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, 2023

OR

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from _____ to _____

Commission File Number 001-38769

The Cigna Group

(Exact name of registrant as specified in its charter)

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 28, 2023, 295,872,231 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	35
	Item 3. Quantitative and Qualitative Disclosures About Market Risk	50
	Item 4. Controls and Procedures	51
PART II	OTHER INFORMATION
	Item 1. Legal Proceedings	52
	Item 1A. Risk Factors	52
	Item 2. Unregistered Sales of Equity Securities and Use of Proceeds	52
	Item 5. Other Information	52
	Item 6. Exhibits	53
SIGNATURE		54

As used herein, the "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)	2023		2022 (1)
Revenues
Pharmacy revenues	$	32,144	$	30,697
Premiums	11,025		10,356
Fees and other revenues	3,071		2,539
Net investment income	277		414
TOTAL REVENUES	46,517		44,006
Benefits and expenses
Pharmacy and other service costs	31,459		29,813
Medical costs and other benefit expenses	9,046		8,272
Selling, general and administrative expenses	3,538		3,275
Amortization of acquired intangible assets	459		458
TOTAL BENEFITS AND EXPENSES	44,502		41,818
Income from operations	2,015		2,188
Interest expense and other	(358)		(299)
Net realized investment losses	(56)		(322)
Income before income taxes	1,601		1,567
TOTAL INCOME TAXES	295		355
Net income	1,306		1,212
Less: Net income attributable to noncontrolling interests	39		15
SHAREHOLDERS' NET INCOME	$	1,267	$	1,197
Shareholders' net income per share
Basic	$	4.28	$	3.76
Diluted	$	4.24	$	3.73

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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

3

The Cigna Group Consolidated Statements of Comprehensive Income
	Unaudited
	Three Months Ended March 31,
(In millions)	2023		2022 (1)
Net income	$	1,306	$	1,212
Other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives	194		(843)
Net long-duration insurance and contractholder liabilities measurement adjustments	(331)		459
Net translation gains (losses) on foreign currencies	16		(63)
Postretirement benefits liability adjustment	10		13
Other comprehensive loss, net of tax	(111)		(434)
Total comprehensive income	1,195		778
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests	34		3
Net income attributable to other noncontrolling interests	5		12
Other comprehensive loss attributable to redeemable noncontrolling interests	—		(2)
Total comprehensive income attributable to noncontrolling interests	39		13
SHAREHOLDERS' COMPREHENSIVE INCOME	$	1,156	$	765

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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

4

The Cigna Group Consolidated Balance Sheets
	Unaudited
	As of March 31,		As of December 31,
(In millions)	2023		2022 (1)
Assets
Cash and cash equivalents	$	7,935	$	5,924
Investments	914		905
Accounts receivable, net	17,704		17,218
Inventories	4,211		4,777
Other current assets	1,263		1,298
Total current assets	32,027		30,122
Long-term investments	19,010		16,288
Reinsurance recoverables	5,286		5,416
Property and equipment	3,837		3,774
Goodwill	45,811		45,811
Other intangible assets	32,102		32,492
Other assets	2,563		2,704
Separate account assets	7,340		7,278
TOTAL ASSETS	$	147,976	$	143,885
Liabilities
Current insurance and contractholder liabilities	$	7,166	$	5,409
Pharmacy and other service costs payable	17,609		17,070
Accounts payable	7,360		7,775
Accrued expenses and other liabilities	9,174		7,978
Short-term debt	3,418		2,993
Total current liabilities	44,727		41,225
Non-current insurance and contractholder liabilities	11,790		11,976
Deferred tax liabilities, net	7,707		7,786
Other non-current liabilities	2,692		2,766
Long-term debt	29,124		28,100
Separate account liabilities	7,340		7,278
TOTAL LIABILITIES	103,380		99,131
Contingencies — Note 16
Redeemable noncontrolling interests	78		66
Shareholders' equity
Common stock (2)	4		4
Additional paid-in capital	30,332		30,233
Accumulated other comprehensive loss	(1,769)		(1,658)
Retained earnings	38,841		37,940
Less: Treasury stock, at cost	(22,906)		(21,844)
TOTAL SHAREHOLDERS' EQUITY	44,502		44,675
Other noncontrolling interests	16		13
Total equity	44,518		44,688
Total liabilities and equity	$	147,976	$	143,885

(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

(2)Par value per share, $0.01; shares issued, 399 million as of March 31, 2023 and 398 million as of December 31, 2022; authorized shares, 600 million.

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

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The Cigna Group
Consolidated Statements of Changes in Total Equity
Unaudited
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, as retrospectively restated (1)	$	4	$	30,233	$	(1,658)	$	37,940	$	(21,844)	$	44,675	$	13	$	44,688	$	66
Effect of issuing stock for employee benefit 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
Three Months Ended March 31, 2022 (1)
(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, 2021, as retrospectively restated (1)	4		29,574		(1,068)		32,623		(14,175)		46,958		18		46,976		54
Effect of issuing stock for employee benefit plans			162						(72)		90				90
Other comprehensive loss					(432)						(432)				(432)		(2)
Net income							1,197				1,197		12		1,209		3
Common dividends declared (per share: $1.12)							(356)				(356)				(356)
Repurchase of common stock			—						(1,334)		(1,334)				(1,334)
Other transactions impacting noncontrolling interests			—								—		(8)		(8)		—
Balance at March 31, 2022	$	4	$	29,736	$	(1,500)	$	33,464	$	(15,581)	$	46,123	$	22	$	46,145	$	55

(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements to the Consolidated Financial Statements for further information.

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

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The Cigna Group

Consolidated Statements of Cash Flows

	Unaudited
	Three Months Ended March 31,
(In millions)	2023		2022 (1)
Cash Flows from Operating Activities
Net income	$	1,306	$	1,212
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	749		717
Realized investment losses, net	56		322
Deferred income tax benefit	(108)		(134)
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net	(479)		(983)
Inventories	566		222
Reinsurance recoverable and Other assets	72		584
Insurance liabilities	1,533		142
Pharmacy and other service costs payable	539		(74)
Accounts payable and Accrued expenses and other liabilities	690		85
Other, net	104		(63)
NET CASH PROVIDED BY OPERATING ACTIVITIES	5,028		2,030
Cash Flows from Investing Activities
Proceeds from investments sold:
Debt securities and equity securities	196		757
Investment maturities and repayments:
Debt securities and equity securities	257		456
Commercial mortgage loans	4		65
Other sales, maturities and repayments (primarily short-term and other long-term investments)	160		479
Investments purchased or originated:
Debt securities and equity securities	(2,794)		(1,246)
Commercial mortgage loans	—		(59)
Other (primarily short-term and other long-term investments)	(377)		(425)
Property and equipment purchases, net	(408)		(288)
Divestitures, net of cash sold	22		(57)
Other, net	(43)		(6)
NET CASH USED IN INVESTING ACTIVITIES	(2,983)		(324)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds	45		43
Withdrawals and benefit payments from contractholder deposit funds	(48)		(49)
Net change in short-term debt	(9)		(463)
Repayment of long-term debt	(80)		—
Net proceeds on issuance of long-term debt	1,491		—
Repurchase of common stock	(962)		(1,368)
Issuance of common stock	30		93
Common stock dividend paid	(368)		(357)
Other, net	(136)		(70)
NET CASH USED IN FINANCING ACTIVITIES	(37)		(2,171)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash	5		(23)
Net increase (decrease) in cash, cash equivalents and restricted cash	2,013		(488)
Cash, cash equivalents and restricted cash January 1, (2)	5,976		5,548
Cash, cash equivalents and restricted cash, March 31,	7,989		5,060
Cash and cash equivalents reclassified to Assets of businesses held for sale	—		(591)
Cash, cash equivalents and restricted cash March 31, per Consolidated Balance Sheets (3)	$	7,989	$	4,469
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds	$	77	$	43
Interest paid	$	322	$	308

(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

(2)Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.

(3)Restricted cash and cash equivalents were reported in other long-term investments.

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

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	11
4	Supplier Finance Program	11
5	Mergers, Acquisitions and Divestitures	11
6	Earnings Per Share	12
7	Debt	13
8	Common and Preferred Stock	14
INSURANCE INFORMATION
9	Insurance and Contractholder Liabilities	15
10	Reinsurance	20
INVESTMENTS
11	Investments	21
12	Fair Value Measurements	24
13	Variable Interest Entities	28
14	Accumulated Other Comprehensive Income (Loss)	29
COMPLIANCE, REGULATION AND CONTINGENCIES
15	Income Taxes	30
16	Contingencies and Other Matters	30
RESULTS DETAILS
17	Segment Information	32

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Note 1 – Description of Business

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

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these ongoing operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

Evernorth Health Services includes a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to health plans, employers, government organizations and health care providers.

Cigna Healthcare includes the U.S. Commercial, U.S. Government and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental and other products and services for insured and self-insured clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exited businesses. Our ongoing businesses include continuing business (corporate-owned life insurance ("COLI")) and our run-off businesses. Our run-off businesses include (i) variable annuity reinsurance business (also referred to as "guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business) that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses comprised of deferred gains from the sales of these businesses. Our exited businesses include our interest in a joint venture in Türkiye, which was sold in December 2022 and the international life, accident and supplemental benefits businesses sold in July 2022 (the "Chubb transaction").

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate debt 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 intersegment eliminations for products and services sold between segments.

Note 2 – Summary of Significant Accounting Policies    

Basis of Presentation

The Consolidated Financial Statements include the accounts of The Cigna Group and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP"). Certain amounts in prior years have been reclassified to conform to the current year presentation.

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

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

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Recent Accounting Pronouncements

The Company's 2022 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. The following information provides updates on recently adopted accounting pronouncements that have occurred since the Company filed its 2022 Form 10-K. There are no accounting pronouncements not yet adopted as of March 31, 2023.

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

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

•Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:

•Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.

•Discount rate assumptions are updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.

•Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts are amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.

•Market risk benefits ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.

•Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.

•The transition methods applied at adoption were:

•The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.

•DAC followed the transition method used for future policyholder benefits.

•Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in accumulated other comprehensive income.

Effects of adoption:

•The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.

•The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the year ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the year ended December 31, 2022 and December 31, 2021, respectively.

•The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.

•Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 9 to the Consolidated Financial Statements for the Company's updated accounting policies.

•It is possible that our income recognition pattern could change on a prospective basis for several reasons:

•Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.

10

•DAC amortization is on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.

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

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2023		December 31, 2022
Noninsurance customer receivables	$	7,845	$	6,899
Pharmaceutical manufacturers receivables	7,128		7,108
Insurance customer receivables	2,467		2,963
Other receivables	264		248
Total	$	17,704	$	17,218

These receivables are reported net of our allowances of $2.1 billion as of March 31, 2023 and $1.9 billion as of December 31, 2022. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain receivables 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 $87 million as of March 31, 2023 and $86 million as of December 31, 2022.

Note 4 – Supplier Finance Program

The Company facilitates a voluntary supplier finance program (the "program") that provides suppliers the opportunity to sell their receivables due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require. The Cigna Group is not a party to the program and agrees to commercial terms with its suppliers independently of their participation in the program. Amounts due to suppliers that participate in the program are generally paid within one month following the invoice date. A supplier's participation in the program has no impact on the Company's payment terms and the Company has no economic interest in a supplier's decision to participate in the program. The suppliers, at their sole discretion, determine which invoices, if any, to sell to the financial institution. No guarantees or pledged assets are provided by the Company or any of our subsidiaries under the program.

As of March 31, 2023 and December 31, 2022, $1.5 billion and $1.3 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the program by the financial institution and reflected in Accounts payable in the Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. We have been informed by the financial institution that $324 million as of March 31, 2023 of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the program.

Note 5 – Mergers, Acquisitions and Divestitures

A.Divestiture of International Businesses

In July 2022, the Company completed the sale of its life, accident and supplemental benefits businesses in six countries (Hong Kong, Indonesia, New Zealand, South Korea, Taiwan and Thailand) (the "Chubb transaction") for approximately $5.4 billion in cash. The Company recognized a gain of $1.7 billion pre-tax ($1.4 billion after-tax), which includes recognition of previously unrealized capital losses on investments sold and translation loss on foreign currencies. In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.

B.Integration and Transaction-related Costs

In 2023 and 2022, the Company incurred net costs mainly related to the Chubb transaction. In the first three months of 2022, the Company also incurred net costs related to the sale of the Group Disability and Life business and acquisition of MDLIVE. These net

11

costs were $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023 and $52 million pre-tax ($37 million after-tax) for the three months ended March 31, 2022. These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.

Note 6 – Earnings Per Share

Basic and diluted earnings per share were computed as follows:

	Three Months Ended
	March 31, 2023						March 31, 2022
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net income	$	1,267			$	1,267	$	1,197			$	1,197
Shares:
Weighted average	295,706				295,706		318,487				318,487
Common stock equivalents			3,293		3,293				2,795		2,795
Total shares	295,706		3,293		298,999		318,487		2,795		321,282
Earnings per share	$	4.28	$	(0.04)	$	4.24	$	3.76	$	(0.03)	$	3.73

Amounts reflected above for the three months ended March 31, 2022 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).

The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:

	Three Months Ended March 31,
(In millions)	2023	2022
Anti-dilutive options	0.9	2.8

The Company held approximately 102.7 million shares of common stock in treasury at March 31, 2023, 99.1 million shares as of December 31, 2022 and 77.3 million shares as of March 31, 2022.

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Note 7 – Debt

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

(In millions)	March 31, 2023		December 31, 2022
Short-term debt
$17 million, 8.300% Notes due January 2023	—		17
$63 million, 7.650% Notes due March 2023	—		63
$700 million, Floating Rate Notes due July 2023	700		700
$1,000 million, 3.000% Notes due July 2023	996		994
$1,187 million, 3.750% Notes due July 2023	1,187		1,186
$500 million, 0.613% Notes due March 2024	499		—
Other, including finance leases	36		33
Total short-term debt	$	3,418	$	2,993
Long-term debt
$500 million, 0.613% Notes due March 2024	—		499
$1,000 million, 3.500% Notes due June 2024	992		990
$900 million, 3.250% Notes due April 2025 (1)	878		872
$2,200 million, 4.125% Notes due November 2025	2,195		2,195
$1,500 million, 4.500% Notes due February 2026	1,503		1,503
$800 million, 1.250% Notes due March 2026	797		797
$700 million, 5.685% Notes due March 2026	697		—
$1,500 million, 3.400% Notes due March 2027	1,440		1,436
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	597		597
$3,800 million, 4.375% Notes due October 2028	3,785		3,785
$1,500 million, 2.400% Notes due March 2030	1,492		1,492
$1,500 million, 2.375% Notes due March 2031 (1)	1,398		1,380
$45 million, 8.080% Step Down Notes due January 2033 (2)	45		45
$800 million, 5.400% Notes due March 2033	794		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,192		2,192
$750 million, 3.200% Notes due March 2040	743		743
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	488		488
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,466		1,466
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,969		2,968
$1,250 million, 3.400% Notes due March 2050	1,236		1,236
$1,500 million, 3.400% Notes due March 2051	1,478		1,478
Other, including finance leases	67		66
Total long-term debt	$	29,124	$	28,100

(1)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 in the Company's 2022 Form 10-K for further information about the Company's interest rate risk management and these derivative instruments.

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

Long-term debt

Debt Issuance. On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance will be used for general corporate purposes, and may include repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$700 million (1)	March 15, 2026	5.685%	$698 million
$800 million (2)	March 15, 2033	5.400%	$796 million

(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.

(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.

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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, 2023, The Cigna Group had a $3.0 billion five-year revolving credit and letter of credit agreement maturing in April 2027; a $1.0 billion three-year revolving credit agreement maturing in April 2025; and a $1.0 billion 364-day revolving credit agreement maturing in April 2023. There were no outstanding balances under these revolving credit agreements as of March 31, 2023.

In April 2023, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"), which replaced the agreements discussed above:

•a $4.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2028 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 $4.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.

•a $1.0 billion 364-day revolving credit agreement that will mature in April 2024. The Company can borrow up to $1.0 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.

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 $6.5 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 21 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization as of March 31, 2023. 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. There was no commercial paper outstanding balance as of March 31, 2023.

Debt Covenants. The Company was in compliance with its debt covenants as of March 31, 2023.

Interest Expense

Interest expense on long-term and short-term debt was $345 million for the three months ended March 31, 2023 and $314 million for the three months ended March 31, 2022.

Note 8 – Common and Preferred Stock

Dividends

In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock. In the first quarter of 2022, The Cigna Group declared quarterly cash dividends of $1.12 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)
2023
March 8, 2023	March 23, 2023	$1.23	$368
2022
March 9, 2022	March 24, 2022	$1.12	$357

On April 26, 2023, the Board of Directors declared the second quarter cash dividend of $1.23 per share of The Cigna Group common stock to be paid on June 22, 2023 to shareholders of record on June 7, 2023. The Company currently intends to pay regular quarterly

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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.

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, 2023						December 31, 2022						March 31, 2022
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	4,880	$	79	$	4,959	$	4,117	$	59	$	4,176	$	4,491
Other Operations	97		175		272		107		177		284		744
Future policy benefits
Cigna Healthcare	59		542		601		43		544		587		681
Other Operations	290		3,341		3,631		150		3,442		3,592		7,981
Contractholder deposit funds
Cigna Healthcare	12		151		163		14		157		171		181
Other Operations	361		6,309		6,670		351		6,358		6,709		6,843
Market risk benefits	48		1,172		1,220		51		1,217		1,268		1,558
Unearned premiums	1,419		21		1,440		576		22		598		1,030
Total													23,509
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)													(4,562)
Total insurance and contractholder liabilities	$	7,166	$	11,790	$	18,956	$	5,409	$	11,976	$	17,385	$	18,947

(1)Amounts classified as Liabilities of businesses held for sale primarily include $3.7 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of March 31, 2022.

Insurance and contractholder liabilities expected to be paid within one year are classified as current. The Company adopted amended accounting guidance for long-duration insurance contracts on January 1, 2023, discussed further in Note 2 to the Consolidated Financial Statements, which resulted in restatement of prior period amounts. Additionally, see below updated accounting policies and incremental disclosures associated with future policy benefits (Note 9C), contractholder deposit funds (Note 9D), and market risk benefits (Note 9E).

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, including expected development on reported claims, those 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, including reported claims in process, was $4.6 billion at March 31, 2023 and $4.2 billion at March 31, 2022.

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

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Beginning balance	$	4,176	$	4,261
Less: Reinsurance and other amounts recoverable	221		261
Beginning balance, net	3,955		4,000
Incurred costs related to:
Current year	9,041		8,024
Prior years	(144)		(276)
Total incurred	8,897		7,748
Paid costs related to:
Current year	5,316		4,634
Prior years	2,795		2,822
Total paid	8,111		7,456
Ending balance, net	4,741		4,292
Add: Reinsurance and other amounts recoverable	218		199
Ending balance	$	4,959	$	4,491

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, 2023				March 31, 2022
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	1	—	%	$	99	0.3	%
Medical cost trend	143		0.5		177		0.6
Total favorable variance	$	144	0.5	%	$	276	0.9	%

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

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2021.

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

C.Future Policy Benefits

Accounting Policy. Future policy benefits represent the present value of estimated future obligations, estimated using actuarial methods, for long-term insurance policies and annuity products currently in force, consisting primarily of reserves for annuity contracts, life insurance benefits, and certain supplemental health products that are guaranteed renewable beyond one year.

Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency. Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require. Interest rate assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"). For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss. For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach. For contracts issued by foreign operating entities with functional currencies other than the U.S. dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low credit risk fixed income instrument. For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.

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For the annuity business, the premium paying period is shorter than the benefit coverage period, and a deferred profit liability ("DPL") is reported in future policy benefits representing gross premium received in excess of net premiums. DPL is amortized based on expected future benefit payments.

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, 2023		March 31, 2022
Interest accretion rate	2.59	%	2.64	%
Current discount rate	5.29	%	4.90	%
Weighted average duration	8.05 years		7.45 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 are as follows:

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Present value of expected net premiums
Beginning balance	$	8,557	$	9,314
Reversal of effect of beginning of period discount rate assumptions	1,537		(367)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	306		143
Net premiums collected	(326)		(310)
Interest and other (1)	56		46
Ending balance at original discount rate	10,130		8,826
Effect of end of period discount rate assumptions	(1,312)		(376)
Ending balance (2)	$	8,818	$	8,450
Present value of expected policy benefits
Beginning balance	$	8,945	$	9,794
Reversal of effect of discount rate assumptions	1,611		(379)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	307		215
Benefit payments	(326)		(385)
Interest and other (1)	58		52
Ending balance at original discount rate	10,595		9,297
Effect of discount rate assumptions	(1,378)		(392)
Ending balance (3)	$	9,217	$	8,905
Liability for future policy benefits	$	399	$	455
Other (4)	202		226
Total liability for future policy benefits (5)	$	601	$	681

(1)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.

(2)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future gross premiums were $17.6 billion and $13.5 billion. As of March 31, 2023 and March 31, 2022, respectively, discounted expected future gross premiums were $12.5 billion and $10.7 billion.

(3)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future policy benefits were $12.8 billion and $11.2 billion.

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

(5)$154 million and $171 million of reinsurance recoverable asset reported in the Consolidated Balance Sheets as of March 31, 2023 and March 31, 2022, respectively, relate to the liability for future policy benefits.

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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, 2023		March 31, 2022
Interest accretion rate	5.64	%	5.64	%
Current discount rate	4.95	%	3.59	%
Weighted average duration	11.7 years		13.9 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 DPL.

Future policy benefits for Other Operations includes DPL of $392 million as of March 31, 2023 and $384 million as of March 31, 2022. Future policy benefits excluding DPL, were $3.2 billion as of both March 31, 2023 and December 31, 2022 and $3.9 billion and $4.3 billion as of March 31, 2022 and December 31, 2021, respectively. These balances exclude amounts classified as Liabilities of businesses held for sale of $3.7 billion as of March 31, 2022 and $3.8 billion as of December 31, 2021. The change in future policy benefits reserves year-to-date was primarily driven by changes in the current discount rate.

Undiscounted expected future policy benefits were $4.6 billion as of March 31, 2023 and $4.7 billion as of March 31, 2022. As of March 31, 2023 and March 31, 2022, $1.0 billion and $1.2 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

D.Contractholder Deposit Funds

Accounting Policy. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances in Other Operations. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. Interest credited on these funds is accrued ratably over the contract period.

Contractholder deposit fund liabilities within Other Operations were $6.7 billion as of both March 31, 2023 and December 31, 2022 and $6.8 billion and $6.9 billion as of March 31, 2022 and December 31, 2021, respectively. Approximately 39% 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, 2023, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not externally reinsured were 3.25%, $3.2 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2022 were 3.18%, $3.5 billion and $2.9 billion, respectively. As of both March 31, 2023 and March 31, 2022, more than 99% of the $4.1 billion liability 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 bps above the guarantee and the remaining $1.7 billion 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 (also referred to as GMDB and GMIB 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.

Accounting Policy. Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefits expense while fluctuations in the Company's own

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nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss. Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e. nonpayment risk). The nonperformance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral. The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable. As discussed further in Note 10 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefits expense and does not offset the nonperformance risk valuation on the liability. Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates).

Market risk benefits activity was as follows:

	Three Months Ended
(Dollars in millions)	March 31, 2023		March 31, 2022
Balance, beginning of year	$	1,268	$	1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,379		1,949
Changes due to expected run-off	(6)		(19)
Changes due to capital markets versus expected	(41)		(271)
Changes due to policyholder behavior versus expected	6		(9)
Assumption changes	(33)		39
Balance, end of year, before the effect of changes in nonperformance risk (own credit risk)	1,305		1,689
Nonperformance risk (own credit risk), end of period	(85)		(131)
Balance, end of period	$	1,220	$	1,558
Reinsured market risk benefit, end of period	$	1,301	$	1,681

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, 2023		March 31, 2022
Net amount at risk	$	2,183	$	1,892
Average attained age of contractholders (weighted by exposure)	75.4 years		76.4 years

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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.

The Company's reinsurance recoverables as of March 31, 2023 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 (3)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (1)	$	—	$	—	$	94	$	94
BBB- to BBB+ equivalent current credit ratings (1)	—		—		59		59
Not rated	142		5		63		210
Total recoverables related to ongoing operations (2)	142		5		216		363
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,750		—		2,750
Empower Annuity Insurance Company	—		—		133		133
Prudential Insurance Company of America	380		—		—		380
Life Insurance Company of North America	—		386		—		386
Other	187		25		15		227
Not rated	—		9		3		12
Total recoverables related to acquisition, disposition or run-off activities	567		3,170		151		3,888
Total reinsurance recoverables before market risk benefits	$	709	$	3,175	$	367	$	4,251
Allowance for uncollectible reinsurance							(35)
Market risk benefits (4)							1,301
Total reinsurance recoverables (2)							$	5,517

(1)Certified by a Nationally Recognized Statistical Rating Organization ("NRSRO").

(2)Includes $231 million of current reinsurance recoverables that are reported in Other current assets.

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

(4)Total Berkshire and certain Other recoverables reflected under acquisition, disposition or run-off activities in the Company's 2022 Form 10-K that relate to the Company’s variable annuity reinsurance products discussed in section B below are now reported at fair market value as MRBs, as further discussed in Note 9 to the Consolidated Financial Statements. At December 31, 2022, we reported $711 million related to these recoverables related to the GMDB variable annuity reinsurance product. The restated December 31, 2022 variable annuity reinsurance recoverable balance is $1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.

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

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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, 2023. As a result of the reinsurance transaction, reserve increases are offset by a corresponding increase in the recorded reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)	March 31, 2023		December 31, 2022		Collateral and Other Terms at March 31, 2023
Berkshire	$	1,043	$	1,116	90% were secured by assets in a trust.
Sun Life Assurance Company of Canada	117		115
Liberty Re (Bermuda) Ltd.	128		128		100% were secured by assets in a trust.
SCOR SE	35		39		70% were secured by a letter of credit.
Market risk benefits (2)	$	1,323	$	1,398

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

(2)Includes IBNR and outstanding claims of $25 million offset by premium due of $3 million. These amounts are excluded from market risk benefits at March 31, 2023 in Note 9 and Note 10A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

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, 2023 and March 31, 2022.

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 11 in the Company's 2022 Form 10-K.

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

	March 31, 2023						December 31, 2022
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	616	$	9,293	$	9,909	$	654	$	9,218	$	9,872
Equity securities	51		3,069		3,120		45		577		622
Commercial mortgage loans	106		1,501		1,607		67		1,547		1,614
Policy loans	—		1,211		1,211		—		1,218		1,218
Other long-term investments	—		3,936		3,936		—		3,728		3,728
Short-term investments	141		—		141		139		—		139
Total	$	914	$	19,010	$	19,924	$	905	$	16,288	$	17,193

A.Investment Portfolio

Debt Securities

Accounting policy. Our accounting policy for debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) remains materially consistent with the policy disclosed in the Company's 2022 Form 10-K. However, with the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is no longer reported in Non-current insurance and contractholder liabilities but rather is reported in Accumulated other comprehensive loss. See Note 14 to the Consolidated Financial Statements for the impact to Accumulated other comprehensive loss.

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The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2023:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	638	$	630
Due after one year through five years	3,972		3,752
Due after five years through ten years	3,227		2,915
Due after ten years	2,450		2,268
Mortgage and other asset-backed securities	381		344
Total	$	10,668	$	9,909

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, 2023
Federal government and agency	$	276	$	—	$	29	$	(8)	$	297
State and local government	42		—		—		(1)		41
Foreign government	373		—		16		(18)		371
Corporate	9,596		(41)		124		(823)		8,856
Mortgage and other asset-backed	381		—		1		(38)		344
Total	$	10,668	$	(41)	$	170	$	(888)	$	9,909
December 31, 2022
Federal government and agency	$	292	$	—	$	32	$	(12)	$	312
State and local government	43		—		—		(2)		41
Foreign government	375		—		11		(21)		365
Corporate	9,742		(44)		89		(981)		8,806
Mortgage and other asset-backed	390		—		1		(43)		348
Total	$	10,842	$	(44)	$	133	$	(1,059)	$	9,872

Review of declines in fair value. Management reviews impaired debt securities 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, 2023							December 31, 2022
(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	$	3,176	$	3,362	$	(186)	1,019	$	5,533	$	6,127	$	(594)	1,659
Below investment grade	353		371		(18)		936	887		964		(77)		1,287
More than one year
Investment grade	3,222		3,808		(586)		1,035	1,151		1,487		(336)		462
Below investment grade	682		780		(98)		770	330		382		(52)		369
Total	$	7,433	$	8,321	$	(888)	3,760	$	7,901	$	8,960	$	(1,059)	3,777

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Equity Securities

The following table provides the values of the Company's equity security investments as of March 31, 2023 and December 31, 2022:

	March 31, 2023				December 31, 2022
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	680	$	91	$	673	$	138
Equity securities with no readily determinable fair value	2,926		3,029		380		484
Total	$	3,606	$	3,120	$	1,053	$	622

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 95% 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 11 in the Company's 2022 Form 10-K.

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

(Dollars in millions)	March 31, 2023					December 31, 2022
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%	$	912	2.11			$	901	2.12
60% to 79%	504		1.73			564		1.73
80% to 100%	191		1.32			149		1.17
Total	$	1,607	1.89	60	%	$	1,614	1.89	60	%

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, 2023		December 31, 2022
Real estate investments	$	1,434	$	1,319
Securities partnerships	2,259		2,166
Other	243		243
Total	$	3,936	$	3,728

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

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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, 2023, there have been no material changes to the Company's derivative financial instruments. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2023 and December 31, 2022. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

Please refer to the Company's 2022 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies.

C.Realized Investment Gains and Losses

Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.

The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:

	Three Months Ended March 31,
(In millions)	2023		2022
Net realized investment (losses), excluding credit loss expense and asset write-downs	$	(51)	$	(322)
Credit loss recoveries	3		—
Other investment asset write-downs	(8)		—
Net realized investment (losses), before income taxes	$	(56)	$	(322)

Net realized investment losses for the three months ended March 31, 2023 and March 31, 2022 were primarily due to mark-to-market losses on a strategic health care equity securities investment.

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 12 in the Company's 2022 Form 10-K.

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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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Financial assets at fair value
Debt securities
Federal government and agency	$	151	$	147	$	146	$	165	$	—	$	—	$	297	$	312
State and local government	—		—		41		41		—		—		41		41
Foreign government	—		—		371		365		—		—		371		365
Corporate	—		—		8,421		8,394		435		412		8,856		8,806
Mortgage and other asset-backed	—		—		309		313		35		35		344		348
Total debt securities	151		147		9,288		9,278		470		447		9,909		9,872
Equity securities (1)	6		6		84		132		1		—		91		138
Short-term investments	—		—		141		139		—		—		141		139
Derivative assets	—		—		206		230		1		1		207		231

(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 9 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 ("bps") 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, 2023		December 31, 2022		Unobservable input March 31, 2023	March 31, 2023		December 31, 2022
Debt securities
Corporate and government debt securities	$	433	$	412	Liquidity	60 - 1060 (300)	bps	60 - 1060 (270)	bps
Mortgage and other asset-backed securities	35		35		Liquidity	105 - 520 (310)	bps	110 - 520 (310)	bps
Other debt securities	2		—
Total Level 3 debt securities	$	470	$	447

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

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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.

	For the Three Months Ended March 31,
(In millions)	2023		2022
Debt and Equity Securities
Beginning balance	$	447	$	796
Gains included in Shareholders' net income	1		12
Gains (losses) included in Other comprehensive loss	5		(15)
Losses required to adjust future policy benefits for settlement annuities (1)	—		(12)
Purchases, sales and settlements
Purchases	4		49
Settlements	(9)		(81)
Total purchases, sales and settlements	(5)		(32)
Transfers into/(out of) Level 3
Transfers into Level 3	39		101
Transfers out of Level 3	(16)		(164)
Total transfers into/(out of) Level 3	23		(63)
Ending balance	$	471	$	686
Total gains included in Shareholders' net income attributable to instruments held at the reporting date	$	1	$	—
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	5	$	(13)

(1)Amounts do not accrue to shareholders.

Total gains and losses included in Shareholders' net 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 (depreciation) 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 2023 and 2022 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.

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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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Guaranteed separate accounts (See Note 16)	$	213	$	203	$	349	$	382	$	—	$	—	$	562	$	585
Non-guaranteed separate accounts (1)	221		211		5,586		5,522		213		203		6,020		5,936
Subtotal	$	434	$	414	$	5,935	$	5,904	$	213	$	203	6,582		6,521
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													758		757
Total													$	7,340	$	7,278

(1)Non-guaranteed separate accounts include $4.0 billion as of March 31, 2023 and December 31, 2022 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of March 31, 2023 and December 31, 2022.

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, 2023 or 2022.

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, 2023		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2023		December 31, 2022
Securities partnerships	$	467	$	451	$	228	Not applicable	Not applicable
Real estate funds	287		302		—		Quarterly	30 - 90 days
Hedge funds	4		4		—		Up to annually, varying by fund	30 - 90 days
Total	$	758	$	757	$	228

As of March 31, 2023, 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, 2023 and 2022, impairments recognized requiring these assets to be measured at fair value were not material. Realized investment gains and losses from these observable price changes for the three months ended March 31, 2023 and March 31, 2022 were not material.

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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, 2023				December 31, 2022
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,509	$	1,607	$	1,491	$	1,614
Long-term debt, including current maturities, excluding finance leases	Level 2	$	30,679	$	32,439	$	28,653	$	30,994

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, 2023 or December 31, 2022. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not changed materially from December 31, 2022. 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 13 in the Company's 2022 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.

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Note 14 – Accumulated Other Comprehensive Income (Loss) ("AOCI")

AOCI includes net unrealized (depreciation) 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 income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI, including the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements), were as follows:

	Three Months Ended March 31,
(In millions)	2023		2022
Securities and Derivatives
Beginning balance, as retrospectively restated	$	(332)	1,266
Unrealized appreciation (depreciation) on securities and derivatives	252		(1,065)
Tax (expense) benefit	(54)		231
Net unrealized appreciation (depreciation) on securities and derivatives	198		(834)
Reclassification adjustment for (gains) included in Shareholders' net income (Net realized investment losses)	(5)		(11)
Reclassification adjustment for tax expense included in Shareholders' net income	1		2
Net (gains) reclassified from AOCI to Shareholders' net income	(4)		(9)
Other comprehensive income (loss), net of tax	194		(843)
Ending balance	$	(138)	$	423
Net long-duration insurance and contractholder liabilities measurement adjustments (1)
Beginning balance	(256)		(765)
Current period change in discount rate for certain long duration liabilities	(411)		584
Tax benefit (expense)	101		(130)
Net current period change in discount rate for certain long duration liabilities	(310)		454
Current period change in instrument-specific credit risk for market risk benefits	(26)		6
Tax benefit (expense)	5		(1)
Net current period change in instrument-specific credit risk for market risk benefits	(21)		5
Other comprehensive (loss) income, net of tax	(331)		459
Ending balance	(587)		(306)
Translation of foreign currencies
Beginning balance, as retrospectively restated	$	(154)	(233)
Translation of foreign currencies	15		(60)
Tax benefit (expense)	1		(3)
Net translation of foreign currencies	16		(63)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests	—		(2)
Shareholders' other comprehensive income (loss), net of tax	16		(61)
Ending balance	$	(138)	$	(294)
Postretirement benefits liability
Beginning balance	$	(916)	$	(1,336)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)	13		16
Reclassification adjustment for tax (benefit) included in Shareholders' net income	(3)		(3)
Net adjustments reclassified from AOCI to Shareholders' net income	10		13
Other comprehensive income, net of tax	10		13
Ending balance	$	(906)	$	(1,323)
Total Accumulated other comprehensive loss
Beginning balance, as retrospectively restated	(1,658)		(1,068)
Shareholders' other comprehensive (loss), net of tax	(111)		(432)
Ending balance	$	(1,769)	$	(1,500)

(1)Established upon the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Note 15 – Income Taxes

Income Tax Expense

The 18.4% effective tax rate for the three months ended March 31, 2023 was lower than the 22.7% rate for the three months ended March 31, 2022. This decrease was driven largely by favorable results relative to the Company's foreign operations, partially offset by an increase pertaining to the year over year impact of remeasurement of deferred taxes.

As of March 31, 2023, we had approximately $255 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. We have determined that a valuation allowance against the DTAs is not currently required based on the Company's ability to carryback losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any valuation allowance in the future.

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, 2023, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $420 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, 2023. 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, 2023 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 law 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 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 liabilities for these indemnification obligations as of March 31, 2023.

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, 2023.

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

30

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 accruals for the matters discussed below under "Litigation Matters" and "Regulatory Matters" are not material. Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if any) for these matters at this time. In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company. An adverse outcome in one or more of these matters 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 these ongoing litigation matters 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. On June 10, 2022, Express Scripts filed a Motion for Partial Summary Judgment seeking to limit Elevance's remaining prior authorization claims and a Motion to Exclude certain opinions offered by its experts. Elevance filed its opposition to both motions, and a cross-motion to submit a supplemental expert report, on July 9, 2022. Express Scripts' pending Motions were fully briefed at the end of July 2022. On March 8, 2023, the Court granted Express Scripts' Motion for Partial Summary Judgement, excluding in full the testimony of four of Elevance's experts and in part the testimony of two additional experts, and granted Elevance leave to submit a supplemental expert report. On April 5, 2023, the Court entered a scheduling order setting a trial on Elevance's remaining prior authorization claims to commence on December 4, 2023.

Medicare Advantage. A qui tam action that was filed by a private individual on behalf of the government in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020. The action asserts claims related to risk adjustment practices arising from certain health exams conducted as part of the Company's Medicare Advantage business. In September 2021, the qui tam action was transferred to the United States District Court for the Middle District of Tennessee. On January 11, 2022, the U.S. Department of Justice ("DOJ") (U.S. Attorney's Offices for the Southern District of New York and the Middle District of Tennessee) filed a motion to partially intervene, which was granted on August 2, 2022. On October 14, 2022, the DOJ filed its complaint-in-intervention alleging that certain diagnoses made during in-home exams were invalid for risk adjustment purposes, seeking unspecified damages and penalties under the federal False Claims Act. The Company filed motions to dismiss the DOJ's complaint and the remainder of the qui tam complaint on December 16, 2022. Briefing is complete and the matter is pending before the court.

Regulatory Matters

Civil Investigative Demand. The DOJ is conducting industry-wide investigations of Medicare Advantage organizations' risk adjustment practices. For certain Medicare Advantage organizations, including The Cigna Group, those investigations have resulted in litigation (see "Litigation Matters—Medicare Advantage" above). The Company has responded to information requests (civil investigative demands) from the DOJ (U.S. Attorney's Office for the Eastern District of Pennsylvania) and is continuing to cooperate with the DOJ.

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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 from operations as income 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.

Special items charges (benefits) recorded by the Company were $1 million both pre-tax and after-tax for the three months ended March 31, 2023 and $52 million pre-tax ($37 million after-tax) for the three months ended March 31, 2022.

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. See Note 2 to the Consolidated Financial Statements for further information. Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting. Summarized segment financial information was as follows:

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(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
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2022
Revenues from external customers	$	32,289	$	10,462	$	841	$	—	$	43,592
Intersegment revenues	1,287		562		—		(1,849)
Net investment income	10		266		138		—		414
Total revenues	33,586		11,290		979		(1,849)		44,006
Net realized investment results from certain equity method investments	—		103		—		—		103
Adjusted revenues	$	33,586	$	11,393	$	979	$	(1,849)	$	44,109
Income (loss) before income taxes	$	870	$	877	$	215	$	(395)	$	1,567
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(11)		(1)		(5)		—		(17)
Net realized investment losses (gains) (1)	—		406		19		—		425
Amortization of acquired intangible assets	443		15		—		—		458
Special items
Integration and transaction-related costs	—		—		—		52		52
Pre-tax adjusted income (loss) from operations	$	1,302	$	1,297	$	229	$	(343)	$	2,485

(1)Includes 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.

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Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. Prior period amounts have been retrospectively adjusted to reflect adoption of amended accounting guidance for long-duration insurance contracts, as discussed in Note 2 to the Consolidated Financial Statements. The following table presents these revenues by product, premium and service type:

	Three Months Ended March 31,
(In millions)	2023		2022
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	15,748	$	15,531
Home delivery and specialty revenues	16,025		14,699
Other revenues	1,867		1,712
Intercompany eliminations	(1,496)		(1,245)
Total pharmacy revenues	32,144		30,697
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Commercial
Insured	4,080		3,720
Stop loss	1,503		1,325
Other (1)	368		360
U.S. Government
Medicare Advantage	2,236		2,078
Medicare Part D	415		401
Other (1), (2)
Short-duration (Individual and family plans)	1,208		611
Long-duration (Individual Medicare supplement and limited benefit health products)	334		329
International Health (2)
Short-duration (Group medical insurance)	700		620
Long-duration (Individual private medical insurance)	86		82
Total Cigna Healthcare	10,930		9,526
Divested International businesses	—		763
Other	79		69
Intercompany eliminations	16		(2)
Total premiums	11,025		10,356
Services (Fees) (ASC 606)
Evernorth Health Services	2,499		1,624
Cigna Healthcare	1,606		1,496
Other Operations	1		5
Other revenues	66		16
Intercompany eliminations	(1,101)		(602)
Total fees and other revenues	3,071		2,539
Total revenues from external customers	$	46,240	$	43,592

(1)Other than supplemental benefits, all of U.S. Commercial and U.S. Government are short duration.

(2)U.S. Government and International Health recognize premium revenue on long-duration insurance contracts (coverage greater than one year or guaranteed to be renewed at the option of the policyholder beyond one year) related to certain medicare supplement, supplemental health and life products. All other premium revenue recognized as of March 31, 2023 and March 31, 2022 is primarily related to short-duration insurance contracts.

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 $1.5 billion as of March 31, 2023 and $1.3 billion as of December 31, 2022.

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

	PAGE
Executive Overview	36
Liquidity and Capital Resources	40
Critical Accounting Estimates	43
Segment Reporting	43
Evernorth Health Services	44
Cigna Healthcare	46
Other Operations	47
Corporate	48
Investment Assets	48

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, 2023, compared with December 31, 2022 and our results of operations for the three months ended March 31, 2023, 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, 2022 ("2022 Form 10-K"). In particular, we encourage you to refer to the "Risk Factors" contained in Part I, Item 1A of our 2022 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 2022 Form 10-K for additional information regarding the Company's significant accounting policies and see Notes 2 and 9 to the Consolidated Financial Statements in this Form 10-Q for updates to those policies resulting from adopting Accounting Standards Update 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts ("LDTI"), and related amendments, effective January 1, 2023. 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," "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 (or income 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. See the below Financial Highlights section for a reconciliation of consolidated adjusted income from operations to shareholders' net income.

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

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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.

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; 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, including bank failures, 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 2022 Form 10-K, Part II, Item 7 – Management's Discussion and Analysis of Financial Condition and Results of Operations in our 2022 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.

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 Item 1, "Business" of our 2022 Form 10-K.

Financial Highlights

See Note 1 to the Consolidated Financial Statements for a description of our segments. Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. Prior period Financial highlights and Results of operations have

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been retrospectively adjusted to conform to this new basis of accounting. For the three months ended March 31, 2023, the impact of this amended guidance is immaterial. See Note 2 to the Consolidated Financial Statements for additional information.

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)	2023		2022		% Change
Revenues
Adjusted revenues by segment
Evernorth Health Services	$	36,179	$	33,586	8	%
Cigna Healthcare	12,718		11,393		12
Other Operations	157		979		(84)
Corporate, net of eliminations	(2,575)		(1,849)		(39)
Adjusted revenues	46,479		44,109		5
Net realized investment results from certain equity method investments	38		(103)		N/M
Total revenues	$	46,517	$	44,006	6	%
Shareholders' net income	$	1,267	$	1,197	6	%
Adjusted income from operations	$	1,618	$	1,948	(17)	%
Earnings per share (diluted)
Shareholders' net income	$	4.24	$	3.73	14	%
Adjusted income from operations	$	5.41	$	6.06	(11)	%
Pre-tax adjusted income (loss) from operations by segment
Evernorth Health Services	$	1,320	$	1,302	1	%
Cigna Healthcare	1,115		1,297		(14)
Other Operations	15		229		(93)
Corporate, net of eliminations	(414)		(343)		(21)
Consolidated pre-tax adjusted income from operations	2,036		2,485		(18)
Income attributable to noncontrolling interests	43		17		153
Net realized investment losses (1)	(18)		(425)		96
Amortization of acquired intangible assets	(459)		(458)		—
Special items	(1)		(52)		98
Income before income taxes	$	1,601	$	1,567	2	%

(1)Includes 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.

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

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Consolidated Results of Operations (GAAP basis)
	Three Months Ended March 31,
(Dollars in millions)	2023			2022			% Change
Pharmacy revenues	$	32,144		$	30,697		5	%
Premiums	11,025			10,356			6
Fees and other revenues	3,071			2,539			21
Net investment income	277			414			(33)
Total revenues	46,517			44,006			6
Pharmacy and other service costs	31,459			29,813			6
Medical costs and other benefit expenses	9,046			8,272			9
Selling, general and administrative expenses	3,538			3,275			8
Amortization of acquired intangible assets	459			458			—
Total benefits and expenses	44,502			41,818			6
Income from operations	2,015			2,188			(8)
Interest expense and other	(358)			(299)			(20)
Net realized investment losses	(56)			(322)			83
Income before income taxes	1,601			1,567			2
Total income taxes	295			355			(17)
Net income	1,306			1,212			8
Less: Net income attributable to noncontrolling interests	39			15			160
Shareholders' net income	$	1,267		$	1,197		6	%
Consolidated effective tax rate	18.4		%	22.7		%	(430)	bps
Medical customers (in thousands)	19,473			17,779			10	%

Reconciliation of Shareholders' Net Income (GAAP) to Adjusted Income from Operations
	Three Months Ended March 31,
	2023				2022
(Dollars in millions)	Pre-tax		After-tax		Pre-tax		After-tax
Shareholders' net income			$	1,267			$	1,197
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (1)	$	18	6		$	425	358
Amortization of acquired intangible assets	459		344		458		356
Special items
Integration and transaction-related costs	1		1		52		37
Total special items	$	1	1		$	52	37
Adjusted income from operations			$	1,618			$	1,948

(1)Includes 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.

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Reconciliation of Shareholders' Net Income (GAAP) to Adjusted Income from Operations
	Three Months Ended March 31,
	2023				2022
(Diluted Earnings Per Share)	Pre-tax		After-tax		Pre-tax		After-tax
Shareholders' net income			$	4.24			$	3.73
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (1)	$	0.06	0.02		$	1.32	1.10
Amortization of acquired intangible assets	1.54		1.15		1.43		1.11
Special items
Integration and transaction-related costs	—		—		0.16		0.12
Total special items	$	—	—		$	0.16	0.12
Adjusted income from operations			$	5.41			$	6.06

(1)Includes 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.

Recent Events

Economic Conditions

We continue to monitor global economic conditions, including inflation, labor market dynamics and the recent banking failures. We did not have a material exposure to banks recently impacted by the financial environment. We continue to proactively address impacts to our pricing with third parties (including vendors, health care providers and drug providers), our investment portfolio and our workforce. We are also monitoring the potential impact on client and customer health care needs.

Our results of operations or cash flows for the three months ended March 31, 2023, were not materially impacted by inflation, labor market dynamics, or the recent banking failures. For further information regarding risks we encounter in our business due to economic conditions, see "Risk Factors" contained in Part I, Item 1A of our 2022 Form 10-K.

Commentary: Three Months Ended March 31, 2023 versus Three Months Ended March 31, 2022

The commentary presented below, and in the segment discussions that follow, compare results for the three months ended March 31, 2023 with results for the three months ended March 31, 2022.

Shareholders' net income increased 6% due primarily to improved realized investment results reflecting lower mark to market losses on equity securities. This favorable effect was partially offset by lower adjusted income from operations.

Adjusted income from operations declined 17%, driven primarily by the absence of earnings from our life, accident and supplemental health benefits business in six countries sold in 2022 (the "Chubb transaction") and lower net investment income (see below).

Medical customers increased 10%, reflecting growth in fee-based products as well as a higher customer base in our Individual and Medicare Advantage businesses. See Part I, Item 1 of our 2022 Form 10-K for definitions of Cigna Healthcare's market segments.

Pharmacy revenues increased 5%, reflecting higher specialty claims volume as well as inflation on, and higher sales of, branded drugs. See the "Segment Reporting - Evernorth Health Services Segment" section of this MD&A for further discussion.

Premiums increased 6%, reflecting growth in the insured customer base (primarily within our Individual business), the favorable impact of increased specialty contributions and higher premium rates in Cigna Healthcare due to anticipated underlying medical cost trend. See the "Segment Reporting - Cigna Healthcare Segment" section of this MD&A for further discussion. These favorable effects were partially offset by a decline in premiums due to the Chubb transaction.

Fees and other revenues increased 21%, primarily reflecting client growth from our continued contract affordability services within Evernorth Health Services and higher net realized investment results in certain equity method investments within Cigna Healthcare.

Net investment income decreased 33%, primarily reflecting lower returns on our partnership investments and the unfavorable impact of the Chubb transaction. See the "Investment Assets" section of this MD&A for further discussion.

Pharmacy and other service costs increased 6%, reflecting higher specialty claims volume as well as inflation on, and higher sales of, branded drugs.

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Medical costs and other benefit expenses increased 9%, primarily reflecting an increased insured customer base (primarily within our Individual business) and trend in Cigna Healthcare, partially offset by the impact of the Chubb transaction.

Selling, general and administrative expenses increased 8%, primarily driven by volume-related expenses in Cigna Healthcare and Evernorth Health Services due to business growth, as well as strategic investments to support business growth and continued advancement of our capabilities in Evernorth Health Services and Cigna Healthcare. These increases were partially offset by the impact of the Chubb transaction.

Interest expense and other increased 20%, primarily reflecting higher interest rates on our indebtedness and increased pension costs.

Realized investment results were substantially improved, primarily due to lower mark to market losses on equity securities. See Note 11 to the Consolidated Financial Statements for further discussion.

The effective tax rate decreased by 430 basis points, driven by favorable results relative to the Company's foreign operations, partially offset by an increase pertaining to the year over year impact of remeasurement of deferred taxes.

Developments

Medicare Advantage Rates

On March 31, 2023, Centers for Medicare and Medicaid Services ("CMS") released the final Calendar Year 2024 Medicare Advantage Program and Part D Payment Policies (the "2024 Final Notice"). The 2024 Final Notice rates were improved from the advance notice rates (previously released on February 1, 2023). We do not expect the final rates to have a material impact on our consolidated results of operations in 2024.

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 21 to the Consolidated Financial Statements in our 2022 Form 10-K for additional information regarding these

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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)	2023		2022
Operating activities	$	5,028	$	2,030
Investing activities	$	(2,983)	$	(324)
Financing activities	$	(37)	$	(2,171)

The following discussion explains variances in the various categories of cash flows for the three months ended March 31, 2023 compared with the same period in 2022.

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 for the three months ended March 31, 2023 included the benefits from the early receipt of April Medicare premiums from CMS and a higher CMS Medicare Part D annual settlement. The remaining increase was driven by higher insurance liabilities, timing of pharmacy and services cost payable and lower inventory purchases.

Investing activities

The Company invested $2.5 billion in VillageMD in 2023, which resulted in an increase in cash used in investing activities.

Financing activities

The Company issued new debt, had lower payments for commercial paper and lower share repurchases. These factors resulted in a decrease in cash used in financing activities in 2023.

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 flow from operations, some of which is subject to regulatory restrictions relative to the amount and timing of dividend payments to the parent company. Dividends from U.S. regulated subsidiaries were $258 million for the three months ended March 31, 2023 and $475 million for the three months ended March 31, 2022. Non-regulated subsidiaries also generate significant cash flow 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.

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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 amount of $5.0 billion. The net proceeds of issuances have been and are expected to be used for general corporate purposes.

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 April 2023, 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, 2023, we had $5.0 billion of undrawn committed capacity under our revolving credit agreements that have since been replaced with the revolving credit agreements described above (these amounts are available for general corporate purposes, including providing liquidity support for our commercial paper program), $5.0 billion of remaining capacity under our commercial paper program and $8.1 billion in cash and short-term investments, approximately $1.1 billion of which was held by the parent company or certain non-regulated subsidiaries.

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 42.2% at March 31, 2023 and 41.0% at December 31, 2022.

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 $2.8 billion from its subsidiaries without further approvals as of March 31, 2023.

Use of Capital Resources

Capital expenditures. Capital expenditures for property, equipment and computer software were $0.4 billion in the three months ended March 31, 2023 compared to $0.3 billion in the three months ended March 31, 2022. This increase reflects our continued strategic investment in technology for future growth. We expect to deploy approximately $1.4 billion to capital expenditures in 2023. Anticipated capital expenditures will be funded primarily from operating cash flow.

Dividends. In the first quarter of 2023, The Cigna Group declared and paid quarterly cash dividends of $1.23 per share of its common stock, compared to $1.12 per share in first quarter 2022. See Note 8 to the Consolidated Financial Statements for further information on our dividend payments. On April 26, 2023, the Board of Directors declared the second quarter cash dividend of $1.23 per share of The Cigna Group common stock to be paid on June 22, 2023 to shareholders of record on June 7, 2023. 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.

We repurchased 3.2 million shares for approximately $1.0 billion during the three months ended March 31, 2023, compared to 5.8 million shares for approximately $1.3 billion during the three months ended March 31, 2022. From April 1, 2023, through May 4, 2023, we repurchased 0.5 million shares for approximately $139 million. Share repurchase authority was $2.5 billion as of May 4, 2023.

Strategic investments. In January 2023, we became a minority owner in VillageMD by investing $2.5 billion in VillageMD preferred equity. In April 2023, the Company invested an additional $200 million for a total investment of $2.7 billion. VillageMD provides health care services for individuals and communities across the United States, with primary, multi-specialty and urgent care providers serving patients in traditional clinic settings, in patients' homes and online appointments.

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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 2022 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.

The Company adopted amended accounting guidance for long-duration insurance contracts effective January 1, 2023, which impacted the amounts presented on our Consolidated Balance Sheets. Within our Consolidated Financial Statements, see Note 2 for a summary of this accounting change and Note 9 for a summary of the insurance liabilities on our Consolidated Balance Sheets as well as future expected cash flow information. With the adoption of amended accounting guidance for long-duration insurance contracts and enhanced disclosure within Note 9 to the Consolidated Financial Statements, we will no longer present additional information regarding insurance liabilities within this section.

Our long-term debt obligations previously provided in our 2022 Form 10-K have been updated as of March 31, 2023 due to the issuance of $700 million in aggregate principal amount of our 5.685% senior notes due March 2026 and $800 million in aggregate principal amount of our 5.400% senior notes due March 2033. See Note 7 to the Consolidated Financial Statements for a discussion of the debt issuance.

•Total scheduled payments on long-term debt are $48.5 billion through March 2051, which include scheduled interest payments and maturities of long-term debt.

•We expect $3.9 billion of long-term debt payments (including scheduled interest payments) to be paid for the remainder of 2023.

There have been no other material changes to other information presented in guarantees and contractual obligations set forth in our 2022 Form 10-K.

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 2022 Form 10-K. We regularly evaluate items that may impact critical accounting estimates.

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 2022 Form 10-K. As of March 31, 2023, there were no significant changes to the critical accounting estimates from what was reported in our 2022 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

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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 before income taxes to pre-tax adjusted income 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, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions. 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 revenues, Fee and other revenues and Pharmacy and other service costs are volume, mix of claims and price. These key factors are discussed further below. See Note 2 to the Consolidated Financial Statements included in our 2022 Form 10-K for additional information on revenue and cost recognition policies for this segment.

•As our clients' claim volumes increase or decrease, our resulting revenues and cost of revenues correspondingly increase or decrease. Our gross profit, defined as Total revenues less Pharmacy and other service costs, could also increase or decrease as a result of changes in purchasing discounts.

•The mix of claims generally considers the type of drug and distribution method used for dispensing and fulfilling. Types of drugs can have an impact on our Pharmacy revenues, Pharmacy and other service costs and gross profit, including amounts payable under certain financial and performance guarantees with our clients. In addition to the types of drugs, the mix of generic claims (i.e., generic fill rate) also impacts our gross profit. Generally, higher generic fill rates reduce 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, higher generic fill rates generally have a favorable impact on our gross profit. The home delivery generic fill rate is currently lower than the network generic fill rate as fewer generic substitutions are available among maintenance medications (such as therapies for chronic conditions) commonly dispensed from home delivery pharmacies as compared to acute medications that are primarily dispensed by pharmacies in our retail networks. Furthermore, our gross profit differs among network, home delivery and specialty distribution methods and can impact our profitability.

•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 contract 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. Our revenues, cost of revenues and gross profit could increase or decrease as a result of these contract affordability services. 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.

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

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Results of Operations

Financial Summary
	Three Months Ended March 31,						Change Favorable (Unfavorable)
(Dollars in millions)	2023			2022
Total revenues	$	36,179		$	33,586		8	%
Adjusted revenues (1)	$	36,179		$	33,586		8	%
Pharmacy and other service costs	$	33,973		$	31,575		8	%
Gross profit (2)	$	2,206		$	2,011		10	%
Adjusted gross profit (1),(2)	$	2,206		$	2,011		10	%
Pre-tax adjusted income from operations	$	1,320		$	1,302		1	%
Pre-tax adjusted margin	3.6		%	3.9		%
Adjusted expense ratio (3)	2.3		%	2.1		%

Selected Financial Information
	Three Months Ended March 31,						Change Favorable (Unfavorable)
(Dollars and adjusted scripts in millions)	2023			2022
Pharmacy revenue by distribution channel
Adjusted network revenues (1)	$	15,748		$	15,531		1	%
Adjusted home delivery and specialty revenues (1)	16,025			14,699			9
Other pharmacy revenues	1,867			1,712			9
Total adjusted pharmacy revenues (1)	$	33,640		$	31,942		5	%
Adjusted fees and other revenues (1)	2,489			1,634			52
Net investment income	50			10			N/M
Adjusted revenues (1)	$	36,179		$	33,586		8	%
Pharmacy script volume (4)
Adjusted network scripts	315			315			—	%
Adjusted home delivery and specialty scripts	66			70			(6)
Total adjusted scripts	381			385			(1)	%
Generic fill rate (5)
Network	88.2		%	87.2		%	100	bps
Home delivery	84.0		%	85.4		%	(140)	bps
Overall generic fill rate	87.8		%	87.0		%	80	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 total revenues less pharmacy and other services costs.

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

(4)Non-specialty network scripts filled through 90-day programs and home delivery scripts are multiplied by three. All other network and specialty scripts are counted as one script.

(5)Generic fill rate is defined as the total number of generic scripts divided by the total overall scripts filled.

Three Months Ended March 31, 2023 versus Three Months Ended March 31, 2022

Adjusted network revenues slightly increased, reflecting inflation on branded drugs, partially offset by a decrease in mix and an increase in the generic fill rate.

Adjusted home delivery and specialty revenues increased 9%, reflecting higher specialty claims volume and inflation on, and higher sales of, branded drugs. These increases were partially offset by lower home delivery claims volume.

Other pharmacy revenues increased 9%, reflecting higher volume from our CuraScript Specialty Distribution business.

Adjusted fees and other revenues increased 52%, reflecting client growth of our Care Delivery and Management Solutions, including cross-enterprise leverage, and client growth from our continued contract affordability services.

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Adjusted gross profit and pre-tax adjusted income from operations increased 10% and 1%, respectively, reflecting growth in specialty pharmacy, partially offset by strategic investments to support business growth and continued advancement of our capabilities.

The adjusted expense ratio increased 20 bps, reflecting increased strategic investments to support business growth and continued advancement of our capabilities.

Cigna Healthcare Segment

Cigna Healthcare includes the U.S. Commercial, U.S. Government 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).

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. For the Cigna Healthcare segment, prior period results of operations have been retrospectively adjusted to conform to this new basis of accounting. For the three months ended March 31, 2023, the impact of this amended guidance is immaterial. See Note 2 to the Consolidated Financial Statements for additional information.

Results of Operations

Financial Summary
	Three Months Ended March 31,						Change Favorable (Unfavorable)
(Dollars in millions)	2023			2022
Adjusted revenues	$	12,718		$	11,393		12	%
Pre-tax adjusted income from operations	$	1,115		$	1,297		(14)	%
Pre-tax adjusted margin	8.8		%	11.4		%	(260)	bps
Medical care ratio	81.3		%	81.5		%	20	bps
Adjusted expense ratio	21.4		%	20.5		%	(90)	bps

Three Months Ended March 31, 2023 versus Three Months Ended March 31, 2022

Adjusted revenues increased 12%, reflecting customer growth in U.S. Government and U.S. Commercial mostly driven by our Individual business, increased specialty contributions and higher premium rates due to anticipated underlying medical cost trend, partially offset by lower net investment income.

Pre-tax adjusted income from operations decreased 14%, primarily due to a higher adjusted expense ratio and lower net investment income, partially offset by a lower medical care ratio.

The medical care ratio decreased 20 bps, reflecting effective pricing execution and favorable cost trends, inclusive of lower COVID-19 costs.

The adjusted expense ratio increased 90 bps, primarily due to volume-related expenses, higher spend on investments to support growth and lower net investment income, partially offset by revenue growth across all segments.

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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 service 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)	2023	2022	% Change
Insured	5,205	4,682	11	%
U.S. Commercial	2,218	2,166	2
U.S. Government	1,837	1,397	31
International Health (1)	1,150	1,119	3
Services only	14,268	13,097	9
U.S. Commercial	13,808	12,455	11
U.S. Government	6	5	20
International Health (1)	454	637	(29)
Total	19,473	17,779	10	%

(1)International Health excludes medical customers served by less than 100% owned subsidiaries. International Health lives as of March 31, 2023 reflect the transition of certain run-off business to Other Operations beginning January 1, 2023.

Our medical customer base increased 10%, primarily driven by growth in fee-based customers as well as growth in Individual and Medicare Advantage customers.

See Part I, Item 1 of our 2022 Form 10-K for definitions of Cigna Healthcare's market segments.

Unpaid Claims and Claim Expenses

(In millions)	As of March 31, 2023		As of December 31, 2022		% Change
Unpaid claims and claim expenses – Cigna Healthcare	$	4,959	$	4,176	19	%

Our unpaid claims and claim expenses liability increased 19%, driven by stop loss seasonality and higher volumes in our Individual and Medicare Advantage businesses.

Other Operations

Other Operations includes corporate owned life insurance ("COLI") and the Company's run-off operations. In the prior period, Other Operations also included the International businesses sold in July 2022 and our interest in a joint venture in Türkiye sold in December 2022. As described in the introduction of Segment Reporting, performance of Other Operations is measured using adjusted revenues and pre-tax adjusted income from operations.

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. For the Other Operations segment, prior period results of operations have been retrospectively adjusted to conform to this new basis of accounting. For the three months ended March 31, 2023, the impact of this amended guidance is immaterial. See Note 2 to the Consolidated Financial Statements for additional information.

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Results of Operations

Financial Summary	Three Months Ended March 31,						Change Favorable (Unfavorable)
(Dollars in millions)	2023			2022
Adjusted revenues	$	157		$	979		(84)	%
Pre-tax adjusted income from operations	$	15		$	229		(93)	%
Pre-tax adjusted margin	9.6		%	23.4		%	(1,380)	bps

Three Months Ended March 31, 2023 versus Three Months Ended March 31, 2022

Adjusted revenues and pre-tax adjusted income from operations decreased 84% and 93%, respectively, primarily due to the absence of revenues and earnings from the businesses divested in the Chubb transaction.

Corporate

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate debt 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 intersegment eliminations for products and services sold between segments.

Financial Summary	Three Months Ended March 31,				Change Favorable (Unfavorable)
(In millions)	2023		2022
Pre-tax adjusted loss from operations	$	(414)	$	(343)	(21)	%

Three Months Ended March 31, 2023 versus Three Months Ended March 31, 2022

Pre-tax adjusted loss from operations increased 21%, primarily due to higher interest rates on our indebtedness and increased pension costs due to lower asset returns and a higher discount rate. While our pension expense has increased year-over-year, we continue to expect the required contributions for 2023 to be immaterial.

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, 2023		December 31, 2022
Debt securities	$	9,909	$	9,872
Equity securities	3,120		622
Commercial mortgage loans	1,607		1,614
Policy loans	1,211		1,218
Other long-term investments	3,936		3,728
Short-term investments	141		139
Total	$	19,924	$	17,193

Investment Outlook

We continue to actively monitor economic conditions including the impact of inflation, higher interest rates and the potential for a recession in 2023 on the investment portfolio. Although there has been very limited impact to date on our investment portfolio as a result of recent banking failures, we are also monitoring this situation and any potential impacts on our investments. 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 adverse effect on our financial condition or liquidity.

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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.

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

(In millions)	March 31, 2023		December 31, 2022
Federal government and agency	$	297	$	312
State and local government	41		41
Foreign government	371		365
Corporate	8,856		8,806
Mortgage and other asset-backed	344		348
Total	$	9,909	$	9,872

Our debt securities portfolio increased during the three months ended March 31, 2023 primarily due to an increase in valuations due to a slight decrease in 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, 2023, $8.1 billion, or 82%, of the debt securities in our investment portfolio were investment grade (Baa and above, or equivalent) and the remaining $1.8 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 $4.2 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. Elevated global inflation, higher interest rates, continuing supply chain disruptions and potential fallout from the current stress in the banking system are the primary risks that many of the issuers in our portfolio are facing. To date, most issuers have been successful in managing the cost escalation and product shortages without undue margin pressure. 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, 2023, 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, 2023. 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 less than 65% 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 fiscal 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 2022 confirmed ongoing strong overall credit quality in line with the previous year's results.

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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 regional shopping malls and less than 30% exposure to office properties.

Other Long-term Investments

Other long-term investments of $3.9 billion as of March 31, 2023 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. The increase in other long-term investments of $0.2 billion since December 31, 2022 is primarily driven by net additional funding activity. 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 90 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. Accordingly, our net investment income in the first quarter largely reflects the underlying financial information from the fourth quarter of 2022. 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 5% 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 and report our share of the net assets of $0.4 billion in Other assets. Our 50% share of the investment portfolio supporting the joint venture's liabilities is approximately $10.3 billion as of March 31, 2023. These investments were comprised of approximately 70% debt securities, including government and corporate debt diversified by issuer, industry and geography; 20% equities, including mutual funds, equity securities and private equity partnerships; and 10% long-term deposits and policy loans. We participate in the approval of the joint venture's investment strategy and continuously review its execution. There were no investments with a material unrealized loss as of March 31, 2023.

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 exposure is interest rate risk. We encourage you to read this in conjunction with "Market Risk – Financial Instruments" included in the MD&A section of our 2022 Form 10-K. As of March 31, 2023, there were no material changes in our risk exposures from those reported in our 2022 Form 10-K.

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.

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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 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, 2023 that have materially affected, or are reasonably likely to materially affect, The Cigna Group's internal control over financial reporting.

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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, 2022.

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, 2023:

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, 2023	1,645,320	$	312.03	1,645,228	$	3,060
February 1-28, 2023	836,644	$	297.60	675,164	$	2,860
March 1-31, 2023	1,070,256	$	279.47	878,786	$	2,619
Total	3,552,220	$	298.82	3,199,178	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 92 shares in January, 161,480 shares in February and 191,470 shares in March 2023.

(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. From April 1, 2023 through May 4, 2023, the Company repurchased 0.5 million shares for approximately $139 million, leaving repurchase authority at $2.5 billion as of May 4, 2023.

(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

The information contained under "Supplemental Pharmacy Benefit Management Model Disclosure" in Exhibit 20.1 to this Form 10-Q is incorporated herein by reference.

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Item 6. EXHIBITS

INDEX TO EXHIBITS

Number	Description	Method of Filing
3.1	Restated Certificate of Incorporation of The Cigna Group	Filed herewith.
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.
4.1(g)	Supplemental Indenture No. 6 dated as of March 7, 2023, 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 March 7, 2023 and incorporated herein by reference.
10.31	Offer letter for Noelle Eder dated July 22, 2020	Filed herewith.
20.1	Supplemental Pharmacy Benefit Management Model Disclosure	Filed herewith.
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, 2023, 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.

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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 5, 2023

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

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EX-3.1

Exhibit 3.1

RESTATED CERTIFICATE OF INCORPORATION OF THE CIGNA GROUP

The undersigned hereby certifies on behalf of The Cigna Group as follows:

1.    The present name of the corporation is The Cigna Group. The corporation was incorporated under the name "Halfmoon Parent, Inc." by the filing of its original Certificate of Incorporation with the Secretary of State of the State of Delaware on March 6, 2018.

2.    This Restated Certificate of Incorporation was duly adopted in accordance with the provisions of Sections 242 and 245 of the Delaware General Corporation Law.

3.    The Certificate of Incorporation of the corporation is hereby integrated and restated to read in its entirety as follows:

First: The name of the Corporation is The Cigna Group.

Second: The address of the Corporation’s registered office in the State of Delaware is 1209 Orange Street in the City of Wilmington, County of New Castle, Delaware 19801. The name of its registered agent at such address is The Corporation Trust Company.

Third: The nature of the business or purposes to be conducted or promoted is to engage in any lawful act or activity for which corporations may be organized under the General Corporation Law of the State of Delaware.

Fourth: The total number of shares of all classes of capital stock which the Corporation shall have the authority to issue is 625,000,000 shares divided into two classes as follows: 600,000,000 shares of Common Stock of the par value of $0.01 per share and 25,000,000 shares of Preferred Stock of the par value of $1.00 per share.

A.PREFERRED STOCK

The Board of Directors is expressly authorized to provide for the issue of all or any shares of the Preferred Stock, in one or more series, and to fix for each such series such voting powers, full or limited, or no voting powers, and such designations, preferences and relative, participating, optional or other special rights and such qualifications, limitations or restrictions thereof, as shall be stated and expressed in the resolution or resolutions adopted by the Board of Directors providing for the issue of such series and as may be permitted by the General Corporation Law of the State of Delaware, including, without limitation, the authority to provide that any such series may be (i) subject to redemption at such time or times and at such price or prices; (ii) entitled to receive dividends (which may be cumulative or non-cumulative) at such rates, on such conditions, and at such times, and payable in preference to, or in such relation to, the dividends payable on any other class or classes or any other series; (iii) entitled to such rights upon the dissolution of, or upon any distribution of the assets of, the Corporation; or (iv) convertible into, or exchangeable for, shares of any other class or classes of stock, or of any other series of the same or any other class or classes of stock, of the Corporation at such price or prices or at such rates of exchange and with such adjustments; all as may be stated in such resolution or resolutions.

B.COMMON STOCK

1.Voting Rights. Except as provided by law or this Certificate of Incorporation, each holder of Common Stock shall have one vote in respect of each share of stock held by him of record on the books of the Corporation for the election of directors and on all matters submitted to a vote of stockholders of the Corporation.

2.Dividends. Subject to the preferential rights of the Preferred Stock, the holders of shares of Common Stock shall be entitled to receive, when and if declared by the Board of Directors, out of the assets of the Corporation which are by law available therefor, dividends payable either in cash, in property, or in shares of capital stock.

3.Dissolution, Liquidation or Winding Up. In the event of any dissolution, liquidation or winding up of the affairs of the Corporation, after distribution in full of the preferential amounts, if any, to be distributed to the holders of shares of Preferred Stock, holders of Common Stock shall be entitled to receive all of the remaining assets of the Corporation of whatever kind available for distribution to stockholders ratably in proportion to the number of shares of Common Stock held by them respectively. The Board of Directors may distribute in kind to the holders of Common Stock such remaining assets of the Corporation or may sell, transfer or otherwise dispose of all or any part of such remaining assets to any other corporation, trust or other entity and receive payment therefor in cash, stock or obligations of such other corporation, trust or entity, or any combination thereof, and may sell all or any part of the consideration so received and distribute any balance thereof in kind to holders of Common Stock. Neither the merger or consolidation of the Corporation into or with any other corporation, nor the merger of any other corporation into it, nor any purchase or redemption of shares of stock of the Corporation of any class, shall be deemed to be a dissolution, liquidation or winding up of the Corporation for the purpose of this paragraph.

Fifth: The By-Laws of the Corporation may be adopted, amended or repealed by the affirmative vote of the holders of a majority of the voting power of the capital stock of the Corporation outstanding and entitled to vote thereon. The Board of Directors shall also have the power to adopt, amend or repeal any provision of the By-Laws of the Corporation without any vote of the stockholders of the Corporation.

Sixth: Elections of directors need not be by written ballot unless the By-Laws of the Corporation shall otherwise provide.

Seventh: Notwithstanding any provision of the General Corporation Law of the State of Delaware, no action may be taken by stockholders without a meeting, without prior notice and without a vote, unless a consent in writing setting forth the action so taken shall be signed by the holders of all the outstanding stock who would be entitled to vote thereon.

Eighth: Whenever a compromise or arrangement is proposed between this Corporation and its creditors or any class of them and/or between this Corporation and its stockholders or any class of them, any court of equitable jurisdiction within the State of Delaware may, on the application in a summary way of this Corporation or of any creditor or stockholder thereof or on the application of any receiver or receivers appointed for this Corporation under the provisions of Section 291 of Title 8 of the Delaware Code or on the application of

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trustees in dissolution or of any receiver or receivers appointed for this Corporation under the provisions of Section 279 of Title 8 of the Delaware Code order a meeting of the creditors or class of creditors, and/or of the stockholders or class of stockholders of this Corporation, as the case may be, to be summoned in such manner as the said court directs. If a majority in number representing three-fourths in value of the creditors or class of creditors, and/or of the stockholders or class of stockholders of this Corporation, as the case may be, agree to any compromise or arrangement and to any reorganization of this Corporation as consequence of such compromise or arrangement, the said compromise or arrangement and the said reorganization shall, if sanctioned by the court to which the said application has been made, be binding on all the creditors or class of creditors, and/or on all of the stockholders or class of stockholders, of this Corporation, as the case may be, and also on this Corporation.

Ninth: The Corporation reserves the right to amend, alter, change or repeal any provision contained in this Certificate of Incorporation, in the manner now or hereafter prescribed by statute, and all rights conferred upon stockholders herein are granted subject to this reservation.

Tenth: 1. Vote for Certain Business Combinations. In addition to any affirmative vote of holders of a class or series of capital stock of the Corporation required by law or this Certificate, a Business Combination (as hereinafter defined) with or upon a proposal by a Related Person (as hereinafter defined) shall require the affirmative vote of the holders of at least a majority of the voting power of all outstanding Voting Stock (as hereinafter defined) of the Corporation, voting together as a single class. Such affirmative votes shall be required notwithstanding the fact that no vote may be required, or that a lesser percentage may be specified, by law or the Board.

2.When Vote Is Not Required. The provisions of this Article shall not be applicable to a particular Business Combination, and such Business Combination shall require only such affirmative vote as is required by law and any other provision of this Certificate or the By-Laws of the Corporation, if all of the conditions specified in any one of the following Paragraphs (A), (B) or (C) are met:

(A)Approval by Directors. The Business Combination has been approved by a vote of a majority of all the Continuing Directors (as hereinafter defined); or

(B)Combination with Subsidiary. The Business Combination is solely between the Corporation and a subsidiary of the Corporation and such Business Combination does not have the direct or indirect effect set forth in Paragraph 3(B)(v) of this Article Tenth; or

(C)Price and Procedural Conditions. The proposed Business Combination will be consummated within three years after the date the Related Person became a Related Person (the “Determination Date”) and all of the following conditions have been met:

(i)The aggregate amount of (x) cash and (y) fair market value (as of the date of the consummation of the Business

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Combination) of consideration other than cash, to be received per share of Common or Preferred Stock of the Corporation in such Business Combination by holders thereof shall be at least equal to the highest per share price (including any brokerage commissions, transfer taxes and soliciting dealers’ fees) paid by the Related Person for any shares of such class or series of stock acquired by it; provided, that if either (a) the highest preferential amount per share of a series of Preferred Stock to which the holders thereof would be entitled in the event of any voluntary or involuntary liquidation, dissolution or winding-up of the affairs of the Corporation (regardless of whether the Business Combination to be consummated constitutes such an event) or (b) the highest reported sales price per share for any shares of such series of Preferred Stock on any national securities exchange on which such series is traded and if not traded on any such exchange, the highest reported closing bid quotation per share with respect to shares of such series on the National Association of Securities Dealers, Inc. Automated Quotation System or on any system then in use, at any time after the Related Person became a holder of any shares of Common Stock, is greater than such aggregate amount, holders of such series of Preferred Stock shall receive an amount for each such share at least equal to the greater of (a) or (b).

(ii)The consideration to be received by holders of a particular class or series of outstanding Common or Preferred Stock shall be in cash or in the same form as the Related Person has previously paid for shares of such class or series of stock. If the Related Person has paid for shares of any class or series of stock with varying forms of consideration, the form of consideration given for such class or series of stock in the Business Combination shall be either cash or the form used to acquire the largest number of shares of such class or series of stock previously acquired by it.

(iii)No Extraordinary Event (as hereinafter defined) occurs after the Determination Date and prior to the consummation of the Business Combination.

(iv)A proxy or information statement describing the proposed Business Combination and complying with the requirements of the Securities Exchange Act of 1934, as amended, and the rules and regulations

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thereunder (or any subsequent provisions replacing such Act, rules or regulations) is mailed to public stockholders of the Corporation at least 30 days prior to the consummation of such Business Combination (whether or not such proxy or information statement is required pursuant to such Act or subsequent provisions).

3.Certain Definitions. For purposes of this Article Tenth:

(A)A “person” shall mean any individual, firm, corporation or other entity, or a group of “persons” acting or agreeing to act together in the manner set forth in Rule 13d-5 under the Securities Exchange Act of 1934, as in effect on April 24, 1985.

(B)The term “Business Combination” shall mean any of the following transactions, when entered into by the Corporation or a subsidiary of the Corporation with, or upon a proposal by, a Related Person:

(i)the merger or consolidation of the Corporation or any subsidiary of the Corporation; or

(ii)the sale, lease, exchange, mortgage, pledge, transfer or other disposition (in one or a series of transactions) of any assets of the Corporation or any subsidiary of the Corporation having an aggregate fair market value of $100 million or more; or

(iii)the issuance or transfer by the Corporation or any subsidiary of the Corporation (in one or a series of transactions) of securities of the Corporation or any subsidiary having an aggregate fair market value of$50 million or more; or

(iv)the adoption of a plan or proposal for the liquidation or dissolution of the Corporation; or

(v)the reclassification of securities (including a reverse stock split), recapitalization, consolidation or any other transaction (whether or not involving a Related Person) which has the direct or indirect effect of increasing the voting power, whether or not then exercisable, of a Related Person in any class or series of capital stock of the Corporation or any subsidiary of the Corporation; or

(vi)any agreement, contract or other arrangement providing directly or indirectly for any of the foregoing.

(C)The term “Related Person” shall mean any person (other than the Corporation, a subsidiary of the Corporation or any profit sharing, employee stock ownership or other employee benefit plan of the Corporation or of a subsidiary of the Corporation or any trustee of or fiduciary with respect to any such plan acting in such capacity) that is the direct or indirect beneficial owner (as defined in Rule 13d-3 and Rule 13d-5 under the Securities Exchange Act of

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1934) of more than ten percent (10%) of the outstanding Voting Stock of the Corporation, and any Affiliate or Associate of any such person.

(D)The term “Continuing Director” shall mean any member of the Board of Directors who is not affiliated with a Related Person and who was a member of the Board of Directors immediately prior to the time that the Related Person became a Related Person, and any successor to a Continuing Director who is not affiliated with the Related Person and is recommended to succeed a Continuing Director by a majority of Continuing Directors who are then members of the Board of Directors.

(E)“Affiliate” and “Associate” shall have the respective meanings ascribed to such terms in Rule 12b-2 under the Securities Exchange Act of 1934.

(F)The term “Extraordinary Event” shall mean, as to any Business Combination and Related Person, any of the following events that is not approved by a majority of all Continuing Directors:

(i)any failure to declare and pay at the regular date therefor any full quarterly dividend (whether or not cumulative) on outstanding Preferred Stock; or

(ii)any reduction in the annual rate of dividends paid on the Common Stock (except as necessary to reflect any subdivision of the Common Stock); or

(iii)any failure to increase the annual rate of dividends paid on the Common Stock as necessary to reflect any reclassification (including any reverse stock split), recapitalization, reorganization or any similar transaction that has the effect of reducing the number of outstanding shares of the Common Stock; or

(iv)the receipt by the Related Person, after the Determination Date, of a direct or indirect benefit (except proportionately as a stockholder) from any loans, advances, guarantees, pledges or other financial assistance or any tax credits or other tax advantages provided by the Corporation or any subsidiary of the Corporation, whether in anticipation of or in connection with the Business Combination or otherwise.

(G)A majority of all Continuing Directors shall have the power to make all determinations with respect to this Article Tenth, including, without limitation, the transactions that are Business Combinations, the persons who are Related Persons, the time at which a Related Person became a Related Person, and the fair market value of any assets, securities or other property, and any such determinations of such directors shall be conclusive and binding.

(H)The term “Voting Stock” shall mean all outstanding shares of the Common or Preferred Stock of the Corporation entitled to vote generally and each reference to a proportion of Voting Stock shall refer to shares having such proportion of the number of shares entitled to be cast.

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4.No Effect on Fiduciary Obligations of Related Persons. Nothing contained in this Article Tenth shall be construed to relieve any Related Person from any fiduciary obligation imposed by law.

Eleventh: To the fullest extent permitted by the General Corporation Law of the State of Delaware as the same exists or may hereafter be amended, no director or officer of the Corporation shall be liable to the Corporation or its stockholders for monetary damages for breach of fiduciary duty as a director or officer. Any repeal or modification of the preceding sentence shall not adversely affect any right or protection of a director or officer existing at the time of such repeal or modification. For purposes of this Article Eleventh, “officer” shall have the meaning provided in Section 102(b)(7) of the General Corporation Law of the State of Delaware as the same exists or may hereafter be amended.

[Signature page follows]

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IN WITNESS WHEREOF, the Corporation has caused this Restated Certificate of Incorporation to be signed in its name by the undersigned officer on the 26th day of April, 2023.

THE CIGNA GROUP

By:   /s/ Kari K. Stevens

Name:    Kari K. Stevens

Title:     Secretary

[Signature Page to Restated Certificate of Incorporation]

EX-10.31

EX-20.1

Exhibit 20.1

Supplemental Pharmacy Benefit Management Model Disclosure

On each of April 13 and 20, 2023, Express Scripts, Inc. (“Express Scripts”) issued a press release announcing several actions to further evolve its pharmacy benefit management (“PBM”) model. The purpose of this disclosure is to provide additional information regarding Express Scripts’ business model that is described in the 2022 Annual Report on Form 10-K of The Cigna Group. We do not consider the information contained herein to be material to making an investment decision in The Cigna Group. We do, however, believe it may be helpful to our various stakeholders who are looking to understand more about our recent announcements and our PBM model more generally. Additional information regarding Express Scripts’ PBM model can be accessed at www.ExpressScriptsFacts.com. Information on, or accessible through, this site is expressly not incorporated by reference into this disclosure beyond the information provided below. The industry metrics referenced below are based on what we believe is the most recent information that is publicly available. All financial and operational information for Express Scripts is presented on a stand-alone basis separate from the other operations of The Cigna Group.

Overview

Innovation in the pharmaceutical industry has resulted in a growing number of drugs that provide valuable medical benefits, but these same drugs are also expensive and contribute to rising health care costs for the private sector and the government. According to an article in the American Journal of Health-System Pharmacy, prescription drug spending in the United States totaled $576.9 billion in 2021, which was up 7.7% from the prior year. At the same time, the American population is aging, which is a well‐established risk factor for the development of multiple chronic diseases that in turn increase the demand for new and expensive drugs. PBMs help ensure access to these important, often life-saving drugs, while ensuring they can be obtained in an affordable way. PBMs are a key part of the health care system, working with health plans, as well as employers and other plan sponsors who provide health benefits to their employees to help drive down the cost of prescription drugs and help coordinate care programs. Most importantly, PBMs provide these benefits at a cost which is significantly lower than the benefit PBMs bring to the health care system. In 2022, based on publicly available information, the average pre-tax adjustedoperating margin of PBMs was between 4.0% and 4.5%, well below any other healthcare subsectors (including pharmaceutical manufacturers), and below the 5-year average net profit margin for the S&P 500 of 11.4%. 

Express Scripts’ PBM is within the Evernorth Health Services (“Evernorth”) segment of The Cigna Group. Express Scripts serves a diverse base of approximately 2,500 clients representing nearly 100 million people. In 2022 alone, Express Scripts saved consumers and clients more than $37 billion (including savings from Home Delivery Services and Specialty Services). It achieves these savings in four primary ways:

•Helping clients (employers, health plans and government programs) and customers (individuals) afford and finance their drug spend. Medications can be expensive.PBMs, including Express Scripts, aggregate the buying power of the multiple clients they serve to negotiate more affordable costs for medications that their respective populations need. This allows each client and customer that Express Scripts serves to save more on necessary and in some cases life-saving medications than they could ever achieve on their own.

1

Exhibit 20.1

•Providing clinical support to help ensure our clients and customers receive the outcomes they expect. Unique to Express Scripts are its SafeGuardRxSM programs that use available evidence to facilitate appropriate and effective treatments for eleven complex and costly disease states, including oncology, inflammatory conditions, multiple sclerosis and rare conditions. Not only do our programs help to limit our clients’ financial exposure through innovative value-based arrangements, they also provide proactive medication adherence coaching services to customers. Through this service, Express Scripts pharmacists are available to talk through topics such as: medication options, side effects, barriers to medication adherence and possible interactions. In 2022, approximately 86 million customers were enrolled in SafeGuardRxSM programs and, as a result, achieved better medication adherence, lower costs, higher therapy completion rates and greater clinical compliance.

•Helping our clients decide which medications to offer as part of their benefit plan. Express Scripts clients have to make a number of decisions when creating a pharmacy benefit plan, including deciding which of the hundreds of thousands of available drugs they will offer to their covered population. PBMs, including Express Scripts, utilize their expertise to support clients with designing a pharmacy benefit that works for them, including through the use of drug formulary options. A drug formulary, or preferred drug list, is a continually updated list of medications and related products supported by current evidence-based medicine, judgment of physicians, pharmacists and other experts in the diagnosis and treatment of disease and preservation of health. The primary purpose of the formulary is to encourage the use of safe, effective and affordable medications while maintaining or improving quality patient care.

•Providing administrative and care coordination services.In addition to processing claims, Express Scripts can analyze claim data to improve patient care and safety by, for example, monitoring patient drug adherence, detecting fraud, waste and abuse (which, according to a study by the Academy of Managed Care Pharmacists accounts for approximately 1%, or billions of dollars in unnecessary costs) and using models that inform prescribing doctors of the medication options that are therapeutically similar (i.e., drugs that provide similar treatment outcomes) but that would be more cost-effective for their patients’ specific situations, with the doctor and patient making the ultimate determination of what is best.

Driving Cost Savings and Transparency for Consumers and Clients

Express Scripts believes that all individuals should have access to the medications they need at affordable prices. That means special care should be taken to: (1) remove barriers to routine care and treatment for those with conditions that can be effectively managed to optimize health (e.g., chronic conditions) and (2) create programs that put more complex and costly treatments in the hands of those who need them most. In furtherance of this belief, Express Scripts has announced a series of actions designed to increase access to affordable medicines and drive greater transparency and predictability for the thousands of clients and millions of customers it serves every day.

2

Exhibit 20.1

Cost Savings

In April 2023, Express Scripts announced a new and innovative solution, the Copay Assurance plan, which caps consumer out-of-pocket costs for prescription drugs under a client’s prescription drug benefit. This means customers enrolled in the program will pay no more than $5 for generics and specialty generics, $25 for preferred brand drugs and $45 for preferred specialty brand drugs every time they fill their prescription. The program will immediately guarantee these lower out-of-pocket rates – customers will not have to wait to meet any deductible levels.

Additionally, Express Scripts is working with employer and health plan clients offering high deductible health plans to offer consultative options to bring better affordability and predictability. This includes: adopting the broadest lists of preventive prescription drugs that are either fully covered or covered at a discount, lowering premiums and deductibles, and increasing Health Savings Account contributions for lower-income consumers based on Internal Revenue Service income requirements.

All of this is in addition to existing programs and initiatives that Express Scripts offers, including:

•Express Scripts Patient Assurance Program, launched in 2020, caps out of pocket costs for eligible customers for select diabetes and cardiovascular medications. Customers taking insulin saved more than $18 million with point-of-sale discounts in 2022 alone, part of more than $45 million in customer savings on insulin since the program launched. In addition to capping the cost of insulin, the Patient Assurance Program has helped improve adherence by removing cost as a barrier to care.

•Express Scripts “lesser of” logic when processing a prescription claim ensures customers pay the lowest price available when picking up their medication at the pharmacy, whether that price is their co-payment or the pharmacy’s cash price for the medication. The key to “lesser of” logic is that it doesn’t require customers to take any action or price shop. In most cases, the best prescription medication price comes from our negotiated price within the benefit, but there are instances where cash discount pricing is lower, particularly for customers in high deductible health plans where the customer is responsible for the full cost of the medication until they meet their deductible.

Transparency

Express Scripts also believes in providing our clients and customers the transparency they need to understand the value they are getting. We have developed several innovations, including those described below, for our customers and clients to increase transparency and help them to better understand the value we deliver.

Express Scripts recently announced that starting in 2024, all prescriptions will include an easy-to-understand digital pharmacy benefits statement for consumers that will share drug price information, out-of-pocket costs and the value delivered by Express Scripts. This benefit will be implemented across all of the nearly 64,000 pharmacies in Express Scripts’ networks, including

3

Exhibit 20.1

Accredo® specialty pharmacy and Express Scripts Pharmacy, which are not part of the Express Scripts’ PBM business.

This is in addition to the transparency initiatives that Express Scripts has already implemented, including:

•Express Scripts Real Time Prescription Benefit helps to simplify the patient’s experience with their prescriber and improve transparency of drug costs. Express Scripts uploads patient-specific information and pricing information directly into the physician’s Electronic Health Record within seconds. Physicians using electronic prescribing have access to the following information to inform prescribing decisions: alternative drugs and associated details, such as generic versus brand pricing; coverage information, including electronic prior authorization requirements, step therapy requirements, or quantity limits; and the patient’s cost through each pharmacy dispensing channel: retail, home delivery or specialty pharmacy.

•Express Scripts also directly provides customers real-time pricing information, customized to their individual plans, via the Express Scripts website and mobile app, so patients can choose the pharmacy that provides the most affordable dispensing option. Express Scripts’ medication pricing tool allows customers to compare prescription options, based on health care needs, real-time costs and plan benefits. Customers can then determine if a medication is covered under their plan, and how much it will cost at local participating retail pharmacies, as well as through home delivery (if available). Additionally, costs for generic medications, when available, are displayed when searching for brand-name drugs. Cost estimates for 30- and 90-day supplies are personalized, based on the customer’s benefits. Finally, alerts appear for medications with coverage limitations (e.g., quantity limits and prior authorizations). Express Scripts’ innovations help better inform patients of their cost sharing and treatment options, thereby improving affordability and predictability.

Our New Transparent Client Offering

Express Scripts’ new ClearCareRx program offers employer, health plan and government employer clients the option of a transparent economic model by providing clear and predictable costs for prescription drug benefits:

•Clients pay exactly what Express Scripts pays pharmacies for a prescription.

•Clients receive 100% of drug rebates that Express Scripts receives.

•Clients pay one simple fee to cover the administration of pharmacy benefits, PBM product services and, reporting and analytics.

•Provides guarantees that keep Express Scripts accountable to clinical and financial performance measures, including improvements in drug performance, adherence, and overall patient outcomes.

This new offering will add to the choices already available to clients to finance the cost of the services that Express Scripts provides.

4

Exhibit 20.1

Clients not participating in ClearCareRx will continue to customize the pricing model they select for the value that Express Scripts delivers. A key principle underlying Express Scripts’ overall pricing models is client choice. Clients’ needs vary significantly. Some prefer predictability, some value cash flow, while others prioritize visibility into discounts that Express Scripts negotiates with its network of retail pharmacies and other providers. Generally, clients will issue requests for proposal (RFPs) that specify the financing mechanism and other features that will meet their particular needs. Express Scripts responds to those RFPs with a package of products and services to best address those needs.The marketplace for the services Express Scripts provides is highly competitive and the majority of clients are sophisticated purchasers that are utilizing the services of consultants and brokers to secure the highest service levels and savings available to them. Clients typically have three-year contracts with terms that allow them to ensure that pricing remains competitive throughout the life of the contract.

Clients can choose to finance the services provided by Express Scripts through any of following mechanisms: (1) administrative fees; (2) value-sharing arrangements on the discounted pricing Express Scripts negotiates with retail pharmacies (“spread pricing”); and/or (3) value sharing arrangements on rebate savings. Many of these arrangements include a “guarantee” in which Express Scripts guarantees a minimum discount that a client will receive from drug manufacturers and/or retail pharmacies, which represents the maximum price that a client will pay for prescription drugs. If Express Scripts is not able to secure the discount that has been guaranteed, Express Scripts recognizes a loss; and therefore is at risk based on its ability to perform.

Each of these pricing arrangements is described more fully below.

Pass Through Pricing Model. In this model, Express Scripts passes through the discounted pricing that it has negotiated for prescription drugs with its network of retail pharmacies and other providers. In a pass through arrangement, the client typically pays Express Scripts administrative fees for the services it provides, such as claims adjudication, retail network management, formulary management, clinical programs and utilization management programs. The amount of fees Express Scripts earns is driven by the specific services and customization it provides to clients in a highly competitive marketplace.

Spread Pricing Model. Clients select the pricing model that determines how and whether they will share in the discounts that Express Scripts negotiates with retail pharmacies. In the spread pricing model, the client elects predictable aggregate pricing guarantees (and Express Scripts takes on the pricing risk) for prescription drugs dispensed by Express Scripts’ contracted retail pharmacies. The client does not generally pay administrative fees for claims adjudication, network management, formulary management and other core administrative services the PBM provides. Under a spread arrangement, if the rate paid by a client for prescription drug claims exceeds the rate contracted with a particular pharmacy, ESI will realize a positive margin on the applicable claim. The reverse also may be true, resulting in negative margin for ESI. Incremental value retained by Express Scripts under a spread arrangement represents value sharing and Express Scripts’ compensation for providing a number of services. The actual discount secured by Express Scripts is dependent upon its negotiations with its network of pharmacies. The actual amount of gain or loss experienced by Express Scripts is further impacted by the client’s drug utilization mix. Express Scripts’ clients have the option to choose either a spread or a pass through pricing model.

5

Exhibit 20.1

In April 2023, Express Scripts committed to provide clients who choose spread pricing arrangements with enhanced financial and fee disclosure regarding their spread pricing arrangements for Form 5500 reporting and other plan administration functions beginning with the 2023 plan year. The Form 5500 Series is a compliance, research and disclosure tool for the U.S. Department of Labor, other Federal agencies and Congress, as well as for plan participants and beneficiaries, and the private sector to assess employee benefit, tax and economic trends and policies. Express Scripts will provide the same level of increased disclosure to its non-ERISA (Employee Retirement Income Security Act of 1974) clients to help support them in understanding the services Express Scripts provides.

Value Sharing Arrangements on Rebate Model. Express Scripts negotiates to obtain additional discounts based on the utilization of certain prescription drugs and supplies. These additional discounts can be paid to Express Scripts in the form of a rebate. While clients have options with respect to their rebate arrangements, in 2022, Express Scripts shared over 95% of the rebates it received with its PBM clients, and two-thirds of Express Scripts’ clients received 100% of rebates. In most rebate pricing arrangements, clients receive the greater of a minimum rebate guarantee or a contractually agreed upon percentage of rebates. Some clients have elected to receive less than 100% of rebates, or to receive only a minimum guaranteed rebate amount. In most rebate arrangements, Express Scripts takes on the risk of securing the rebate value necessary to meet the value guaranteed to its client. The actual amount of value secured by Express Scripts is dependent upon the result of its negotiations for rebates. The actual amount of gain or loss experienced by Express Scripts is further impacted by the client’s drug utilization mix.

Rebates

A rebate is a retrospective discount off of a manufacturer’s list price based on utilization of a particular drug by a member. Pharmaceutical manufacturers decide whether to offer a rebate on any particular drug, and if so, the amount to offer. Many factors can affect the amount of the rebate including aggregate volume and purchasing power, but in general, higher rebates are achieved when a client adopts a formulary and plan design that provides greater incentives to its participants to use a formulary (preferred) drug (see description of formulary below). Rebates are not typically offered for drugs without market competition or drugs that have obtained “orphan” designation (drugs used to prevent, diagnose or treat a rare disease or condition). Rebates are also not typically offered for generic medications, which comprise the majority of medications dispensed by volume. In the first quarter of 2023, approximately 88% of all prescriptions processed by Express Scripts were generics and the vast majority of these were not subject to any rebate. In the first quarter 2023, approximately 93% of all prescriptions processed by Express Scripts had no rebate associated with them.

Rebate discounts are an important tool to drive down drug cost, and can translate into lower premiums for consumers. In May 2019, the nonpartisan Congressional Budget Office found that a proposed rule to limit the use of rebates would increase federal spending in Medicare and Medicaid by $177 billion from 2020 through 2029 due to premium increases driven by higher drug prices. A similar report from the Centers for Medicare & Medicaid Services actuaries concluded that the same proposed rule would increase government spending by $196.1 billion over a decade. A United States Government Accountability Office study in 2019 found that 99.6% of prescription drug rebates in Medicare Part D are passed through to plan sponsors and

6

Exhibit 20.1

used to lower costs for Medicare beneficiaries. These savings have contributed to reductions in Part D basic premiums, from $34.70 in 2017 to a projected $31.50 in 2023.

In 2019, Express Scripts and a co-founder established Ascent Health Services (“Ascent”), a group purchasing organization. Since inception, a number of additional participants have joined Ascent. Ascent’s mission is to aggregate commercial lives across health plans and pharmacy benefit management companies to negotiate greater discounts with pharmaceutical manufacturers than any of the participants in Ascent could achieve alone. Ascent negotiates directly with pharmaceutical manufacturers for rebates. For non-commercial lives, Express Scripts contracts directly with pharmaceutical manufacturers for rebates. Ascent receives limited information from participants and has robust and strict firewalls in place to ensure that any one participant’s discount or other information is not shared with other participants. By enabling commercial payers to directly contract with Ascent, payers realize the savings benefits of aggregating their purchasing volume with Express Scripts and other participants, without engaging in a direct client relationship with Express Scripts. This model drives down premiums and other costs for more customers.

Ascent is subject to regular audits from its participants, who have a contractual right to audit the operations of Ascent and its firewalls. Ascent’s annual financial results are separately audited by a leading international auditing firm.

Formularies

Express Scripts works with its clients to provide affordable access to clinically sound, high-quality medications. Drug formularies are one method of achieving this result.

The Express Scripts formulary development process is based on the following principles:

•Clinical appropriateness of the drug, safety and effectiveness, not cost, are Express Scripts’ foremost considerations.

•The prescribing physician always makes the final decision regarding an individual patient’s drug therapy.

•Express Scripts will develop clinically sound formularies based on evaluations of independent physicians.

Consistent with these principles, Express Scripts offers a variety of standard formularies. Clients, based on their own unique situation, can select a formulary that is most appropriate for their population. A medication’s placement on a formulary generally determines the availability of any rebate payable with respect to the medicine.

Express Scripts develops formularies through a four-step process involving the work of three distinct committees:

1.The Therapeutic Assessment Committee (“TAC”) is an internal clinical review body, consisting of clinical pharmacists and physicians who are employed by Express Scripts. From a formulary development perspective, the committee is tasked to review specific medications following approval by the Food and Drug Administration (“FDA”). Before discussing a new drug at TAC, Express Scripts’ clinical team conducts a search of the

7

Exhibit 20.1

medical literature, evaluates published data from clinical trials and develops comprehensive drug evaluation summary documents. The drug evaluation documents are developed with the aid of a wide range of resources including, but not limited to: primary literature, clinical practice guidelines and FDA-approved package inserts. The drug evaluation documents include, at a minimum: a summary of the pharmacology, safety, efficacy, dosage, mode of administration and the relative place in therapy of the medication under review compared to other pharmacologic alternatives. Following a review of the drug evaluation summary document, TAC ultimately provides a formulary placement recommendation which is shared with the Express Scripts’ National Pharmacy and Therapeutics Committee (described below). TAC formulary recommendations are merely a suggestion and cannot be formally implemented without the approval of the P&T.

2.The National Pharmacy & Therapeutics Committee (P&T”) is a group of independent, actively practicing physicians and pharmacists who are not employed by Express Scripts. The P&T is tasked to review medications from a purely clinical perspective. The committee does not have access to, nor does it consider, any information regarding Express Scripts' rebates/negotiated discounts, or the net cost of the drug after application of all discounts. The committee does not use price, in any way, to make formulary placement decisions. The P&T reviews a much broader range of formulary placement topics than TAC, including: new drug evaluations, new FDA-approved indications for existing drugs, new clinical line extensions and new published or clinical practice trends that may impact previous formulary placement decisions. The P&T can establish one of the following four formulary placement designations: include, access, optional or exclude from a formulary.

3.The Value Assessment Committee (“VAC”) considers the value of drugs by evaluating the net cost, market share and drug utilization trends of clinically similar medications. VAC consists of Express Scripts' employees from formulary management, product management, finance and clinical account management. No member of VAC can serve in any capacity on TAC (and vice-versa). VAC reviews drugs designated as “access” or “optional” by the P&T, and develops a formulary placement recommendation. VAC is required to add medications with an “include” designation to formulary, while drugs with an “exclude” designation may not be preferred on the formulary. In both cases, economic considerations are superseded by the clinical requirements of the P&T. Once complete, formulary and tier placement recommendations are then forwarded to the P&T for final approval.

4.Annual Review. On an annual basis, the P&T will review the final formulary recommendations, by drug class, for the upcoming plan year. The committee uses this opportunity to ensure adherence to previously established formulary placement recommendations, and to validate continued alignment with best medical practices. The committee also ensures that all Express Scripts national formularies cover a broad distribution of therapeutic classes and categories and that the formularies provide all enrollees and patient populations a comprehensive, clinically sound formulary.

Express Scripts’ clients often adopt Express Scripts-developed formularies as their own or use them as the foundation to create their own custom formularies. The decision to cover non-formulary medications, as well as the mechanism by which it is administered, is entirely determined by the client, not Express Scripts.

8

Exhibit 20.1

Our Enhanced Reimbursements and Other Initiatives to Support Independent Pharmacists

Industry commentators sometimes categorize retail pharmacies into four types:

•Chain pharmacies. Chain pharmacies are the largest and most prevalent of the four pharmacy types, representing approximately 37% of stores and 34% of prescription drug revenues in 2021. Express Scripts does not own or operate this type of pharmacy.

•Regional pharmacies (Grocers, retailers and other partners). This group can be segmented into two types: grocers (supermarkets that also have a pharmacy) and mass retail (large consumer goods retailers that also have a pharmacy). In 2021, regional pharmacies represented around 29% of stores and 15% of prescription drug revenues. Express Scripts does not own or operate this type of pharmacy.

•Independent pharmacies. Independent pharmacies handle approximately 900 million prescriptions per year generating approximately $60 billion in annual prescription revenue. In 2021, independent pharmacies represented around 34% of stores and 12% of prescription drug revenues. Most independent community pharmacies are part of collective bargaining groups called pharmacy services administrative organizations (“PSAOs”) that negotiate contracts with other parties in the pharmaceutical supply and payment chain on behalf of the pharmacies they represent. PSAOs also provide a wide range of business services to all types of pharmacies, which are necessary to run a successful pharmacy. About 83% of independent pharmacies contract with a PSAO. Over 75% of independent and small chain pharmacies contract with PSAOs owned by one of the top wholesalers (AmerisourceBergen, Cardinal Health and McKesson). Express Scripts does not own or operate this type of pharmacy.

•Home delivery pharmacies. Mail order (or home delivery) pharmacies are generally owned by PBMs and fill maintenance and specialty prescriptions. In the past 15 years, many direct-to-consumer online pharmacies have been established. In 2021, these organizations accounted for about 10% of total U.S. prescriptions. Evernorth, the parent company of Express Scripts, owns and operates a mail order pharmacy that primarily dispenses a 90-day supply of maintenance medication (e.g., medication to treat diabetes, high blood pressure and high cholesterol). Clients have the ability to choose the Evernorth mail order pharmacy as a sole and required option. Express Scripts offers clients an option to choose an Evernorth mail order pharmacy as the sole prescription fulfillment supplier. Today, approximately 3.5% of all individuals covered by Express Scripts are enrolled in this program. This excludes the Department of Defense which has its own unique benefits design. In all other cases, the Express Scripts Pharmacy is available to customers at their election, subject to applicable state regulation. Evernorth also owns and operates specialty pharmacies focused on providing medications for people with serious health conditions requiring complex therapies. These services use a unique combination of digital tools and compassionate clinical services to deliver fertility medication, nurse-administered home infusions, and care for people living with everything from rheumatoid arthritis, cancer and HIV to the rarest of rare conditions. 

9

Exhibit 20.1

Express Scripts contracts with all of these types of pharmacies. The chart below depicts the mix of retail pharmacies in Express Scripts’ retail pharmacy network in 2022.

In April 2023, Express Scripts announced that it will increase reimbursements to pharmacies that are independently owned and unaffiliated with a drug wholesaler in areas with only one pharmacy within 10 or more miles from an Express Scripts customer. This includes enhancing performance- and incentive-based programs that pay pharmacies more when they drive better outcomes, such as dispensing 90-day supplies of prescription drugs that improve adherence. In addition, all independent rural pharmacies will have increased opportunities to participate in Express Scripts’ retail pharmacy networks.

Retail networks are critical to the ability of an employer, a health plan or a government program to deliver an affordable, accessible pharmacy benefit for their covered population. Assisting them in creating and executing a holistic pharmacy network strategy is an important service that Express Scripts provides.

Pharmacy networks are a group of pharmacies that Express Scripts contracts with to provide medication at a discounted price. Pharmacy networks are set up to help customers and clients save money, and can be any size. They can include any type of retail pharmacy.

In order for pharmacies to become a part of a pharmacy network, they have to meet certain industry standards that all PBMs require, such as patient safety, meeting government agency requirements and providing best-in-class patient care. Prospective network pharmacies complete initial credentialing as well as re-credentialing at least every three years. Once credentialing is complete, the pharmacy has to agree to a contracted fee that might also be tied to an individual’s health outcomes.

10

Exhibit 20.1

Just like physician networks, pharmacy networks are designed to achieve optimal access, quality and savings for clients and customers. A well-designed network strategy is more than just a list of in- and out-of-network pharmacies, but rather it is comprised of the right coverage to account for population size, geographic area, clinical goals and utilization patterns. Optimizing a pharmacy network does not equate to limiting access. In fact, there are nearly 64,000 pharmacies in the Express Scripts PBM network. By way of reference, that is more locations in the United States than McDonalds and Starbucks combined.

Express Scripts has also announced, in collaboration with other Evernorth businesses, that it will increase access to certain routine, preventive and chronic care services at independent pharmacies – driving new business growth opportunities for pharmacy owners and providing convenient care options for consumers. This includes reimbursing independent pharmacists for a variety of health screenings, testing and clinical services, such as:

•COVID-19 and other routine vaccinations;

•Trainings to empower pharmacists to recognize and combat substance use disorders, including opioid addiction and naloxone administration;

•Additional prescriptions for acute infections;

•Acute viral condition testing (i.e., influenza and strep A);

•Lifestyle counseling, such as nutrition and smoking cessation; and

•Annual behavioral health screenings.

Additionally, to fully realize the vision and potential of this initiative, Express Scripts will establish the industry’s first Independent Pharmacy Advisory Committee. The newly established committee will convene a diverse group of pharmacy leaders across rural, urban and suburban areas – all focused on continuing to drive competitive reimbursement practices, learning from each other’s business models and creating new solutions that leverage independent pharmacists to alleviate provider shortages across the health care delivery system.

11

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 5, 2023	/s/ David M. Cordani
	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 5, 2023	/s/ Brian C. Evanko
	Chief Financial Officer

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, 2023 (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

Chief Executive Officer

May 5, 2023

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, 2023 (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

Chief Financial Officer

May 5, 2023

XML

Cover Page - shares	3 Months Ended
	Mar. 31, 2023	Apr. 28, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
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		295,872,231
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2023
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Entity Central Index Key	0001739940

XML

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	[1]
Revenues
Premiums	$ 11,025	$ 10,356
Net investment income	277	414
TOTAL REVENUES	46,517	44,006
Benefits and expenses
Pharmacy and other service costs	31,459	29,813
Medical costs and other benefit expenses	9,046	8,272
Selling, general and administrative expenses	3,538	3,275
Amortization of acquired intangible assets	459	458
TOTAL BENEFITS AND EXPENSES	44,502	41,818
Income from operations	2,015	2,188
Interest expense and other	(358)	(299)
Net realized investment losses	(56)	(322)
Income before income taxes	1,601	1,567
TOTAL INCOME TAXES	295	355
Net income	1,306	1,212
Less: Net income attributable to noncontrolling interests	39	15
SHAREHOLDERS' NET INCOME	$ 1,267	$ 1,197
Shareholders' net income per share
Basic (in dollars per share)	$ 4.28	$ 3.76
Diluted (in dollars per share)	$ 4.24	$ 3.73
Pharmacy revenues
Revenues
Revenues	$ 32,144	$ 30,697
Fees and other revenues
Revenues
Revenues	$ 3,071	$ 2,539

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

XML

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 1,306	$ 1,212	[1]
Other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives	194	(843)	[2]
Net long-duration insurance and contractholder liabilities measurement adjustments	(331)	459	[2]
Net translation gains (losses) on foreign currencies	16	(63)	[2]
Postretirement benefits liability adjustment	10	13	[2]
Other comprehensive loss, net of tax	(111)	(434)	[2]
Total comprehensive income	1,195	778	[2]
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests	34	3	[2]
Net income attributable to other noncontrolling interests	5	12	[2]
Other comprehensive loss attributable to redeemable noncontrolling interests	0	(2)	[2]
Total comprehensive income attributable to noncontrolling interests	39	13	[2]
SHAREHOLDERS' COMPREHENSIVE INCOME	$ 1,156	$ 765	[2]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

XML

Consolidated Balance Sheets - USD ($) $ in Millions		Mar. 31, 2023	Dec. 31, 2022	[1]
Assets
Cash and cash equivalents		$ 7,935	$ 5,924
Investments		914	905
Accounts receivable, net		17,704	17,218
Inventories		4,211	4,777
Other current assets		1,263	1,298
Total current assets		32,027	30,122
Long-term investments		19,010	16,288
Reinsurance recoverables		5,286	5,416
Property and equipment		3,837	3,774
Goodwill		45,811	45,811
Other intangible assets		32,102	32,492
Other assets		2,563	2,704
Separate account assets		7,340	7,278
TOTAL ASSETS		147,976	143,885
Liabilities
Current insurance and contractholder liabilities		7,166	5,409
Pharmacy and other service costs payable		17,609	17,070
Accounts payable		7,360	7,775
Accrued expenses and other liabilities		9,174	7,978
Short-term debt		3,418	2,993
Total current liabilities		44,727	41,225
Non-current insurance and contractholder liabilities		11,790	11,976
Deferred tax liabilities, net		7,707	7,786
Other non-current liabilities		2,692	2,766
Long-term debt		29,124	28,100
Separate account liabilities		7,340	7,278
TOTAL LIABILITIES		103,380	99,131
Contingencies — Note 16
Redeemable noncontrolling interests		78	66
Shareholders' equity
Common stock	[2]	4	4
Additional paid-in capital		30,332	30,233
Accumulated other comprehensive loss		(1,769)	(1,658)
Retained earnings		38,841	37,940
Less: Treasury stock, at cost		(22,906)	(21,844)
TOTAL SHAREHOLDERS' EQUITY		44,502	44,675
Other noncontrolling interests		16	13
Total equity		44,518	44,688	[3]
Total liabilities and equity		$ 147,976	$ 143,885

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Par value per share, $0.01; shares issued, 399 million as of March 31, 2023 and 398 million as of December 31, 2022; authorized shares, 600 million.

[3] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements to the Consolidated Financial Statements for further information.

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Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	399,000,000	398,000,000
Common stock, shares authorized (in shares)	600,000,000	600,000,000

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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, 2021	[1]	$ 46,976		$ 46,958	$ 4	$ 29,574	$ (1,068)	$ 32,623	$ (14,175)	$ 18
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans		90		90		162			(72)
Other comprehensive income (loss)		(432)		(432)			(432)
Net income		1,209		1,197				1,197		12
Common dividends declared		(356)		(356)				(356)
Repurchase of common stock		(1,334)		(1,334)		0			(1,334)
Other transactions impacting noncontrolling interests		(8)		0		0				(8)
Balance at Mar. 31, 2022		46,145		46,123	4	29,736	(1,500)	33,464	(15,581)	22
Balance at Dec. 31, 2021	[1]	54
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	[2]	(2)
Net income		3
Other transactions impacting noncontrolling interests		0
Balance at Mar. 31, 2022		55
Balance at Dec. 31, 2022	[1]	44,688	[3]	44,675	4	30,233	(1,658)	37,940	(21,844)	13
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans		(5)		(5)		99			(104)
Other comprehensive income (loss)		(111)		(111)			(111)
Net income		1,272		1,267				1,267		5
Common dividends declared		(366)		(366)				(366)
Repurchase of common stock		(958)		(958)					(958)
Other transactions impacting noncontrolling interests		(2)		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	[1]	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

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[3] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 1.23	$ 1.12	$ 1.12	$ 1.12	$ 1.12

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Consolidated Statements of Cash Flows - USD ($) $ in Millions		3 Months Ended
		Mar. 31, 2023	Mar. 31, 2022
Cash Flows from Operating Activities
Net income		$ 1,306	$ 1,212	[1]
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		749	717	[2]
Realized investment losses, net		56	322	[1]
Deferred income tax benefit		(108)	(134)	[2]
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net		(479)	(983)	[2]
Inventories		566	222	[2]
Reinsurance recoverable and Other assets		72	584	[2]
Insurance liabilities		1,533	142	[2]
Pharmacy and other service costs payable		539	(74)	[2]
Accounts payable and Accrued expenses and other liabilities		690	85	[2]
Other, net		104	(63)	[2]
NET CASH PROVIDED BY OPERATING ACTIVITIES		5,028	2,030	[2]
Proceeds from investments sold:
Debt securities and equity securities		196	757	[2]
Investment maturities and repayments:
Debt securities and equity securities		257	456	[2]
Commercial mortgage loans		4	65	[2]
Other sales, maturities and repayments (primarily short-term and other long-term investments)		160	479	[2]
Investments purchased or originated:
Debt securities and equity securities		(2,794)	(1,246)	[2]
Commercial mortgage loans		0	(59)	[2]
Other (primarily short-term and other long-term investments)		(377)	(425)	[2]
Property and equipment purchases, net		(408)	(288)	[2]
Divestitures, net of cash sold		22	(57)	[2]
Other, net		(43)	(6)	[2]
NET CASH USED IN INVESTING ACTIVITIES		(2,983)	(324)	[2]
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		45	43	[2]
Withdrawals and benefit payments from contractholder deposit funds		(48)	(49)	[2]
Net change in short-term debt		(9)	(463)	[2]
Repayment of long-term debt		(80)	0	[2]
Net proceeds on issuance of long-term debt		1,491	0	[2]
Repurchase of common stock		(962)	(1,368)	[2]
Issuance of common stock		30	93	[2]
Common stock dividend paid		(368)	(357)	[2]
Other, net		(136)	(70)	[2]
NET CASH USED IN FINANCING ACTIVITIES		(37)	(2,171)	[2]
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		5	(23)	[2]
Net increase (decrease) in cash, cash equivalents and restricted cash		2,013	(488)	[2]
Cash, cash equivalents and restricted cash January 1, including held for sale assets	[2],[3]		5,548
Cash, cash equivalents and restricted cash December 31, including held for sale assets	[2]		5,060
Cash and cash equivalents reclassified to Assets of businesses held for sale		0	(591)	[2]
Cash, cash equivalents and restricted cash and cash equivalents January 1,	[3]	5,976
Cash, cash equivalents and restricted cash and cash equivalents December 31,	[4]	7,989	4,469	[2]
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		77	43	[2]
Interest paid		$ 322	$ 308	[2]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[3] Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.

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

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Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Statement of Cash Flows [Abstract]
Cash, cash equivalents and restricted cash, reported in Assets of businesses held for sale	$ 0	$ 425	$ 591	[1]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Description of Business

3 Months Ended

Mar. 31, 2023

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 with a mission of helping those we serve improve their health and vitality. Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services.

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these ongoing operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

Evernorth Health Services includes a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to health plans, employers, government organizations and health care providers.

Cigna Healthcare includes the U.S. Commercial, U.S. Government and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental and other products and services for insured and self-insured clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exited businesses. Our ongoing businesses include continuing business (corporate-owned life insurance ("COLI")) and our run-off businesses. Our run-off businesses include (i) variable annuity reinsurance business (also referred to as "guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business) that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses comprised of deferred gains from the sales of these businesses. Our exited businesses include our interest in a joint venture in Türkiye, which was sold in December 2022 and the international life, accident and supplemental benefits businesses sold in July 2022 (the "Chubb transaction").

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate debt 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 intersegment eliminations for products and services sold between segments.

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Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2023

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"). Certain amounts in prior years have been reclassified to conform to the current year presentation.

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

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

Recent Accounting Pronouncements

The Company's 2022 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. The following information provides updates on recently adopted accounting pronouncements that have occurred since the Company filed its 2022 Form 10-K. There are no accounting pronouncements not yet adopted as of March 31, 2023.

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

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

•Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:

•Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.

•Discount rate assumptions are updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.

•Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts are amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.

•Market risk benefits ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.

•Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.

•The transition methods applied at adoption were:

•The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.

•DAC followed the transition method used for future policyholder benefits.

•Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in accumulated other comprehensive income.

Effects of adoption:

•The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.

•The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the year ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the year ended December 31, 2022 and December 31, 2021, respectively.

•The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.

•Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 9 to the Consolidated Financial Statements for the Company's updated accounting policies.

•It is possible that our income recognition pattern could change on a prospective basis for several reasons:

•Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.

•DAC amortization is on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.

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

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Accounts Receivable, Net

3 Months Ended

Mar. 31, 2023

Receivables [Abstract]

Accounts Receivable, Net

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2023		December 31, 2022
Noninsurance customer receivables	$	7,845	$	6,899
Pharmaceutical manufacturers receivables	7,128		7,108
Insurance customer receivables	2,467		2,963
Other receivables	264		248
Total	$	17,704	$	17,218

These receivables are reported net of our allowances of $2.1 billion as of March 31, 2023 and $1.9 billion as of December 31, 2022. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain receivables 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 $87 million as of March 31, 2023 and $86 million as of December 31, 2022.

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Supplier Finance Program	3 Months Ended
	Mar. 31, 2023
Payables and Accruals [Abstract]
Supplier Finance Program	Note 4 – Supplier Finance ProgramThe Company facilitates a voluntary supplier finance program (the "program") that provides suppliers the opportunity to sell their receivables due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require. The Cigna Group is not a party to the program and agrees to commercial terms with its suppliers independently of their participation in the program. Amounts due to suppliers that participate in the program are generally paid within one month following the invoice date. A supplier's participation in the program has no impact on the Company's payment terms and the Company has no economic interest in a supplier's decision to participate in the program. The suppliers, at their sole discretion, determine which invoices, if any, to sell to the financial institution. No guarantees or pledged assets are provided by the Company or any of our subsidiaries under the program. As of March 31, 2023 and December 31, 2022, $1.5 billion and $1.3 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the program by the financial institution and reflected in Accounts payable in the Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. We have been informed by the financial institution that $324 million as of March 31, 2023 of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the program.

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Mergers, Acquisitions and Divestitures	3 Months Ended
	Mar. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Mergers, Acquisitions and Divestitures	Note 5 – Mergers, Acquisitions and Divestitures Divestiture of International BusinessesIn July 2022, the Company completed the sale of its life, accident and supplemental benefits businesses in six countries (Hong Kong, Indonesia, New Zealand, South Korea, Taiwan and Thailand) (the "Chubb transaction") for approximately $5.4 billion in cash. The Company recognized a gain of $1.7 billion pre-tax ($1.4 billion after-tax), which includes recognition of previously unrealized capital losses on investments sold and translation loss on foreign currencies. In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.Integration and Transaction-related CostsIn 2023 and 2022, the Company incurred net costs mainly related to the Chubb transaction. In the first three months of 2022, the Company also incurred net costs related to the sale of the Group Disability and Life business and acquisition of MDLIVE. These net costs were $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023 and $52 million pre-tax ($37 million after-tax) for the three months ended March 31, 2022. These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.

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Earnings Per Share

3 Months Ended

Mar. 31, 2023

Earnings Per Share [Abstract]

Earnings Per Share

Note 6 – Earnings Per ShareBasic and diluted earnings per share were computed as follows:

	Three Months Ended
	March 31, 2023						March 31, 2022
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net income	$	1,267			$	1,267	$	1,197			$	1,197
Shares:
Weighted average	295,706				295,706		318,487				318,487
Common stock equivalents			3,293		3,293				2,795		2,795
Total shares	295,706		3,293		298,999		318,487		2,795		321,282
Earnings per share	$	4.28	$	(0.04)	$	4.24	$	3.76	$	(0.03)	$	3.73

Amounts reflected above for the three months ended March 31, 2022 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).

The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:

	Three Months Ended March 31,
(In millions)	2023	2022
Anti-dilutive options	0.9	2.8

The Company held approximately 102.7 million shares of common stock in treasury at March 31, 2023, 99.1 million shares as of December 31, 2022 and 77.3 million shares as of March 31, 2022.

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Debt

3 Months Ended

Mar. 31, 2023

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, 2023		December 31, 2022
Short-term debt
$17 million, 8.300% Notes due January 2023	—		17
$63 million, 7.650% Notes due March 2023	—		63
$700 million, Floating Rate Notes due July 2023	700		700
$1,000 million, 3.000% Notes due July 2023	996		994
$1,187 million, 3.750% Notes due July 2023	1,187		1,186
$500 million, 0.613% Notes due March 2024	499		—
Other, including finance leases	36		33
Total short-term debt	$	3,418	$	2,993
Long-term debt
$500 million, 0.613% Notes due March 2024	—		499
$1,000 million, 3.500% Notes due June 2024	992		990
$900 million, 3.250% Notes due April 2025 (1)	878		872
$2,200 million, 4.125% Notes due November 2025	2,195		2,195
$1,500 million, 4.500% Notes due February 2026	1,503		1,503
$800 million, 1.250% Notes due March 2026	797		797
$700 million, 5.685% Notes due March 2026	697		—
$1,500 million, 3.400% Notes due March 2027	1,440		1,436
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	597		597
$3,800 million, 4.375% Notes due October 2028	3,785		3,785
$1,500 million, 2.400% Notes due March 2030	1,492		1,492
$1,500 million, 2.375% Notes due March 2031 (1)	1,398		1,380
$45 million, 8.080% Step Down Notes due January 2033 (2)	45		45
$800 million, 5.400% Notes due March 2033	794		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,192		2,192
$750 million, 3.200% Notes due March 2040	743		743
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	488		488
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,466		1,466
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,969		2,968
$1,250 million, 3.400% Notes due March 2050	1,236		1,236
$1,500 million, 3.400% Notes due March 2051	1,478		1,478
Other, including finance leases	67		66
Total long-term debt	$	29,124	$	28,100

(1)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 in the Company's 2022 Form 10-K for further information about the Company's interest rate risk management and these derivative instruments.

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

Long-term debt

Debt Issuance. On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance will be used for general corporate purposes, and may include repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$700 million (1)	March 15, 2026	5.685%	$698 million
$800 million (2)	March 15, 2033	5.400%	$796 million

(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.

(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.

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, 2023, The Cigna Group had a $3.0 billion five-year revolving credit and letter of credit agreement maturing in April 2027; a $1.0 billion three-year revolving credit agreement maturing in April 2025; and a $1.0 billion 364-day revolving credit agreement maturing in April 2023. There were no outstanding balances under these revolving credit agreements as of March 31, 2023.

In April 2023, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"), which replaced the agreements discussed above:

•a $4.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2028 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 $4.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.

•a $1.0 billion 364-day revolving credit agreement that will mature in April 2024. The Company can borrow up to $1.0 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.

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 $6.5 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 21 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization as of March 31, 2023. 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. There was no commercial paper outstanding balance as of March 31, 2023.Debt Covenants. The Company was in compliance with its debt covenants as of March 31, 2023.

Interest Expense

Interest expense on long-term and short-term debt was $345 million for the three months ended March 31, 2023 and $314 million for the three months ended March 31, 2022.

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Common and Preferred Stock

3 Months Ended

Mar. 31, 2023

Equity [Abstract]

Common and Preferred Stock

Note 8 – Common and Preferred Stock

Dividends

In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock. In the first quarter of 2022, The Cigna Group declared quarterly cash dividends of $1.12 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)
2023
March 8, 2023	March 23, 2023	$1.23	$368
2022
March 9, 2022	March 24, 2022	$1.12	$357

On April 26, 2023, the Board of Directors declared the second quarter cash dividend of $1.23 per share of The Cigna Group common stock to be paid on June 22, 2023 to shareholders of record on June 7, 2023. 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.

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Insurance and Contractholder Liabilities

3 Months Ended

Mar. 31, 2023

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, 2023						December 31, 2022						March 31, 2022
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	4,880	$	79	$	4,959	$	4,117	$	59	$	4,176	$	4,491
Other Operations	97		175		272		107		177		284		744
Future policy benefits
Cigna Healthcare	59		542		601		43		544		587		681
Other Operations	290		3,341		3,631		150		3,442		3,592		7,981
Contractholder deposit funds
Cigna Healthcare	12		151		163		14		157		171		181
Other Operations	361		6,309		6,670		351		6,358		6,709		6,843
Market risk benefits	48		1,172		1,220		51		1,217		1,268		1,558
Unearned premiums	1,419		21		1,440		576		22		598		1,030
Total													23,509
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)													(4,562)
Total insurance and contractholder liabilities	$	7,166	$	11,790	$	18,956	$	5,409	$	11,976	$	17,385	$	18,947

(1)Amounts classified as Liabilities of businesses held for sale primarily include $3.7 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of March 31, 2022.

Insurance and contractholder liabilities expected to be paid within one year are classified as current. The Company adopted amended accounting guidance for long-duration insurance contracts on January 1, 2023, discussed further in Note 2 to the Consolidated Financial Statements, which resulted in restatement of prior period amounts. Additionally, see below updated accounting policies and incremental disclosures associated with future policy benefits (Note 9C), contractholder deposit funds (Note 9D), and market risk benefits (Note 9E).

Unpaid Claims and Claim Expenses – Cigna HealthcareThis liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those 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, including reported claims in process, was $4.6 billion at March 31, 2023 and $4.2 billion at March 31, 2022.

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

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Beginning balance	$	4,176	$	4,261
Less: Reinsurance and other amounts recoverable	221		261
Beginning balance, net	3,955		4,000
Incurred costs related to:
Current year	9,041		8,024
Prior years	(144)		(276)
Total incurred	8,897		7,748
Paid costs related to:
Current year	5,316		4,634
Prior years	2,795		2,822
Total paid	8,111		7,456
Ending balance, net	4,741		4,292
Add: Reinsurance and other amounts recoverable	218		199
Ending balance	$	4,959	$	4,491

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, 2023				March 31, 2022
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	1	—	%	$	99	0.3	%
Medical cost trend	143		0.5		177		0.6
Total favorable variance	$	144	0.5	%	$	276	0.9	%

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

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2021.

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

Future Policy Benefits

Accounting Policy. Future policy benefits represent the present value of estimated future obligations, estimated using actuarial methods, for long-term insurance policies and annuity products currently in force, consisting primarily of reserves for annuity contracts, life insurance benefits, and certain supplemental health products that are guaranteed renewable beyond one year.

Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency. Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require. Interest rate assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"). For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss. For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach. For contracts issued by foreign operating entities with functional currencies other than the U.S. dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low credit risk fixed income instrument. For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.

For the annuity business, the premium paying period is shorter than the benefit coverage period, and a deferred profit liability ("DPL") is reported in future policy benefits representing gross premium received in excess of net premiums. DPL is amortized based on expected future benefit payments.

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, 2023		March 31, 2022
Interest accretion rate	2.59	%	2.64	%
Current discount rate	5.29	%	4.90	%
Weighted average duration	8.05 years		7.45 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 are as follows:

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Present value of expected net premiums
Beginning balance	$	8,557	$	9,314
Reversal of effect of beginning of period discount rate assumptions	1,537		(367)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	306		143
Net premiums collected	(326)		(310)
Interest and other (1)	56		46
Ending balance at original discount rate	10,130		8,826
Effect of end of period discount rate assumptions	(1,312)		(376)
Ending balance (2)	$	8,818	$	8,450
Present value of expected policy benefits
Beginning balance	$	8,945	$	9,794
Reversal of effect of discount rate assumptions	1,611		(379)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	307		215
Benefit payments	(326)		(385)
Interest and other (1)	58		52
Ending balance at original discount rate	10,595		9,297
Effect of discount rate assumptions	(1,378)		(392)
Ending balance (3)	$	9,217	$	8,905
Liability for future policy benefits	$	399	$	455
Other (4)	202		226
Total liability for future policy benefits (5)	$	601	$	681

(1)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.

(2)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future gross premiums were $17.6 billion and $13.5 billion. As of March 31, 2023 and March 31, 2022, respectively, discounted expected future gross premiums were $12.5 billion and $10.7 billion.

(3)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future policy benefits were $12.8 billion and $11.2 billion.

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

(5)$154 million and $171 million of reinsurance recoverable asset reported in the Consolidated Balance Sheets as of March 31, 2023 and March 31, 2022, respectively, relate to the liability for future policy benefits.

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, 2023		March 31, 2022
Interest accretion rate	5.64	%	5.64	%
Current discount rate	4.95	%	3.59	%
Weighted average duration	11.7 years		13.9 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 DPL.

Future policy benefits for Other Operations includes DPL of $392 million as of March 31, 2023 and $384 million as of March 31, 2022. Future policy benefits excluding DPL, were $3.2 billion as of both March 31, 2023 and December 31, 2022 and $3.9 billion and $4.3 billion as of March 31, 2022 and December 31, 2021, respectively. These balances exclude amounts classified as Liabilities of businesses held for sale of $3.7 billion as of March 31, 2022 and $3.8 billion as of December 31, 2021. The change in future policy benefits reserves year-to-date was primarily driven by changes in the current discount rate.

Undiscounted expected future policy benefits were $4.6 billion as of March 31, 2023 and $4.7 billion as of March 31, 2022. As of March 31, 2023 and March 31, 2022, $1.0 billion and $1.2 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

Contractholder Deposit FundsAccounting Policy. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances in Other Operations. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. Interest credited on these funds is accrued ratably over the contract period. Contractholder deposit fund liabilities within Other Operations were $6.7 billion as of both March 31, 2023 and December 31, 2022 and $6.8 billion and $6.9 billion as of March 31, 2022 and December 31, 2021, respectively. Approximately 39% 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, 2023, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not externally reinsured were 3.25%, $3.2 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2022 were 3.18%, $3.5 billion and $2.9 billion, respectively. As of both March 31, 2023 and March 31, 2022, more than 99% of the $4.1 billion liability 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 bps above the guarantee and the remaining $1.7 billion 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 BenefitsLiabilities for market risk benefits consist of variable annuity reinsurance contracts (also referred to as GMDB and GMIB 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.Accounting Policy. Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefits expense while fluctuations in the Company's own nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss. Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e. nonpayment risk). The nonperformance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral. The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable. As discussed further in Note 10 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefits expense and does not offset the nonperformance risk valuation on the liability. Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates). Market risk benefits activity was as follows:

	Three Months Ended
(Dollars in millions)	March 31, 2023		March 31, 2022
Balance, beginning of year	$	1,268	$	1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,379		1,949
Changes due to expected run-off	(6)		(19)
Changes due to capital markets versus expected	(41)		(271)
Changes due to policyholder behavior versus expected	6		(9)
Assumption changes	(33)		39
Balance, end of year, before the effect of changes in nonperformance risk (own credit risk)	1,305		1,689
Nonperformance risk (own credit risk), end of period	(85)		(131)
Balance, end of period	$	1,220	$	1,558
Reinsured market risk benefit, end of period	$	1,301	$	1,681

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, 2023		March 31, 2022
Net amount at risk	$	2,183	$	1,892
Average attained age of contractholders (weighted by exposure)	75.4 years		76.4 years

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Reinsurance

3 Months Ended

Mar. 31, 2023

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.

The Company's reinsurance recoverables as of March 31, 2023 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 (3)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (1)	$	—	$	—	$	94	$	94
BBB- to BBB+ equivalent current credit ratings (1)	—		—		59		59
Not rated	142		5		63		210
Total recoverables related to ongoing operations (2)	142		5		216		363
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,750		—		2,750
Empower Annuity Insurance Company	—		—		133		133
Prudential Insurance Company of America	380		—		—		380
Life Insurance Company of North America	—		386		—		386
Other	187		25		15		227
Not rated	—		9		3		12
Total recoverables related to acquisition, disposition or run-off activities	567		3,170		151		3,888
Total reinsurance recoverables before market risk benefits	$	709	$	3,175	$	367	$	4,251
Allowance for uncollectible reinsurance							(35)
Market risk benefits (4)							1,301
Total reinsurance recoverables (2)							$	5,517

(1)Certified by a Nationally Recognized Statistical Rating Organization ("NRSRO").

(2)Includes $231 million of current reinsurance recoverables that are reported in Other current assets.

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

(4)Total Berkshire and certain Other recoverables reflected under acquisition, disposition or run-off activities in the Company's 2022 Form 10-K that relate to the Company’s variable annuity reinsurance products discussed in section B below are now reported at fair market value as MRBs, as further discussed in Note 9 to the Consolidated Financial Statements. At December 31, 2022, we reported $711 million related to these recoverables related to the GMDB variable annuity reinsurance product. The restated December 31, 2022 variable annuity reinsurance recoverable balance is $1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.

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 BusinessThe 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, 2023. As a result of the reinsurance transaction, reserve increases are offset by a corresponding increase in the recorded reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)	March 31, 2023		December 31, 2022		Collateral and Other Terms at March 31, 2023
Berkshire	$	1,043	$	1,116	90% were secured by assets in a trust.
Sun Life Assurance Company of Canada	117		115
Liberty Re (Bermuda) Ltd.	128		128		100% were secured by assets in a trust.
SCOR SE	35		39		70% were secured by a letter of credit.
Market risk benefits (2)	$	1,323	$	1,398

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

(2)Includes IBNR and outstanding claims of $25 million offset by premium due of $3 million. These amounts are excluded from market risk benefits at March 31, 2023 in Note 9 and Note 10A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

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, 2023 and March 31, 2022.

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Investments

3 Months Ended

Mar. 31, 2023

Investments [Abstract]

Investments

Note 11 – InvestmentsThe 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 11 in the Company's 2022 Form 10-K.

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

	March 31, 2023						December 31, 2022
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	616	$	9,293	$	9,909	$	654	$	9,218	$	9,872
Equity securities	51		3,069		3,120		45		577		622
Commercial mortgage loans	106		1,501		1,607		67		1,547		1,614
Policy loans	—		1,211		1,211		—		1,218		1,218
Other long-term investments	—		3,936		3,936		—		3,728		3,728
Short-term investments	141		—		141		139		—		139
Total	$	914	$	19,010	$	19,924	$	905	$	16,288	$	17,193

Investment PortfolioDebt SecuritiesAccounting policy. Our accounting policy for debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) remains materially consistent with the policy disclosed in the Company's 2022 Form 10-K. However, with the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is no longer reported in Non-current insurance and contractholder liabilities but rather is reported in Accumulated other comprehensive loss. See Note 14 to the Consolidated Financial Statements for the impact to Accumulated other comprehensive loss.

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2023:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	638	$	630
Due after one year through five years	3,972		3,752
Due after five years through ten years	3,227		2,915
Due after ten years	2,450		2,268
Mortgage and other asset-backed securities	381		344
Total	$	10,668	$	9,909

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, 2023
Federal government and agency	$	276	$	—	$	29	$	(8)	$	297
State and local government	42		—		—		(1)		41
Foreign government	373		—		16		(18)		371
Corporate	9,596		(41)		124		(823)		8,856
Mortgage and other asset-backed	381		—		1		(38)		344
Total	$	10,668	$	(41)	$	170	$	(888)	$	9,909
December 31, 2022
Federal government and agency	$	292	$	—	$	32	$	(12)	$	312
State and local government	43		—		—		(2)		41
Foreign government	375		—		11		(21)		365
Corporate	9,742		(44)		89		(981)		8,806
Mortgage and other asset-backed	390		—		1		(43)		348
Total	$	10,842	$	(44)	$	133	$	(1,059)	$	9,872

Review of declines in fair value. Management reviews impaired debt securities 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, 2023							December 31, 2022
(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	$	3,176	$	3,362	$	(186)	1,019	$	5,533	$	6,127	$	(594)	1,659
Below investment grade	353		371		(18)		936	887		964		(77)		1,287
More than one year
Investment grade	3,222		3,808		(586)		1,035	1,151		1,487		(336)		462
Below investment grade	682		780		(98)		770	330		382		(52)		369
Total	$	7,433	$	8,321	$	(888)	3,760	$	7,901	$	8,960	$	(1,059)	3,777

Equity Securities

The following table provides the values of the Company's equity security investments as of March 31, 2023 and December 31, 2022:

	March 31, 2023				December 31, 2022
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	680	$	91	$	673	$	138
Equity securities with no readily determinable fair value	2,926		3,029		380		484
Total	$	3,606	$	3,120	$	1,053	$	622

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 95% of our investments in equity securities are in the health care sector.

Commercial Mortgage LoansMortgage 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 11 in the Company's 2022 Form 10-K.

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

(Dollars in millions)	March 31, 2023					December 31, 2022
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%	$	912	2.11			$	901	2.12
60% to 79%	504		1.73			564		1.73
80% to 100%	191		1.32			149		1.17
Total	$	1,607	1.89	60	%	$	1,614	1.89	60	%

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, 2023		December 31, 2022
Real estate investments	$	1,434	$	1,319
Securities partnerships	2,259		2,166
Other	243		243
Total	$	3,936	$	3,728

Derivative Financial InstrumentsThe 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, 2023, there have been no material changes to the Company's derivative financial instruments. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2023 and December 31, 2022. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements. Please refer to the Company's 2022 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. Realized Investment Gains and LossesAccounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.

The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:

	Three Months Ended March 31,
(In millions)	2023		2022
Net realized investment (losses), excluding credit loss expense and asset write-downs	$	(51)	$	(322)
Credit loss recoveries	3		—
Other investment asset write-downs	(8)		—
Net realized investment (losses), before income taxes	$	(56)	$	(322)

Net realized investment losses for the three months ended March 31, 2023 and March 31, 2022 were primarily due to mark-to-market losses on a strategic health care equity securities investment.

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Fair Value Measurements

3 Months Ended

Mar. 31, 2023

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 12 in the Company's 2022 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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Financial assets at fair value
Debt securities
Federal government and agency	$	151	$	147	$	146	$	165	$	—	$	—	$	297	$	312
State and local government	—		—		41		41		—		—		41		41
Foreign government	—		—		371		365		—		—		371		365
Corporate	—		—		8,421		8,394		435		412		8,856		8,806
Mortgage and other asset-backed	—		—		309		313		35		35		344		348
Total debt securities	151		147		9,288		9,278		470		447		9,909		9,872
Equity securities (1)	6		6		84		132		1		—		91		138
Short-term investments	—		—		141		139		—		—		141		139
Derivative assets	—		—		206		230		1		1		207		231

(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 9 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 ("bps") 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, 2023		December 31, 2022		Unobservable input March 31, 2023	March 31, 2023		December 31, 2022
Debt securities
Corporate and government debt securities	$	433	$	412	Liquidity	60 - 1060 (300)	bps	60 - 1060 (270)	bps
Mortgage and other asset-backed securities	35		35		Liquidity	105 - 520 (310)	bps	110 - 520 (310)	bps
Other debt securities	2		—
Total Level 3 debt securities	$	470	$	447

A significant 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.

	For the Three Months Ended March 31,
(In millions)	2023		2022
Debt and Equity Securities
Beginning balance	$	447	$	796
Gains included in Shareholders' net income	1		12
Gains (losses) included in Other comprehensive loss	5		(15)
Losses required to adjust future policy benefits for settlement annuities (1)	—		(12)
Purchases, sales and settlements
Purchases	4		49
Settlements	(9)		(81)
Total purchases, sales and settlements	(5)		(32)
Transfers into/(out of) Level 3
Transfers into Level 3	39		101
Transfers out of Level 3	(16)		(164)
Total transfers into/(out of) Level 3	23		(63)
Ending balance	$	471	$	686
Total gains included in Shareholders' net income attributable to instruments held at the reporting date	$	1	$	—
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	5	$	(13)

(1)Amounts do not accrue to shareholders.

Total gains and losses included in Shareholders' net 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 (depreciation) 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 2023 and 2022 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.

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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Guaranteed separate accounts (See Note 16)	$	213	$	203	$	349	$	382	$	—	$	—	$	562	$	585
Non-guaranteed separate accounts (1)	221		211		5,586		5,522		213		203		6,020		5,936
Subtotal	$	434	$	414	$	5,935	$	5,904	$	213	$	203	6,582		6,521
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													758		757
Total													$	7,340	$	7,278

(1)Non-guaranteed separate accounts include $4.0 billion as of March 31, 2023 and December 31, 2022 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of March 31, 2023 and December 31, 2022.

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, 2023 or 2022.

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, 2023		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2023		December 31, 2022
Securities partnerships	$	467	$	451	$	228	Not applicable	Not applicable
Real estate funds	287		302		—		Quarterly	30 - 90 days
Hedge funds	4		4		—		Up to annually, varying by fund	30 - 90 days
Total	$	758	$	757	$	228

As of March 31, 2023, 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, 2023 and 2022, impairments recognized requiring these assets to be measured at fair value were not material. Realized investment gains and losses from these observable price changes for the three months ended March 31, 2023 and March 31, 2022 were not material.

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, 2023				December 31, 2022
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,509	$	1,607	$	1,491	$	1,614
Long-term debt, including current maturities, excluding finance leases	Level 2	$	30,679	$	32,439	$	28,653	$	30,994

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Variable Interest Entities	3 Months Ended
	Mar. 31, 2023
Variable Interest Entities [Abstract]
Variable Interest Entities	Note 13 – Variable Interest EntitiesWe 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, 2023 or December 31, 2022. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not changed materially from December 31, 2022. 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 13 in the Company's 2022 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.

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Accumulated Other Comprehensive Income (Loss)

3 Months Ended

Mar. 31, 2023

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

Accumulated Other Comprehensive Income (Loss)

Note 14 – Accumulated Other Comprehensive Income (Loss) ("AOCI")

AOCI includes net unrealized (depreciation) 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 income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI, including the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements), were as follows:

	Three Months Ended March 31,
(In millions)	2023		2022
Securities and Derivatives
Beginning balance, as retrospectively restated	$	(332)	1,266
Unrealized appreciation (depreciation) on securities and derivatives	252		(1,065)
Tax (expense) benefit	(54)		231
Net unrealized appreciation (depreciation) on securities and derivatives	198		(834)
Reclassification adjustment for (gains) included in Shareholders' net income (Net realized investment losses)	(5)		(11)
Reclassification adjustment for tax expense included in Shareholders' net income	1		2
Net (gains) reclassified from AOCI to Shareholders' net income	(4)		(9)
Other comprehensive income (loss), net of tax	194		(843)
Ending balance	$	(138)	$	423
Net long-duration insurance and contractholder liabilities measurement adjustments (1)
Beginning balance	(256)		(765)
Current period change in discount rate for certain long duration liabilities	(411)		584
Tax benefit (expense)	101		(130)
Net current period change in discount rate for certain long duration liabilities	(310)		454
Current period change in instrument-specific credit risk for market risk benefits	(26)		6
Tax benefit (expense)	5		(1)
Net current period change in instrument-specific credit risk for market risk benefits	(21)		5
Other comprehensive (loss) income, net of tax	(331)		459
Ending balance	(587)		(306)
Translation of foreign currencies
Beginning balance, as retrospectively restated	$	(154)	(233)
Translation of foreign currencies	15		(60)
Tax benefit (expense)	1		(3)
Net translation of foreign currencies	16		(63)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests	—		(2)
Shareholders' other comprehensive income (loss), net of tax	16		(61)
Ending balance	$	(138)	$	(294)
Postretirement benefits liability
Beginning balance	$	(916)	$	(1,336)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)	13		16
Reclassification adjustment for tax (benefit) included in Shareholders' net income	(3)		(3)
Net adjustments reclassified from AOCI to Shareholders' net income	10		13
Other comprehensive income, net of tax	10		13
Ending balance	$	(906)	$	(1,323)
Total Accumulated other comprehensive loss
Beginning balance, as retrospectively restated	(1,658)		(1,068)
Shareholders' other comprehensive (loss), net of tax	(111)		(432)
Ending balance	$	(1,769)	$	(1,500)

(1)Established upon the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Income Taxes

3 Months Ended

Mar. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Note 15 – Income Taxes

Income Tax Expense

The 18.4% effective tax rate for the three months ended March 31, 2023 was lower than the 22.7% rate for the three months ended March 31, 2022. This decrease was driven largely by favorable results relative to the Company's foreign operations, partially offset by an increase pertaining to the year over year impact of remeasurement of deferred taxes.

As of March 31, 2023, we had approximately $255 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. We have determined that a valuation allowance against the DTAs is not currently required based on the Company's ability to carryback losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any valuation allowance in the future.

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Contingencies and Other Matters

3 Months Ended

Mar. 31, 2023

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, 2023, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $420 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, 2023. 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, 2023 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 law 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 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 liabilities for these indemnification obligations as of March 31, 2023.

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, 2023.

Legal and Regulatory MattersThe 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 accruals for the matters discussed below under "Litigation Matters" and "Regulatory Matters" are not material. Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if any) for these matters at this time. In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company. An adverse outcome in one or more of these matters 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 these ongoing litigation matters 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. On June 10, 2022, Express Scripts filed a Motion for Partial Summary Judgment seeking to limit Elevance's remaining prior authorization claims and a Motion to Exclude certain opinions offered by its experts. Elevance filed its opposition to both motions, and a cross-motion to submit a supplemental expert report, on July 9, 2022. Express Scripts' pending Motions were fully briefed at the end of July 2022. On March 8, 2023, the Court granted Express Scripts' Motion for Partial Summary Judgement, excluding in full the testimony of four of Elevance's experts and in part the testimony of two additional experts, and granted Elevance leave to submit a supplemental expert report. On April 5, 2023, the Court entered a scheduling order setting a trial on Elevance's remaining prior authorization claims to commence on December 4, 2023.

Medicare Advantage. A qui tam action that was filed by a private individual on behalf of the government in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020. The action asserts claims related to risk adjustment practices arising from certain health exams conducted as part of the Company's Medicare Advantage business. In September 2021, the qui tam action was transferred to the United States District Court for the Middle District of Tennessee. On January 11, 2022, the U.S. Department of Justice ("DOJ") (U.S. Attorney's Offices for the Southern District of New York and the Middle District of Tennessee) filed a motion to partially intervene, which was granted on August 2, 2022. On October 14, 2022, the DOJ filed its complaint-in-intervention alleging that certain diagnoses made during in-home exams were invalid for risk adjustment purposes, seeking unspecified damages and penalties under the federal False Claims Act. The Company filed motions to dismiss the DOJ's complaint and the remainder of the qui tam complaint on December 16, 2022. Briefing is complete and the matter is pending before the court.

Regulatory Matters

Civil Investigative Demand. The DOJ is conducting industry-wide investigations of Medicare Advantage organizations' risk adjustment practices. For certain Medicare Advantage organizations, including The Cigna Group, those investigations have resulted in litigation (see "Litigation Matters—Medicare Advantage" above). The Company has responded to information requests (civil investigative demands) from the DOJ (U.S. Attorney's Office for the Eastern District of Pennsylvania) and is continuing to cooperate with the DOJ.

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Segment Information

3 Months Ended

Mar. 31, 2023

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 from operations as income 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.

Special items charges (benefits) recorded by the Company were $1 million both pre-tax and after-tax for the three months ended March 31, 2023 and $52 million pre-tax ($37 million after-tax) for the three months ended March 31, 2022. Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. See Note 2 to the Consolidated Financial Statements for further information. Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting. 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, 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
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2022
Revenues from external customers	$	32,289	$	10,462	$	841	$	—	$	43,592
Intersegment revenues	1,287		562		—		(1,849)
Net investment income	10		266		138		—		414
Total revenues	33,586		11,290		979		(1,849)		44,006
Net realized investment results from certain equity method investments	—		103		—		—		103
Adjusted revenues	$	33,586	$	11,393	$	979	$	(1,849)	$	44,109
Income (loss) before income taxes	$	870	$	877	$	215	$	(395)	$	1,567
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(11)		(1)		(5)		—		(17)
Net realized investment losses (gains) (1)	—		406		19		—		425
Amortization of acquired intangible assets	443		15		—		—		458
Special items
Integration and transaction-related costs	—		—		—		52		52
Pre-tax adjusted income (loss) from operations	$	1,302	$	1,297	$	229	$	(343)	$	2,485

(1)Includes 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.

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. Prior period amounts have been retrospectively adjusted to reflect adoption of amended accounting guidance for long-duration insurance contracts, as discussed in Note 2 to the Consolidated Financial Statements. The following table presents these revenues by product, premium and service type:

	Three Months Ended March 31,
(In millions)	2023		2022
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	15,748	$	15,531
Home delivery and specialty revenues	16,025		14,699
Other revenues	1,867		1,712
Intercompany eliminations	(1,496)		(1,245)
Total pharmacy revenues	32,144		30,697
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Commercial
Insured	4,080		3,720
Stop loss	1,503		1,325
Other (1)	368		360
U.S. Government
Medicare Advantage	2,236		2,078
Medicare Part D	415		401
Other (1), (2)
Short-duration (Individual and family plans)	1,208		611
Long-duration (Individual Medicare supplement and limited benefit health products)	334		329
International Health (2)
Short-duration (Group medical insurance)	700		620
Long-duration (Individual private medical insurance)	86		82
Total Cigna Healthcare	10,930		9,526
Divested International businesses	—		763
Other	79		69
Intercompany eliminations	16		(2)
Total premiums	11,025		10,356
Services (Fees) (ASC 606)
Evernorth Health Services	2,499		1,624
Cigna Healthcare	1,606		1,496
Other Operations	1		5
Other revenues	66		16
Intercompany eliminations	(1,101)		(602)
Total fees and other revenues	3,071		2,539
Total revenues from external customers	$	46,240	$	43,592

(1)Other than supplemental benefits, all of U.S. Commercial and U.S. Government are short duration.

(2)U.S. Government and International Health recognize premium revenue on long-duration insurance contracts (coverage greater than one year or guaranteed to be renewed at the option of the policyholder beyond one year) related to certain medicare supplement, supplemental health and life products. All other premium revenue recognized as of March 31, 2023 and March 31, 2022 is primarily related to short-duration insurance contracts.

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 $1.5 billion as of March 31, 2023 and $1.3 billion as of December 31, 2022.

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Summary of Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2023

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"). Certain amounts in prior years have been reclassified to conform to the current year presentation.

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2022 Annual Report on Form 10-K ("2022 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care 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 2022 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. The following information provides updates on recently adopted accounting pronouncements that have occurred since the Company filed its 2022 Form 10-K. There are no accounting pronouncements not yet adopted as of March 31, 2023.

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

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

•Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:

•Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.

•Discount rate assumptions are updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.

•Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts are amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.

•Market risk benefits ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.

•Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.

•The transition methods applied at adoption were:

•The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.

•DAC followed the transition method used for future policyholder benefits.

•Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in accumulated other comprehensive income.

Effects of adoption:

•The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.

•The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the year ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the year ended December 31, 2022 and December 31, 2021, respectively.

•The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.

•Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 9 to the Consolidated Financial Statements for the Company's updated accounting policies.

•It is possible that our income recognition pattern could change on a prospective basis for several reasons:

•Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.

•DAC amortization is on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.

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

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.

Unpaid Claims and Claims Expenses

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those 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

Accounting Policy. Future policy benefits represent the present value of estimated future obligations, estimated using actuarial methods, for long-term insurance policies and annuity products currently in force, consisting primarily of reserves for annuity contracts, life insurance benefits, and certain supplemental health products that are guaranteed renewable beyond one year.

Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency. Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require. Interest rate assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"). For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss. For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach. For contracts issued by foreign operating entities with functional currencies other than the U.S. dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low credit risk fixed income instrument. For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.

For the annuity business, the premium paying period is shorter than the benefit coverage period, and a deferred profit liability ("DPL") is reported in future policy benefits representing gross premium received in excess of net premiums. DPL is amortized based on expected future benefit payments.

Contractholder Deposit Funds

Accounting Policy. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances in Other Operations. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. Interest credited on these funds is accrued ratably over the contract period.

Market Risk Benefits

Accounting Policy. Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefits expense while fluctuations in the Company's own nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss. Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e. nonpayment risk). The nonperformance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral. The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable. As discussed further in Note 10 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefits expense and does not offset the nonperformance risk valuation on the liability. Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates).

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 reinsuranceThe 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.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.

Investments

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.Further information about our accounting policies for investment assets can be found in Note 11 in the Company's 2022 Form 10-K.Accounting policy. Our accounting policy for debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) remains materially consistent with the policy disclosed in the Company's 2022 Form 10-K. However, with the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is no longer reported in Non-current insurance and contractholder liabilities but rather is reported in Accumulated other comprehensive loss.

Review of declines in fair value. Management reviews impaired debt securities 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.

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 11 in the Company's 2022 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. Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.

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.Please refer to the Company's 2022 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 12 in the Company's 2022 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 9 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 InputsThe 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 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 (depreciation) 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 ConditionsSome 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.

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 13 in the Company's 2022 Form 10-K.

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, 2023 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 law 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 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 AssessmentsThe 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 from operations as income 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.

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Accounts Receivable, Net (Tables)

3 Months Ended

Mar. 31, 2023

Receivables [Abstract]

Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)	March 31, 2023		December 31, 2022
Noninsurance customer receivables	$	7,845	$	6,899
Pharmaceutical manufacturers receivables	7,128		7,108
Insurance customer receivables	2,467		2,963
Other receivables	264		248
Total	$	17,704	$	17,218

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Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2023

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, 2023						March 31, 2022
(Shares in thousands, dollars in millions, except per share amounts)	Basic		Effect of Dilution		Diluted		Basic		Effect of Dilution		Diluted
Shareholders' net income	$	1,267			$	1,267	$	1,197			$	1,197
Shares:
Weighted average	295,706				295,706		318,487				318,487
Common stock equivalents			3,293		3,293				2,795		2,795
Total shares	295,706		3,293		298,999		318,487		2,795		321,282
Earnings per share	$	4.28	$	(0.04)	$	4.24	$	3.76	$	(0.03)	$	3.73

Amounts reflected above for the three months ended March 31, 2022 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).

Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share

The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:

	Three Months Ended March 31,
(In millions)	2023	2022
Anti-dilutive options	0.9	2.8

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Debt (Tables)

3 Months Ended

Mar. 31, 2023

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, 2023		December 31, 2022
Short-term debt
$17 million, 8.300% Notes due January 2023	—		17
$63 million, 7.650% Notes due March 2023	—		63
$700 million, Floating Rate Notes due July 2023	700		700
$1,000 million, 3.000% Notes due July 2023	996		994
$1,187 million, 3.750% Notes due July 2023	1,187		1,186
$500 million, 0.613% Notes due March 2024	499		—
Other, including finance leases	36		33
Total short-term debt	$	3,418	$	2,993
Long-term debt
$500 million, 0.613% Notes due March 2024	—		499
$1,000 million, 3.500% Notes due June 2024	992		990
$900 million, 3.250% Notes due April 2025 (1)	878		872
$2,200 million, 4.125% Notes due November 2025	2,195		2,195
$1,500 million, 4.500% Notes due February 2026	1,503		1,503
$800 million, 1.250% Notes due March 2026	797		797
$700 million, 5.685% Notes due March 2026	697		—
$1,500 million, 3.400% Notes due March 2027	1,440		1,436
$259 million, 7.875% Debentures due May 2027	259		259
$600 million, 3.050% Notes due October 2027	597		597
$3,800 million, 4.375% Notes due October 2028	3,785		3,785
$1,500 million, 2.400% Notes due March 2030	1,492		1,492
$1,500 million, 2.375% Notes due March 2031 (1)	1,398		1,380
$45 million, 8.080% Step Down Notes due January 2033 (2)	45		45
$800 million, 5.400% Notes due March 2033	794		—
$190 million, 6.150% Notes due November 2036	190		190
$2,200 million, 4.800% Notes due August 2038	2,192		2,192
$750 million, 3.200% Notes due March 2040	743		743
$121 million, 5.875% Notes due March 2041	119		119
$448 million, 6.125% Notes due November 2041	488		488
$317 million, 5.375% Notes due February 2042	315		315
$1,500 million, 4.800% Notes due July 2046	1,466		1,466
$1,000 million, 3.875% Notes due October 2047	989		989
$3,000 million, 4.900% Notes due December 2048	2,969		2,968
$1,250 million, 3.400% Notes due March 2050	1,236		1,236
$1,500 million, 3.400% Notes due March 2051	1,478		1,478
Other, including finance leases	67		66
Total long-term debt	$	29,124	$	28,100

(1)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 in the Company's 2022 Form 10-K for further information about the Company's interest rate risk management and these derivative instruments.

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

Summary of Debt Issuances

On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance will be used for general corporate purposes, and may include repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

Principal	Maturity Date	Interest Rate	Net Proceeds
$700 million (1)	March 15, 2026	5.685%	$698 million
$800 million (2)	March 15, 2033	5.400%	$796 million

(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.

(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.

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Common and Preferred Stock (Tables)

3 Months Ended

Mar. 31, 2023

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)
2023
March 8, 2023	March 23, 2023	$1.23	$368
2022
March 9, 2022	March 24, 2022	$1.12	$357

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Insurance and Contractholder Liabilities (Tables)

3 Months Ended

Mar. 31, 2023

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, 2023						December 31, 2022						March 31, 2022
(In millions)	Current		Non-current		Total		Current		Non-current		Total		Total
Unpaid claims and claim expenses
Cigna Healthcare	$	4,880	$	79	$	4,959	$	4,117	$	59	$	4,176	$	4,491
Other Operations	97		175		272		107		177		284		744
Future policy benefits
Cigna Healthcare	59		542		601		43		544		587		681
Other Operations	290		3,341		3,631		150		3,442		3,592		7,981
Contractholder deposit funds
Cigna Healthcare	12		151		163		14		157		171		181
Other Operations	361		6,309		6,670		351		6,358		6,709		6,843
Market risk benefits	48		1,172		1,220		51		1,217		1,268		1,558
Unearned premiums	1,419		21		1,440		576		22		598		1,030
Total													23,509
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)													(4,562)
Total insurance and contractholder liabilities	$	7,166	$	11,790	$	18,956	$	5,409	$	11,976	$	17,385	$	18,947

(1)Amounts classified as Liabilities of businesses held for sale primarily include $3.7 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of March 31, 2022.

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

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Beginning balance	$	4,176	$	4,261
Less: Reinsurance and other amounts recoverable	221		261
Beginning balance, net	3,955		4,000
Incurred costs related to:
Current year	9,041		8,024
Prior years	(144)		(276)
Total incurred	8,897		7,748
Paid costs related to:
Current year	5,316		4,634
Prior years	2,795		2,822
Total paid	8,111		7,456
Ending balance, net	4,741		4,292
Add: Reinsurance and other amounts recoverable	218		199
Ending balance	$	4,959	$	4,491

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, 2023				March 31, 2022
(Dollars in millions)	$		% (1)		$		% (2)
Actual completion factors	$	1	—	%	$	99	0.3	%
Medical cost trend	143		0.5		177		0.6
Total favorable variance	$	144	0.5	%	$	276	0.9	%

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

(2)Percentage of current year incurred costs as reported for the year ended December 31, 2021.

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, 2023		March 31, 2022
Interest accretion rate	2.59	%	2.64	%
Current discount rate	5.29	%	4.90	%
Weighted average duration	8.05 years		7.45 years

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

	Three Months Ended
(In millions)	March 31, 2023		March 31, 2022
Present value of expected net premiums
Beginning balance	$	8,557	$	9,314
Reversal of effect of beginning of period discount rate assumptions	1,537		(367)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	306		143
Net premiums collected	(326)		(310)
Interest and other (1)	56		46
Ending balance at original discount rate	10,130		8,826
Effect of end of period discount rate assumptions	(1,312)		(376)
Ending balance (2)	$	8,818	$	8,450
Present value of expected policy benefits
Beginning balance	$	8,945	$	9,794
Reversal of effect of discount rate assumptions	1,611		(379)
Effect of assumption changes and actual variances from expected experience	—		—
Issuances and lapses	307		215
Benefit payments	(326)		(385)
Interest and other (1)	58		52
Ending balance at original discount rate	10,595		9,297
Effect of discount rate assumptions	(1,378)		(392)
Ending balance (3)	$	9,217	$	8,905
Liability for future policy benefits	$	399	$	455
Other (4)	202		226
Total liability for future policy benefits (5)	$	601	$	681

(1)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.

(2)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future gross premiums were $17.6 billion and $13.5 billion. As of March 31, 2023 and March 31, 2022, respectively, discounted expected future gross premiums were $12.5 billion and $10.7 billion.

(3)As of March 31, 2023 and March 31, 2022, respectively, undiscounted expected future policy benefits were $12.8 billion and $11.2 billion.

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

(5)$154 million and $171 million of reinsurance recoverable asset reported in the Consolidated Balance Sheets as of March 31, 2023 and March 31, 2022, respectively, relate to the liability for future policy benefits.

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, 2023		March 31, 2022
Interest accretion rate	5.64	%	5.64	%
Current discount rate	4.95	%	3.59	%
Weighted average duration	11.7 years		13.9 years

Summary of Market Risk Benefit

Market risk benefits activity was as follows:

	Three Months Ended
(Dollars in millions)	March 31, 2023		March 31, 2022
Balance, beginning of year	$	1,268	$	1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,379		1,949
Changes due to expected run-off	(6)		(19)
Changes due to capital markets versus expected	(41)		(271)
Changes due to policyholder behavior versus expected	6		(9)
Assumption changes	(33)		39
Balance, end of year, before the effect of changes in nonperformance risk (own credit risk)	1,305		1,689
Nonperformance risk (own credit risk), end of period	(85)		(131)
Balance, end of period	$	1,220	$	1,558
Reinsured market risk benefit, end of period	$	1,301	$	1,681

(In millions)
Reinsurer (1)	March 31, 2023		December 31, 2022		Collateral and Other Terms at March 31, 2023
Berkshire	$	1,043	$	1,116	90% were secured by assets in a trust.
Sun Life Assurance Company of Canada	117		115
Liberty Re (Bermuda) Ltd.	128		128		100% were secured by assets in a trust.
SCOR SE	35		39		70% were secured by a letter of credit.
Market risk benefits (2)	$	1,323	$	1,398

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

(2)Includes IBNR and outstanding claims of $25 million offset by premium due of $3 million. These amounts are excluded from market risk benefits at March 31, 2023 in Note 9 and Note 10A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

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, 2023		March 31, 2022
Net amount at risk	$	2,183	$	1,892
Average attained age of contractholders (weighted by exposure)	75.4 years		76.4 years

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Reinsurance (Tables)

3 Months Ended

Mar. 31, 2023

Reinsurance Disclosures [Abstract]

Reinsurance Recoverables by Range of External Credit Rating and Collateral Level

The Company's reinsurance recoverables as of March 31, 2023 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 (3)		No collateral		Total
Ongoing Operations
A- equivalent and higher current ratings (1)	$	—	$	—	$	94	$	94
BBB- to BBB+ equivalent current credit ratings (1)	—		—		59		59
Not rated	142		5		63		210
Total recoverables related to ongoing operations (2)	142		5		216		363
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,750		—		2,750
Empower Annuity Insurance Company	—		—		133		133
Prudential Insurance Company of America	380		—		—		380
Life Insurance Company of North America	—		386		—		386
Other	187		25		15		227
Not rated	—		9		3		12
Total recoverables related to acquisition, disposition or run-off activities	567		3,170		151		3,888
Total reinsurance recoverables before market risk benefits	$	709	$	3,175	$	367	$	4,251
Allowance for uncollectible reinsurance							(35)
Market risk benefits (4)							1,301
Total reinsurance recoverables (2)							$	5,517

(1)Certified by a Nationally Recognized Statistical Rating Organization ("NRSRO").

(2)Includes $231 million of current reinsurance recoverables that are reported in Other current assets.

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

(4)Total Berkshire and certain Other recoverables reflected under acquisition, disposition or run-off activities in the Company's 2022 Form 10-K that relate to the Company’s variable annuity reinsurance products discussed in section B below are now reported at fair market value as MRBs, as further discussed in Note 9 to the Consolidated Financial Statements. At December 31, 2022, we reported $711 million related to these recoverables related to the GMDB variable annuity reinsurance product. The restated December 31, 2022 variable annuity reinsurance recoverable balance is $1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.

Reinsurance Recoverables for Variable Annuity Business

Market risk benefits activity was as follows:

	Three Months Ended
(Dollars in millions)	March 31, 2023		March 31, 2022
Balance, beginning of year	$	1,268	$	1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,379		1,949
Changes due to expected run-off	(6)		(19)
Changes due to capital markets versus expected	(41)		(271)
Changes due to policyholder behavior versus expected	6		(9)
Assumption changes	(33)		39
Balance, end of year, before the effect of changes in nonperformance risk (own credit risk)	1,305		1,689
Nonperformance risk (own credit risk), end of period	(85)		(131)
Balance, end of period	$	1,220	$	1,558
Reinsured market risk benefit, end of period	$	1,301	$	1,681

(In millions)
Reinsurer (1)	March 31, 2023		December 31, 2022		Collateral and Other Terms at March 31, 2023
Berkshire	$	1,043	$	1,116	90% were secured by assets in a trust.
Sun Life Assurance Company of Canada	117		115
Liberty Re (Bermuda) Ltd.	128		128		100% were secured by assets in a trust.
SCOR SE	35		39		70% were secured by a letter of credit.
Market risk benefits (2)	$	1,323	$	1,398

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

(2)Includes IBNR and outstanding claims of $25 million offset by premium due of $3 million. These amounts are excluded from market risk benefits at March 31, 2023 in Note 9 and Note 10A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

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Investments (Tables)

3 Months Ended

Mar. 31, 2023

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, 2023						December 31, 2022
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	616	$	9,293	$	9,909	$	654	$	9,218	$	9,872
Equity securities	51		3,069		3,120		45		577		622
Commercial mortgage loans	106		1,501		1,607		67		1,547		1,614
Policy loans	—		1,211		1,211		—		1,218		1,218
Other long-term investments	—		3,936		3,936		—		3,728		3,728
Short-term investments	141		—		141		139		—		139
Total	$	914	$	19,010	$	19,924	$	905	$	16,288	$	17,193

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, 2023:

(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	638	$	630
Due after one year through five years	3,972		3,752
Due after five years through ten years	3,227		2,915
Due after ten years	2,450		2,268
Mortgage and other asset-backed securities	381		344
Total	$	10,668	$	9,909

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, 2023
Federal government and agency	$	276	$	—	$	29	$	(8)	$	297
State and local government	42		—		—		(1)		41
Foreign government	373		—		16		(18)		371
Corporate	9,596		(41)		124		(823)		8,856
Mortgage and other asset-backed	381		—		1		(38)		344
Total	$	10,668	$	(41)	$	170	$	(888)	$	9,909
December 31, 2022
Federal government and agency	$	292	$	—	$	32	$	(12)	$	312
State and local government	43		—		—		(2)		41
Foreign government	375		—		11		(21)		365
Corporate	9,742		(44)		89		(981)		8,806
Mortgage and other asset-backed	390		—		1		(43)		348
Total	$	10,842	$	(44)	$	133	$	(1,059)	$	9,872

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, 2023							December 31, 2022
(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	$	3,176	$	3,362	$	(186)	1,019	$	5,533	$	6,127	$	(594)	1,659
Below investment grade	353		371		(18)		936	887		964		(77)		1,287
More than one year
Investment grade	3,222		3,808		(586)		1,035	1,151		1,487		(336)		462
Below investment grade	682		780		(98)		770	330		382		(52)		369
Total	$	7,433	$	8,321	$	(888)	3,760	$	7,901	$	8,960	$	(1,059)	3,777

Equity Security Investments

The following table provides the values of the Company's equity security investments as of March 31, 2023 and December 31, 2022:

	March 31, 2023				December 31, 2022
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	680	$	91	$	673	$	138
Equity securities with no readily determinable fair value	2,926		3,029		380		484
Total	$	3,606	$	3,120	$	1,053	$	622

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, 2023					December 31, 2022
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%	$	912	2.11			$	901	2.12
60% to 79%	504		1.73			564		1.73
80% to 100%	191		1.32			149		1.17
Total	$	1,607	1.89	60	%	$	1,614	1.89	60	%

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, 2023		December 31, 2022
Real estate investments	$	1,434	$	1,319
Securities partnerships	2,259		2,166
Other	243		243
Total	$	3,936	$	3,728

Realized Gains and Losses on Investments

The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:

	Three Months Ended March 31,
(In millions)	2023		2022
Net realized investment (losses), excluding credit loss expense and asset write-downs	$	(51)	$	(322)
Credit loss recoveries	3		—
Other investment asset write-downs	(8)		—
Net realized investment (losses), before income taxes	$	(56)	$	(322)

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Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2023

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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Financial assets at fair value
Debt securities
Federal government and agency	$	151	$	147	$	146	$	165	$	—	$	—	$	297	$	312
State and local government	—		—		41		41		—		—		41		41
Foreign government	—		—		371		365		—		—		371		365
Corporate	—		—		8,421		8,394		435		412		8,856		8,806
Mortgage and other asset-backed	—		—		309		313		35		35		344		348
Total debt securities	151		147		9,288		9,278		470		447		9,909		9,872
Equity securities (1)	6		6		84		132		1		—		91		138
Short-term investments	—		—		141		139		—		—		141		139
Derivative assets	—		—		206		230		1		1		207		231

(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 ("bps") 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, 2023		December 31, 2022		Unobservable input March 31, 2023	March 31, 2023		December 31, 2022
Debt securities
Corporate and government debt securities	$	433	$	412	Liquidity	60 - 1060 (300)	bps	60 - 1060 (270)	bps
Mortgage and other asset-backed securities	35		35		Liquidity	105 - 520 (310)	bps	110 - 520 (310)	bps
Other debt securities	2		—
Total Level 3 debt securities	$	470	$	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.

	For the Three Months Ended March 31,
(In millions)	2023		2022
Debt and Equity Securities
Beginning balance	$	447	$	796
Gains included in Shareholders' net income	1		12
Gains (losses) included in Other comprehensive loss	5		(15)
Losses required to adjust future policy benefits for settlement annuities (1)	—		(12)
Purchases, sales and settlements
Purchases	4		49
Settlements	(9)		(81)
Total purchases, sales and settlements	(5)		(32)
Transfers into/(out of) Level 3
Transfers into Level 3	39		101
Transfers out of Level 3	(16)		(164)
Total transfers into/(out of) Level 3	23		(63)
Ending balance	$	471	$	686
Total gains included in Shareholders' net income attributable to instruments held at the reporting date	$	1	$	—
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period	$	5	$	(13)

(1)Amounts do not accrue to shareholders.

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, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022		March 31, 2023		December 31, 2022
Guaranteed separate accounts (See Note 16)	$	213	$	203	$	349	$	382	$	—	$	—	$	562	$	585
Non-guaranteed separate accounts (1)	221		211		5,586		5,522		213		203		6,020		5,936
Subtotal	$	434	$	414	$	5,935	$	5,904	$	213	$	203	6,582		6,521
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)													758		757
Total													$	7,340	$	7,278

(1)Non-guaranteed separate accounts include $4.0 billion as of March 31, 2023 and December 31, 2022 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of March 31, 2023 and December 31, 2022.

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, 2023		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	March 31, 2023		December 31, 2022
Securities partnerships	$	467	$	451	$	228	Not applicable	Not applicable
Real estate funds	287		302		—		Quarterly	30 - 90 days
Hedge funds	4		4		—		Up to annually, varying by fund	30 - 90 days
Total	$	758	$	757	$	228

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, 2023				December 31, 2022
(In millions)		Fair Value		Carrying Value		Fair Value		Carrying Value
Commercial mortgage loans	Level 3	$	1,509	$	1,607	$	1,491	$	1,614
Long-term debt, including current maturities, excluding finance leases	Level 2	$	30,679	$	32,439	$	28,653	$	30,994

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Segment Information (Tables)

3 Months Ended

Mar. 31, 2023

Segment Reporting [Abstract]

Summarized Segment Financial Information

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. See Note 2 to the Consolidated Financial Statements for further information. Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting. 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, 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
(In millions)	Evernorth Health Services		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
Three months ended March 31, 2022
Revenues from external customers	$	32,289	$	10,462	$	841	$	—	$	43,592
Intersegment revenues	1,287		562		—		(1,849)
Net investment income	10		266		138		—		414
Total revenues	33,586		11,290		979		(1,849)		44,006
Net realized investment results from certain equity method investments	—		103		—		—		103
Adjusted revenues	$	33,586	$	11,393	$	979	$	(1,849)	$	44,109
Income (loss) before income taxes	$	870	$	877	$	215	$	(395)	$	1,567
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(11)		(1)		(5)		—		(17)
Net realized investment losses (gains) (1)	—		406		19		—		425
Amortization of acquired intangible assets	443		15		—		—		458
Special items
Integration and transaction-related costs	—		—		—		52		52
Pre-tax adjusted income (loss) from operations	$	1,302	$	1,297	$	229	$	(343)	$	2,485

(1)Includes 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.

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Description of Business (Details) $ in Billions	Jul. 01, 2022 USD ($)
International life, accident, supplemental benefits businesses sold to Chubb | Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price	$ 5.4

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Summary of Significant Accounting Policies (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended			12 Months Ended
	Mar. 31, 2023	Mar. 31, 2022		Dec. 31, 2022		Dec. 31, 2021		Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Decrease to shareholders' equity	$ (44,518)	$ (46,145)		$ (44,688)	[1],[2]	$ (46,976)	[2]
Increase to shareholders' net income	$ 1,267	$ 1,197	[3]
Increase to diluted earnings per share (in dollars per share)	$ 4.24	$ 3.73	[3]
Revision of Prior Period, Accounting Standards Update, Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Increase to shareholders' net income				$ 36		$ 5
Increase to diluted earnings per share (in dollars per share)				$ 0.11		$ 0.02
Adjustment upon Adoption
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Decrease to shareholders' equity								$ 139
Pharmacy Benefits Management Services | Guarantees
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Performance guarantee liability	$ 1,500			$ 1,300

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements to the Consolidated Financial Statements for further information.

[3] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Accounts Receivable, Net - Summary of Accounts Receivable, Net (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Noninsurance customer receivables	$ 7,845	$ 6,899
Pharmaceutical manufacturers receivables	7,128	7,108
Insurance customer receivables	2,467	2,963
Other receivables	264	248
Accounts receivable, net	$ 17,704	$ 17,218	[1]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Accounts Receivable, Net - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Allowance for receivables, current	$ 2,100	$ 1,900
Allowance for current expected credit losses on accounts receivable	$ 87	$ 86

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Supplier Finance Program (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Payment term (in months)	1 month
Outstanding payment obligations, current	$ 1,500	$ 1,300
Outstanding payment obligations, current, voluntarily elected by suppliers to be sold to the financial institution	$ 324

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Mergers, Acquisitions and Divestitures - Narrative (Details) - USD ($) $ in Millions		3 Months Ended
	Jul. 01, 2022	Mar. 31, 2023	Mar. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Integration and transaction-related costs, pre-tax		$ 1	$ 52
Integration and transaction-related costs, after-tax		$ 1	$ 37
International life, accident, supplemental benefits businesses sold to Chubb | Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price	$ 5,400
Gain (loss) on sale of business, pre-tax	1,700
Gain (loss) on sale of business, after-tax	$ 1,400

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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, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Shareholders' net income	$ 1,267	$ 1,197	[1]
Shares:
Weighted average (in shares)	295,706	318,487
Common stock equivalents (in shares)	3,293	2,795
Total shares (in shares)	298,999	321,282
EPS, basic (in dollars per share)	$ 4.28	$ 3.76	[1]
EPS, effect of dilution (in dollars per share)	(0.04)	(0.03)
EPS, diluted (in dollars per share)	$ 4.24	$ 3.73	[1]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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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, 2023	Mar. 31, 2022
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)	0.9	2.8

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Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares shares in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Earnings Per Share [Abstract]
Shares of common stock held in treasury	102.7	99.1	77.3

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Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Mar. 31, 2023	Jan. 15, 2023	Dec. 31, 2022
Short-term debt
Other, including finance leases	$ 36,000,000		$ 33,000,000
Total short-term debt	3,418,000,000		2,993,000,000	[1]
Long-term debt
Other, including finance leases	67,000,000		66,000,000
Total long-term debt	29,124,000,000		28,100,000,000	[1]
$17 million, 8.3% Notes due January 2023
Short-term debt
Current maturities	0		17,000,000
Long-term debt
Gross value	$ 17,000,000
Interest Rate	8.30%
$63 million, 7.65% Notes due March 2023
Short-term debt
Current maturities	$ 0		63,000,000
Long-term debt
Gross value	$ 63,000,000
Interest Rate	7.65%
$700 million, Floating Rate Notes due July 2023
Short-term debt
Current maturities	$ 700,000,000		700,000,000
Long-term debt
Gross value	700,000,000
$1,000 million, 3% Notes due July 2023
Short-term debt
Current maturities	996,000,000		994,000,000
Long-term debt
Gross value	$ 1,000,000,000
Interest Rate	3.00%
$1,187 million, 3.75% Notes due July 2023
Short-term debt
Current maturities	$ 1,187,000,000		1,186,000,000
Long-term debt
Gross value	$ 1,187,000,000
Interest Rate	3.75%
$500 million, 0.613% Notes due March 2024
Short-term debt
Current maturities	$ 499,000,000		0
Long-term debt
Long-term debt	0		499,000,000
Gross value	$ 500,000,000
Interest Rate	0.613%
$1,000 million, 3.500% Notes due June 2024
Long-term debt
Long-term debt	$ 992,000,000		990,000,000
Gross value	$ 1,000,000,000
Interest Rate	3.50%
$900 million, 3.250% Notes due April 2025 (1)
Long-term debt
Long-term debt	$ 878,000,000		872,000,000
Gross value	$ 900,000,000
Interest Rate	3.25%
$2,200 million, 4.125% Notes due November 2025
Long-term debt
Long-term debt	$ 2,195,000,000		2,195,000,000
Gross value	$ 2,200,000,000
Interest Rate	4.125%
$1,500 million, 4.500% Notes due February 2026
Long-term debt
Long-term debt	$ 1,503,000,000		1,503,000,000
Gross value	$ 1,500,000,000
Interest Rate	4.50%
$800 million, 1.250% Notes due March 2026
Long-term debt
Long-term debt	$ 797,000,000		797,000,000
Gross value	$ 800,000,000
Interest Rate	1.25%
$700 million, 5.685% Notes due March 2026
Long-term debt
Long-term debt	$ 697,000,000		0
Gross value	$ 700,000,000
Interest Rate	5.685%
$1,500 million, 3.400% Notes due March 2027
Long-term debt
Long-term debt	$ 1,440,000,000		1,436,000,000
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	$ 597,000,000		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	$ 3,785,000,000		3,785,000,000
Gross value	$ 3,800,000,000
Interest Rate	4.375%
$1,500 million, 2.400% Notes due March 2030
Long-term debt
Long-term debt	$ 1,492,000,000		1,492,000,000
Gross value	$ 1,500,000,000
Interest Rate	2.40%
$1,500 million, 2.375% Notes due 2031
Long-term debt
Long-term debt	$ 1,398,000,000		1,380,000,000
Gross value	$ 1,500,000,000
Interest Rate	2.375%
$45 million, 8.080% Step Down Notes due January 2033 (2)
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		0
Gross value	$ 800,000,000
Interest Rate	5.40%
$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	$ 2,192,000,000		2,192,000,000
Gross value	$ 2,200,000,000
Interest Rate	4.80%
$750 million, 3.200% Notes due March 2040
Long-term debt
Long-term debt	$ 743,000,000		743,000,000
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	$ 488,000,000		488,000,000
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	$ 1,466,000,000		1,466,000,000
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	$ 2,969,000,000		2,968,000,000
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	$ 1,236,000,000		1,236,000,000
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	$ 1,478,000,000		$ 1,478,000,000
Gross value	$ 1,500,000,000
Interest Rate	3.40%

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Debt - Debt Issuances and Redemptions (Details) $ in Millions	Mar. 07, 2023 USD ($)	Mar. 31, 2023
Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,500
$700 million, 5.685% Notes due March 2026
Debt Instrument [Line Items]
Interest rate		5.685%
$700 million, 5.685% Notes due March 2026 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 700
Interest rate	5.685%
Net proceeds	$ 698
$700 million, 5.685% Notes due March 2026 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0020
$800 million, 5.400% Notes due March 2033
Debt Instrument [Line Items]
Interest rate		5.40%
$800 million, 5.400% Notes due March 2033 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 800
Interest rate	5.40%
Net proceeds	$ 796
$800 million, 5.400% Notes due March 2033 | Senior Notes | Treasury rate
Debt Instrument [Line Items]
Redemption price discount, spread on variable rate	0.0025

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Debt - Narrative (Details)	1 Months Ended		3 Months Ended
	Apr. 30, 2023 USD ($) revolvingCreditFacility position	Apr. 30, 2022 USD ($)	Mar. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)
Debt Instrument [Line Items]
Interest expense on long-term and short-term debt			$ 345,000,000	$ 314,000,000
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity			5,000,000,000
Outstanding balances			0
Revolving credit agreements, April 2023
Debt Instrument [Line Items]
Number of revolving credit facilities | revolvingCreditFacility	2
Revolving credit agreements, April 2023 | Subsequent Event
Debt Instrument [Line Items]
Aggregate amount of options to increase commitments	$ 1,500,000,000
Maximum total commitment	$ 6,500,000,000
Number of participating banks | position	21
Leverage ratio covenant	60.00%
Five-year Revolving Credit Agreement, Maturing April 2028 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 4,000,000,000
Credit agreement term	5 years
Credit agreement extension term	1 year
Five-year Revolving Credit Agreement, Maturing April 2028 | Letter of Credit | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
364-day Revolving Credit Agreement, Maturing April 2024 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Credit agreement term	364 days
Credit facility, conversion to term loan, term	1 year
Revolving credit agreements, April 2022
Debt Instrument [Line Items]
Outstanding balances			$ 0
Revolving Credit And Letter Of Credit Facility Maturing April 2027
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 3,000,000,000
Credit agreement term		5 years
Revolving Credit Facility Maturing April 2025
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,000,000,000
Credit agreement term		3 years
364 Day Revolving Credit Agreement, Maturing April 2023
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,000,000,000
Credit agreement term		364 days

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Common and Preferred Stock - Dividends (Details) - USD ($) $ / shares in Units, $ in Millions				3 Months Ended
	Apr. 26, 2023	Mar. 23, 2023	Mar. 24, 2022	Mar. 31, 2023	Dec. 31, 2022	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)				$ 1.23	$ 1.12	$ 1.12	$ 1.12	$ 1.12
Amount per share (in dollars per share)		$ 1.23	$ 1.12
Total amount paid		$ 368	$ 357	$ 368				$ 357	[1]
Subsequent Event
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)	$ 1.23

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 958	$ 1,334
Treasury Stock
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 958	1,334
Additional Paid-in Capital
Accelerated Share Repurchases [Line Items]
Stock repurchased		$ 0

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Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022		Mar. 31, 2022	Dec. 31, 2021
Current
Market risk benefits, current	$ 48	$ 51
Unearned Premiums, Current	1,419	576
Current insurance and contractholder liabilities	7,166	5,409	[1]
Non-current
Market risk benefits, noncurrent	1,172	1,217
Unearned premiums, noncurrent	21	22
Non-current insurance and contractholder liabilities	11,790	11,976	[1]
Total
Market risk benfits	1,220	1,268		$ 1,558
Unearned premiums	1,440	598
Unearned premiums, including held for sale liabilities				1,030
Total				23,509
Insurance and contractholder liabilities classified as held for sale				(4,562)
Total insurance and contractholder liabilities	18,956	17,385		18,947
Unpaid claims classified as liabilities of business held for sale				400
Contractholder deposit funds classified as liabilities of business held for sale				400
Cigna Healthcare
Current
Unpaid claims and claim expenses, current	4,880	4,117
Future policy benefits, current	59	43
Contractholder deposit funds, current	12	14
Non-current
Unpaid claims and claim expenses, noncurrent	79	59
Future policy benefits, noncurrent	542	544
Contractholder deposit funds, noncurrent	151	157
Total
Unpaid claims and claim expenses	4,959	4,176		4,491	$ 4,261
Unpaid claims and claim expenses, including held for sale liabilities				4,491
Future policy benefits	601	587		681
Future policy benefits, including held for sale liabilities				681
Contractholder deposit funds	163	171		181
Other Operations
Current
Unpaid claims and claim expenses, current	97	107
Future policy benefits, current	290	150
Contractholder deposit funds, current	361	351
Non-current
Unpaid claims and claim expenses, noncurrent	175	177
Future policy benefits, noncurrent	3,341	3,442
Contractholder deposit funds, noncurrent	6,309	6,358
Total
Unpaid claims and claim expenses	272	284
Unpaid claims and claim expenses, including held for sale liabilities				744
Future policy benefits	3,631	3,592
Future policy benefits, including held for sale liabilities				7,981
Contractholder deposit funds	$ 6,670	$ 6,709		6,843	6,900
Future policy benefits classified as liabilities of business held for sale				$ 3,700	$ 3,800

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - Cigna Healthcare - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
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	$ 4,600	$ 4,200
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Beginning balance	4,176	4,261
Less: Reinsurance and other amounts recoverable	221	261
Beginning balance, net	3,955	4,000
Incurred costs related to:
Current year	9,041	8,024
Prior years	(144)	(276)
Total incurred	8,897	7,748
Paid costs related to:
Current year	5,316	4,634
Prior years	2,795	2,822
Total paid	8,111	7,456
Ending balance, net	4,741	4,292
Add: Reinsurance and other amounts recoverable	218	199
Ending balance	$ 4,959	$ 4,491

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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, 2023	Mar. 31, 2022
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 144	$ 276
Favorable (unfavorable) variance, percentage	0.50%	0.90%
Actual completion factors
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 1	$ 99
Favorable (unfavorable) variance, percentage	0.00%	0.30%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 143	$ 177
Favorable (unfavorable) variance, percentage	0.50%	0.60%

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Insurance and Contractholder Liabilities - Future Policy Benefits - Interest Rates and Duration (Details)	Mar. 31, 2023	Mar. 31, 2022
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	2.59%	2.64%
Current discount rate	5.29%	4.90%
Weighted average duration	8 years 18 days	7 years 5 months 12 days
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	5.64%	5.64%
Current discount rate	4.95%	3.59%
Weighted average duration	11 years 8 months 12 days	13 years 10 months 24 days

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Insurance and Contractholder Liabilities - Future Policy Benefits - Present Value of Expected Premiums and Benefits (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Observable inputs from published spot rate curve term (in years)	30 years
Cigna Healthcare
Liability for Future Policy Benefit, Expected Net Premium [Roll Forward]
Beginning balance	$ 8,557	$ 9,314
Reversal of effect of beginning of period discount rate assumptions	1,537	(367)
Effect of assumption changes and actual variances from expected experience			$ 0	$ 0
Issuances and lapses	306	143
Net premiums collected	(326)	(310)
Interest and other	56	46
Ending balance at original discount rate	10,130	8,826
Effect of end of period discount rate assumptions	(1,312)	(376)
Ending balance	8,818	8,450	8,557	9,314
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Beginning balance	8,945	9,794
Reversal of effect of discount rate assumptions	1,611	(379)
Effect of assumption changes and actual variances from expected experience			0	0
Issuances and lapses	307	215
Benefit payments	(326)	(385)
Interest and other	58	52
Ending balance at original discount rate	10,595	9,297
Effect of discount rate assumptions	(1,378)	(392)
Ending balance	9,217	8,905	8,945	9,794
Liability for future policy benefits	399	455
Other	202	226
Future policy benefits	601	681	587
Undiscounted expected future gross premiums	17,600	13,500
Discounted expected future gross premiums	12,500	10,700
Undiscounted expected future policy benefits	12,800	11,200
Future policy benefit reserve, reinsurance recoverable	154	171
Other Operations
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Future policy benefits	3,631		3,592
Undiscounted expected future policy benefits	4,600	4,700
Future policy benefit reserve, reinsurance recoverable	1,000	1,200
Future policy benefits, DPL	392	384
Future policy benefit, excluding DPL	$ 3,200	3,900	$ 3,200	4,300
Future policy benefits classified as liabilities of business held for sale		$ 3,700		$ 3,800

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Insurance and Contractholder Liabilities - Contractholder Deposit Funds (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit fund liabilities, approximate percent reinsured externally	39.00%
Weighted average crediting rate	3.25%		3.18%
Net amount at risk	$ 3,200		$ 3,500
Cash surrender value	$ 2,800		$ 2,900
Minimum crediting rate	99.00%		99.00%
Percentage with cash values at more than 110% of guaranteed cash value	90.00%		90.00%
Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Policyholder account balance	$ 1,200		$ 1,200
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]
Policyholder account balance	1,700		1,700
Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400
Insurance and Contractholder Liabilities [Line Items]
Policyholder account balance	4,100		4,100
Policyholder Account Balance, at Guaranteed Minimum Crediting Rate
Insurance and Contractholder Liabilities [Line Items]
Policyholder account balance	$ 1,200		$ 1,200
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%
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%
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds	$ 163	$ 171	$ 181
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds	$ 6,670	$ 6,709	$ 6,843	$ 6,900

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Insurance and Contractholder Liabilities - Summary of Market Risk Benefit (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Insurance Loss Reserves [Abstract]
Annuitization election period	30 days
Market Risk Benefit [Roll Forward]
Balance, beginning of year	$ 1,268	$ 1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)	1,379	1,949
Changes due to expected run-off	(6)	(19)
Changes due to capital markets versus expected	(41)	(271)
Changes due to policyholder behavior versus expected	6	(9)
Assumption changes	(33)	39
Balance, end of year, before the effect of changes in nonperformance risk (own credit risk)	1,305	1,689
Nonperformance risk (own credit risk), end of period	(85)	(131)
Balance, end of period	1,220	1,558
Reinsured market risk benefit, end of period	$ 1,301	$ 1,681

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Insurance and Contractholder Liabilities - Net Amount of Risk and Average Age of Contractholders (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Net Amount at Risk by Product and Guarantee [Line Items]
Net amount at risk	$ 85	$ 131
Variable Annuity
Net Amount at Risk by Product and Guarantee [Line Items]
Net amount at risk	$ 2,183	$ 1,892
Average attained age of contractholders (weighted by exposure)	75 years 4 months 24 days	76 years 4 months 24 days

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Reinsurance - Reinsurance Recoverables (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 4,251
Allowance for uncollectible reinsurance	(35)
Market risk benefits	1,301		$ 1,681
Total reinsurance recoverables	5,517
Other Current Assets
Ceded Credit Risk [Line Items]
Reinsurance recoverables	231
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	709
Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,175
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	367
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables	363
Ongoing Operations | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables	94
Ongoing Operations | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables	59
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	210
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	142
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	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	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	142
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	5
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	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	0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	5
Ongoing Operations | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	216
Ongoing Operations | No collateral | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables	94
Ongoing Operations | No collateral | BBB- to BBB+ equivalent current credit ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables	59
Ongoing Operations | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	63
Acquisition, disposition or run-off activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,888
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	2,750
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company
Ceded Credit Risk [Line Items]
Reinsurance recoverables	133
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America
Ceded Credit Risk [Line Items]
Reinsurance recoverables	380
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	386
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	227
Acquisition, disposition or run-off activities | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	12
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	567
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	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	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	380
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	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	187
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	0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,170
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	2,750
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	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	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	386
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	25
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	9
Acquisition, disposition or run-off activities | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	151
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	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	133
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	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	0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	15
Acquisition, disposition or run-off activities | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 3
Variable Annuity
Ceded Credit Risk [Line Items]
Market risk benefits		$ 1,400
Variable Annuity | GMDB
Ceded Credit Risk [Line Items]
Market risk benefits		$ 711

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Reinsurance - Effective Exit of Variable Annuity Reinsurance Business (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Ceded Credit Risk [Line Items]
Market risk benefits	$ 1,301	$ 1,681
Variable Annuity
Ceded Credit Risk [Line Items]
Impact of non-performance risk
Berkshire | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	90.00%
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 | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	70.00%
Variable Annuity
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 1,323		$ 1,398
Market risk benefits			1,400
Incurred but not yet paid and outstanding claims	25		27
Premiums due	$ 3		3
Variable Annuity | 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	1,043		1,116
Variable Annuity | Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	117		115
Variable Annuity | Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	128		128
Variable Annuity | SCOR SE
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 35		$ 39

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Investments - Investments by Category (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Current
Investments per Consolidated Balance Sheets	$ 914	$ 905	[1]
Long-term
Investments per Consolidated Balance Sheets	19,010	16,288	[1]
Total
Investments per Consolidated Balance Sheets	19,924	17,193
Debt securities
Current
Investments per Consolidated Balance Sheets	616	654
Long-term
Investments per Consolidated Balance Sheets	9,293	9,218
Total
Investments per Consolidated Balance Sheets	9,909	9,872
Equity securities
Current
Investments per Consolidated Balance Sheets	51	45
Long-term
Investments per Consolidated Balance Sheets	3,069	577
Total
Investments per Consolidated Balance Sheets	3,120	622
Commercial mortgage loans
Current
Investments per Consolidated Balance Sheets	106	67
Long-term
Investments per Consolidated Balance Sheets	1,501	1,547
Total
Investments per Consolidated Balance Sheets	1,607	1,614
Policy loans
Current
Investments per Consolidated Balance Sheets	0	0
Long-term
Investments per Consolidated Balance Sheets	1,211	1,218
Total
Investments per Consolidated Balance Sheets	1,211	1,218
Other long-term investments
Current
Investments per Consolidated Balance Sheets	0	0
Long-term
Investments per Consolidated Balance Sheets	3,936	3,728
Total
Investments per Consolidated Balance Sheets	3,936	3,728
Short-term investments
Current
Investments per Consolidated Balance Sheets	141	139
Long-term
Investments per Consolidated Balance Sheets	0	0
Total
Investments per Consolidated Balance Sheets	$ 141	$ 139

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Amortized Cost
Due in one year or less	$ 638
Due after one year through five years	3,972
Due after five years through ten years	3,227
Due after ten years	2,450
Mortgage and other asset-backed securities	381
Total	10,668	$ 10,842
Fair Value
Due in one year or less	630
Due after one year through five years	3,752
Due after five years through ten years	2,915
Due after ten years	2,268
Mortgage and other asset-backed securities	344
Total	$ 9,909	$ 9,872

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Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 10,668	$ 10,842
Allowance for Credit Loss	(41)	(44)
Unrealized Appreciation	170	133
Unrealized Depreciation	(888)	(1,059)
Fair Value	9,909	9,872
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	276	292
Allowance for Credit Loss	0	0
Unrealized Appreciation	29	32
Unrealized Depreciation	(8)	(12)
Fair Value	297	312
State and local government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	42	43
Allowance for Credit Loss	0	0
Unrealized Appreciation	0	0
Unrealized Depreciation	(1)	(2)
Fair Value	41	41
Foreign government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	373	375
Allowance for Credit Loss	0	0
Unrealized Appreciation	16	11
Unrealized Depreciation	(18)	(21)
Fair Value	371	365
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	9,596	9,742
Allowance for Credit Loss	(41)	(44)
Unrealized Appreciation	124	89
Unrealized Depreciation	(823)	(981)
Fair Value	8,856	8,806
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	381	390
Allowance for Credit Loss	0	0
Unrealized Appreciation	1	1
Unrealized Depreciation	(38)	(43)
Fair Value	$ 344	$ 348

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Investments - Summary of Debt Securities with a Decline in Fair Value (Details) $ in Millions	Mar. 31, 2023 USD ($) position	Dec. 31, 2022 USD ($) position
Total
Fair Value	$ 7,433	$ 7,901
Total Amortized Cost	8,321	8,960
Unrealized Depreciation	$ (888)	$ (1,059)
Number of Issues | position	3,760	3,777
Investment grade | Debt securities
One year or less
Fair Value	$ 3,176	$ 5,533
Amortized Cost	3,362	6,127
Unrealized Depreciation	$ (186)	$ (594)
Number of Issues | position	1,019	1,659
More than one year
Fair Value	$ 3,222	$ 1,151
Amortized Cost	3,808	1,487
Unrealized Depreciation	$ (586)	$ (336)
Number of Issues | position	1,035	462
Below investment grade | Debt securities
One year or less
Fair Value	$ 353	$ 887
Amortized Cost	371	964
Unrealized Depreciation	$ (18)	$ (77)
Number of Issues | position	936	1,287
More than one year
Fair Value	$ 682	$ 330
Amortized Cost	780	382
Unrealized Depreciation	$ (98)	$ (52)
Number of Issues | position	770	369

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Investments - Equity Security Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	[1]	Dec. 31, 2022
Cost
Equity securities with readily determinable fair values	$ 680			$ 673
Equity securities with no readily determinable fair value	2,926			380
Total	3,606			1,053
Carrying Value
Equity securities with readily determinable fair values	91			138
Equity securities with no readily determinable fair value	3,029			484
Total	3,120			$ 622
Other Commitments [Line Items]
Amount funded	$ 2,794	$ 1,246
Equity Securities FV NI | Product Concentration Risk | Health Care Sector
Other Commitments [Line Items]
Concentration percentage	95.00%

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Investments - Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss	$ 1,607	$ 1,614
Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.89	1.89
Average Loan-to-Value Ratio	60.00%	60.00%
Below 60%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss	$ 912	$ 901
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.11	2.12
60% to 79%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss	$ 504	$ 564
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.73	1.73
80% to 100%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss	$ 191	$ 149
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.32	1.17

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Investments - Carrying Values of Other Long-Term Investments (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Schedule of Investments [Line Items]
Other long-term investments	$ 3,936	$ 3,728
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	1,434	1,319
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	2,259	2,166
Other
Schedule of Investments [Line Items]
Other long-term investments	$ 243	$ 243

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Investments - Components of Net Investment Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Net Investment Income [Line Items]
Net investment income	$ 277	$ 414	[1]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Investments - Realized Gains and Losses on Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Investments [Abstract]
Net realized investment (losses), excluding credit loss expense and asset write-downs	$ (51)	$ (322)
Credit loss recoveries	3	0
Other investment asset write-downs	(8)	0
Net realized investment (losses), before income taxes	$ (56)	$ (322)	[1]

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Financial assets at fair value:
Equity securities	$ 91	$ 138
Recurring
Financial assets at fair value:
Debt Securities	9,909	9,872
Equity securities	91	138
Short-term investments	141	139
Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	207	231
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	151	147
Equity securities	6	6
Short-term investments	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	0	0
Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	9,288	9,278
Equity securities	84	132
Short-term investments	141	139
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	206	230
Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	470	447
Equity securities	1	0
Short-term investments	0	0
Significant Unobservable Inputs (Level 3) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	1	1
Federal government and agency | Recurring
Financial assets at fair value:
Debt Securities	297	312
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	151	147
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	146	165
Federal government and agency | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	0	0
State and local government | Recurring
Financial assets at fair value:
Debt Securities	41	41
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	0	0
State and local government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	41	41
State and local government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	0	0
Foreign government | Recurring
Financial assets at fair value:
Debt Securities	371	365
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	0	0
Foreign government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	371	365
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	0	0
Corporate | Recurring
Financial assets at fair value:
Debt Securities	8,856	8,806
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	0	0
Corporate | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	8,421	8,394
Corporate | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	435	412
Mortgage and other asset-backed | Recurring
Financial assets at fair value:
Debt Securities	344	348
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt Securities	0	0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities	309	313
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities	$ 35	$ 35

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Fair Value Measurements - Narrative (Details) - Separate Account Assets - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
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
Recurring | Securities partnerships
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Expected liquidation period after inception	10 years

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Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3) $ in Millions	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 470	$ 447
Corporate and government debt securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 433	$ 412
Corporate and government debt securities | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0060	0.0060
Corporate and government debt securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.1060	0.1060
Corporate and government debt securities | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0300	0.0270
Mortgage and other asset-backed securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 35	$ 35
Mortgage and other asset-backed securities | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0105	0.0110
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0520	0.0520
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	0.0310	0.0310
Other debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 2	$ 0

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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, 2023	Mar. 31, 2022
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	$ 5	$ (13)
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		796
Gains included in Shareholders' net income	1	12
Gains (losses) included in Other comprehensive loss	5	(15)
Gains (losses) required to adjust future policy benefits for settlement annuities	0	(12)
Purchases, sales and settlements
Purchases	4	49
Settlements	(9)	(81)
Total purchases, sales and settlements	(5)	(32)
Transfers into/(out of) Level 3
Transfers into Level 3	39	101
Transfers out of Level 3	(16)	(164)
Total transfers into/(out of) Level 3	23	(63)
Ending balance	471
Ending balance, including held for sale assets		686
Total gains included in Shareholders' net income attributable to instruments held at the reporting date	$ 1	$ 0

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Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 562	$ 585
Non-guaranteed separate accounts	6,020	5,936
Subtotal	6,582	6,521
Non-guaranteed separate accounts priced at NAV as a practical expedient	758	757
Separate account assets	7,340	7,278	[1]
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	213	203
Non-guaranteed separate accounts	221	211
Subtotal	434	414
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	349	382
Non-guaranteed separate accounts	5,586	5,522
Subtotal	5,935	5,904
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	213	203
Subtotal	213	203
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

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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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, 2023	Dec. 31, 2022
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 228
Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	758	$ 757
Securities partnerships
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	228
Securities partnerships | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	467	451
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	$ 287	302
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	$ 4	$ 4

XML

Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
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, 2023	Dec. 31, 2022
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	$ 30,679	$ 28,653
Fair Value | Significant Unobservable Inputs (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,509	1,491
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,607	1,614
Long-term debt, including current maturities, excluding finance leases	$ 32,439	$ 30,994

XML

Variable Interest Entities (Details) - entity	Mar. 31, 2023	Dec. 31, 2022
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, 2023		Mar. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	[2]	$ 44,688	[1]	$ 46,976
Other comprehensive loss, net of tax		(111)		(434)	[3]
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests		0		(2)	[3]
Shareholders other comprehensive income (loss), net of tax		(111)		(432)
Balance		44,518		46,145
Accumulated Other Comprehensive (Loss)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	[2]	(1,658)		(1,068)
Shareholders other comprehensive income (loss), net of tax		(111)		(432)
Balance		(1,769)		(1,500)
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(332)		1,266
Other comprehensive income (loss) before reclassifications, before tax		252		(1,065)
Other comprehensive income (loss), before reclassifications, tax		(54)		231
Other comprehensive income (loss) before reclassifications, after-tax		198		(834)
Reclassification adjustment, tax		1		2
Net amounts reclassified from AOCI to net income		(4)		(9)
Shareholders other comprehensive income (loss), net of tax		194		(843)
Balance		(138)		423
Reclassification adjustment for (gains) included in Shareholders' net income (Net realized investment losses)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax		(5)		(11)
AOCI, Liability For Future Policy Benefit And Market Risk Benefit, Instrument-Specific Credit Risk, Parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(256)		(765)
Shareholders other comprehensive income (loss), net of tax		(331)		459
Balance		(587)		(306)
AOCI, Liability for Future Policy Benefit, Parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax		(411)		584
Other comprehensive income (loss), before reclassifications, tax		101		(130)
Shareholders other comprehensive income (loss), net of tax		(310)		454
AOCI, Market Risk Benefit, Instrument-Specific Credit Risk, Parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax		(26)		6
Other comprehensive income (loss), before reclassifications, tax		5		(1)
Shareholders other comprehensive income (loss), net of tax		(21)		5
Translation of foreign currencies attributable to parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(154)		(233)
Shareholders other comprehensive income (loss), net of tax		16		(61)
Balance		(138)		(294)
Translation of foreign currencies including portion attributable to noncontrolling interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) including temporary equity, before reclassifications, before tax		15		(60)
Other comprehensive income (loss) including temporary equity, before reclassifications, tax		1		(3)
Other comprehensive income (loss) including temporary equity, before reclassifications, after-tax		16		(63)
Translation of foreign currencies attributable to noncontrolling interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests		0		(2)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(916)		(1,336)
Reclassification adjustment, tax		(3)		(3)
Net amounts reclassified from AOCI to net income		10		13
Shareholders other comprehensive income (loss), net of tax		10		13
Balance		(906)		(1,323)
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		$ 13		$ 16

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements to the Consolidated Financial Statements for further information.

[3] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Income Taxes - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	18.40%	22.70%
Deferred tax assets associated with unrealized investment losses	$ 255

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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, 2023 USD ($)	Mar. 08, 2023 expert
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
Commitments And Contingencies [Line Items]
Number of experts | expert					4
Number of additional experts | expert					2
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
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				420,000,000
Assets maintained by employers (minimum)				420,000,000
Liability for guarantees				$ 0

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Segment Information - Summary of Special Items (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Pre-tax
Integration and transaction-related costs, pre-tax	$ 1	$ 52
Total impact from special items	1	52
After-tax
Integration and transaction-related costs, after-tax	1	37
Total impact from special items	$ 1	$ 37

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Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Revenues from customers	$ 46,240	$ 43,592
Net investment income (loss)	277	414	[1]
TOTAL REVENUES	46,517	44,006	[1]
Net realized investment results from certain equity method investments	(38)	103
Adjusted revenues	46,479	44,109
Depreciation and amortization	749	717	[2]
Income before income taxes	1,601	1,567	[1]
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(43)	(17)
Net realized investment (gains) losses	18	425
Amortization of acquired intangible assets	459	458	[1]
Special items
Integration and transaction-related costs	1	52
Pre-tax adjusted income (loss) from operations	2,036	2,485
Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	34,511	32,289
Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	11,650	10,462
Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	79	841
Operating Segments | Evernorth Health Services
Segment Reporting Information [Line Items]
Net investment income (loss)	50	10
TOTAL REVENUES	36,179	33,586
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	36,179	33,586
Income before income taxes	918	870
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(42)	(11)
Net realized investment (gains) losses	0	0
Amortization of acquired intangible assets	444	443
Special items
Integration and transaction-related costs	0	0
Pre-tax adjusted income (loss) from operations	1,320	1,302
Operating Segments | Cigna Healthcare
Segment Reporting Information [Line Items]
Net investment income (loss)	143	266
TOTAL REVENUES	12,756	11,290
Net realized investment results from certain equity method investments	(38)	103
Adjusted revenues	12,718	11,393
Income before income taxes	1,077	877
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(1)	(1)
Net realized investment (gains) losses	24	406
Amortization of acquired intangible assets	15	15
Special items
Integration and transaction-related costs	0	0
Pre-tax adjusted income (loss) from operations	1,115	1,297
Operating Segments | Other Operations
Segment Reporting Information [Line Items]
Net investment income (loss)	78	138
TOTAL REVENUES	157	979
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	157	979
Income before income taxes	21	215
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	(5)
Net realized investment (gains) losses	(6)	19
Amortization of acquired intangible assets	0	0
Special items
Integration and transaction-related costs	0	0
Pre-tax adjusted income (loss) from operations	15	229
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net investment income (loss)	6	0
TOTAL REVENUES	(2,575)	(1,849)
Net realized investment results from certain equity method investments	0	0
Adjusted revenues	(2,575)	(1,849)
Income before income taxes	(415)	(395)
Special items
Pre-tax adjusted income (loss) from operations	(414)	(343)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	0	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	1	52
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(2,581)	(1,849)
Intersegment Eliminations | Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	(1,618)	(1,287)
Intersegment Eliminations | Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	(963)	(562)
Intersegment Eliminations | Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	$ 0	$ 0

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

[2] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenue from External Customer [Line Items]
Premiums	$ 11,025	$ 10,356	[1]
Total revenues from external customers	46,240	43,592
Intersegment Eliminations
Revenue from External Customer [Line Items]
Premiums	16	(2)
Total revenues from external customers	(2,581)	(1,849)
Operating Segments | Divested International businesses
Revenue from External Customer [Line Items]
Premiums	0	763
Operating Segments | Other
Revenue from External Customer [Line Items]
Premiums	79	69
Evernorth Health Services
Revenue from External Customer [Line Items]
Total revenues from external customers	34,511	32,289
Evernorth Health Services | Intersegment Eliminations
Revenue from External Customer [Line Items]
Total revenues from external customers	(1,618)	(1,287)
Cigna Healthcare
Revenue from External Customer [Line Items]
Total revenues from external customers	11,650	10,462
Cigna Healthcare | Intersegment Eliminations
Revenue from External Customer [Line Items]
Total revenues from external customers	(963)	(562)
Other Operations
Revenue from External Customer [Line Items]
Total revenues from external customers	79	841
Other Operations | Intersegment Eliminations
Revenue from External Customer [Line Items]
Total revenues from external customers	0	0
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	32,144	30,697	[1]
Pharmacy revenues | Intersegment Eliminations
Revenue from External Customer [Line Items]
Revenues	(1,496)	(1,245)
Network revenues | Operating Segments
Revenue from External Customer [Line Items]
Revenues	15,748	15,531
Home delivery and specialty revenues | Operating Segments
Revenue from External Customer [Line Items]
Revenues	16,025	14,699
Other revenues | Operating Segments
Revenue from External Customer [Line Items]
Revenues	1,867	1,712
Cigna Healthcare | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	10,930	9,526
Insured | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	4,080	3,720
Stop loss | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	1,503	1,325
Other Commercial Medical Products | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	368	360
Medicare Advantage | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	2,236	2,078
Medicare Part D | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	415	401
Short-duration (Individual and family plans) | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	1,208	611
Long-duration (Individual Medicare supplement and limited benefit health products) | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	334	329
Short-duration (Group medical insurance) | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	700	620
Long-duration (Individual private medical insurance) | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Premiums	86	82
Service
Revenue from External Customer [Line Items]
Revenues	3,071	2,539	[1]
Service | Intersegment Eliminations
Revenue from External Customer [Line Items]
Revenues	(1,101)	(602)
Fees | Evernorth Health Services | Operating Segments
Revenue from External Customer [Line Items]
Revenues	2,499	1,624
Fees | Cigna Healthcare | Operating Segments
Revenue from External Customer [Line Items]
Revenues	1,606	1,496
Fees | Other Operations | Operating Segments
Revenue from External Customer [Line Items]
Revenues	1	5
Other revenues | Operating Segments
Revenue from External Customer [Line Items]
Revenues	$ 66	$ 16

[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.

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Segment Information - Financial and Performance Guarantees (Details) - USD ($) $ in Billions	Mar. 31, 2023	Dec. 31, 2022
Pharmacy Benefits Management Services | Guarantees
Loss Contingencies [Line Items]
Guarantee liability	$ 1.5	$ 1.3