Segment Information

9 Months Ended

Sep. 30, 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 reflect the underlying results of business operations and facilitate 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 September 30,								Nine Months Ended September 30,
	2024				2023				2024				2023
(In millions)	Pre-tax		After-tax		Pre-tax		After-tax		Pre-tax		After-tax		Pre-tax		After-tax
Impairment of dividend receivable  (Net investment income)	$	182	$	138	$	—	$	—	$	182	$	138	$	—	$	—
Integration and transaction-related costs  (Selling, general and administrative expenses)	77		59		13		9		177		135		20		15
Loss on sale of businesses	87		62		21		19		106		19		21		19
Deferred tax expenses, net  (Income taxes, less amount attributable to noncontrolling interests)	—		41		—		—		—		75		—		—
Charges associated with litigation matters  (Selling, general and administrative expenses)	—		—		201		171		—		—		201		171
Total impact from special items	$	346	$	300	$	235	$	199	$	465	$	367	$	242	$	205

Summarized segment financial information was as follows:

(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended September 30, 2024
Revenues from external customers	$	51,552	$	11,919	$	137	$	1	$	63,609
Intersegment revenues	1,045		1,279		18		(2,342)
Net investment (loss) income	(142)		142		79		6		85
Total revenues	52,455		13,340		234		(2,335)		63,694
Net realized investment results from certain equity method investments	—		(177)		—		—		(177)
Special item related to impairment of dividend receivable	182		—		—		—		182
Adjusted revenues	$	52,637	$	13,163	$	234	$	(2,335)	$	63,699
Income (loss) before income taxes	$	631	$	1,073	$	(10)	$	(502)	$	1,192
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(99)		—		—		—		(99)
Net realized investment losses (gains) (1)	748		(8)		4		—		744
Amortization of acquired intangible assets	414		22		—		—		436
Special items
Impairment of dividend receivable	182		—		—		—		182
Integration and transaction-related costs	—		—		—		77		77
Loss on sale of businesses	—		87		—		—		87
Pre-tax adjusted income (loss) from operations	$	1,876	$	1,174	$	(6)	$	(425)	$	2,619
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended September 30, 2023
Revenues from external customers	$	37,230	$	11,426	$	71	$	—	$	48,727
Intersegment revenues	1,303		1,136		—		(2,439)
Net investment income	63		176		76		6		321
Total revenues	38,596		12,738		147		(2,433)		49,048
Net realized investment results from certain equity method investments	—		30		—		—		30
Adjusted revenues	$	38,596	$	12,768	$	147	$	(2,433)	$	49,078
Income (loss) before income taxes	$	1,272	$	1,019	$	(3)	$	(448)	$	1,840
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(44)		—		—		—		(44)
Net realized investment losses (1)	1		35		8		—		44
Amortization of acquired intangible assets	443		11		—		—		454
Special items
Integration and transaction-related costs	—		—		—		13		13
Loss on sale of businesses	—		—		21		—		21
Charges associated with litigation matters	44		157		—		—		201
Pre-tax adjusted income (loss) from operations	$	1,716	$	1,222	$	26	$	(435)	$	2,529

(1) Includes Net realized investment losses/gains 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.

(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Nine months ended September 30, 2024
Revenues from external customers	$	144,689	$	35,752	$	333	$	2	$	180,776
Intersegment revenues	3,558		3,606		63		(7,227)
Net investment (loss) income	(18)		463		231		20		696
Total revenues	148,229		39,821		627		(7,205)		181,472
Net realized investment results from certain equity method investments	—		(238)		—		—		(238)
Special item related to impairment of dividend receivable	182		—		—		—		182
Adjusted revenues	$	148,411	$	39,583	$	627	$	(7,205)	$	181,416
Income (loss) before income taxes	$	1,494	$	3,221	$	(9)	$	(1,446)	$	3,260
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(271)		—		—		—		(271)
Net realized investment losses (1)	2,203		359		5		—		2,567
Amortization of acquired intangible assets	1,247		32		—		—		1,279
Special items
Impairment of dividend receivable	182		—		—		—		182
Integration and transaction-related costs	—		—		—		177		177
Loss on sale of businesses	—		106		—		—		106
Pre-tax adjusted income (loss) from operations	$	4,855	$	3,718	$	(4)	$	(1,269)	$	7,300
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Nine months ended September 30, 2023
Revenues from external customers	$	108,462	$	34,581	$	232	$	—	$	143,275
Intersegment revenues	4,343		3,143		—		(7,486)
Net investment income	175		454		230		17		876
Total revenues	112,980		38,178		462		(7,469)		144,151
Net realized investment results from certain equity method investments	—		22		—		—		22
Adjusted revenues	$	112,980	$	38,200	$	462	$	(7,469)	$	144,173
Income (loss) before income taxes	$	3,318	$	3,252	$	47	$	(1,292)	$	5,325
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(140)		(2)		—		—		(142)
Net realized investment losses (1)	—		64		2		—		66
Amortization of acquired intangible assets	1,330		38		—		—		1,368
Special items
Integration and transaction-related costs	—		—		—		20		20
Loss on sale of businesses	—		—		21		—		21
Charges associated with litigation matters	44		157		—		—		201
Pre-tax adjusted income (loss) from operations	$	4,552	$	3,509	$	70	$	(1,272)	$	6,859

(1)Includes Net realized investment losses/gains 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 September 30,				Nine Months Ended September 30,
(In millions)	2024		2023		2024		2023
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	27,353	$	16,926	$	76,795	$	49,080
Home delivery and specialty revenues	18,909		16,324		53,384		48,943
Other revenues	2,990		2,390		8,433		6,506
Total Evernorth Health Services	49,252		35,640		138,612		104,529
Total Other Operations	14		—		47		—
Intercompany eliminations	(982)		(1,109)		(3,238)		(3,890)
Total Pharmacy revenues	48,284		34,531		135,421		100,639
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured	4,382		4,144		13,125		12,315
Medicare Advantage	2,110		2,189		6,604		6,605
Stop loss	1,689		1,548		5,022		4,565
Individual and Family Plans	1,001		1,269		3,016		3,770
Other	1,203		927		3,681		3,091
U.S. Healthcare	10,385		10,077		31,448		30,346
International Health	911		834		2,687		2,440
Total Cigna Healthcare	11,296		10,911		34,135		32,786
Other	122		70		285		225
Intercompany eliminations	18		17		73		51
Total Premiums	11,436		10,998		34,493		33,062
Services (Fees) (ASC 606)
Evernorth Health Services	3,314		2,862		9,508		8,199
Cigna Healthcare	1,671		1,639		4,850		4,847
Other Operations	15		1		57		3
Other revenues	267		43		509		172
Intercompany eliminations	(1,378)		(1,347)		(4,062)		(3,647)
Total Fees and other revenues	3,889		3,198		10,862		9,574
Total revenues from external customers	$	63,609	$	48,727	$	180,776	$	143,275

(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 and nine months ended September 30, 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 $2.0 billion as of September 30, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 16% of consolidated revenues for the three and nine months ended September 30, 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 10% and 11% of consolidated revenues for the three and nine months ended September 30, 2024, respectively. 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.