The Cigna Group Reports Fourth Quarter and Full Year 2024 Results

Global health company The Cigna Group (NYSE: CI) today reported 2024 results, reflecting continued strength in Evernorth Health Services, while Cigna Healthcare results were impacted by higher stop loss medical costs.

“While higher medical costs in our stop loss product impacted fourth quarter earnings, we are taking corrective actions to address these near-term pressures and we are simultaneously taking steps to further advance our long-term growth strategy,” said David M. Cordani, chairman and CEO of The Cigna Group. “Through a dynamic environment, we are continuing to focus on building a sustainable model for healthcare by addressing the areas that matter most to our patients and clients, including greater transparency, support, and value.”

Shareholders’ net income for fourth quarter 2024 was $1.4 billion, or $5.13 per share, compared with $1.0 billion, or $3.49 per share, for fourth quarter 2023.

The Cigna Group’s adjusted income from operations¹ for fourth quarter 2024 was $1.8 billion, or $6.64 per share, compared with $2.0 billion, or $6.79 per share, for fourth quarter 2023. The decrease was primarily driven by lower contributions from Cigna Healthcare due to higher stop loss medical costs, partially offset by strong contributions from Evernorth Health Services, particularly within Specialty and Care Services.

Shareholders’ net income for 2024 was $3.4 billion, or $12.12 per share, including a non-cash after tax investment loss of $2.7 billion, or $9.53 per share related to the impairment of VillageMD equity securities. This compares with $5.2 billion, or $17.39 per share, for 2023.

The Cigna Group’s adjusted income from operations¹ for 2024 was $7.7 billion, or $27.33 per share, compared with $7.4 billion, or $25.09 per share, for 2023.

The previously announced divestiture of the Company’s Medicare businesses to HCSC is expected to close in the first quarter of 2025.

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 to adjusted income from operations¹:

• Total revenues for fourth quarter and full year 2024 increased 28% and 27%, respectively, relative to fourth quarter and full year 2023, primarily driven by significant growth in Evernorth Health Services, reflecting large client wins and strong specialty volume growth.
• Adjusted income from operations¹ for fourth quarter 2024 decreased 8% from fourth quarter 2023, primarily driven by lower contributions from Cigna Healthcare due to higher stop loss medical costs, partially offset by strong contributions from Evernorth Health Services, particularly within Specialty and Care Services.
• Adjusted income from operations¹ for 2024 increased 4% from 2023, primarily reflecting strong contributions from Evernorth Health Services.
• The SG&A expense ratio⁴ and adjusted SG&A expense ratio⁴ were 5.9% and 5.7%, respectively, for fourth quarter 2024, compared to 7.9% and 7.4%, respectively, in fourth quarter 2023, reflecting business mix shift, strong revenue growth, and continued operating efficiency. The SG&A expense ratio⁴ and adjusted SG&A expense ratio⁴ were 6.0% and 5.9%, respectively, for 2024, compared to 7.6% and 7.3%, respectively, in 2023.
• In 2024, the Company repurchased 20.9 million shares of common stock for approximately $7.0 billion. In addition, the Board of Directors has approved an increase of $6.0 billion in incremental share repurchase authorization, bringing the company’s total share repurchase authority to $10.3 billion as of December 31, 2024.
• On January 30, 2025, the Company’s Board of Directors declared a cash quarterly dividend of $1.51 per share of Cigna common stock to be paid on March 20, 2025 to shareholders of record as of the close of trading on March 5, 2025. This reflects an 8% increase from the 2024 cash quarterly dividend of $1.40 per share.

CUSTOMER RELATIONSHIPS

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

Customer Relationships (in thousands):

• Total customer relationships⁵ at December 31, 2024 increased 11% from December 31, 2023 to 182.2 million.
• Total pharmacy customers⁵ at December 31, 2024 increased 20% from December 31, 2023 to 118.3 million due to new sales and the continued expansion of relationships.
• Total medical customers⁵ at December 31, 2024 were 19.1 million, primarily reflecting a decrease in Individual and Family Plans customers, driven by targeted pricing actions in certain geographies.

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 Specialty and Care Services operating segments, which provide independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live richer, healthier lives.

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 services.

• Evernorth Health Services fourth quarter 2024 adjusted revenues³ and adjusted income from operations, pre-tax¹, increased 33% and 14%, respectively, relative to fourth quarter 2023. For the full year, adjusted revenues³ and adjusted income from operations, pre-tax¹, increased 32% and 9%, respectively, relative to 2023.
• For Pharmacy Benefit Services:
  • Fourth quarter and full year 2024 adjusted revenues³ increased 47% and 46%, relative to fourth quarter and full year 2023, respectively, reflecting client wins and organic growth.
  • Fourth quarter and full year 2024, adjusted income from operations, pre-tax¹, increased 5% and 3%, relative to fourth quarter and full year 2023, reflecting continued affordability improvements, partially offset by planned investments to support future growth.
• For Specialty and Care Services:
  • Fourth quarter and full year 2024 adjusted revenues³ both increased 18%, relative to fourth quarter and full year 2023, reflecting client wins and strong specialty volume growth.
  • Fourth quarter and full year 2024 adjusted income from operations, pre-tax¹, increased 27% and 15%, respectively, relative to fourth quarter and full year 2023, reflecting strong organic growth in specialty businesses, including increased Humira biosimilar adoption, as well as growth in clinical care services, partially offset by strategic investments to support business growth and the continued advancement of our 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 medical plans and other 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.

• Fourth quarter and full year 2024 adjusted revenues^3,7 both increased 3% relative to fourth quarter and full year 2023, reflecting premium rate increases, partially offset by a decrease in Individual and Family Plans customers. Excluding the impact of lower Individual and Family Plans premiums, adjusted revenues^3,7 for both periods increased 6%.
• Fourth quarter and full year 2024 adjusted income from operations, pre-tax¹, decreased 47% and 6%, respectively, relative to fourth quarter and full year 2023, primarily driven by a higher MCR⁴, partially offset by continued operating efficiency.
• The Cigna Healthcare MCR⁴ was 87.9% and 83.2% for fourth quarter and full year 2024, respectively, compared to 82.2% and 81.3% for fourth quarter and full year 2023. The increases for both the fourth quarter and the full year were primarily driven by higher stop loss medical costs.
• Cigna Healthcare net medical costs payable⁸ was $4.86 billion at December 31, 2024, $4.93 billion at September 30, 2024, and $4.86 billion at December 31, 2023. Favorable prior year reserve development on a gross pre-tax basis was $456 million and $279 million for 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.

• Fourth quarter and full year 2024 adjusted loss from operations, pre-tax¹, was $424 million and $1,697 million, respectively, compared to $400 million and $1,602 million for fourth quarter and full year 2023, primarily reflecting the impact of higher interest expense.

2025 OUTLOOK²

The Cigna Group’s outlook² for full year 2025 consolidated adjusted income from operations^1,2 is at least $29.50 per share². Additionally, this outlook includes the impact of expected future share repurchases, anticipated 2025 dividends and assumes that the previously announced divestiture of the Company’s Medicare businesses will close in the first quarter of 2025.

The foregoing statements represent the Company’s current estimates of The Cigna Group’s 2025 consolidated and segment adjusted income from operations^1,2 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 182 million customer relationships around the world. Learn more at thecignagroup.com.