The Cigna Group Reports Strong Second Quarter 2024 Results

Global health company The Cigna Group (NYSE: CI) today reported strong second quarter 2024 results reflecting broad-based revenue and earnings growth across its businesses.

“Our second quarter results underscore the strength of our diversified portfolio. We continue to deliver innovative solutions to meet the evolving needs of those we serve,” said David M. Cordani, chairman and CEO of The Cigna Group. “We remain disciplined in our approach to executing our strategy, enabling us to consistently deliver value and sustain our growth in a dynamic environment.”

Shareholders’ net income for second quarter 2024 was $1.5 billion, or $5.45 per share, compared with $1.5 billion, or $4.92 per share, for second quarter 2023.

The Cigna Group’s adjusted income from operations1 for second quarter 2024 was $1.9 billion, or $6.72 per share, compared with $1.8 billion, or $6.13 per share, for second quarter 2023, reflecting strong contributions from both Evernorth Health Services and Cigna Healthcare.

A reconciliation of shareholders’ net income to adjusted income from operations1 is provided on the following page and on Exhibit 1 of this earnings release.

CONSOLIDATED HIGHLIGHTS

The following table includes highlights of results and reconciliations of total revenues to adjusted revenues3 and shareholders’ net income (loss) to adjusted income from operations1:

Consolidated Financial Results (dollars in millions):

Three Months Ended

Six Months Ended

June 30,

March 31,

June 30,

2024

2023

2024

2024

Total Revenues

$           60,523

$           48,586

$           57,255

117,778

Net Realized Investment Results from Equity Method Investments3

(53)

30

(8)

(61)

Adjusted Revenues3

$           60,470

$           48,616

$           57,247

$         117,717

Consolidated Earnings, net of taxes

Shareholders’ Net Income (Loss)

$             1,548

$             1,460

$              (277)

$             1,271

Net Realized Investment (Gains) Losses1

(20)

9

1,827

1,807

Amortization of Acquired Intangible Assets1

317

346

322

639

Special Items1

64

5

3

67

Adjusted Income from Operations1

$             1,909

$             1,820

$             1,875

$             3,784

Shareholders’ Net Income (Loss), per share 

$               5.45

$               4.92

$             (0.97)

$               4.43

Adjusted Income from Operations1, per share 

$               6.72

$               6.13

$               6.47

$             13.19

  • Total revenues for second quarter 2024 increased 25% from second quarter 2023, primarily driven by significant growth in Evernorth Health Services, reflecting large client wins.

  • Adjusted income from operations1 for second quarter 2024 increased 5% from second quarter 2023, reflecting strong contributions from Evernorth Health Services and Cigna Healthcare.

  • The SG&A expense ratio4 and adjusted SG&A expense ratio4 were 6.1% and 6.0%, respectively, for second quarter 2024, compared to 7.1% for both ratios in second quarter 2023, reflecting business mix shift and continued operating efficiency.

  • The debt-to-capitalization ratio was 43.6% at June 30, 2024 compared to 44.3% at March 31, 2024.

  • Year to date through July 31, 2024, the company purchased 14.7 million shares of common stock for approximately $5.0 billion. This includes the purchase of 9.3 million shares of common stock for $3.2 billion in accordance with the previously disclosed Accelerated Share Repurchase (ASR) Agreements.

CUSTOMER RELATIONSHIPS

The following table summarizes The Cigna Group’s medical customers and overall customer relationships:

Customer Relationships (in thousands):

As of the Periods Ended

June 30,

March 31,

December 31,

2024

2023

2024

2023

Total Pharmacy Customers5

122,470

98,638

122,767

98,570

U.S. Healthcare

17,404

17,882

17,562

18,170

International Health

1,639

1,624

1,622

1,610

Total Medical Customers5

19,043

19,506

19,184

19,780

Behavioral Care

23,816

26,383

23,801

24,956

Dental

18,339

18,634

18,443

18,543

Medicare Part D

2,564

2,542

2,558

2,550

Total Customer Relationships5

186,232

165,703

186,753

164,399

  • Total customer relationships5 at June 30, 2024 increased 13% from December 31, 2023 to 186.2 million.

  • Total pharmacy customers5 at June 30, 2024 increased 24% from December 31, 2023 to 122.5 million due to new sales and the continued expansion of relationships.

  • Total medical customers5 at June 30, 2024 were 19.0 million, primarily reflecting a year-to-date decrease in Individual and Family Plans customers, driven by targeted pricing actions in certain geographies.

  • Behavioral Care customers5 at June 30, 2024 were 23.8 million. The year-over-year decrease was primarily due to known non-renewal of supplemental behavioral coverage contracts, which were insignificant to total revenues and adjusted income from operations.

HIGHLIGHTS OF SEGMENT RESULTS

See Exhibit 1 for a reconciliation of adjusted income from operations1 to shareholders’ net income.

Evernorth Health Services

This segment includes 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.

Financial Results (dollars in millions):

Three Months Ended

Six Months

Ended

June 30,

March 31,

June 30,

2024

2023

2024

2024

Total adjusted revenues

   Pharmacy Benefit Services

$           26,612

$           18,819

$           26,095

$           52,707

   Specialty and Care Services

$           22,871

$           19,324

$           20,072

$           42,943

   Net investment income

$                  65

$                  62

$                  59

$                124

Adjusted Revenues3

$           49,548

$           38,205

$           46,226

$           95,774

Adjusted Income from Operations, Pre-Tax

Pharmacy Benefit Services

$                798

$                777

$                513

$             1,311

Specialty and Care Services

$                756

$                677

$                788

$             1,544

Net investment income

$                  65

$                  62

$                  59

$                124

Adjusted Income from Operations, Pre-Tax1

$             1,619

$             1,516

$             1,360

$             2,979

Adjusted Margin, Pre-Tax6

3.3 %

4.0 %

2.9 %

3.1 %

  • Evernorth Health Services second quarter 2024 adjusted revenues3 and adjusted income from operations, pre-tax1, increased 30% and 7%, respectively, relative to second quarter 2023.

  • For Pharmacy Benefit Services second quarter 2024 relative to second quarter 2023:
    • Adjusted revenues3 increased 41%, reflecting client wins and organic growth.
    • Adjusted income from operations, pre-tax1, increased 3%, reflecting continued affordability improvements, partially offset by planned investments to support new and existing client growth.

  • For Specialty and Care Services second quarter 2024 relative to second quarter 2023:
    • Adjusted revenues3 increased 18%, reflecting client wins and organic growth in specialty businesses.
    • Adjusted income from operations, pre-tax1, increased 12%, reflecting organic growth in specialty businesses and clinical care services, partially offset by increased investments to support business growth and the continued advancement of our digital capabilities and solutions.

Cigna Healthcare

This 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 commercial medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

Financial Results (dollars in millions):

Three Months Ended

Six Months
Ended

June 30,

March 31,

June 30,

2024

2023

2024

2024

Adjusted Revenues3,7

$            13,143

$            12,714

$            13,277

$            26,420

Adjusted Income from Operations, Pre-Tax1

$              1,204

$              1,172

$              1,340

$              2,544

Adjusted Margin, Pre-Tax6

9.2 %

9.2 %

10.1 %

9.6 %

  • Second quarter 2024 adjusted revenues3,7 increased 3% relative to second quarter 2023, reflecting premium rate increases to cover expected increases in underlying medical costs, partially offset by business mix.

  • Second quarter 2024 adjusted income from operations, pre-tax1, increased 3% relative to second quarter 2023, primarily driven by continued operating efficiency and higher net investment income, partially offset by a higher MCR4.

  • The Cigna Healthcare MCR4 was 82.3% for second quarter 2024 and includes approximately $50 million of unfavorable prior year revenue impacts, or 40 bps, primarily related to Medicare Advantage risk adjustment. The second quarter 2024 MCR4 compares to 81.2% for second quarter 2023, reflecting business mix and the aforementioned prior year revenue adjustments, partially offset by effective pricing execution and affordability initiatives.

  • Cigna Healthcare net medical costs payablewas $5.04 billion at June 30, 2024$5.66 billion at March 31, 2024, and $5.12 billion at June 30, 2023. The current net medical costs payable reflects more normalized levels after first quarter was elevated due to claims submission and payment process disruptions related to a third-party cyber incident. Favorable prior year reserve development on a gross pre-tax basis was $284 million and $202 million for the six months ended June 30, 2024 and 2023, respectively.

Corporate and Other Operations

Corporate reflects interest expense, amounts not allocated to operating segments and includes intersegment eliminations. Additionally, this discussion includes items reported in Other Operations, which is comprised of Corporate Owned Life Insurance (“COLI”), the Company’s run-off operations and other non-strategic businesses.

Financial Results (dollars in millions):

Three Months Ended

Six Months

Ended

June 30,

March 31,

June 30,

2024

2023

2024

2024

Adjusted (Loss) from Operations, Pre-Tax1

$              (451)

$              (394)

$              (391)

$              (842)

  • Second quarter 2024 adjusted loss from operations, pre-tax1, was $451 million compared to $394 million for second quarter 2023, primarily reflecting the impact of higher interest expense.

2024 OUTLOOK2

The Cigna Group’s outlook2 for full year 2024 adjusted revenues2,3 is at least $235.0 billion. The Cigna Group’s outlook2 for full year 2024 consolidated adjusted income from operations1,2 is at least $8.065 billion, or at least $28.40 per share2. Additionally, this outlook includes the impact of expected future share repurchases and anticipated 2024 dividends.

(dollars in millions, except where noted and per share amounts)

2024 Consolidated Metrics

Projection for Full Year Ending

December 31, 2024

Adjusted Revenues2,3

at least $235,000

Adjusted Income from Operations1,2

at least $8,065

Adjusted Income from Operations, per share1,2

at least $28.40

Adjusted SG&A Expense Ratio2,4

~6.1%

Adjusted Effective Tax Rate2,9

20.5% to 21.0%

Cash Flow from Operations2

at least $11,000

Weighted Average Shares Outstanding (millions)2

282 to 286

2024 Evernorth Metrics

Adjusted Income from Operations, Pre-Tax1,2

at least $7,000

2024 Cigna Healthcare Metrics

Adjusted Income from Operations, Pre-Tax1,2

at least $4,775

Medical Care Ratio2,4

81.7% to 82.5%

Total Medical Customers2,5

~19.3M

The foregoing statements represent the Company’s current estimates of The Cigna Group’s 2024 consolidated and segment adjusted income from operations1,2 and other key metrics as of the date of this release.  Actual results may differ materially depending on a number of factors.  Investors are urged to read the Cautionary Note Regarding Forward-Looking Statements included in this release.  Management does not assume any obligation to update these estimates.

About The Cigna Group

The Cigna Group (NYSE: CI) 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. The Cigna Group includes products and services marketed under Evernorth Health Services, Cigna Healthcare, or its subsidiaries. The Cigna Group maintains sales capabilities in more than 30 markets and jurisdictions, and has approximately 186 million customer relationships around the world. Learn more at thecignagroup.com.