Segment Information

3 Months Ended

Mar. 31, 2024

Segment Reporting [Abstract]

Segment Information

Note 17 – Segment Information

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

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

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

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

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

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

Summarized segment financial information was as follows:

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

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

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

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

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

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

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

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