.685% Notes due March 2026
Long-term debt
Long-term debt	$ 698,000,000	698,000,000
Gross value	$ 700,000,000
Interest Rate	5.685%
$1,500 million, 3.400% Notes due March 2027
Long-term debt
Long-term debt	$ 1,454,000,000	1,450,000,000
Gross value	$ 1,500,000,000
Interest Rate	3.40%
$259 million, 7.875% Debentures due May 2027
Long-term debt
Long-term debt	$ 259,000,000	259,000,000
Gross value	$ 259,000,000
Interest Rate	7.875%
$600 million, 3.050% Notes due October 2027
Long-term debt
Long-term debt	$ 598,000,000	597,000,000
Gross value	$ 600,000,000
Interest Rate	3.05%
$3,800 million, 4.375% Notes due October 2028
Long-term debt
Long-term debt	$ 3,788,000,000	3,787,000,000
Gross value	$ 3,800,000,000
Interest Rate	4.375%
$1,000 million, 5.000% Notes due May 2029
Long-term debt
Long-term debt	$ 994,000,000	0
Gross value	$ 1,000,000,000
Interest Rate	5.00%
$1,400 million, 2.400% Notes due March 2030 (1)
Long-term debt
Long-term debt	$ 1,394,000,000	1,493,000,000
Gross value	$ 1,400,000,000
Interest Rate	2.40%
$1,500 million, 2.375% Notes due March 2031 (2)
Long-term debt
Long-term debt	$ 1,382,000,000	1,397,000,000
Gross value	$ 1,500,000,000
Interest Rate	2.375%
$750 million, 5.125% Notes due May 2031
Long-term debt
Long-term debt	$ 745,000,000	0
Gross value	$ 750,000,000
Interest Rate	5.125%
$45 million, 8.080% Step Down Notes due January 2033 (3)
Long-term debt
Long-term debt	$ 45,000,000	45,000,000
Gross value	$ 45,000,000
Interest Rate	8.08%		8.08%
$800 million, 5.400% Notes due March 2033
Long-term debt
Long-term debt	$ 794,000,000	794,000,000
Gross value	$ 800,000,000
Interest Rate	5.40%
$1,250 million, 5.250% Notes due February 2034
Long-term debt
Long-term debt	$ 1,242,000,000	0
Gross value	$ 1,250,000,000
Interest Rate	5.25%
$190 million, 6.150% Notes due November 2036
Long-term debt
Long-term debt	$ 190,000,000	190,000,000
Gross value	$ 190,000,000
Interest Rate	6.15%
$2,200 million, 4.800% Notes due August 2038
Long-term debt
Long-term debt	$ 2,193,000,000	2,193,000,000
Gross value	$ 2,200,000,000
Interest Rate	4.80%
$750 million, 3.200% Notes due March 2040
Long-term debt
Long-term debt	$ 744,000,000	744,000,000
Gross value	$ 750,000,000
Interest Rate	3.20%
$121 million, 5.875% Notes due March 2041
Long-term debt
Long-term debt	$ 119,000,000	119,000,000
Gross value	$ 121,000,000
Interest Rate	5.875%
$448 million, 6.125% Notes due November 2041
Long-term debt
Long-term debt	$ 487,000,000	487,000,000
Gross value	$ 448,000,000
Interest Rate	6.125%
$317 million, 5.375% Notes due February 2042
Long-term debt
Long-term debt	$ 315,000,000	315,000,000
Gross value	$ 317,000,000
Interest Rate	5.375%
$1,500 million, 4.800% Notes due July 2046
Long-term debt
Long-term debt	$ 1,467,000,000	1,467,000,000
Gross value	$ 1,500,000,000
Interest Rate	4.80%
$1,000 million, 3.875% Notes due October 2047
Long-term debt
Long-term debt	$ 989,000,000	989,000,000
Gross value	$ 1,000,000,000
Interest Rate	3.875%
$3,000 million, 4.900% Notes due December 2048
Long-term debt
Long-term debt	$ 2,970,000,000	2,970,000,000
Gross value	$ 3,000,000,000
Interest Rate	4.90%
$1,250 million, 3.400% Notes due March 2050
Long-term debt
Long-term debt	$ 1,237,000,000	1,237,000,000
Gross value	$ 1,250,000,000
Interest Rate	3.40%
$1,500 million, 3.400% Notes due March 2051
Long-term debt
Long-term debt	$ 1,479,000,000	1,479,000,000
Gross value	$ 1,500,000,000
Interest Rate	3.40%
$1,500 million, 5.600% Notes due February 2054
Long-term debt
Long-term debt	$ 1,482,000,000	$ 0
Gross value	$ 1,500,000,000
Interest Rate	5.60%

XML

Debt - Short-term and Credit Facilities Debt (Details)	1 Months Ended		3 Months Ended
	Apr. 30, 2024 USD ($) revolvingCreditFacility position	Apr. 30, 2023 USD ($)	Mar. 31, 2024 USD ($)
Debt Instrument [Line Items]
Commercial paper average interest rate			5.54%
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity			$ 5,000,000,000
Revolving Credit Agreements, April 2024 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 6,500,000,000
Aggregate amount of options to increase commitments	1,500,000,000
Maximum total commitment	$ 8,000,000,000
Number of revolving credit facilities | revolvingCreditFacility	2
Number of participating banks | position	22
Leverage ratio covenant	60.00%
Five-year Revolving Credit Agreement, Maturing April 2029 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 5,000,000,000
Credit agreement term	5 years
Credit agreement extension term	1 year
Five-year Revolving Credit Agreement, Maturing April 2029 | Letter of Credit | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
364-day Revolving Credit Agreement, Maturing April 2025 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,500,000,000
Credit agreement term	364 days
Credit facility, conversion to term loan, term	1 year
Revolving credit agreements, April 2023
Debt Instrument [Line Items]
Outstanding balances			$ 0
Maximum borrowing capacity		$ 5,000,000,000
Five-year Revolving Credit Agreement, Maturing April 2028
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 4,000,000,000
Credit agreement term		5 years
364-day Revolving Credit Agreement, Maturing April 2024
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,000,000,000
Credit agreement term		364 days

XML

Debt - Long-term Debt (Details)	1 Months Ended	3 Months Ended
	Feb. 29, 2024 USD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities redeemed		$ 1,800,000,000
Repayment of long-term debt		$ 2,210,000,000	$ 80,000,000
Senior Notes
Debt Instrument [Line Items]
Principal	$ 4,500,000,000
$700 million, 5.685% Notes due March 2026
Debt Instrument [Line Items]
Interest rate		5.685%
Gross value		$ 700,000,000
$800 million, 5.400% Notes due March 2033
Debt Instrument [Line Items]
Interest rate		5.40%
Gross value		$ 800,000,000
$790 million, 3.500% Notes due June 2024
Debt Instrument [Line Items]
Interest rate		3.50%
Gross value		$ 790,000,000
$1,000 million, 5.000% Notes due May 2029
Debt Instrument [Line Items]
Interest rate		5.00%
Gross value		$ 1,000,000,000
$1,000 million, 5.000% Notes due May 2029 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,000,000,000
Interest rate	5.00%
Net proceeds	$ 995,000,000
$1,000 million, 5.000% Notes due May 2029 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0015
$750 million, 5.125% Notes due May 2031
Debt Instrument [Line Items]
Interest rate		5.125%
Gross value		$ 750,000,000
$750 million, 5.125% Notes due May 2031 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 750,000,000
Interest rate	5.125%
Net proceeds	$ 746,000,000
$750 million, 5.125% Notes due May 2031 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0015
$1,250 million, 5.250% Notes due February 2034
Debt Instrument [Line Items]
Interest rate		5.25%
Gross value		$ 1,250,000,000
$1,250 million, 5.250% Notes due February 2034 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,250,000,000
Interest rate	5.25%
Net proceeds	$ 1,244,000,000
$1,250 million, 5.250% Notes due February 2034 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0020
$1,500 million, 5.600% Notes due February 2054
Debt Instrument [Line Items]
Interest rate		5.60%
Gross value		$ 1,500,000,000
$1,500 million, 5.600% Notes due February 2054 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,500,000,000
Interest rate	5.60%
Net proceeds	$ 1,485,000,000
$1,500 million, 5.600% Notes due February 2054 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0020

XML

Debt - Interest Expense (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Debt Disclosure [Abstract]
Interest expense on long-term and short-term debt	$ 369	$ 345

XML

Common and Preferred Stock - Dividends (Details) - USD ($) $ / shares in Units, $ in Millions				3 Months Ended
	Apr. 24, 2024	Mar. 21, 2024	Mar. 23, 2023	Mar. 31, 2024	Mar. 31, 2023
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)				$ 1.40	$ 1.23
Amount per share (in dollars per share)		$ 1.40	$ 1.23
Total amount paid		$ 401	$ 368	$ 401	$ 368
Subsequent Event
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)	$ 1.40

XML

Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($) shares in Millions		3 Months Ended
	Feb. 15, 2024	Jun. 30, 2024	Mar. 31, 2024	Mar. 31, 2023
Accelerated Share Repurchases [Line Items]
Stock repurchased			$ 4,057,000,000	$ 958,000,000
Treasury Stock
Accelerated Share Repurchases [Line Items]
Stock repurchased			3,417,000,000	958,000,000
Additional Paid-in Capital
Accelerated Share Repurchases [Line Items]
Stock repurchased			$ 640,000,000	$ 0
Accelerated Share Repurchase Agreement, February 2024
Accelerated Share Repurchases [Line Items]
Accelerated stock repurchase, amount authorized	$ 3,200,000,000
Accelerated stock repurchase, amount remitted	$ 3,200,000,000
Stock repurchased (in shares)	7.6
Accelerated Share Repurchase Agreement, February 2024 | Treasury Stock
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 2,600,000,000
Accelerated Share Repurchase Agreement, February 2024 | Treasury Stock | Forecast
Accelerated Share Repurchases [Line Items]
Stock repurchased		$ 640,000,000
Accelerated Share Repurchase Agreement, February 2024 | Additional Paid-in Capital
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 640,000,000
Accelerated Share Repurchase Agreement, February 2024 | Additional Paid-in Capital | Forecast
Accelerated Share Repurchases [Line Items]
Stock repurchased		$ (640,000,000)

XML

Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Current
Market risk benefits, current	$ 26	$ 37
Unearned premiums, current, including held for sale liabilities	815	846
Total, current	7,357	6,633
Current insurance and contractholder liabilities	5,788	5,514
Non-current
Market risk benefits, non-current	865	966
Unearned premiums, non-current, including held for sale liabilities	21	22
Total, non-current	11,153	11,421
Non-current insurance and contractholder liabilities	10,641	10,904
Total
Market risk benefits	891	1,003	$ 1,220
Unearned premiums			1,440
Unearned premiums, including held for sale liabilities	836	868
Total	18,510	18,054
Total insurance and contractholder liabilities	16,429	16,418	18,956
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Current
Insurance and contractholder liabilities current, classified as held for sale	(1,569)	(1,119)
Non-current
Insurance and contractholder liabilities, non-current, classified as held for sale	(512)	(517)
Total
Insurance and contractholder liabilities classified as held for sale	(2,081)	(1,636)
Unpaid claims classified as liabilities of business held for sale	1,378	823
Future policy benefits classified as liabilities of business held for sale		429
Unearned premiums classified as liabilities of business held for sale	161	261
Contractholder deposit funds classified as liabilities held for sale	115	123
Cigna Healthcare
Current
Unpaid claims and claim expenses, current, including held for sale liabilities	5,786	5,017
Future policy benefits, current, including held for sale liabilities	92	97
Contractholder deposit funds, current, including held for sale liabilities	11	12
Non-current
Unpaid claims and claim expenses, non-current, including held for sale liabilities	77	75
Future policy benefits, non-current, including held for sale liabilities	515	518
Contractholder deposit funds, non-current, including liabilities held for sale	130	133
Total
Unpaid claims and claim expenses			4,959	$ 4,176
Unpaid claims and claim expenses, including held for sale liabilities	5,863	5,092
Total liability for future policy benefits			601
Future policy benefits, including held for sale liabilities	607	615
Contractholder deposit funds			163
Contractholder deposit funds, including liabilities held for sale	141	145
Cigna Healthcare | Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Total
Future policy benefits classified as liabilities of business held for sale	427
Other Operations
Current
Unpaid claims and claim expenses, current	99	99
Future policy benefits, current	163	163
Contractholder deposit funds, current	365	362
Non-current
Unpaid claims and claim expenses, non-current	161	154
Future policy benefits, non-current	3,297	3,375
Contractholder deposit funds, non-current	6,087	6,178
Total
Unpaid claims and claim expenses	260	253	272
Total liability for future policy benefits	3,460	3,538	3,631
Contractholder deposit funds	$ 6,452	$ 6,540	$ 6,670	$ 6,700

XML

Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Paid costs related to:
Unpaid claims classified as liabilities of business held for sale	$ 1,378		$ 823
Cigna Healthcare
Liability for Claims and Claims Adjustment Expense [Line Items]
Total of incurred but not reported liabilities plus expected claim development on reported claims, including reported claims in process	5,400	$ 4,600
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Beginning balance		4,176
Less: Reinsurance and other amounts recoverable		221
Beginning balance, net		3,955
Beginning balance, including held for sale liabilities	5,092
Less: Reinsurance, including held for sale liabilities	236
Beginning balance, net, including held for sale liabilities	4,856
Incurred costs related to:
Current year	9,452	9,041
Prior years	(226)	(144)
Total incurred	9,226	8,897
Paid costs related to:
Current year	5,072	5,316
Prior years	3,352	2,795
Total paid	8,424	8,111
Ending balance, net		4,741
Add: Reinsurance and other amounts recoverable		218
Ending balance		$ 4,959
Ending balance, net, including held for sale liabilities	5,658
Add: Reinsurance, including held for sale liabilities	205
Ending balance, including held for sale liabilities	$ 5,863

XML

Insurance and Contractholder Liabilities - Unpaid Claims and Claims Expenses - Cigna Healthcare - Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses (Details) - Cigna Healthcare - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 226	$ 144
Favorable (unfavorable) variance, percentage	0.60%	0.50%
Actual completion factors
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 76	$ 1
Favorable (unfavorable) variance, percentage	0.20%	0.00%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 150	$ 143
Favorable (unfavorable) variance, percentage	0.40%	0.50%

XML

Insurance and Contractholder Liabilities - Future Policy Benefits - Interest Rates and Duration (Details)	Mar. 31, 2024	Mar. 31, 2023
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	2.56%	2.59%
Current discount rate	5.11%	5.29%
Weighted average duration	7 years 9 months 18 days	8 years 1 month 6 days
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	5.64%	5.64%
Current discount rate	5.16%	4.95%
Weighted average duration	11 years 3 months 18 days	11 years 8 months 12 days

XML

Insurance and Contractholder Liabilities - Future Policy Benefits - Present Value of Expected Premiums and Benefits (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023	Dec. 31, 2022
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Future policy benefits classified as liabilities of business held for sale			$ 429
Cigna Healthcare
Liability for Future Policy Benefit, Expected Net Premium [Roll Forward]
Beginning balance	$ 9,233	$ 8,557
Reversal of effect of beginning of period discount rate assumptions	1,154	1,537
Issuances and lapses	446	306
Net premiums collected	(350)	(326)
Interest and other	73	56
Ending balance at original discount rate	10,556	10,130
Effect of end of period discount rate assumptions	(1,309)	(1,312)
Ending balance	9,247	8,818	9,233	$ 8,557
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Beginning balance	9,633	8,945
Reversal of effect of discount rate assumptions	1,220	1,611
Issuances and lapses	457	307
Benefit payments	(362)	(326)
Interest and other	71	58
Ending balance at original discount rate	11,019	10,595
Effect of discount rate assumptions	(1,381)	(1,378)
Ending balance	9,638	9,217	9,633	8,945
Liability for future policy benefits	391	399
Other	216	202
Total liability for future policy benefits		601
Total liability for future policy benefits, including assets held for sale	607
Undiscounted expected future gross premiums	19,000	17,600
Discounted expected future gross premiums	13,300	12,500
Undiscounted expected future policy benefits	13,600	12,800
Future policy benefits reserve, reinsurance recoverables	72	154
Cigna Healthcare | Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Future policy benefits reserve, reinsurance recoverables reported in assets of businesses held for sale	81
Future policy benefits classified as liabilities of business held for sale	427
Other Operations
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Total liability for future policy benefits	3,460	3,631	3,538
Undiscounted expected future policy benefits	4,400	4,600
Future policy benefits reserve, reinsurance recoverables	1,000	1,000
Future policy benefits, DPL	379	392
Future policy benefit, excluding DPL	$ 3,100	$ 3,200	$ 3,200	$ 3,200

XML

Insurance and Contractholder Liabilities - Contractholder Deposit Funds (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit fund liabilities, approximate percent reinsured externally	38.00%
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds			$ 163
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds	$ 6,452	$ 6,540	$ 6,670	$ 6,700
Weighted average crediting rate	3.33%		3.25%
Net amount at risk	$ 3,000		$ 3,200
Cash surrender value	$ 2,800		$ 2,800
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds not reinsured externally, percent with guaranteed interest rates of 0300 to 0400	99.00%		99.00%
Contractholder deposit funds not reinsured externally	$ 4,000		$ 4,100
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, at Guaranteed Minimum Crediting Rate
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds not reinsured externally	1,200		1,200
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds not reinsured externally	1,200		1,200
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, Above Guaranteed Minimum Crediting Rate, Based On Greater Of Guaranteed Minimum Cash Value Or Actual Cash Value
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds not reinsured externally	$ 1,600		$ 1,700
Percentage with cash values at more than 110% of guaranteed cash value	90.00%		90.00%
Other Operations | Minimum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Above guaranteed minimum crediting rate	0.0050		0.0050
Other Operations | Minimum | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400
Insurance and Contractholder Liabilities [Line Items]
Guaranteed minimum credit rating	3.00%		3.00%
Other Operations | Maximum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Above guaranteed minimum crediting rate	0.0150		0.0150
Other Operations | Maximum | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400
Insurance and Contractholder Liabilities [Line Items]
Guaranteed minimum credit rating	4.00%		4.00%

XML

Insurance and Contractholder Liabilities - Summary of Market Risk Benefit (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Insurance Loss Reserves [Abstract]
Annuitization election period	30 days
Market Risk Benefit [Roll Forward]
Balance, beginning of year	$ 1,003	$ 1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,085	1,379
Changes due to expected run-off	(3)	(6)
Changes due to capital markets versus expected	(113)	(41)
Changes due to policyholder behavior versus expected	(14)	6
Assumption changes	0	(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	955	1,305
Nonperformance risk (own credit risk), end of period	(64)	(85)
Balance, end of period	891	1,220
Reinsured market risk benefit, end of period	$ 951	$ 1,301

XML

Insurance and Contractholder Liabilities - Net Amount of Risk and Average Age of Contractholders (Details) - Variable Annuity - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Net Amount at Risk by Product and Guarantee [Line Items]
Net amount at risk	$ 1,441	$ 2,183
Average attained age of contractholders (weighted by exposure)	77 years 8 months 12 days	75 years 4 months 24 days

XML

Reinsurance - Reinsurance Recoverables (Details) - USD ($) $ in Millions	Mar. 31, 2024	Mar. 31, 2023
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	$ 4,131
Allowance for uncollectible reinsurance, including assets held for sale	(35)
Market risk benefits	951	$ 1,301
Total reinsurance recoverables, including assets held for sale	5,047
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Ceded Credit Risk [Line Items]
Reinsurance recoverable classified as assets of businesses held for sale	209
Other Current Assets
Ceded Credit Risk [Line Items]
Reinsurance recoverables	166
Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables
Ceded Credit Risk [Line Items]
Market risk benefits	951
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	663
Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	2,989
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	479
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	485
Ongoing Operations | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	85
Ongoing Operations | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	60
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	340
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	145
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	145
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	7
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	7
Ongoing Operations | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	333
Ongoing Operations | No collateral | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	85
Ongoing Operations | No collateral | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	60
Ongoing Operations | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	188
Acquisition, disposition or run-off activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	3,646
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	2,619
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	128
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	351
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	334
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	204
Acquisition, disposition or run-off activities | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	10
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	518
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	351
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	167
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	2,982
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	2,619
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	334
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	23
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	6
Acquisition, disposition or run-off activities | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	146
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	128
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	14
Acquisition, disposition or run-off activities | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	$ 4

XML

Reinsurance - Effective Exit of Variable Annuity Reinsurance Business (Details) - Variable Annuity - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 974		$ 1,100
Incurred but not yet paid and outstanding claims	23		19
Impact of non-performance risk
Berkshire
Ceded Credit Risk [Line Items]
Percent of future claim payments reinsured	100.00%
Remaining overall limit under reinsurance agreement	$ 3,100
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 777		873
Berkshire | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 79		92
Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 91		104
Liberty Re (Bermuda) Ltd. | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
SCOR SE
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 27		$ 31
SCOR SE | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	75.00%

XML

Investments - Investments by Category (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Current
Investments including held for sale assets	$ 1,193	$ 1,009
Current investments	1,108	925
Long-term
Investments including held for sale assets	17,281	19,339
Investments per Consolidated Balance Sheets	16,025	17,985
Total
Investments including held for sale assets	18,474	20,348
Total investments	17,133	18,910
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Current
Investments classified as assets of business held for sale	(85)	(84)
Long-term
Investments classified as assets of business held for sale	(1,256)	(1,354)
Total
Investments classified as assets of business held for sale	(1,341)	(1,438)
Debt securities
Current
Investments including held for sale assets	604	590
Long-term
Investments including held for sale assets	8,876	9,265
Total
Investments including held for sale assets	9,480	9,855
Equity securities
Current
Investments including held for sale assets	18	31
Long-term
Investments including held for sale assets	1,553	3,331
Total
Investments including held for sale assets	1,571	3,362
Commercial mortgage loans
Current
Investments including held for sale assets	197	182
Long-term
Investments including held for sale assets	1,365	1,351
Total
Investments including held for sale assets	1,562	1,533
Policy loans
Current
Investments including held for sale assets	0	0
Long-term
Investments including held for sale assets	1,186	1,211
Total
Investments including held for sale assets	1,186	1,211
Other long-term investments
Current
Investments including held for sale assets	0	0
Long-term
Investments including held for sale assets	4,301	4,181
Total
Investments including held for sale assets	4,301	4,181
Short-term investments
Current
Investments including held for sale assets	374	206
Long-term
Investments including held for sale assets	0	0
Total
Investments including held for sale assets	$ 374	$ 206

XML

Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Amortized Cost
Due in one year or less, including assets held for sale	$ 633
Due after one year through five years, including assets held for sale	3,768
Due after five years through ten years, including assets held for sale	3,144
Due after ten years, including assets held for sale	2,186
Mortgage and other asset-backed securities, including assets held for sale	389
Total, including assets held for sale	10,120	$ 10,379
Fair Value
Due in one year or less, including assets held for sale	619
Due after one year through five years, including assets held for sale	3,587
Due after five years through ten years, including assets held for sale	2,921
Due after ten years, including assets held for sale	2,000
Mortgage and other asset-backed securities, including assets held for sale	353
Total, including assets held for sale	$ 9,480	$ 9,855

XML

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Schedule of Investments [Line Items]
Derivative gain (loss) recognized in the income statement
Derivative gain (loss) recognized in other comprehensive income
Derivative gain (loss) reclassified from other comprehensive income into shareholders' net income
Equity securities with no readily determinable fair value	1,532		$ 3,311
Realized investment losses, net	1,836	$ 56
VillageMD
Schedule of Investments [Line Items]
Equity securities with no readily determinable fair value	900
Realized investment losses, net	$ 1,800

XML

Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	$ 10,120	$ 10,379
Allowance for Credit Loss, including held for sale assets	(50)	(33)
Unrealized Appreciation, including held for sale assets	153	195
Unrealized Depreciation, including held for sale assets	(743)	(686)
Fair Value, including held for sale assets	9,480	9,855
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	289	251
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	21	24
Unrealized Depreciation, including held for sale assets	(10)	(8)
Fair Value, including held for sale assets	300	267
State and local government
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	37	37
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	2	2
Unrealized Depreciation, including held for sale assets	(1)	(1)
Fair Value, including held for sale assets	38	38
Foreign government
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	354	355
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	8	10
Unrealized Depreciation, including held for sale assets	(14)	(13)
Fair Value, including held for sale assets	348	352
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	9,051	9,338
Allowance for Credit Loss, including held for sale assets	(50)	(33)
Unrealized Appreciation, including held for sale assets	122	158
Unrealized Depreciation, including held for sale assets	(682)	(630)
Fair Value, including held for sale assets	8,441	8,833
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	389	398
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	0	1
Unrealized Depreciation, including held for sale assets	(36)	(34)
Fair Value, including held for sale assets	$ 353	$ 365

XML

Investments - Debt Securities with a Decline in Fair Value (Details) $ in Millions	Mar. 31, 2024 USD ($) position	Dec. 31, 2023 USD ($) position
Total
Total Fair Value, including held for sale assets	$ 6,577	$ 6,633
Total Amortized Cost, including held for sale assets	7,320	7,319
Total Unrealized Depreciation, including held for sale assets	$ (743)	$ (686)
Total Number of Issues, including held for sale assets | position	2,413	2,353
Investment grade | Debt securities
One year or less
Fair Value, including held for sale assets	$ 562	$ 330
Amortized Cost, including held for sale assets	576	338
Unrealized Depreciation, including held for sale assets	$ (14)	$ (8)
Number of Issues, including held for sale assets | position	232	142
More than one year
Fair Value, including held for sale assets	$ 5,284	$ 5,441
Amortized Cost, including held for sale assets	5,946	6,036
Unrealized Depreciation, including held for sale assets	$ (662)	$ (595)
Number of Issues, including held for sale assets | position	1,561	1,590
Below investment grade | Debt securities
One year or less
Fair Value, including held for sale assets	$ 133	$ 161
Amortized Cost, including held for sale assets	137	170
Unrealized Depreciation, including held for sale assets	$ (4)	$ (9)
Number of Issues, including held for sale assets | position	253	135
More than one year
Fair Value, including held for sale assets	$ 598	$ 701
Amortized Cost, including held for sale assets	661	775
Unrealized Depreciation, including held for sale assets	$ (63)	$ (74)
Number of Issues, including held for sale assets | position	367	486

XML

Investments - Equity Security Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Cost
Equity securities with readily determinable fair values	$ 647	$ 656
Equity securities with no readily determinable fair value	3,281	3,248
Total	3,928	3,904
Carrying Value
Equity securities with readily determinable fair values	39	51
Equity securities with no readily determinable fair value	1,532	3,311
Total	$ 1,571	$ 3,362
Equity Securities FV NI | Product Concentration Risk | Health Care Sector
Other Commitments [Line Items]
Concentration percentage	90.00%

XML

Investments - Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 1,562	$ 1,533
Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	1.81	1.82
Average Loan-to-Value Ratio, including assets held for sale	0.64	0.64
Below 60%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 810	$ 802
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	2.12	2.13
60% to 79%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 594	$ 574
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	1.75	1.77
80% to 100%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 158	$ 157
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	0.63	0.65

XML

Investments - Other Long-Term Investments (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Schedule of Investments [Line Items]
Other long term investments, including held for sale assets	$ 4,301	$ 4,181
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	1,696	1,606
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	2,423	2,400
Other
Schedule of Investments [Line Items]
Other long term investments, including held for sale assets	$ 182	$ 175

XML

Investments - Realized Gains and Losses on Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Investments [Abstract]
Net realized investment losses, before income taxes	$ (1,836)	$ (56)

XML

Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Financial assets at fair value:
Equity securities	$ 39	$ 51
Recurring
Financial assets at fair value:
Equity securities	39	51
Short-term investments	374	206
Debt Securities, including held for sale assets	9,480	9,855
Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	147	132
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	4	4
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Equity securities	2	4
Short-term investments	0	0
Debt Securities, including held for sale assets	165	130
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	0	0
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	0	0
Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Equity securities	37	47
Short-term investments	374	206
Debt Securities, including held for sale assets	8,893	9,278
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	147	131
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	4	4
Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Equity securities	0	0
Short-term investments	0	0
Debt Securities, including held for sale assets	422	447
Significant Unobservable Inputs (Level 3) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	0	1
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	0	0
Federal government and agency | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	300	267
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	165	130
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	135	137
Federal government and agency | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
State and local government | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	38	38
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
State and local government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	38	38
State and local government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
Foreign government | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	348	352
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
Foreign government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	348	352
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
Corporate | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	8,441	8,833
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
Corporate | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	8,072	8,432
Corporate | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	369	401
Mortgage and other asset-backed | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	353	365
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	0	0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	300	319
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	$ 53	$ 46

XML

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity securities with no readily determinable fair value	$ 1,532		$ 3,311
Realized investment losses, net	1,836	$ 56
VillageMD
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity securities with no readily determinable fair value	900
Realized investment losses, net	1,800
Separate Account Assets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Separate accounts assets classified in Level 3, period increase (decrease), including transfers in and out of Level 3
Separate Account Assets | Recurring
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Expected liquidation period after inception	10 years

XML

Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3) $ in Millions	Mar. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value, including held for sale assets	$ 422	$ 447
Corporate | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value, including held for sale assets	$ 369	$ 401
Corporate | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.0055	0.0070
Corporate | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.1230	0.1235
Corporate | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.0280	0.0310
Mortgage and other asset-backed securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value, including held for sale assets	$ 53	$ 46
Mortgage and other asset-backed securities | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.0110	0.0095
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.0605	0.0640
Mortgage and other asset-backed securities | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment, including held for sale assets	0.0280	0.0310

XML

Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Transfers into/(out of) Level 3
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$ (4)	$ 5
Debt and Equity Securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance		447
Beginning balance, including held for sale assets	447
(Losses) gains included in Shareholders' net (loss) income	(21)	1
(Losses) gains included in Other comprehensive loss	(3)	5
Purchases, sales and settlements
Purchases	0	4
Settlements	(14)	(9)
Total purchases, sales and settlements	(14)	(5)
Transfers into/(out of) Level 3
Transfers into Level 3	16	39
Transfers out of Level 3	(3)	(16)
Total transfers into/(out of) Level 3	13	23
Ending balance		471
Ending balance, including held for sale assets	422
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date	$ (21)	$ 1

XML

Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 569	$ 578
Non-guaranteed separate accounts	6,181	6,172
Subtotal	6,750	6,750
Non-guaranteed separate accounts priced at NAV as a practical expedient	666	680
Separate account assets	7,416	7,430
Pension Plans
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	4,000	4,000
Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	230	226
Non-guaranteed separate accounts	158	158
Subtotal	388	384
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	339	352
Non-guaranteed separate accounts	5,794	5,797
Subtotal	6,133	6,149
Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	0	0
Non-guaranteed separate accounts	229	217
Subtotal	229	217
Significant Unobservable Inputs (Level 3) | Pension Plans
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	$ 200	$ 200

XML

Fair Value Measurements - Additional Information on Separate Account Assets Priced at Net Asset Value (Details) - Separate Account Assets - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 252
Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	666	$ 680
Securities partnerships
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	252
Securities partnerships | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	412	419
Real estate funds
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Real estate funds | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Real estate funds | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Real estate funds | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 251	258
Hedge funds
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Hedge funds | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Hedge funds | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Hedge funds | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 3	$ 3

XML

Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Realized investment losses on assets measured at fair value under certain conditions, after-tax
Realized investment gains on equity securities with no readily determinable fair value

XML

Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Fair Value | Significant Other Observable Inputs (Level 2)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt, including current maturities, excluding finance leases	$ 29,806	$ 28,033
Fair Value | Significant Unobservable Inputs (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans, including assets held for sale	1,451	1,430
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt, including current maturities, excluding finance leases	31,783	29,585
Commercial mortgage loans, including assets held for sale	$ 1,562	$ 1,533

XML

Variable Interest Entities (Details) - entity	Mar. 31, 2024	Dec. 31, 2023
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Number of VIEs	0	0

XML

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 46,244	$ 44,688
Other comprehensive loss, net of tax	(460)	(111)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests	0	0
Shareholders other comprehensive income (loss), net of tax	(460)	(111)
Balance	41,350	44,518
Accumulated Other Comprehensive (Loss)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(1,864)	(1,658)
Shareholders other comprehensive income (loss), net of tax	(460)	(111)
Balance	(2,324)	(1,769)
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	171	(332)
Other comprehensive income (loss) before reclassifications, before tax	143	252
Other comprehensive income (loss), before reclassifications, tax	(39)	(54)
Other comprehensive income (loss) before reclassifications, after-tax	104	198
Reclassification adjustment, tax	(5)	1
Net amounts reclassified from AOCI to net income	17	(4)
Shareholders other comprehensive income (loss), net of tax	121	194
Balance	292	(138)
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	22	(5)
Net long-duration insurance and contractholder liabilities measurement adjustments
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(971)	(256)
Shareholders other comprehensive income (loss), net of tax	(560)	(331)
Balance	(1,531)	(587)
Current period change in discount rate for certain long-duration liabilities
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax	(732)	(411)
Other comprehensive income (loss), before reclassifications, tax	186	101
Other comprehensive income (loss) before reclassifications, after-tax	(546)	(310)
Current period change in instrument-specific credit risk for market risk benefits
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax	(18)	(26)
Other comprehensive income (loss), before reclassifications, tax	4	5
Other comprehensive income (loss) before reclassifications, after-tax	(14)	(21)
Translation of foreign currencies including portion attributable to noncontrolling interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Translation of foreign currencies, before tax	(24)	15
Other Comprehensive Income (Loss), Tax, Including Temporary Equity	(2)	1
Other comprehensive loss, net of tax	(26)	16
Translation of foreign currencies attributable to parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(149)	(154)
Balance	(175)	(138)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(915)	(916)
Reclassification adjustment, tax	(3)	(3)
Shareholders other comprehensive income (loss), net of tax	5	10
Balance	(910)	(906)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	$ 8	$ 13

XML

Income Taxes - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	368.40%	18.40%
Deferred tax assets associated with unrealized investment losses	$ 664
Valuation allowance of deferred tax assets associated with unrealized investment losses	$ 427

XML

Contingencies and Other Matters (Details)			1 Months Ended	3 Months Ended
	Mar. 31, 2022 USD ($)	Apr. 19, 2016 claim	Mar. 31, 2016 USD ($)	Mar. 31, 2024 USD ($)
Guaranty Fund Assessments
Commitments And Contingencies [Line Items]
Loss contingency accrual provision
Litigation Matters and Regulatory Matters
Commitments And Contingencies [Line Items]
Reserves for litigation matters, pre-tax
Express Scripts Litigation with Elevance | Judicial Ruling | Pricing Concessions
Commitments And Contingencies [Line Items]
Damages sought by Elevance	$ 14,800,000,000
Express Scripts Litigation with Elevance | Pending Litigation | Pricing Concessions Through Remaining Contract Term
Commitments And Contingencies [Line Items]
Damages sought by Elevance			$ 13,000,000,000
Express Scripts Litigation with Elevance | Pending Litigation | Pricing Concessions After Remaining Term of Agreement
Commitments And Contingencies [Line Items]
Damages sought by Elevance			1,800,000,000
Express Scripts Litigation with Elevance | Pending Litigation | Damages for Service Issues
Commitments And Contingencies [Line Items]
Damages sought by Elevance			$ 150,000,000	100,000,000
Express Scripts counterclaims against Elevance
Commitments And Contingencies [Line Items]
Number of counts dismissed | claim		2
Number of counts | claim		6
Indemnification obligations
Commitments And Contingencies [Line Items]
Liability for guarantees				0
Retiree and Life Insurance Benefits | Financial Guarantees
Commitments And Contingencies [Line Items]
Maximum guarantee exposure				410,000,000
Assets maintained by employers (minimum)				410,000,000
Liability for guarantees				$ 0

XML

Segment Information - Summary of Special Items (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pre-tax
Integration and transaction-related costs, pre-tax	$ 37	$ 1
(Gain) loss on sale of business	19	0
Deferred tax (benefits), net (Income taxes, less amount attributable to noncontrolling interests)	0	0
Total impact from special items	56	1
After-tax
Integration and transaction-related costs, after-tax (Selling, general and administrative expenses)	29	1
(Gain) loss on sale of business, after-tax	(43)	0
Deferred tax (benefits), net, after-tax (Income taxes, less amount attributable to noncontrolling interests)	17	0
Total impact from special items	$ 3	$ 1

XML

Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Revenues from customers	$ 56,965	$ 46,240
Net investment income (loss)	290	277
TOTAL REVENUES	57,255	46,517
Net realized investment results from certain equity method investments	(8)	(38)
Adjusted revenues	57,247	46,479
Depreciation and amortization	741	749
Income before income taxes	79	1,601
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(77)	(43)
Net realized investment (gains) losses	1,828	18
Amortization of acquired intangible assets	423	459
Special items
Integration and transaction-related costs	37	1
(Gain) loss on sale of business	19	0
Pre-tax adjusted income (loss) from operations	2,309	2,036
Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	44,886	34,511
Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	12,012	11,650
Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	66	79
Operating Segments | Evernorth Health Services
Segment Reporting Information [Line Items]
Net investment income (loss)	59	50
TOTAL REVENUES	46,226	36,179
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	46,226	36,179
Income before income taxes	(436)	918
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(77)	(42)
Net realized investment (gains) losses	1,456	0
Amortization of acquired intangible assets	417	444
Special items
Integration and transaction-related costs	0	0
(Gain) loss on sale of business	0
Pre-tax adjusted income (loss) from operations	1,360	1,320
Operating Segments | Cigna Healthcare
Segment Reporting Information [Line Items]
Net investment income (loss)	149	143
TOTAL REVENUES	13,285	12,756
Net realized investment results from certain equity method investments	(8)	(38)
Adjusted revenues	13,277	12,718
Income before income taxes	943	1,077
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	(1)
Net realized investment (gains) losses	372	24
Amortization of acquired intangible assets	6	15
Special items
Integration and transaction-related costs	0	0
(Gain) loss on sale of business	19
Pre-tax adjusted income (loss) from operations	1,340	1,115
Operating Segments | Other Operations
Segment Reporting Information [Line Items]
Net investment income (loss)	75	78
TOTAL REVENUES	166	157
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	166	157
Income before income taxes	18	21
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	0
Net realized investment (gains) losses	0	(6)
Amortization of acquired intangible assets	0	0
Special items
Integration and transaction-related costs	0	0
(Gain) loss on sale of business	0
Pre-tax adjusted income (loss) from operations	18	15
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net investment income (loss)	7	6
TOTAL REVENUES	(2,422)	(2,575)
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	(2,422)	(2,575)
Income before income taxes	(446)	(415)
Special items
Pre-tax adjusted income (loss) from operations	(409)	(414)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	1	0
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	0
Net realized investment (gains) losses	0	0
Amortization of acquired intangible assets	0	0
Special items
Integration and transaction-related costs	37	1
(Gain) loss on sale of business	0
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(2,430)	(2,581)
Intersegment Eliminations | Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	(1,281)	(1,618)
Intersegment Eliminations | Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	(1,124)	(963)
Intersegment Eliminations | Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	$ (25)	$ 0

XML

Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue from External Customer [Line Items]
Premiums	$ 11,603	$ 11,025
Total revenues from external customers	56,965	46,240
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	42,036	32,144
Service
Revenue from External Customer [Line Items]
Revenues	3,326	3,071
Evernorth Health Services
Revenue from External Customer [Line Items]
Total revenues from external customers	44,886	34,511
Cigna Healthcare
Revenue from External Customer [Line Items]
Total revenues from external customers	12,012	11,650
Other Operations
Revenue from External Customer [Line Items]
Total revenues from external customers	66	79
Intersegment Eliminations
Revenue from External Customer [Line Items]
Premiums	24	16
Total revenues from external customers	(2,430)	(2,581)
Intersegment Eliminations | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	(1,151)	(1,496)
Intersegment Eliminations | Service
Revenue from External Customer [Line Items]
Revenues	(1,303)	(1,101)
Intersegment Eliminations | Evernorth Health Services
Revenue from External Customer [Line Items]
Total revenues from external customers	(1,281)	(1,618)
Intersegment Eliminations | Cigna Healthcare
Revenue from External Customer [Line Items]
Total revenues from external customers	(1,124)	(963)
Intersegment Eliminations | Other Operations
Revenue from External Customer [Line Items]
Total revenues from external customers	(25)	0
Operating Segments | Other revenues
Revenue from External Customer [Line Items]
Revenues	90	66
Operating Segments | Evernorth Health Services | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	43,170	33,640
Operating Segments | Evernorth Health Services | Network revenues
Revenue from External Customer [Line Items]
Revenues	24,166	15,748
Operating Segments | Evernorth Health Services | Home delivery and specialty revenues
Revenue from External Customer [Line Items]
Revenues	16,458	16,025
Operating Segments | Evernorth Health Services | Other revenues
Revenue from External Customer [Line Items]
Revenues	2,546	1,867
Operating Segments | Evernorth Health Services | Fees
Revenue from External Customer [Line Items]
Revenues	2,943	2,499
Operating Segments | Cigna Healthcare
Revenue from External Customer [Line Items]
Premiums	11,531	10,930
Operating Segments | Cigna Healthcare | Fees
Revenue from External Customer [Line Items]
Revenues	1,571	1,606
Operating Segments | Cigna Healthcare | U.S. Healthcare
Revenue from External Customer [Line Items]
Premiums	10,646	10,144
Operating Segments | Cigna Healthcare | U.S. Healthcare | Employer insured
Revenue from External Customer [Line Items]
Premiums	4,393	4,080
Operating Segments | Cigna Healthcare | U.S. Healthcare | Medicare Advantage
Revenue from External Customer [Line Items]
Premiums	2,287	2,236
Operating Segments | Cigna Healthcare | U.S. Healthcare | Stop loss
Revenue from External Customer [Line Items]
Premiums	1,668	1,503
Operating Segments | Cigna Healthcare | U.S. Healthcare | Individual and Family Plans
Revenue from External Customer [Line Items]
Premiums	1,040	1,208
Operating Segments | Cigna Healthcare | U.S. Healthcare | Other
Revenue from External Customer [Line Items]
Premiums	1,258	1,117
Operating Segments | Cigna Healthcare | International Health
Revenue from External Customer [Line Items]
Premiums	885	786
Operating Segments | Other Operations
Revenue from External Customer [Line Items]
Premiums	48	79
Operating Segments | Other Operations | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	17	0
Operating Segments | Other Operations | Fees
Revenue from External Customer [Line Items]
Revenues	$ 25	$ 1

XML

Segment Information - Financial and Performance Guarantees (Details) - USD ($) $ in Billions	Mar. 31, 2024	Dec. 31, 2023
Pharmacy Benefits Management Services | Guarantees
Loss Contingencies [Line Items]
Guarantee liability	$ 1.9	$ 1.6

XML

Segment Information - Major Customers (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Loss Contingencies [Line Items]
Revenues from external customers	$ 56,965	$ 46,240
Revenue | Customer Concentration Risk | U.S. Federal Government Agencies
Loss Contingencies [Line Items]
Concentration percentage	13.00%
Revenue | Customer Concentration Risk | Single Pharmacy Benefit Client
Loss Contingencies [Line Items]
Concentration percentage	15.00%