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美国
证券交易委员会
华盛顿特区20549
cignagroup_logo_color_pos_rgb_600ppi.jpg
表格 10-Q
☒ 根据13或15(d)条款的季度报告
1934年证券交易所法
截至2024年6月30日季度结束 2024年9月30日
或
☐ 根据第13或第15(d)条规定的过渡报告
1934年证券交易所法
过渡期从_____到_____
委员会档案编号 001-38769
信诺集团
（依凭章程所载的完整登记名称）
特拉华州82-4991898
(成立地或组织其他管辖区)（联邦税号）
900 Cottage Grove Road
布鲁姆菲尔德, 康涅狄格州 06002
(主要行政办公室的地址)（邮政编码）
(860) 226-6000
(注册公司之电话号码，包括区号)

不适用
(如与上次报告不同，列明前名称、前地址及前财政年度)
根据法案第12(b)条规定注册的证券：
每种类别的名称交易标的（s）每个注册交易所的名称
普通股，面值 $0.01CI
纽约证券交易所，公司。
标示√表示登记者（1）已在前述12个月内（或者对于需要提交此类报告的较短期间）按照1934年证券交易法第13条或15(d)条的规定提交了所有要提交的报告；以及（2）在过去90天内一直受到此类提交要求的约束。 ☒ 是 ☐ 否
请用勾选标记表示，报表申报人在过去12个月内（或报表申报人被要求申报这些文件的更短时段内）是否已按照S-t法规第405条的要求，递交了每个互动资料档案。 ☒ 是 ☐ 否
请用勾选方式指示，此登记者是否为大幅度加速递交者、加速递交者、非加速递交者、较小的报告公司或新兴成长公司。请参阅《交易所法》第120亿2条中对「大幅度加速递交者」、「加速递交者」、「较小的报告公司」和「新兴成长公司」的定义。

大型加速归档人☒加速归档人☐
非加速归档人☐小型报告公司☐
新兴成长型企业☐
若为新兴成长公司，请打勾表示公司已选择不使用信托期延长来遵守根据《交易所法》第13(a)条提供的任何新的或修订的财务会计准则。 ☐
请用核取标记指示是否该登记人是否属于壳牌公司（定义于交易所法规120亿2条）。 ☐ 是 ☒ 没有
截至2024年10月25日， 278,152,606 发行人普通股的股份已发行


信诺集团
目 录
页面
本文件中使用的「公司」一词指的是信诺集团及其合并子公司之一或多家。


第一部分。 财务信息
项目1。 基本报表
信诺集团
综合损益表
未经核实的未经核实的
截至9月30日的三个月截至9月30日的九个月
（单位：百万美元，除每股金额外）2024
2023
2024
2023
收益
药房收入$48,284 $34,531 $135,421 $100,639 
保险费11,436 10,998 34,493 33,062 
费用和其他收入3,889 3,198 10,862 9,574 
净投资收益85 321 696 876 
总收入63,694 49,048 181,472 144,151 
福利和支出
药房和其他服务成本47,565 33,639 133,488 98,540 
医疗支出和其他福利支出9,527 8,927 28,482 27,007 
销售、一般及管理费用3,590 3,788 10,979 10,760 
取得无形资产摊销436 454 1,279 1,368 
医疗利益和费用总额61,118 46,808 174,228 137,675 
营业收入
2,576 2,240 7,244 6,476 
利息支出和其他(376)(365)(1,073)(1,086)
业务出售亏损
(87)(21)(106)(21)
投资损失实现
(921)(14)(2,805)(44)
税前收入
1,192 1,840 3,260 5,325 
总收入税额367 391 1,018 1,060 
净利润
825 1,449 2,242 4,265 
减：非控制权益所享有之净利润
86 41 232 130 
股东的净利润$739 $1,408 $2,010 $4,135 
每股股东的净利润
基础$2.65 $4.79 $7.13 $14.03 
稀释$2.63 $4.74 $7.05 $13.89 

随附的综合基本报表附注（未经核数）是这些报表的一部分。
3

信诺集团
综合损益表
未经核实的未经核实的
截至9月30日的三个月截至9月30日的九个月
（以百万为单位）
2024
2023
2024
2023
净利润$825 $1,449 $2,242 $4,265 
其他综合收益（损失）- 税后
证券和衍生品的未实现升值（贬值）
264 (192)493 22 
长期保险和合约持有人负债的净额调整(28)(28)(800)(476)
外汇的净翻译收益（损失）
39 (29)8 (32)
退休福利负债调整4 8 — 25 
其他综合收益（损失）- 税后
279 (241)(299)(461)
累计综合收益
1,104 1,208 1,943 3,804 
非控股利益（损失）归属于非控股股东
净利润归可赎回非控制权益— 37 — 116 
净利润归其他非控制权益86 4 232 14 
归属于非控制权益的综合收益总额86 41 232 130 
股东综合收益
$1,018 $1,167 $1,711 $3,674 

随附的综合基本报表附注（未经核数）是这些报表的一部分。
4


信诺集团
合并资产负债表
未经核实的
截至
九月三十日，		截至
12月31日，
（以百万为单位）2024
2023
资产
现金及现金等价物$5,888 $7,822 
投资864 925 
应收帐款净额27,846 17,722 
存货5,083 5,645 
其他流动资产2,667 2,169 
待售企业资产6,874 3,068 
全部流动资产49,222 37,351 
长期投资15,270 17,985 
再保险资产追回4,557 4,835 
财产和设备3,594 3,695 
商誉44,374 44,259 
其他无形资产29,791 30,863 
其他资产3,180 3,421 
单独账户资产7,651 7,430 
待售业务资产，非流动资产— 2,922 
总资产$157,639 $152,761 
负债
当前保险和合同持有人负债$5,477 $5,514 
药房和其他服务成本应付款28,801 19,815 
应付账款8,515 8,553 
应计费用及其他负债8,920 9,955 
短期债务2,572 2,775 
待售企业负债2,775 2,104 
流动负债合计57,060 48,716 
非流动保险和保单持有人负债10,573 10,904 
递延所得税负债，净额6,794 7,173 
其他非流动负债3,033 3,441 
长期负债30,230 28,155 
分户账户负债7,651 7,430 
待售业务的负债，非流动— 591 
负债合计115,341 106,410 
条款 - 注16
可赎回的非控制权益。— 107 
股东权益
普通股 (1)
4 4 
资本公积额额外增资31,186 30,669 
累积其他全面损失(2,163)(1,864)
保留收益42,480 41,652 
扣除：按成本核算的库藏股份(29,412)(24,238)
股东权益总计42,095 46,223 
其他非控股权益203 21 
总股本42,298 46,244 
负债加股东权益总额$157,639 $152,761 
(1)每股面值，$0.01；已发行股份， 402截止到2024年9月30日为 百万， 400 截止到2023年12月31日为 百万；授权股份， 600 百万美元。

附注是基本报表（未经审计）的重要组成部分。
5

信诺集团
综合股东权益变动表
未经审计
截至2024年9月30日的三个月
(以百万计)普通股股本溢价其他综合收益（亏损）留存收益库藏股股东权益其他非控股权益总权益可赎回的非控股权益
2024年6月30日余额$4 $31,048 $(2,442)$42,132 $(29,410)$41,332 $195 $41,527 $— 
发行股票用于雇员福利计划的影响138 (2)136 136 
其他综合收益279 279 279 — 
净利润
739 739 86 825 — 
普通股分红宣布（每股：$1.40)
(391)(391)(391)
回购普通股— — — — 
其他影响非控股权益的交易— — (78)(78)— 
2024年9月30日的结余$4 $31,186 $(2,163)$42,480 $(29,412)$42,095 $203 $42,298 $— 
截至2023年9月30日的三个月
(以百万计)普通股股本溢价其他综合收益（亏损）留存收益库藏股股东权益其他非控股权益总权益可赎回的非控股权益
2023年6月30日的余额
$4 $30,436 $(1,878)$39,936 $(23,053)$45,445 $19 $45,464 $62 
发行股票以实施员工福利计划的影响127 (5)122 122 
其他综合损失(241)(241)(241)— 
净利润1,408 1,408 4 1,412 37 
宣布的普通股分红（每股：$1.23)
(362)(362)(362)
回购普通股— (681)(681)(681)
其他影响非控股权益的交易— — (12)(12)(35)
2023年9月30日的余额$4 $30,563 $(2,119)$40,982 $(23,739)$45,691 $11 $45,702 $64 

附注是基本报表（未经审计）的重要组成部分。
6

信诺集团
综合股东权益变动表
未经审计
截至2024年9月30日的九个月
(以百万计)普通股股本溢价其他综合收益（亏损）留存收益库藏股股东权益其他非控股权益总权益可赎回的非控股权益
 
$4 $30,669 $(1,864)$41,652 $(24,238)$46,223 $21 $46,244 $107 
发行股票用于员工福利计划的影响517 (117)400 400 
其他综合损失(299)(299)(299)— 
净利润2,010 2,010 232 2,242 — 
普通股分红宣布（每股：$4.20)
(1,182)(1,182)(1,182)
回购普通股— (5,057)(5,057)(5,057)
其他影响非控股权益的交易— — (50)(50)(107)
2024年9月30日的结余$4 $31,186 $(2,163)$42,480 $(29,412)$42,095 $203 $42,298 $— 
2023年9月30日止九个月的净利润
(以百万计)普通股股本溢价其他综合收益（亏损）留存收益库藏股股东权益其他非控制权益总权益可赎回的非控股权益
2022年12月31日的余额
$4 $30,233 $(1,658)$37,940 $(21,844)$44,675 $13 $44,688 $66 
发行股票以供员工福利计划使用的影响332 (110)222 222 
其他综合损失(461)(461)(461)— 
净利润4,135 4,135 14 4,149 116 
普通股息宣布（每股：$3.69)
(1,093)(1,093)(1,093)
回购普通股— (1,785)(1,785)(1,785)
其他影响非控股权益的交易(2)(2)(16)(18)(118)
2023年9月30日的余额$4 $30,563 $(2,119)$40,982 $(23,739)$45,691 $11 $45,702 $64 

附注是基本报表（未经审计）的重要组成部分。
7

信诺集团
合并现金流量表
未经审计
截至9月30日的九个月
(以百万计)
2024
2023
经营活动产生的现金流量
净利润$2,242 $4,265 
调整净利润以计入经营活动现金流量:
折旧和摊销2,129 2,270 
实现的投资损失，净值
2,805 44 
递延所得税收益
(351)(303)
出售业务的损失
106 21 
资产和负债的净变化，扣除非经营性影响：
应收账款，净额(10,600)(1,916)
存货577 360 
可追回的再保险和其他资产(358)281 
保险负债(214)1,482 
药品和其他应付服务费用8,979 2,250 
应付账款、应计费用及其他负债(819)1,337 
其他，净数655 255 
营业活动产生的现金流量净额5,151 10,346 
投资活动产生的现金流量
出售投资所得：
债务证券和股票证券569 757 
投资到期和偿还：
债务证券和权益证券585 715 
商用抵押贷款79 86 
其他销售、到期和还款（主要是短期和其他长期投资）
567 453 
购买或创设的投资：
债务证券和权益证券(943)(4,005)
商用抵押贷款(54)(94)
其他（主要是短期和其他长期投资）
(1,028)(891)
物业和设备购买，净额(1,069)(1,208)
收购，净现金收购(132)(443)
剥离，扣除出售的现金— 13 
其他，净数(485)(117)
投资活动产生的净现金流量(1,911)(4,734)
筹资活动产生的现金流量
存入资金及利息计入合同持有人存款基金120 127 
从合同持有人存款基金中提取和支付利益(180)(139)
短期债务净变化366 1,484 
偿还长期债务(3,000)(2,967)
长期债务发行的净收益4,462 1,491 
回购普通股(5,012)(1,740)
普通股发行283 113 
已支付普通股股息(1,183)(1,092)
其他，净数(255)(321)
融资活动中使用的净现金(4,399)(3,044)
外汇汇率变化对现金、现金等价物及限制性现金的影响 6 2 
现金、现金等价物和受限制现金的净(减少)增加额(1,153)2,570 
现金及现金等价物和受限制现金，2023年1月1日， (1)
8,337 5,976 
现金及现金等价物和受限制现金，2023年9月30日， (2)
7,184 8,546 
重新分类为待售业务资产的现金及现金等价物
(1,249)— 
根据合并资产负债表，2023年9月30日的现金、现金及现金等价物和受限制现金 (2)
$5,935 $8,546 
现金信息的补充披露:
所支付的所得税净额，减去退款$839 $1,380 
支付的利息$1,037 $1,019 
(1)Includes $467 million reported in Assets of businesses held for sale as of January 1, 2024.
(2)Restricted cash and cash equivalents were reported in other long-term investments.

附带的合并基本报表（未经审计）附注是这些报表不可或缺的一部分.
8

信诺集团
合并基本报表附注（未经审计）
目录
备注编号脚注页面
B业务与 C资本 S结构
I保险 I资讯
I投资
C合规, R监管和 C应急情况
RESULTS D细节

9

注 1 — 业务描述
信诺集团及其子公司（无论是单独还是集体称为“公司”，“我们”，“我们”或“我们的”）是一家致力于为每个个人和每个社区创造更美好未来的全球健康公司。我们不断挑战自己，与合作伙伴合作创新解决方案，以改善健康。凭借我们的员工和品牌的力量，我们推动我们的使命，改善我们服务对象的健康和活力。

我们的子公司提供一系列差异化的药房、医疗、行为、牙科及相关产品和服务。这些产品和服务主要通过雇主和其他实体提供，例如政府和非政府组织、工会和协会。信诺医疗还向美国和部分国际市场的个人提供健康和牙科保险产品。除了这些业务，信诺集团还拥有某些运行结束的业务。

以下是我们各个部分的完整描述：
The Evernorth健康服务 可报告的业务部门包括药房福利服务以及专业护理服务运营部门，这些部门与健康计划、雇主、政府组织和医疗保健提供者合作，解决药房福利、家庭送药、专业药房、专业配送，以及护理交付和管理解决方案等领域的挑战。

药房福利服务通过药物索赔裁定、零售药房网络管理、福利设计咨询、药物使用评审、药物目录管理以及提供家庭配送药房服务等多种服务提供高质量、经济实惠的药房护理。专业和护理服务为复杂和罕见疾病的治疗提供专业药物、药品和宠物-医疗产品的专业分销，以及临床项目，以帮助我们的客户通过护理交付和管理解决方案推动更好的整体健康结果。公司的报告单元与其经营部门保持一致，Evernorth健康服务的商誉在截至2024年3月31日的三个月期间以相对公允价值基础分配。

The Cigna医疗保健 可报告的部门包括美国医疗和国际医疗运营部门，为客户提供全面的医疗和协调解决方案。美国医疗为投保和自保客户提供医疗计划和专项福利解决方案，为老年人提供医保计划、医保补充保险和独立医保处方药计划，以及个人健康保险计划。国际医疗在我们的国际市场提供医疗保健解决方案，为全球移动人员和跨国组织的员工提供医疗保险福利。
在2024年1月，公司签署了一项最终协议，将美国医疗保健经营部门的医疗保险优势、独立医疗处方药计划、医疗保险及其他补充福利和CareAllies业务出售给医疗保健服务公司（"HCSC"），交易金额约为$亿现金，需遵循适用的监管审批和其他习惯性成交条件，包括对剥离业务最终资产负债表的调整（"HCSC交易"）。详细信息请参见综合基本报表的第5号附注。 美国医疗保健 大约$3.3 十亿现金，需遵循适用的监管审批和其他习惯性成交条件，包括对剥离业务最终资产负债表的调整，
其他运营 包括我们业务运营的其余部分，这包括我们持续的业务（企业自有寿险（"COLI"））和我们的结清及其他非战略业务。我们的结清业务包括（i）通过与内布拉斯加州伯克希尔哈撒韦人寿保险公司（"伯克希尔"）的再保险有效退出的 变量年金再保险业务，（ii）结算年金业务，和（iii）通过再保险协议出售的个体人寿保险和年金及 养老 福利业务。
企业 反映了未分配给运营部门的金额，包括净利息费用（定义为企业融资的利息减去不支持部门及其他业务的投资净收益）、某些诉讼事项、与我们冻结的养老金计划相关的费用、慈善捐款、运营解雇、某些间接费用和企业范围的项目成本以及部门间销售的产品和服务的消除。
注释2 - 重要会计政策摘要    
报告基础
合并的基本报表包含信诺集团及其合并子公司的账户。在合并中，内部交易和账户已被消除。这些合并的基本报表是根据美国公认会计原则（“GAAP”）编制的。
在合并基本报表中记录的金额必然反映了管理层对医疗成本、投资、税收和应收账款估值、利率期货和其他因素的估计和假设。重要的估计在整个报告中都有讨论
10

这些注释；然而，实际结果可能会有所不同。估计变更的影响通常包含在调整期间的收益中。

这些中期合并基本报表未经审计，但包括管理层认为在公平呈现报告期的财务状况和经营成果所需的所有调整（包括正常的经常性调整）。中期合并基本报表和附注应与2023年10-K表格（"2023年10-K表格"）中包含的合并基本报表和附注一起阅读。中期合并基本报表的编制在很大程度上依赖于估算。包括医疗保健及相关福利业务的季节性特征以及其他竞争和市场条件，这和其他因素都需要在根据中期经营成果估算全年的结果时保持谨慎。
最近会计宣告
公司的2023年10-K表格包括了对最近重大会计公告的讨论，这些公告已对我们的基本报表产生影响或可能在未来产生影响。自公司提交2023年10-K表格以来，没有关于最近采纳或尚未采纳的重要会计公告的更新。

注3 – 应收账款，净额

应收账款净额中包含以下金额：
（以百万计）2024年9月30日2023年12月31日
药品制造商应收账款$13,708 $8,169 
非保险客户应收账款12,615 8,044 
保险客户应收账款2,732 2,359 
其他应收款323 272 
总计$29,378 $18,844 
应收账款，净额被列为待售企业的资产
(1,532)(1,122)
总计$27,846 $17,722 

这些应收账款在减去我们$的拨备后报告。4.6 截至2024年9月30日为十亿，$3.7 截至2023年12月31日为十亿。这些拨备包括与药品制造商收取的某些折扣应收款项的合同拨备，以及来自第三方付款方的某些应收账款，给予客户的折扣和索赔调整以客户信用的形式，当前预期信贷损失的拨备和其他非信贷调整。

公司对当前预期信用损失的准备金为$88 百万，而截至2023年12月31日为$90 截至2023年12月31日，金额为$百万。

应收账款融资设施
公司维持一个不承诺的保理设施（"设施"），在该设施下，某些应收账款可以在不追索的基础上出售给金融机构。该设施于2023年7月开始，初始期限为 年内。，随后是自动 一年 续期，除非任一方终止该协议。设施在成立时的总容量为$1.0 十亿美元，并在截至2024年6月30日的三个月内修订为$1.5 十亿美元。 有关该设施会计政策的进一步信息可以在公司2023年10-K表格的第3条中找到。
我们在截至2024年9月30日和2023年的三个月分别出售了高达$ 的应收账款。1.3 十月三十日结束的九个月内的零售共支付总额为$1.0 亿美元，以及分别出售了截至2024年9月30日和2023年的九个月的应收账款，金额分别为$。对于截至2024年9月30日和2023年的三个月和九个月，因放款手续费而支付的费用并不重要。4.5 十月三十日结束的九个月内的零售共支付总额为$1.0 从药品制造商处尚未收回的出售应收账款金额为$百万，已从公司的合并资产负债表中除去。2023年12月31日，所有出售的应收账款均已从药品制造商处收回。截至2024年9月30日和2023年12月31日，尚有$ 截至2024年9月30日，未实现的报酬成本分别是$258 的应收账款尚未收回。1.1 十月三十日结束的九个月内的零售共支付总额为$515 自药品制造商处未汇入金融机构的款项分别为x百万美元。这些金额记录在合并资产负债表的应计费用及其他负债中。
11

注意 4 - 供应商融资计划

公司提供一个自愿的供应商融资计划（"计划"），使供应商有机会将其应收账款（即我们对供应商的付款义务）以无追索权方式出售给金融机构，从而比我们的付款条款要求更早收到款项。有关该计划条款的更多信息，可以在公司2023年10-K表格的第4项说明中找到。

截至2024年9月30日和2023年12月31日，分别为$1.6十数亿美元1.5公司的未结支付义务分别已在该计划中得到金融机构确认为有效，并在合并资产负债表中反映。 应付账款 这两个时期确认为有效的金额主要与一家供应商有关。截至2024年9月30日，我们已被金融机构告知公司的未结支付义务中有$534百万已由供应商自愿选择在该计划下出售给金融机构。
注意5 – 待售企业的资产和负债

2024年1月，公司与HCSC达成交易，购价约为10亿美元现金，视适用于监管批准和其他习惯交割条件，包括调整以符合剥离业务的最终资产负债表。预计交易将于2025年第一季度结束。3.3 购价约为10亿美元现金，视适用于监管批准和其他习惯交割条件，包括调整以符合剥离业务的最终资产负债表。预计交易将于2025年第一季度结束。
待售企业的资产和负债如下：
（以百万计）2024年9月30日2023年12月31日
现金及现金等价物$1,249 $467 
投资1,614 1,438 
应收帐款，净额1,532 1,122 
其他资产，包括商誉 (1)
2,479 2,963 
待售业务的总资产6,874 5,990 
保险及合同持有人的负债1,568 1,636 
所有其他负债1,207 1,059 
待售业务的总负债$2,775 $2,695 
(1) 包括商誉 $396截至2024年9月30日和2023年12月31日的 百万。
整合和交易相关成本
在2024年和2023年，公司 incurred 与HCSC交易相关的交易费用。在2023年，公司还 incurred 主要与国际人寿、意外和补充福利业务（“Chubb交易”）的出售相关的净费用。这些在2024年和2023年 incurred 的费用主要包括某些项目用于分离或整合公司的系统、产品和服务，支付的法律、顾问和其他专业服务费用，以及某些与就业相关的费用。这些费用为$77 百万税前（$59 百万税后）截至的三个月为$177 百万税前（$135 百万税后）截至2024年9月30日的九个月为$13 百万税前（$9 百万税后）截至的三个月为$20 百万税前（$15 截至2023年9月30日的九个月内，税后收入为百万。
注6 – 每股收益

基本和稀释后的每股收益计算如下：
截至三个月
2024年9月30日2023年9月30日
(股数以千计，金额以百万美元计算，每股金额除外)基本影响
稀释		摊薄基本影响
稀释		摊薄
股东净利润$739 $739 $1,408 $1,408 
股份：
加权平均278,457 278,457 294,058 294,058 
普通股票等值证券2,939 2,939 3,073 3,073 
总股数278,457 2,939 281,396 294,058 3,073 297,131 
每股收益$2.65 $(0.02)$2.63 $4.79 $(0.05)$4.74 

12

九个月结束
2024年9月30日2023年9月30日
(股数以千计，金额以百万美元计算，每股金额除外)基本影响
稀释		摊薄基本影响
稀释		摊薄
股东净利润
$2,010 $2,010 $4,135 $4,135 
股份：
加权平均282,005 282,005 294,752 294,752 
普通股票等值证券3,037 3,037 2,911 2,911 
总股数282,005 3,037 285,042 294,752 2,911 297,663 
每股收益$7.13 $(0.08)$7.05 $14.03 $(0.14)$13.89 


以下杰出员工的期权未被计算在摊薄每股盈余中，因为它们的影响是防摊薄的：
截至九月三十日的三个月截至九月三十日的九个月。
（以百万计）2024202320242023
反稀释期权0.8 0.9 1.0 0.9 
截至2024年9月30日，公司持有大约 122.5 百万普通股库存， 107.4 截至2023年12月31日， 105.7 截至2023年9月30日，

截至2024年9月30日，国债股票的增加以及截至2024年9月30日的三个月和九个月期间加权平均流通股的减少部分是由于 9.3 我们根据加速回购协议（"ASR协议"）回购的百万股普通股。 S请参见注释8以获取更多信息。
13

注7 - 债务
截至2023年10月，未偿还的债务金额（扣除发行费用、折扣或溢价）和融资租赁额如下：
（以百万计）2024年9月30日2023年12月31日
短期债务
商业本票$1,635 $1,237 
$500 万美元， 0.6132024年3月到期的百分比票据
— 500 
$790部分被减免的租金费用达190万美元， 3.5002024年6月到期的票据 (1)
— 996 
$900部分被减免的租金费用达190万美元， 3.2502025年4月到期的票据 (2)
893 — 
其他，包括融资租赁44 42 
总短期负债$2,572 $2,775 
长期负债
$900部分被减免的租金费用达190万美元， 3.2502025年4月到期的票据 (2)
— 882 
$1,216部分被减免的租金费用达190万美元， 4.1252025年11月到期的债券 (1)
1,215 2,197 
$1,284部分被减免的租金费用达190万美元， 4.5002026年2月到期的债券 (1)
1,285 1,502 
$550 万美元， 1.2502026年3月到期的债券 (1)
549 798 
$700 万美元， 5.6852026年3月到期的债券
698 698 
$1,500部分被减免的租金费用达190万美元， 3.4002027年3月到期的注记
1,462 1,450 
$259部分被减免的租金费用达190万美元， 7.8752027年5月到期的债券
259 259 
$600部分被减免的租金费用达190万美元， 3.0502027年10月到期的注记
598 597 
$3,800部分被减免的租金费用达190万美元， 4.3752028年10月到期的注记
3,789 3,787 
$1,000 万美元， 5.0002029年5月到期的债券
994 — 
$1,400部分被减免的租金费用达190万美元， 2.4002030年3月到期的债券 (1) (2)
1,405 1,493 
$1,500 万美元， 2.3752031年3月到期的债券 (2)
1,411 1,397 
$750 万美元， 5.1252031年5月到期的债券
745 — 
$45部分被减免的租金费用达190万美元， 8.0802033年1月到期的减息票据
45 45 
$800 万美元， 5.4002033年3月到期的票据
795 794 
$1,250 万美元， 5.2502034年2月到期的票据 (2)
1,256 — 
$190部分被减免的租金费用达190万美元， 6.1502036年11月到期的票据
190 190 
$2,200部分被减免的租金费用达190万美元， 4.8002038年8月到期的票据
2,193 2,193 
$750部分被减免的租金费用达190万美元， 3.2002040年3月到期的票据
744 744 
$121部分被减免的租金费用达190万美元， 5.8752041年3月到期的票据
119 119 
$448部分被减免的租金费用达190万美元， 6.1252041年11月到期的票据
486 487 
$317部分被减免的租金费用达190万美元， 5.375% 开空到期日为2042年2月
315 315 
$1,500部分被减免的租金费用达190万美元， 4.800% 开空到期日为2046年7月
1,468 1,467 
$1,000部分被减免的租金费用达190万美元， 3.875% 开空到期日为2047年10月
990 989 
$3,000部分被减免的租金费用达190万美元， 4.900% 开空到期日为2048年12月
2,971 2,970 
$1,250部分被减免的租金费用达190万美元， 3.4002050年3月到期的注记
1,237 1,237 
$1,500 万美元， 3.4002051年3月到期的注记
1,479 1,479 
$1,500 万美元， 5.6002054年2月到期的注记
1,482 — 
其他，包括融资租赁50 66 
总长期负债$30,230 $28,155 
(1)包括在下面讨论的2024年2月债务投标要约中。
(2)公司已签订利率互换合同，对部分固定利率债务工具进行对冲。有关公司利率风险管理及这些衍生工具的更多信息，请参见合并基本报表的第11注解。


开空期和信贷设施债务
循环信贷协议。 我们的循环信贷协议为我们提供了借款的能力，用于一般企业目的，包括根据下文讨论的商业票据计划，在必要时提供流动性支持。截至2024年9月30日， no 这些循环信贷协议下有未偿余额。

14

在2024年4月，信诺替换了之前的循环信用协议，并签署了以下协议（"信用协议"）：
•a $5.0 十亿 五年 一份将于2029年4月到期的循环信贷和信用证协议，具有延长期限的选项， 一年 需经银行同意的周期。公司可以根据信贷协议借贷高达$5.0 十亿美元用于一般企业用途，其中高达$500 百万可用于发行信用证。
•a $1.5 十亿 364天 一项将在2025年4月到期的循环信贷协议。公司可以根据该信贷协议借款高达$1.5 十亿，用于一般企业用途。该协议包括在到期时将任何未偿还的循环贷款转换为到期的定期贷款的选项。 一年 转换的周年纪念日。
每份信贷协议均包括一个选项，可以在两个设施中以总金额增加额度，最高可达$1.5 十亿，总承诺金额最大为$8.0 十亿。信贷协议允许以基准利率或调整后的有担保隔夜融资利率（"SOFR"）加上适用的基差进行借款，每种情况下都基于公司的高级无担保信用评级。

每一位 两 设施在各个银行之间分散 22 大型商业银行，所有银行至少在2024年9月30日之前被至少一家具有国家认可的统计评级机构(NRSRO)评为A-或更高。每家银行还包含一些惯例条款和限制，包括公司杠杆比率不得超过信贷协议中定义的金融条款 60%，在完成收购交易时根据某些特定的例外情况而定。

商业票据。 根据我们的商业票据计划，我们可能随时通过某些经销商以折扣方式私下发行短期无抵押商业票据，总金额不超过$6.5 十亿。我们的商业票据计划规模已从$5.0 十亿美元。6.5 十亿在2024年第三季度增加。计划下可借款、偿还并不时重新借款。发行的净收益已被用于一般企业用途，并有望继续使用。我们商业票据的加权平均利率为 5.33%，截至2024年9月30日。

长期负债
债务发行和债务投标要约。 在2024年2月，我们发行了$4.5 10亿的新高级票据，具体如下表所示。从这笔债务中获得的收益用于支付以下描述的现金投标要约的对价。我们使用剩余的净收益来资助我们于2024年3月到期的高级票据的偿还，以及用于一般公司用途，包括偿还债务和回购我们普通股的股份。对此债务的利息每半年支付一次。

本金到期日年利率净收益
可赎回日期(1)
"补偿"溢价点子超过美国国债利率(2)
$1,000 百万
2029年5月15日5.000%$995 百万2029年4月15日15
$750 百万
2031年5月15日5.125%$746 百万2031年3月15日15
$1,250 百万
2034年2月15日5.250%$1,244 百万2033年11月15日20
$1,500 百万
2054年2月15日5.600%$1,485 百万2053年8月15日20
(1) 在此日期之前可随时赎回，赎回时需支付下文定义的 "完全补偿" 溢价。在此日期或之后可按面值赎回。
(2) "全面补偿"保费是基于最直接可比的美国国债利率加上本栏所列的点子数计算的。
2024年第一季度，公司完成了回购总额达$的现有优先票据。1.8 亿美元的现有优先票据已根据现金要约购买要约被公司赎回。

利息费用
企业融资的利息支出为$380 百万，为截至三个月的时间和$1.1 十亿，为截至2024年9月30日的九个月，比2023年9月30日的$353 百万为截至三个月的时间和$1.0 十亿，为截至2023年9月30日的九个月。
债务契约

截至2024年9月30日，公司遵守了其债务契约。

15

注释 8 – 普通股和优先股

股息

下表提供了公司的股息支付详情：
记录日期付款日期每股金额
支付总额 (以百万为单位)
2024
2024年3月6日2024年3月21日$1.40$401
2024年6月4日6月20日$1.40$392
2024年9月4日在6月30日的六个月内，我们的A级普通股中有109,862股和42,293股分别留存，用于支付根据我们2021年股权激励计划发行给员工的普通股所需缴纳的税款。$1.40$390
2023
2023年3月8日2023年3月23日$1.23$368
2023年6月7日2023年6月22日$1.23$362
2023年9月6日2023年9月21日$1.23$362
在2024年10月23日，董事会宣布将发放第季度现金分红$1.40 每股来自信诺集团的普通股票分红，将于2024年12月19日支付给2024年12月4日的股东。公司目前打算支付定期季度分红，未来的宣布需经董事会批准，并由董事会判断分红的声明是否符合信诺集团及其股东的最佳利益。是否支付未来分红及其金额将基于公司的财务状况、运营结果、现金流、资本需求、适用法律的要求以及董事会认为相关的其他因素。
加速股份回购协议
在2024年2月，作为我们的股票回购计划的一部分，我们与德意志银行和美国银行分别签署了加速股票回购协议（统称为“对方”），以回购$3.2 十亿普通股。根据协议回购的普通股总数约为 9.3 百万股，回购价格为$344.98 每股。每股金额是基于协议有效期内我们普通股的每日成交量加权平均股价计算的，减去折扣。



16

注意事项 9 — 保险和合同持有人负债
A.账户余额 – 保险和合同持有人责任
公司的保险和合同持有人负债包括以下内容：
2024年9月30日2023年12月31日2023年9月30日
（以百万计）当前非当前总计当前非当前总计总计
未支付的索赔和索赔费用
Cigna医疗保健
$5,006 $82 $5,088 $5,017 $75 $5,092 $5,317 
其他运营162 150 312 99 154 253 274 
未来保单利益
Cigna医疗保健
89 510 599 97 518 615 590 
其他运营157 3,301 3,458 163 3,375 3,538 3,380 
合同持有人存入资金
Cigna医疗保健
10 120 130 12 133 145 151 
其他运营364 5,982 6,346 362 6,178 6,540 6,607 
市场风险效益30 914 944 37 966 1,003 934 
未赚保费710 31 741 846 22 868 1,385 
总计6,528 11,090 17,618 6,633 11,421 18,054 
保险和合同持有人负债被归类为待售企业的负债 (1)
(1,051)(517)(1,568)(1,119)(517)(1,636)
保险和合同持有人的总负债$5,477 $10,573 $16,050 $5,514 $10,904 $16,418 $18,638 
(1) 被分类为待售企业负债的金额包括$937百万未付索赔 $422百万未来保单福利 $98百万未赚取保费 $111百万合约持有人存入资金，截至2024年9月30日，还有$823百万 未付索赔 $429百万未来保单福利 $261未赚取的保费为百万，金额为$123截至2023年12月31日，合同持有人存入资金为百万。

预计在一年内支付的保险和合同持有人负债被归类为流动负债。

B.未支付的索赔和索赔费用 - Cigna Healthcare
该负债反映了对已发生但尚未报告的索赔的最终成本的估算，已报告索赔的预期发展，已报告但尚未支付的索赔（正在处理的报告索赔）以及主要包含激励和应付给医疗保健专业人员和设施的其他金额的医疗保健费用和服务。
截至2023年9月30日，发生但未报告的负债总额，加上报告索赔的预期发展和在处理中的报告索赔总额为$4.7 年，而在2023年12月31日为$5.0 亿。
17

Cigna Healthcare部门未偿还索赔负债的活动（扣除公司间交易）如下：
截至九月三十日的九个月。
（以百万计）
2024 (1)
2023
期初余额$5,092 $4,176 
减少：再保险和其他可收回金额236 221 
期初余额，净额4,856 3,955 
与以下相关的发生成本：
当前年度28,314 26,788 
先前年度(422)(237)
已发生损失合计27,892 26,551 
支付与以下相关的费用:
当前年度23,761 22,053 
先前年度4,059 3,362 
总支付27,820 25,415 
期末余额，净额4,928 5,091 
添加：再保险和其他可收回金额160 226 
期末余额$5,088 $5,317 
(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of September 30, 2024 and December 31, 2023, $937 million and $823 million classified as liabilities of businesses held for sale, respectively.
Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance.
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
Nine Months Ended September 30,
20242023
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors and other$212 0.6 %$45 0.2 %
Medical cost trend210 0.6 192 0.6 
Total favorable variance$422 1.2 %$237 0.8 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.

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

C.Future Policy Benefits

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
September 30, 2024September 30, 2023
Interest accretion rate 2.83 %2.85 %
Current discount rate 4.50 %6.03 %
Weighted average duration 9.0 years7.0 years

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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 were as follows:
Nine Months Ended September 30,
(In millions)
2024 (1)
2023
Present value of expected net premiums
Beginning balance$9,233 $8,557 
Reversal of effect of beginning of period discount rate assumptions1,154 1,537 
Effect of assumption changes and actual variances from expected experience (2)
3 314 
Issuances and lapses 1,392 822 
Net premiums collected(1,065)(1,019)
Interest and other (3)
680 58 
Ending balance at original discount rate11,397 10,269 
Effect of end of period discount rate assumptions(865)(1,681)
Ending balance (4)
$10,532 $8,588 
Present value of expected policy benefits
Beginning balance$9,633 $8,945 
Reversal of effect of discount rate assumptions1,220 1,611 
Effect of assumption changes and actual variances from expected experience (2)
203 112 
Issuances and lapses 1,316 902 
Benefit payments(1,096)(1,017)
Interest and other (3)
580 184 
Ending balance at original discount rate11,856 10,737 
Effect of discount rate assumptions(926)(1,765)
Ending balance (5)
$10,930 $8,972 
Liability for future policy benefits $398 $384 
Other (6)
201 206 
Total liability for future policy benefits (1)(7)
$599 $590 
(1)Includes $422 million and $429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of September 30, 2024 and December 31, 2023, respectively.
(2)Includes the effect of actual variances from expectations, which decreased the total liability for future policy benefits by $(43) million and $(12) million, respectively, for the nine months ended September 30, 2024 and September 30, 2023.
(3)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.
(4)As of September 30, 2024 and September 30, 2023, undiscounted expected future gross premiums were $20.7 billion and $18.5 billion, respectively. As of September 30, 2024 and September 30, 2023, discounted expected future gross premiums were $14.4 billion and $12.5 billion, respectively.
(5)As of September 30, 2024 and September 30, 2023, undiscounted expected future policy benefits were $15.6 billion and $13.1 billion, respectively.
(6)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.
(7)$73 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of September 30, 2024 and September 30, 2023, respectively, relate to the liability for future policy benefits. Additionally, $78 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of September 30, 2024.

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
September 30, 2024September 30, 2023
Interest accretion rate 5.64 %5.64 %
Current discount rate 4.81 %5.73 %
Weighted average duration 11.3 years10.9 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;
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therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.

Future policy benefits for Other Operations includes deferred profit liability of $0.4 billion as of both September 30, 2024 and September 30, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of September 30, 2024, $3.0 billion as of September 30, 2023, and $3.2 billion as of both December 31, 2023, and December 31, 2022. The decrease in future policy benefit reserve as of both September 30, 2024 and September 30, 2023 was primarily driven by benefit payments and for the nine months ended September 30, 2023 current discount rate increases were an additional factor contributing to the decrease in future policy benefit reserve. For both periods, the decreases were partially offset by interest accretion. Undiscounted expected future policy benefits were $4.3 billion as of September 30, 2024 and $4.5 billion as of September 30, 2023. As of September 30, 2024 and September 30, 2023, $0.9 billion and $1.0 billion, respectively, of the future policy benefit reserve was recoverable through treaties with external reinsurers.
D.Contractholder Deposit Funds
Contractholder deposit fund liabilities within Other Operations were $6.3 billion as of September 30, 2024, $6.5 billion as of December 31, 2023, $6.6 billion as of September 30, 2023 and $6.7 billion as of December 31, 2022. Approximately 38% 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 September 30, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.33%, $2.9 billion and $2.8 billion, respectively. The comparative amounts as of September 30, 2023 were 3.27%, $3.1 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of September 30, 2024 and the $4.1 billion liability as of September 30, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.1 billion and $1.2 billion, as of September 30, 2024 and September 30, 2023, respectively, represented contracts with policies at the guarantee. As of both September 30, 2024 and September 30, 2023, $1.2 billion was 50-150 basis points ("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. As of both September 30, 2024 and September 30, 2023, 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 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.

Market risk benefits activity was as follows:
Nine Months Ended September 30,
(Dollars in millions)20242023
Balance, beginning of year$1,003 $1,268 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,085 1,379 
Changes due to expected run-off(7)(15)
Changes due to capital markets versus expected(78)(352)
Changes due to policyholder behavior versus expected(26)(1)
Assumption changes37 (16)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)1,011 995 
Nonperformance risk (own credit risk), end of period(67)(61)
Balance, end of period$944 $934 
Reinsured market risk benefit, end of period$1,008 $993 

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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)September 30, 2024September 30, 2023
Net amount at risk$1,361 $1,986 
Average attained age of contractholders (weighted by exposure)77.6 years75.9 years

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 primarily for expected credit losses.

The Company's reinsurance recoverables as of September 30, 2024 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 (1)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (2)
$— $7 $235 $242 
BBB- to BBB+ equivalent current credit ratings (2)
— — 62 62 
Not rated143 11 3 157 
Total recoverables related to ongoing operations143 18 300 461 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York— 2,548 — 2,548 
Empower Annuity Insurance Company— — 123 123 
Prudential Insurance Company of America320 — — 320 
Life Insurance Company of North America— 311 — 311 
Other155 19 14 188 
Not rated— 6 4 10 
Total recoverables related to acquisition, disposition or run-off activities475 2,884 141 3,500 
Total reinsurance recoverables before market risk benefits$618 $2,902 $441 $3,961 
Allowance for uncollectible reinsurance(30)
Market risk benefits1,008 
Total reinsurance recoverables (3)
$4,939 
(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
(2)Certified by an NRSRO.
(3)Includes $188 million of current reinsurance recoverables that are reported in Other current assets and $194 million of reinsurance recoverables classified as assets of businesses held for sale.

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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 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 $3.0 billion remaining at September 30, 2024. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)
September 30, 2024December 31, 2023
Collateral and Other Terms
at September 30, 2024
Berkshire$836 $873 
80% were secured by assets in a trust.
Sun Life Assurance Company of Canada75 92 
Liberty Re (Bermuda) Ltd.87 104 
100% were secured by assets in a trust.
SCOR SE29 31 
65% were secured by a letter of credit.
Market risk benefits (2)
$1,027 $1,100 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes incurred but not reported ("IBNR") and outstanding claims of $19 million as of September 30, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits as of September 30, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

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 and nine months ended September 30, 2024 and September 30, 2023.

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 12 in the Company's 2023 Form 10-K.

The following table summarizes the Company's investments by category and current or long-term classification:
September 30, 2024December 31, 2023
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$596 $9,285 $9,881 $590 $9,265 $9,855 
Equity securities29 488 517 31 3,331 3,362 
Commercial mortgage loans165 1,295 1,460 182 1,351 1,533 
Policy loans— 1,163 1,163 — 1,211 1,211 
Other long-term investments— 4,545 4,545 — 4,181 4,181 
Short-term investments182 — 182 206 — 206 
Total$972 $16,776 $17,748 $1,009 $19,339 $20,348 
Investments classified as assets of businesses held for sale (1)
(108)(1,506)(1,614)(84)(1,354)(1,438)
Investments per Consolidated Balance Sheets$864 $15,270 $16,134 $925 $17,985 $18,910 
(1) Investments related to the HCSC transaction that were held for sale as of September 30, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

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A.Investment Portfolio

Debt Securities

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of September 30, 2024:
(In millions)Amortized
Cost		Fair
Value
Due in one year or less$784 $695 
Due after one year through five years3,897 3,806 
Due after five years through ten years3,117 3,033 
Due after ten years2,097 1,994 
Mortgage and other asset-backed securities378 353 
Total$10,273 $9,881 
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 LossUnrealized
Appreciation		Unrealized
Depreciation		Fair
Value
September 30, 2024
Federal government and agency$273 $— $21 $(5)$289 
State and local government37 — 2 (1)38 
Foreign government373 — 12 (9)376 
Corporate9,212 (104)204 (487)8,825 
Mortgage and other asset-backed378 — 3 (28)353 
Total$10,273 $(104)$242 $(530)$9,881 
December 31, 2023
Federal government and agency$251 $— $24 $(8)$267 
State and local government37 — 2 (1)38 
Foreign government355 — 10 (13)352 
Corporate9,338 (33)158 (630)8,833 
Mortgage and other asset-backed398 — 1 (34)365 
Total$10,379 $(33)$195 $(686)$9,855 


Review of declines in fair value. Management reviews debt securities in an unrealized loss position 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.
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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.
September 30, 2024December 31, 2023
(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$202 $205 $(3)112$330 $338 $(8)142 
Below investment grade91 100 (9)155161 170 (9)135 
More than one year
Investment grade5,076 5,543 (467)1,3825,441 6,036 (595)1,590 
Below investment grade487 538 (51)278701 775 (74)486 
Total$5,856 $6,386 $(530)1,927 $6,633 $7,319 $(686)2,353 

Equity Securities
The following table provides the values of the Company's equity security investments:
September 30, 2024 December 31, 2023
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$657 $49 $656 $51 
Equity securities with no readily determinable fair value3,117 468 3,248 3,311 
Total$3,774 $517 $3,904 $3,362 
We are a minority owner in VillageMD, a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in equity securities with no readily determinable fair value in the above table. We determined our investment in VillageMD was fully impaired and recorded a $2.7 billion loss in Net realized investment losses in the Company's Consolidated Statements of Income.

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. The annual portfolio review performed in the second quarter of 2024 confirmed ongoing strong overall credit quality in line with the previous year's results. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:
(Dollars in millions)September 30, 2024December 31, 2023
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$645 2.15$802 2.13
60% to 79%574 1.85574 1.77
80% to 100%241 0.92157 0.65
Total$1,460 1.8167 %$1,533 1.8264 %

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.
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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 flow estimates 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)September 30, 2024December 31, 2023
Real estate investments$1,760 $1,606 
Securities partnerships2,578 2,400 
Other207 175 
Total$4,545 $4,181 

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 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 September 30, 2024, the notional value of interest rate swap contracts increased to $2.1 billion compared to $1.5 billion as of December 31, 2023. There have been no other material changes to the Company's derivative financial instruments during the nine months ended September 30, 2024. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of September 30, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

C.Realized Investment Gains and Losses

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 September 30,Nine Months Ended September 30,
(In millions)2024202320242023
Net realized investment gains (losses), excluding credit (loss)/recovery and other investment write-downs
$25 $(9)$32 $(29)
Credit (loss)/recovery and other investment write-downs(946)(5)(2,837)(15)
Net realized investment (losses), before income taxes
$(921)$(14)$(2,805)$(44)
Net realized investment losses for the three and nine months ended September 30, 2024 were primarily driven by the impairment of equity securities, as described above.
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
25

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 13 in the Company's 2023 Form 10-K.

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
September 30,
2024		December 31, 2023September 30,
2024		December 31, 2023September 30,
2024		December 31, 2023September 30,
2024		December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency$168 $130 $121 $137 $— $— $289 $267 
State and local government— — 38 38 — — 38 38 
Foreign government— — 376 352 — — 376 352 
Corporate
— — 8,448 8,432 377 401 8,825 8,833 
Mortgage and other asset-backed— — 307 319 46 46 353 365 
Total debt securities168 130 9,290 9,278 423 447 9,881 9,855 
Equity securities (1)
1 4 48 47 — — 49 51 
Short-term investments— — 182 206 — — 182 206 
Derivative assets— — 129 131 — 1 129 132 
Financial liabilities at fair value
Derivative liabilities$— $— $5 $4 $— $— $5 $4 
(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 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.

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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 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 ofUnobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)September 30, 2024December 31, 2023Unobservable Input September 30, 2024September 30, 2024December 31, 2023
Debt securities
Corporate$377 $401 Liquidity
60 - 1495 (380)
bps
70 - 1235 (310)
bps
Mortgage and other asset-backed securities46 46 Liquidity
100 - 635 (320)
bps
95 - 640 (310)
bps
Total Level 3 debt securities$423 $447 

An 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.
Three Months Ended September 30,Nine Months Ended
September 30,
(In millions)2024202320242023
Debt and Equity Securities
Beginning balance$397 $454 $447 $447 
Losses included in Shareholders' net income
(10)(1)(71)(1)
Gains (losses) included in Other comprehensive income (loss)
8 (5)3 (5)
Purchases, sales and settlements
Purchases4 6 15 10 
Sales(2)— (2)— 
Settlements(4)(5)(19)(32)
Total purchases, sales and settlements(2)1 (6)(22)
Transfers into / (out of) Level 3
Transfers into Level 332 — 63 71 
Transfers out of Level 3(2)(13)(13)(54)
Total transfers into / (out of) Level 330 (13)50 17 
Ending balance$423 $436 $423 $436 
Total losses included in Shareholders' net income attributable to instruments held at the reporting date
$(9)$(1)$(71)$(1)
Change in unrealized gain or (loss) included in Other comprehensive income (loss) for assets held at the end of the reporting period
$8 $(4)$3 $(9)

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 income (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
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and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2024 and 2023 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. The separate account activity for the nine months ended September 30, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments.

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)September 30, 2024December 31, 2023September 30, 2024December 31, 2023September 30, 2024December 31, 2023September 30, 2024December 31, 2023
Guaranteed separate accounts (See Note 16)
$247 $226 $353 $352 $— $— $600 $578 
Non-guaranteed separate accounts (1)
166 158 6,007 5,797 227 217 6,400 6,172 
Subtotal$413 $384 $6,360 $6,149 $227 $217 7,000 6,750 
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)
651 680 
Total$7,651 $7,430 
(1)Non-guaranteed separate accounts include $4.0 billion as of both September 30, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both September 30, 2024 and December 31, 2023.

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 and nine months ended September 30, 2024 or 2023.

Separate account investments in securities partnerships, real estate, real estate funds 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 ofUnfunded Commitment as of September 30, 2024Redemption Frequency
(if currently eligible)		Redemption Notice
Period
(In millions)September 30, 2024December 31, 2023
Securities partnerships$413 $419 $224 Not applicableNot applicable
Real estate and real estate funds237 258 3 Quarterly
30 - 90 days
Hedge funds1 3 — Up to annually, varying by fund
30 - 90 days
Total$651 $680 $227 
As of September 30, 2024, 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 nine months ended September 30, 2024, we determined our investment in VillageMD was fully impaired and recorded a $2.7 billion loss in Net realized investment losses in the Company's Consolidated Statements of Income. For the nine months ended
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September 30, 2023, impairments recognized requiring the assets and liabilities described above to be measured at fair value were not material. Observable price changes for equity securities with no readily determinable fair value were not material for the nine months ended September 30, 2024 and September 30, 2023.

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 HierarchySeptember 30, 2024December 31, 2023
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,394 $1,460 $1,430 $1,533 
Long-term debt, including current maturities, excluding finance leasesLevel 2$29,854 $31,073 $28,033 $29,585 

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 September 30, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. 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 14 in the Company's 2023 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.

Note 14 – Accumulated Other Comprehensive Income (Loss)
Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation (depreciation) 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.

Shareholders' other comprehensive loss, net of tax, for the three and nine months ended September 30, 2024 and September 30, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method.

Changes in the components of AOCI were as follows:
Three Months Ended
September 30,		Nine Months Ended
September 30,
(In millions)2024202320242023
Securities and Derivatives
Beginning balance$400 $(118)$171 $(332)
Unrealized appreciation (depreciation) on securities and derivatives
319 (257)568 2 
Tax (expense) benefit
(65)57 (133)(9)
Net unrealized appreciation (depreciation) on securities and derivatives
254 (200)435 (7)
Reclassification adjustment for losses included in Shareholders' net income (Net realized investment losses)
12 12 73 38 
Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses)
— (1)— (1)
Reclassification adjustment for tax (benefit) included in Shareholders' net income
(2)(3)(15)(8)
Net losses reclassified from AOCI to Shareholders' net income
10 8 58 29 
Other comprehensive income (loss), net of tax
264 (192)493 22 
Ending balance$664 $(310)$664 $(310)

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Three Months Ended
September 30,		Nine Months Ended
September 30,
(In millions)2024202320242023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance$(1,743)$(704)$(971)$(256)
Current period change in discount rate for certain long-duration liabilities(34)(27)(1,054)(585)
Tax benefit
3 12 265 149 
Net current period change in discount rate for certain long-duration liabilities(31)(15)(789)(436)
Current period change in instrument-specific credit risk for market risk benefits3 (17)(15)(50)
Tax benefit
— 4 4 10 
Net current period change in instrument-specific credit risk for market risk benefits3 (13)(11)(40)
Other comprehensive (loss), net of tax
(28)(28)(800)(476)
Ending balance$(1,771)$(732)$(1,771)$(732)

Three Months Ended
September 30,		Nine Months Ended
September 30,
(In millions)2024202320242023
Translation of foreign currencies
Beginning balance$(180)$(157)$(149)$(154)
Translation of foreign currencies41 (31)13 (36)
Tax (expense) benefit
(2)2 (5)4 
Other comprehensive income (loss), net of tax
39 (29)8 (32)
Ending balance$(141)$(186)$(141)$(186)

Three Months Ended
September 30,		Nine Months Ended
September 30,
(In millions)2024202320242023
Postretirement benefits liability
Beginning balance$(919)$(899)$(915)$(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)9 11 24 35 
Reclassification adjustment for tax (benefit) included in Shareholders' net income
(5)(3)(8)(9)
Net adjustments reclassified from AOCI to Shareholders' net income
4 8 16 26 
Valuation update(1)— (21)(2)
Tax benefit
1 — 5 1 
Net change due to valuation update— — (16)(1)
Other comprehensive income, net of tax
4 8 — 25 
Ending balance$(915)$(891)$(915)$(891)

Three Months Ended
September 30,		Nine Months Ended
September 30,
(In millions)2024202320242023
Total Accumulated other comprehensive loss
Beginning balance$(2,442)$(1,878)$(1,864)$(1,658)
Shareholders' other comprehensive income (loss), net of tax
279 (241)(299)(461)
Ending balance$(2,163)$(2,119)$(2,163)$(2,119)

Note 15 – Income Taxes
Income Tax Expense
The 30.8% and 31.2% effective tax rates for the three and nine months ended September 30, 2024, respectively, were higher than the 21.3% and 19.9% rates for the three and nine months ended September 30, 2023, respectively. These increases were primarily driven by the establishment of a valuation allowance on the tax benefit related to the impairment of equity securities.

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As of September 30, 2024, we had approximately $836 million in deferred tax assets ("DTAs") associated with the impairment of equity securities as well as unrealized investment losses which are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $635 million, established in the nine months ended September 30, 2024, drove the higher effective tax rate and was almost entirely related to the impairment of equity securities discussed in Note 11 to the Consolidated Financial Statements. For the remainder of the DTAs, we have determined that a valuation allowance is not currently required based on the Company's ability to carry back losses and ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any additional valuation allowance.

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 September 30, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $410 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 September 30, 2024. 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 September 30, 2024 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 laws or regulations 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 stated dollar amount or 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 recorded liabilities for these indemnification obligations as of September 30, 2024.
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 nine months ended September 30, 2024.

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 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
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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 accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter 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 this ongoing litigation matter 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, with alleged damages over $100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retained the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retained the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance filed its opening appellate brief on April 24, 2024. Express Scripts filed its answering appellate brief on July 24, 2024. Oral arguments before the Second Circuit were held on October 22, 2024.

Note 17 – Segment Information
See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments.
The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics reflect the underlying results of business operations and facilitate analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income (loss) from operations as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.
The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.
The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

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The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Impairment of dividend receivable
 (Net investment income)		$182 $138 $— $— $182 $138 $— $— 
Integration and transaction-related costs
 (Selling, general and administrative expenses)		77 59 13 9 177 135 20 15 
Loss on sale of businesses87 62 21 19 106 19 21 19 
Deferred tax expenses, net
 (Income taxes, less amount attributable to noncontrolling interests)		— 41 — — — 75 — — 
Charges associated with litigation matters
 (Selling, general and administrative expenses)		— — 201 171 — — 201 171 
Total impact from special items$346 $300 $235 $199 $465 $367 $242 $205 

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Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended September 30, 2024
Revenues from external customers $51,552 $11,919 $137 $1 $63,609 
Intersegment revenues1,045 1,279 18 (2,342)
Net investment (loss) income
(142)142 79 6 85 
Total revenues52,455 13,340 234 (2,335)63,694 
Net realized investment results from certain equity method investments — (177)— — (177)
Special item related to impairment of dividend receivable182 — — — 182 
Adjusted revenues$52,637 $13,163 $234 $(2,335)$63,699 
Income (loss) before income taxes
$631 $1,073 $(10)$(502)$1,192 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(99)— — — (99)
Net realized investment losses (gains) (1)
748 (8)4 — 744 
Amortization of acquired intangible assets414 22 — — 436 
Special items
Impairment of dividend receivable 182 — — — 182 
Integration and transaction-related costs— — — 77 77 
Loss on sale of businesses— 87 — — 87 
Pre-tax adjusted income (loss) from operations$1,876 $1,174 $(6)$(425)$2,619 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended September 30, 2023
Revenues from external customers $37,230 $11,426 $71 $— $48,727 
Intersegment revenues1,303 1,136 — (2,439)
Net investment income
63 176 76 6 321 
Total revenues38,596 12,738 147 (2,433)49,048 
Net realized investment results from certain equity method investments— 30 — — 30 
Adjusted revenues$38,596 $12,768 $147 $(2,433)$49,078 
Income (loss) before income taxes
$1,272 $1,019 $(3)$(448)$1,840 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(44)— — — (44)
Net realized investment losses (1)
1 35 8 — 44 
Amortization of acquired intangible assets443 11 — — 454 
Special items
Integration and transaction-related costs— — — 13 13 
Loss on sale of businesses— — 21 — 21 
Charges associated with litigation matters44 157 — — 201 
Pre-tax adjusted income (loss) from operations$1,716 $1,222 $26 $(435)$2,529 
(1) Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

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(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Nine months ended September 30, 2024
Revenues from external customers$144,689 $35,752 $333 $2 $180,776 
Intersegment revenues3,558 3,606 63 (7,227)
Net investment (loss) income
(18)463 231 20 696 
Total revenues148,229 39,821 627 (7,205)181,472 
Net realized investment results from certain equity method investments
— (238)— — (238)
Special item related to impairment of dividend receivable182 — — — 182 
Adjusted revenues$148,411 $39,583 $627 $(7,205)$181,416 
Income (loss) before income taxes
$1,494 $3,221 $(9)$(1,446)$3,260 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(271)— — — (271)
Net realized investment losses (1)
2,203 359 5 — 2,567 
Amortization of acquired intangible assets1,247 32 — — 1,279 
Special items
Impairment of dividend receivable 182 — — — 182 
Integration and transaction-related costs— — — 177 177 
Loss on sale of businesses— 106 — — 106 
Pre-tax adjusted income (loss) from operations$4,855 $3,718 $(4)$(1,269)$7,300 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Nine months ended September 30, 2023
Revenues from external customers
$108,462 $34,581 $232 $— $143,275 
Intersegment revenues4,343 3,143 — (7,486)
Net investment income
175 454 230 17 876 
Total revenues112,980 38,178 462 (7,469)144,151 
Net realized investment results from certain equity method investments— 22 — — 22 
Adjusted revenues$112,980 $38,200 $462 $(7,469)$144,173 
Income (loss) before income taxes
$3,318 $3,252 $47 $(1,292)$5,325 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(140)(2)— — (142)
Net realized investment losses (1)
— 64 2 — 66 
Amortization of acquired intangible assets1,330 38 — — 1,368 
Special items
Integration and transaction-related costs— — — 20 20 
Loss on sale of businesses— — 21 — 21 
Charges associated with litigation matters44 157 — — 201 
Pre-tax adjusted income (loss) from operations$4,552 $3,509 $70 $(1,272)$6,859 
(1)Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

35

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:
Three Months Ended September 30,Nine Months Ended September 30,
(In millions)2024202320242023
Products (Pharmacy revenues) (ASC 606)
Network revenues$27,353 $16,926 $76,795 $49,080 
Home delivery and specialty revenues18,909 16,324 53,384 48,943 
Other revenues2,990 2,390 8,433 6,506 
Total Evernorth Health Services
49,252 35,640 138,612 104,529 
Total Other Operations
14 — 47 — 
Intercompany eliminations(982)(1,109)(3,238)(3,890)
Total Pharmacy revenues
48,284 34,531 135,421 100,639 
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured4,382 4,144 13,125 12,315 
Medicare Advantage2,110 2,189 6,604 6,605 
Stop loss1,689 1,548 5,022 4,565 
Individual and Family Plans1,001 1,269 3,016 3,770 
Other1,203 927 3,681 3,091 
U.S. Healthcare
10,385 10,077 31,448 30,346 
International Health911 834 2,687 2,440 
Total Cigna Healthcare11,296 10,911 34,135 32,786 
Other122 70 285 225 
Intercompany eliminations18 17 73 51 
Total Premiums
11,436 10,998 34,493 33,062 
Services (Fees) (ASC 606)
Evernorth Health Services
3,314 2,862 9,508 8,199 
Cigna Healthcare
1,671 1,639 4,850 4,847 
Other Operations
15 1 57 3 
Other revenues267 43 509 172 
Intercompany eliminations(1,378)(1,347)(4,062)(3,647)
Total Fees and other revenues
3,889 3,198 10,862 9,574 
Total revenues from external customers$63,609 $48,727 $180,776 $143,275 
(1)Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Information presented for the three and nine months ended September 30, 2023 has been restated to conform to the new operating segment presentation.

Financial and performance guarantees. Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $2.0 billion as of September 30, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 16% of consolidated revenues for the three and nine months ended September 30, 2024. These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 10% and 11% of consolidated revenues for the three and nine months ended September 30, 2024, respectively. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.

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

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 September 30, 2024, compared with December 31, 2023 and our results of operations for the three and nine months ended September 30, 2024, compared with the same periods 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, 2023 ("2023 Form 10-K"). In particular, we encourage you to refer to the "Risk Factors" contained in Part I, Item 1A of our 2023 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 2023 Form 10-K for additional information regarding the Company's significant accounting policies and see Note 2 to the Consolidated Financial Statements in this Form 10-Q for updates to those policies resulting from adopting new accounting guidance, if any. 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 reflect the underlying results of business operations and facilitate analysis of trends in underlying revenue, expenses and profitability. We define adjusted income (loss) from operations as shareholders' net income (or income (loss) 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 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.
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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; 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 incidents; risks related to our use of artificial intelligence and machine learning; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; risks related to an impairment of goodwill, intangible assets and/or investments (including as a result of the failure to realize the expected benefits of strategic transactions, as well as integration or separation difficulties or underperformance of such transactions 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, 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 2023 Form 10-K, Part II, Item 7 – Management's Discussion and Analysis of Financial Condition and Results of Operations in our 2023 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.

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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 Part 1, Item 1. "Business" of our 2023 Form 10-K.

Financial Highlights
See Note 1 to the Consolidated Financial Statements for a description of our segments.

Summarized below are certain key measures of our performance by segment:
Financial highlights by segment
Three Months Ended September 30,Nine Months Ended September 30,
(Dollars in millions, except per share amounts)20242023Change20242023Change
Revenues
Adjusted revenues by segment
Evernorth Health Services$52,637 $38,596 36 %$148,411 $112,980 31 %
Cigna Healthcare13,163 12,768 3 39,583 38,200 4 
Other Operations234 147 59 627 462 36 
Corporate, net of eliminations(2,335)(2,433)(4)(7,205)(7,469)(4)
Adjusted revenues63,699 49,078 30 181,416 144,173 26 
Net realized investment results from certain equity method investments177 (30)N/M238 (22)N/M
Special item related to impairment of dividend receivable(182)— N/M(182)— N/M
Total revenues$63,694 $49,048 30 %$181,472 $144,151 26 %
Shareholders' net income
$739 $1,408 (48)%$2,010 $4,135 (51)%
Adjusted income from operations
$2,112 $2,011 5 %$5,896 $5,449 8 %
Earnings per share (diluted)
Shareholders' net income
$2.63 $4.74 (45)%$7.05 $13.89 (49)%
Adjusted income from operations
$7.51 $6.77 11 %$20.68 $18.31 13 %
Pre-tax adjusted income (loss) from operations by segment
Evernorth Health Services$1,876 $1,716 9 %$4,855 $4,552 7 %
Cigna Healthcare1,174 1,222 (4)3,718 3,509 6 
Other Operations(6)26 N/M(4)70 N/M
Corporate, net of eliminations(425)(435)(2)(1,269)(1,272)— 
Consolidated pre-tax adjusted income from operations
2,619 2,529 4 7,300 6,859 6 
Income attributable to noncontrolling interests
99 44 125 271 142 91 
Net realized investment (losses) (1)
(744)(44)N/M(2,567)(66)N/M
Amortization of acquired intangible assets(436)(454)(4)(1,279)(1,368)(7)
Special items(346)(235)47 (465)(242)92 
Income before income taxes
$1,192 $1,840 (35)%$3,260 $5,325 (39)%
(1)Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.

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 September 30,Nine Months Ended September 30,
(Dollars in millions)20242023Change20242023Change
Pharmacy revenues$48,284 $34,531 40 %$135,421 $100,639 35 %
Premiums11,436 10,998 4 34,493 33,062 4 
Fees and other revenues3,889 3,198 22 10,862 9,574 13 
Net investment income85 321 (74)696 876 (21)
Total revenues63,694 49,048 30 181,472 144,151 26 
Pharmacy and other service costs47,565 33,639 41 133,488 98,540 35 
Medical costs and other benefit expenses9,527 8,927 7 28,482 27,007 5 
Selling, general and administrative expenses3,590 3,788 (5)10,979 10,760 2 
Amortization of acquired intangible assets436 454 (4)1,279 1,368 (7)
Total benefits and expenses61,118 46,808 31 174,228 137,675 27 
Income from operations
2,576 2,240 15 7,244 6,476 12 
Interest expense and other(376)(365)3 (1,073)(1,086)(1)
Loss on sale of businesses
(87)(21)N/M(106)(21)N/M
Net realized investment losses
(921)(14)N/M(2,805)(44)N/M
Income before income taxes
1,192 1,840 (35)3,260 5,325 (39)
Total income taxes367 391 (6)1,018 1,060 (4)
Net income
825 1,449 (43)2,242 4,265 (47)
Less: Net income attributable to noncontrolling interests
86 41 110 232 130 78 
Shareholders' net income
$739 $1,408 (48)%$2,010 $4,135 (51)%
Consolidated effective tax rate30.8 %21.3 %950 bps31.2 %19.9 %1,130 bps
Medical customers (in thousands)19,048 19,607 (3)%

Reconciliation of Shareholders' Net Income (GAAP) to Adjusted Income from Operations
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Shareholders' net income
$739 $1,408 $2,010 $4,135 
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (1)
$744 740 $44 41 $2,567 2,547 $66 56 
Amortization of acquired intangible assets436 333 454 363 1,279 972 1,368 1,053 
Special items
Impairment of dividend receivable
182 138 — — 182 138 — — 
Integration and transaction-related costs
77 59 13 9 177 135 20 15 
Loss on sale of businesses
87 62 21 19 106 19 21 19 
Deferred tax expenses, net (2)
— 41 — — — 75 — — 
Charges associated with litigation matters
— — 201 171 — — 201 171 
Total special items$346 300 $235 199 $465 367 $242 205 
Adjusted income from operations
$2,112 $2,011 $5,896 $5,449 
(1)Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.
(2)Represents amortization of a foreign tax attribute. See Note 23 to the Consolidated Financial Statements in our 2023 Form 10-K for additional details.
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Reconciliation of Shareholders' Net Income (GAAP) to Adjusted Income from Operations
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
(Diluted Earnings Per Share)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Shareholders' net income
$2.63 $4.74 $7.05 $13.89 
Adjustments to reconcile to adjusted income from operations
Net realized investment losses (1)
$2.64 2.63 $0.15 0.14 $9.00 8.93 $0.22 0.19 
Amortization of acquired intangible assets1.55 1.18 1.53 1.22 4.49 3.41 4.60 3.54 
Special items
Impairment of dividend receivable
0.65 0.49 — — 0.64 0.48 — — 
Integration and transaction-related costs
0.27 0.21 0.04 0.03 0.62 0.48 0.07 0.05 
Loss on sale of businesses
0.31 0.22 0.07 0.06 0.37 0.07 0.07 0.06 
Deferred tax expenses, net (2)
— 0.15 — — — 0.26 — — 
Charges associated with litigation matters
— — 0.68 0.58 — — 0.67 0.58 
Total special items$1.23 1.07 $0.79 0.67 $1.63 1.29 $0.81 0.69 
Adjusted income from operations
$7.51 $6.77 $20.68 $18.31 
(1)Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income.
(2)Represents amortization of a foreign tax attribute. See Note 23 to the Consolidated Financial Statements in our 2023 Form 10-K for additional details.


Commentary: Three and Nine Months Ended September 30, 2024 versus Three and Nine Months Ended September 30, 2023
The commentary presented below, and the segment discussions that follow, compare results for the three and nine months ended September 30, 2024 with results for the three and nine months ended September 30, 2023. Unless specified otherwise, commentary applies to both the three and nine month periods. In addition to the below, see the "Segment Reporting" section of this MD&A for further commentary.

Shareholders' net income decreased 48% and 51%, as higher earnings in Evernorth Health Services in both periods, as well as higher earnings in Cigna Healthcare for the nine months ended were more than offset by the impairment of VillageMD equity securities. See Note 11 to the Consolidated Financial Statements for further discussion of the impairment of VillageMD equity securities.
Adjusted income from operations increased 5% and 8%, reflecting higher earnings in Evernorth Health Services in both periods, as well as higher earnings in Cigna Healthcare for the nine months ended.
Medical customers decreased 3%, primarily reflecting a decrease in Individual and Family Plans customers.
Pharmacy revenues increased 40% and 35%, primarily reflecting higher utilization of prescription drugs from customer growth in Evernorth Health Services.
Premiums increased 4% in both periods, primarily reflecting higher premiums in our U.S. Healthcare operating segment to cover expected increases in underlying medical costs.
Fees and other revenues increased 22% and 13%, primarily reflecting growth in affordability services within our Pharmacy Benefit Services operating segment.
Net investment income decreased 74% and 21%, primarily due to establishing a $182 million impairment of dividend receivable in the third quarter of 2024 related to VillageMD accrued dividends.
Pharmacy and other service costs increased 41% and 35%, primarily reflecting higher utilization of prescription drugs from customer growth in Evernorth Health Services.
Medical costs and other benefit expenses increased 7% and 5%, primarily reflecting higher medical costs in our U.S. Healthcare operating segment.
Selling, general and administrative expenses decreased 5% for the three months ended September 30, 2024, primarily driven by the absence of litigation settlements that occurred during the three months ended September 30, 2023 and increased 2% for the nine
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months ended September 30, 2024, primarily driven by strategic investments to support both business growth and continued advancement of our digital capabilities and solutions.
Realized investment results for the three months and nine months ended September 30, 2024 primarily reflect the impairment of VillageMD equity securities. See Note 11 to the Consolidated Financial Statements for further discussion of the impairment of VillageMD equity securities.
The effective tax rate increased for the three and nine months ended September 30, 2024, primarily driven by a valuation allowance related to the impairment of VillageMD equity securities.

Developments

Sale of Medicare Advantage and Related Businesses
In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC"), subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025 and provide approximately $3.7 billion in transaction value, which consists primarily of the purchase price cash subject to adjustments to align with the final balance sheet of the divested businesses. See Note 5 to the Consolidated Financial Statements for further information.
Medicare Star Quality Ratings ("Star Ratings")
The Centers for Medicare and Medicaid Services ("CMS") uses a Star Rating system to measure how well Medicare Advantage ("MA") plans perform. Categories of measurement include quality of care and customer service. Star Ratings range from one to five stars. CMS recognizes plans with Star Ratings of four stars or greater with quality bonus payments and the ability to offer enhanced benefits. On October 10, 2024, CMS announced Medicare Star Ratings for bonus payments to be received in 2026. We estimate 69% of our MA customers to be in four star or greater plans for bonus payments to be received in 2025 and 2026. See Part I, Item I. "Business - Regulation" section of our 2023 Form 10-K for further discussion of Star Ratings.

Medicare Advantage Rates

On April 1, 2024, CMS released the final Calendar Year 2025 Medicare Advantage Program and Part D Payment Policies (the "2025 Final Notice"). The Final Notice reflects no change from the January 31, 2024 advance notice. We do not expect the final rates to have a material impact on our consolidated results of operations in 2025.

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.
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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 22 to the Consolidated Financial Statements in our 2023 Form 10-K for additional information regarding these 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 nine months ended September 30 were as follows:
Nine Months Ended September 30,
(In millions)20242023
Operating activities$5,151 $10,346 
Investing activities$(1,911)$(4,734)
Financing activities$(4,399)$(3,044)

The following discussion explains variances in the various categories of cash flows for the nine months ended September 30, 2024 compared with the same period in 2023.

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 decreased for the nine months ended September 30, 2024 due to higher accounts receivable as a result of timing and organic business growth, higher insurance claims and related payments, as well as the absence of an early CMS payment received in September 2023. This decrease is partially offset by the favorable net cash flow impacts of new clients in Evernorth Health Services.
Investing activities
The decrease in cash used in investing activities during the nine months ended September 30, 2024 was due to lower purchases of equity securities.
Financing activities
The Company had higher share repurchases, including the completed ASR Agreements (described below), partially offset by net cash provided by debt financing activities in 2024.
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 flows from operations, some of which is subject to regulatory restrictions relative to the amount and timing of dividend payments to the parent company. Dividends received from U.S. regulated subsidiaries were $1.7 billion for the nine months ended September 30, 2024 and $0.8 billion for the nine months ended
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September 30, 2023. Non-regulated subsidiaries also generate significant cash flows 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.
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 $6.5 billion. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The commercial paper program had approximately $1.6 billion outstanding at September 30, 2024.
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 September 30, 2024, The Cigna Group's revolving credit agreements include: a $5.0 billion five-year revolving credit and letter of credit agreement that expires in April 2029; and a $1.5 billion 364-day revolving credit agreement that expires in April 2025.
As of September 30, 2024, we had $6.5 billion of undrawn committed capacity under our revolving credit agreements (these amounts are available for general corporate purposes, including providing liquidity support for our commercial paper program), $4.9 billion of remaining capacity under our commercial paper program and $6.0 billion in cash and short-term investments, approximately $0.5 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 43.8% at September 30, 2024 and 43.6% at June 30, 2024.
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 $1.4 billion from its subsidiaries without further approvals as of September 30, 2024.
Use of Capital Resources
Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes. The proceeds from this debt were used to complete the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes tendered to the Company pursuant to cash tender offers. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, which includes repayment of indebtedness and repurchases of shares of our common stock.

Capital Expenditures. Capital expenditures for property, equipment and computer software were $1.1 billion in the nine months ended September 30, 2024 compared to $1.2 billion in the nine months ended September 30, 2023. Anticipated capital expenditures will be funded primarily from operating cash flows.
Dividends. The Cigna Group declared and paid quarterly cash dividends of $1.40 per share of its common stock during the first nine months of 2024, compared to quarterly cash dividends of $1.23 per share during the first nine months of 2023. See Note 8 to the Consolidated Financial Statements for further information on our dividend payments. On October 23, 2024, the Board of Directors declared the fourth quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on December 19, 2024 to shareholders of record on December 4, 2024. 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.
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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.
In February 2024, as part of our share repurchase program, we entered into separate Accelerated Share Repurchase ("ASR") agreements to repurchase $3.2 billion of common stock in aggregate. The total number of shares of our common stock repurchased under the agreements was approximately 9.3 million. See Note 8 to the Consolidated Financial Statements for further information on our ASR agreements.
Including the ASR agreements, we repurchased 14.7 million shares for approximately $5.0 billion during the nine months ended September 30, 2024, compared to 6.1 million shares for approximately $1.8 billion during the nine months ended September 30, 2023. From October 1, 2024 through October 30, 2024, we repurchased 2.2 million shares for approximately $715 million. Share repurchase authority was $5.6 billion as of October 30, 2024.
Other Sources of Funds and Uses of Capital Resources

Divestiture. In January 2024, we entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to HCSC, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025 and provide approximately $3.7 billion in transaction value, which consists primarily of the purchase price cash subject to adjustments to align with the final balance sheet of the divested businesses. Following the completion of the sale, we anticipate use of the proceeds in alignment with our capital deployment priorities, with the majority allocated to share repurchases.

Risks to Liquidity and Capital Resources

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 2023 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.

Due to the issuance and repurchase of certain senior notes in the three months ended March 31, 2024, we have updated long-term debt obligations as of September 30, 2024 compared to those previously provided in our 2023 Form 10-K. See Note 7 to the Consolidated Financial Statements for discussion of these debt activities. There have been no material changes to other information presented in our guarantees and contractual obligations set forth in our 2023 Form 10-K.
On balance sheet:
•Long-term debt
◦Total scheduled payments on long-term debt are $48.8 billion through February 2054, which include scheduled interest payments and maturities of long-term debt.
◦We expect $0.3 billion of long-term debt payments (including scheduled interest payments) to be paid for the remainder of 2024.

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
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•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 2023 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 2023 Form 10-K. As of September 30, 2024, there were no significant changes to the critical accounting estimates from what was reported in our 2023 Form 10-K.
Goodwill and Other intangible assets
Our annual evaluations of goodwill and other intangible assets for impairments were completed during the third quarter of 2024. These evaluations were performed at the reporting unit level, based on discounted cash flow analyses or market data. The estimated fair value of each of our reporting units exceeded their carrying values by substantial margins.

Management believes the current assumptions used to estimate amounts reflected in our Consolidated Financial Statements are appropriate. However, if actual experience significantly differs from the assumptions used in estimating amounts reflected in our Consolidated Financial Statements, the resulting changes could have a material adverse effect on our consolidated results of operations and in certain situations, could have a material adverse effect on liquidity and our financial condition.

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 Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics reflect the underlying results of business operations and facilitate analysis of trends in underlying revenue, expenses and profitability. 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. 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 (loss) before income taxes to pre-tax adjusted income (loss) 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, within our Pharmacy Benefit Services and Specialty and Care Services operating segments. See Note 1 to the Consolidated Financial Statements for further discussion of these two operating segments. 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.

Key Factors Affecting Segment Performance

The key factors that impact Evernorth Health Services' Pharmacy Benefit Services and Specialty and Care Services revenues and income from operations are volume, mix of claims, price and contract affordability services. Specialty and Care Services revenue is also impacted by specialty distribution customer growth and client growth. These key factors are discussed further below. Certain of the key factors impact both operating segments as services are offered through an integrated client contract. See Note 2 to the
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Consolidated Financial Statements included in our 2023 Form 10-K for additional information on revenue and cost recognition policies for this segment.

Key Factors that impact both Pharmacy Benefit Services and Specialty and Care Services:
•Pharmacy claim volume (also referred to as utilization) relates to processing prescription claims filled by retail pharmacies in our network and from dispensing prescription claims from our home delivery and specialty pharmacies and other claims. As pharmacy prescription claim volumes increase or decrease due to customer utilization, organic customer growth through the expansion of existing clients or new clients, our gross profit and income from operations correspondingly increase or decrease.
•The mix of claims generally considers the type of drug and distribution method used for dispensing and fulfilling. In addition to the types of drugs, the mix of generic or biosimilar claims also impacts our results. Generally, a higher mix of generic and biosimilar drugs reduces revenues, as generic and biosimilar drugs are typically priced lower than the branded drugs they replace. However, as ingredient cost paid to pharmacies on generic and biosimilar drugs is incrementally lower than the price charged to our clients, a higher mix of generic and biosimilar drugs generally has a favorable impact on our gross profit and income from operations.
•Pharmaceutical manufacturer 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.
•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 (also referred to as affordability improvements). Through these affordability services, we seek to improve the effectiveness of our integrated and fee-for-service solutions, for the benefit of our new and existing clients, by continuously innovating, improving affordability and implementing drug purchasing contract initiatives. Our continued affordability improvements further reduce drug costs for the benefit of our consumers and clients and we share in the value delivered, which generally results in a favorable impact on our gross profit and income from operations.

Key factors that impact Specialty and Care Services:
•Customer growth generally results in increased revenues and income from operations. This generally includes both organic customer growth through the expansion of existing business and new business, as well as higher volume in our specialty distribution services where we deliver pharmaceuticals and medical supplies directly to health care providers, clinics and hospitals, primarily to physicians who regularly order costly specialty pharmaceuticals. This business provides competitive pricing on pharmaceuticals and medical supplies and leverages our distribution platform to improve our results.
•Client growth, both organic and new business, in our Care Delivery and Management Solutions business generally results in increased revenues and income from operations. This includes client movement in our virtual care, in-home care, physical primary care, benefits management, and behavioral health services, as we expand our businesses and build upon our cross-enterprise leverage.

In this MD&A, we present our segment performance measures adjusted revenues and pre-tax adjusted income from operations. We also present adjusted gross profit, which is calculated as adjusted revenues less Pharmacy and other service costs (which is inclusive of all costs of revenue). We utilize adjusted revenues in this calculation, consistent with our reporting measure that excludes special items, as this reflects the underlying results of business operations.

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Results of Operations
Financial Summary
Three Months Ended
September 30,		Nine Months Ended
September 30,
(Dollars in millions)20242023Change20242023Change
Total revenues$52,455 $38,596 36%$148,229 $112,980 31 %
Adjusted revenues (1)
$52,637 $38,596 36%$148,411 $112,980 31 %
Pharmacy and other service costs$49,768 $36,000 38%$140,458 $105,819 33 %
Gross profit (2)
$2,687 $2,596 4%$7,771 $7,161 9 %
Adjusted gross profit (1),(2)
$2,869 $2,596 11%$7,953 $7,161 11 %
Pre-tax adjusted income from operations$1,876 $1,716 9%$4,855 $4,552 7 %
Pre-tax adjusted margin (3)
3.6 %4.4 %(80)bps3.3 %4.0 %(70)bps
SG&A expense ratio (4)
1.7 %2.3 %(60)bps1.9 %2.2 %(30)bps
Adjusted SG&A expense ratio (4)
1.7 %2.2 %(50)bps1.9 %2.2 %(30)bps
(1)Adjusted revenues and adjusted gross profit each exclude $182 million of the Special item related to impairment of dividend receivable for each of the three and nine months ended September 30, 2024. There were no special items in the comparable prior periods.
(2)Gross profit and adjusted gross profit are calculated as total revenues and adjusted revenues, respectively, less pharmacy and other service costs.
(3)Pre-tax adjusted margin is calculated as pre-tax adjusted income from operations divided by adjusted revenues. See Note 17 to the Consolidated Financial Statements for reconciliation of pre-tax adjusted income from operations and adjusted revenues to Income before income taxes and Total revenues, respectively.
(4)SG&A expense ratio is calculated as selling, general and administrative expenses including special items ($894 million and $881 million for the three months ended September 30, 2024 and 2023, respectively, and $2,825 million and $2,512 million, for the nine months ended September 30, 2024 and 2023, respectively) divided by total revenues. Adjusted SG&A expense ratio is calculated as selling, general and administrative expenses excluding special items ($894 million and $837 million for the three months ended September 30, 2024 and 2023, respectively, and $2,825 million and $2,468 million for the nine months ended September 30, 2024 and 2023, respectively) as a percentage of adjusted revenues. There were no special items for the three and nine months ended September 30, 2024; special items were $44 million for the three and nine months ended September 30, 2023.

In this selected financial information, we present adjusted revenues and pre-tax income from operations by our two operating segments, Pharmacy Benefit Services and Specialty and Care Services.
Selected Financial Information
Three Months Ended
September 30,		ChangeNine Months Ended
September 30,		Change
(Dollars and adjusted scripts in millions)2024202320242023
Total adjusted revenues
Pharmacy Benefit Services$28,785 $19,158 50 %$81,492 $56,186 45 %
Specialty and Care Services23,812 19,375 23 66,755 56,619 18 
Net investment income (1)
40 63 (37)164 175 (6)
Total adjusted revenues$52,637 $38,596 36 %$148,411 $112,980 31 %
Pre-tax adjusted income from operations
Pharmacy Benefit Services$1,011 $981 3 %$2,322 $2,270 2 %
Specialty and Care Services825 672 23 2,369 2,107 12 
Net investment income (1)
40 63 (37)164 175 (6)
Total pre-tax adjusted income from operations$1,876 $1,716 9 %$4,855 $4,552 7 %
Pharmacy claim volume (2)
531 394 35 %1,577 1,171 35 %
(1)Net investment income excludes the Special item related to impairment of dividend receivable for certain accrued dividends of $182 million for each of the three and nine months ended September 30, 2024.
(2) Non-specialty network prescriptions filled through 90-day programs and home delivery prescriptions are counted as three claims. All other network and specialty prescriptions are counted as one claim.

Three and Nine Months Ended September 30, 2024 versus Three and Nine Months Ended September 30, 2023

Commentary in parentheses regarding percentage changes represents the driver's impact on the overall category.

Adjusted revenues increased 36% and 31%, primarily reflecting higher utilization of prescription drugs from customer growth in both Pharmacy Benefit Services and Specialty and Care Services.

Adjusted gross profit increased 11% for both periods, primarily reflecting relatively equal contributions from customer growth in Specialty and Care Services and continued affordability improvements in Pharmacy Benefit Services.

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Pre-tax adjusted income from operations increased 9% and 7%, primarily reflecting customer growth in Specialty and Care Services (+11% and +10%) and continued affordability improvements in Pharmacy Benefit Services (+3% in both periods). This increase was partially offset by strategic investments to support business growth and continued advancement of our capabilities and solutions (-2% and -4% in Specialty and Care Services and -2% in both periods in Pharmacy Benefit Services).

The adjusted SG&A expense ratio decreased 50 bps and 30 bps, primarily reflecting higher adjusted revenues as discussed above.

Cigna Healthcare Segment
Cigna Healthcare includes the U.S. Healthcare 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.
In January 2024, we entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to HCSC, subject to applicable regulatory approvals and other customary closing conditions. See Note 5 to the Consolidated Financial Statements for further information.
Key Factors Affecting Segment Performance

Key factors affecting results for this segment include:
•customer growth;
•revenue growth, including increases to premium rates in consideration of anticipated medical costs (also referred to as premium rate increases);
•medical cost trend (also referred to as higher medical costs), which is impacted by utilization (the quantity of medical services consumed by our customers), unit costs (the cost per medical service) and mix of services;
•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, which includes affordability initiatives that serve to mitigate medical cost inflation; and
•selling, general and administrative expenses excluding special items as a percentage of adjusted revenues (which we refer to as adjusted SG&A expense ratio).
Results of Operations
Financial Summary
Three Months Ended
September 30,		ChangeNine Months Ended
September 30,		Change
(Dollars in millions)2024202320242023
Adjusted revenues$13,163 $12,768 3 %$39,583 $38,200 4 %
Pre-tax adjusted income from operations$1,174 $1,222 (4)%$3,718 $3,509 6 %
Pre-tax adjusted margin (1)(2)
8.9 %9.6 %(70)bps9.4 %9.2 %20 bps
Medical care ratio82.8 %80.5 %230 bps81.7 %81.0 %70 bps
SG&A expense ratio (2)(3)
19.8 %22.9 %(310)bps20.1 %21.7 %(160)bps
Adjusted SG&A expense ratio (2)(3)
20.0 %21.6 %(160)bps20.2 %21.3 %(110)bps
(1)Pre-tax adjusted margin is calculated as pre-tax adjusted income from operations divided by adjusted revenues.
(2)See Note 17 to the Consolidated Financial Statements for reconciliation of pre-tax adjusted income from operations and adjusted revenues to Income before income taxes and Total revenues, respectively.
(3)SG&A expense ratio is calculated as selling, general and administrative expenses including special items ($2,637 million and $2,920 million for the three months ended September 30, 2024 and 2023, respectively, and $7,986 million and $8,298 million for the nine months ended September 30, 2024 and 2023, respectively) divided by Total revenues. Adjusted SG&A expense ratio is calculated as selling, general and administrative expenses excluding special items ($2,637 million and $2,763 million for the three months ended September 30, 2024 and 2023, respectively, and $7,986 million and $8,141 million for the nine months ended September 30, 2024 and 2023, respectively) as a percentage of adjusted revenues. There were no special items for the three and nine months ended September 30, 2024; special items were $157 million for the three and nine months ended September 30, 2023.
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Three and Nine Months Ended September 30, 2024 versus Three and Nine Months Ended September 30, 2023
Commentary regarding percentage changes (or bps) and dollar variances represents the driver's impact on overall category.
Adjusted revenues increased 3% and 4%, primarily due to higher premiums within employer insured (+$238 million and +$810 million), Medicare Part D (+$202 million and +$410 million) and stop loss (+$141 million and +$457 million), in each case reflecting premium rate increases to cover expected increases in underlying medical costs, partially offset by lower premiums within Individual and Family Plans (-$268 million and -$754 million), reflecting a decrease in customers.
Pre-tax adjusted income from operations decreased 4% for the three months ended September 30, 2024, primarily due to higher medical costs (-$569 million), partially offset by higher adjusted revenues (+$395 million) and lower selling, general and administrative expenses excluding special items (+$126 million), primarily reflecting ongoing efficiencies. Pre-tax adjusted income from operations increased 6% for the nine months ended September 30, 2024, primarily due to higher adjusted revenues (+$1.4 billion) and lower selling, general and administrative expenses excluding special items (+$155 million), primarily reflecting ongoing efficiencies, partially offset by higher medical costs (-$1.3 billion). The impact of higher premiums in adjusted revenues and medical costs are reflected in the medical care ratio calculation.
The medical care ratio increased 230 bps for the three months ended September 30, 2024, primarily due to a higher U.S. Healthcare medical care ratio, reflecting relatively equal contributions from business mix and one additional business day in the third quarter of 2024. The medical care ratio increased 70 bps for the nine months ended September 30, 2024, primarily due to a higher U.S. Healthcare medical care ratio driven by business mix.
The adjusted SG&A expense ratio decreased 160 bps and 110 bps, primarily due to revenue growth outpacing volume-related expenses (-80 bps and -60 bps) and ongoing efficiencies (-60 bps and -30 bps).

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 administrative services 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 September 30,
(In thousands)20242023Change
U.S. Healthcare
3,833 4,189 (8)
International Health (1)
1,209 1,198 1 
Insured5,042 5,387 (6)%
U.S. Healthcare
13,573 13,790 (2)
International Health (1)
433 430 1 
Administrative services only14,006 14,220 (2)
Total19,048 19,607 (3)%
(1)International Health excludes medical customers served by less than 100% owned subsidiaries, as well as certain customers served by our third-party administrator.
Total medical customers decreased 3%, primarily due to a decrease in Individual and Family Plans customers.

See Part I, Item 1 of our 2023 Form 10-K for definitions of Cigna Healthcare's market segments. 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. Medical Customer information presented as of September 30, 2023 has been restated to conform to the new operating segment presentation.

Unpaid Claims and Claim Expenses
As of
September 30,		As of
December 31,
(In millions)20242023Change
Unpaid claims and claim expenses$5,088 $5,092 — %
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Our unpaid claims and claim expenses liability was flat, driven by a decrease in Individual and Family Plans customers (-$290 million), mostly offset by stop loss seasonality (+$175 million) and Medicare Advantage (+$80 million).

Other Operations
Other Operations includes corporate owned life insurance ("COLI"), the Company's run-off operations and other non-strategic businesses. See Note 1 to the Consolidated Financial Statements for additional information regarding these operations. As described in the introduction of Segment Reporting, performance of Other Operations is measured using adjusted revenues and pre-tax adjusted income from operations.
Results of Operations
Financial Summary
Three Months Ended September 30,ChangeNine Months Ended
September 30,		Change
(Dollars in millions)2024202320242023
Adjusted revenues$234 $147 59 %$627 $462 36 %
Pre-tax adjusted (loss) income from operations
$(6)$26 N/M%$(4)$70 N/M%
Pre-tax adjusted margin(2.6)%17.7 %(2,030)bps(0.6)%15.2 %(1,580)bps
Three and Nine Months Ended September 30, 2024 versus Three and Nine Months Ended September 30, 2023
Adjusted revenues for both periods primarily reflect premiums and net investment income associated with COLI, our run-off operations and other non-strategic businesses.
Pre-tax adjusted (loss) income from operations decreased for both periods primarily driven by unfavorable margins in our non-strategic businesses.
Corporate
Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate financing 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 eliminations for products and services sold between segments.

Financial Summary
Three Months Ended September 30,ChangeNine Months Ended
September 30,		Change
(In millions)2024202320242023
Pre-tax adjusted loss from operations
$(425)$(435)(2)%$(1,269)$(1,272)— %

Three and Nine Months Ended September 30, 2024 versus Three and Nine Months Ended September 30, 2023
Commentary regarding bps represents the driver's impact on overall category.

Pre-tax adjusted loss from operations decreased for both periods primarily due to lower operating and pension costs (-800 bps for both periods), partially offset by higher interest rates on our indebtedness (+600 bps for both periods).

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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)September 30,
2024		December 31,
2023
Debt securities$9,881 $9,855 
Equity securities517 3,362 
Commercial mortgage loans1,460 1,533 
Policy loans1,163 1,211 
Other long-term investments4,545 4,181 
Short-term investments182 206 
Total$17,748 $20,348 
Investments classified as assets of businesses held for sale (1)
(1,614)(1,438)
Investments per Consolidated Balance Sheets$16,134 $18,910 
(1) Investments related to the HCSC transaction that were held for sale as of September 30, 2024 and December 31, 2023. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

Investment Outlook
Although impacts to our core insurance and operating business portfolios have been limited to date, we continue to actively monitor geopolitical events and economic conditions and their potential impact on the investment portfolio, including expectations for inflation and interest rates, the potential for a recession, and ongoing conflict in Europe and the Middle East. 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. 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 unfavorable effect on our financial condition or liquidity. The following discussion addresses the strategies and risks associated with our various classes of investment assets.

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)September 30,
2024		December 31,
2023
Federal government and agency$289 $267 
State and local government38 38 
Foreign government376 352 
Corporate
8,825 8,833 
Mortgage and other asset-backed353 365 
Total$9,881 $9,855 

The carrying value of our debt securities portfolio slightly increased during the nine months ended September 30, 2024, reflecting a valuation increase due to a decline of market interest rates, offset by net sales activity. Our portfolio remains in a net unrealized depreciation position due to generally increasing interest rates over the past few years. 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 September 30, 2024, $8.6 billion, or 86%, of the debt securities in our investment portfolio were investment grade (Baa and above, or equivalent) and the remaining $1.3 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.
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Debt securities include private placement assets of $3.9 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. Primary risks facing many of the issuers in our portfolio include on-going geopolitical events and economic conditions, including expectations for a longer period of higher inflation and interest rates. To date, most issuers have been successful in managing these issues without a meaningful change in credit quality. 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 September 30, 2024, our $1.5 billion commercial mortgage loan portfolio consisted of approximately 45 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 September 30, 2024. 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 approximately 60% 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 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 2024 confirmed ongoing strong overall credit quality in line with the previous year's results. See Note 11 to the Consolidated Financial Statements for further information regarding our key credit quality indicators for commercial mortgage loans.
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 25% exposure to office properties. Although future losses remain possible due to further credit deterioration, we do not expect these losses to have a material unfavorable effect on our financial condition or liquidity.
Other Long-term Investments
Other long-term investments of $4.5 billion as of September 30, 2024 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. 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 220 separate partnerships and 110 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 3% 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. 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 4% 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. Our 50% share of the investment portfolio supporting the joint venture's liabilities is approximately $15.1
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billion as of September 30, 2024. These investments were comprised of approximately 75% debt securities, including government and corporate debt diversified by issuer, industry and geography; 15% equities, including mutual funds, equity securities and private equity partnerships; and 10% long-term deposits and policy loans. We continuously review the joint venture's investment strategy and its execution. There were no investments with a material unrealized loss as of September 30, 2024.
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 exposures are interest rate risk and equity price risk. We encourage you to read this in conjunction with "Market Risk – Financial Instruments" included in the MD&A section of our 2023 Form 10-K.

As of September 30, 2024, there was an increase in our interest rate risk due to an increase in the fair value of our long-term debt since December 31, 2023. In the event of a 100 basis point increase in interest rates, the fair value of the Company's long-term debt would decrease approximately $2.1 billion at September 30, 2024 compared to approximately $1.8 billion at December 31, 2023.

If the market price for all equity securities declined by 10%, the fair value of the Company's equity securities would decrease by approximately $0.1 billion as of September 30, 2024, compared to approximately $0.3 billion at December 31, 2023. This decline in our equity price risk exposure is driven by the impairment of equity securities. See Note 11 to the Consolidated Financial Statements for more information regarding the impairment in equity securities.
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.
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
The Cigna Group is in the process of a multi-year enterprise resource planning system implementation to increase efficiency and modernize the tools and technology used in certain financial close and reporting processes. During the quarter ended September 30, 2024, certain subsidiaries completed the initial phase of this implementation.
In conjunction with this implementation, during the quarter ended September 30, 2024, certain internal controls over financial reporting have been added or modified to accommodate related changes in the Company's systems and business processes. There have been no other changes in our internal control over financial reporting during the quarter ended September 30, 2024 that have materially affected, or are reasonably likely to materially affect, The Cigna Group's internal control over financial reporting. As additional phases of the implementation occur, we will continue to monitor and modify, as needed, the design and operating effectiveness of the Company'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, 2023.
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 September 30, 2024:
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)
July 1-31, 20242,879 $267.74 — $6,293 
August 1-31, 20241,719 $276.21 — $6,293 
September 1-30, 20244,202 $285.34 — $6,293 
Total8,800 $277.80 — 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 2,879 shares in July, 1,719 shares in August and 4,202 shares in September 2024.
(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 October 1, 2024 through October 30, 2024, the Company repurchased 2.2 million shares for approximately $715 million, leaving repurchase authority at $5.6 billion as of October 30, 2024.
(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
Rule 10b5-1 Plan Elections
During the quarter ended September 30, 2024, the following 10b5-1 director and officer trading plan arrangement change occurred:
1.On September 12, 2024, Noelle K. Eder, Executive Vice President, Global Chief Information Officer of The Cigna Group, adopted a 10b5-1 plan. Ms. Eder's plan provides for (i) the sale of up to 5,981 shares of The Cigna Group common stock, (ii) the sale of shares of The Cigna Group common stock issuable upon vesting of a performance award (the actual number of shares depends on actual performance achieved and may range from 0% to 200% of the 6,300 shares subject to the award at the target level of performance), and (iii) the exercise of vested stock options and the associated sale of up to 7,026 shares of The Cigna Group common stock, in each case through May 2, 2025.
This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934 and the Company's policies regarding insider transactions.
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Item 6. EXHIBITS
INDEX TO EXHIBITS
NumberDescriptionMethod of Filing
3.1Filed by the registrant as Exhibit 3.1 to the Quarterly Report on Form 10-Q for the period ended June 30, 2023 and incorporated herein by reference.
3.2Filed by the registrant as Exhibit 3.3 to the Current Report on Form 8-K on February 13, 2023 and incorporated herein by reference.
31.1Filed herewith.
31.2Filed herewith.
32.1Furnished herewith.
32.2Furnished herewith.
101
The following materials from The Cigna Group's Quarterly Report on Form 10-Q for the quarter ended September 30, 2024, 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.
104Cover 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: October 31, 2024
THE CIGNA GROUP
/s/ Brian C. Evanko
Brian C. Evanko
Executive Vice President, Chief Financial Officer, The Cigna Group, and President and Chief Executive Officer, Cigna Healthcare
(Principal Financial Officer and Authorized Signatory)

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