What changed in this filing

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Item 1. Financial Statements

2024-05-02 compared with 2023-11-02 · 337 added, 542 removed, 793 unchanged (53% of the section changed)

2 unchanged sentences

Consolidated Statements of Income

Unaudited Unaudited

Three Months Ended September 30, Nine Months Ended September 30,

Three Months Ended March 31,

(In millions, except per share amounts) 2024 2023

2023 2022 (1)

Pharmacy revenues $ 42,036 $ 32,144

11 unchanged sentences

Interest expense and other ( 322 ) ( 358 )

(Loss) gain on sale of businesses ( 21 ) 1,735 ( 21 ) 1,735

Loss on sale of businesses ( 19 ) —

Net realized investment losses

2 unchanged sentences

TOTAL INCOME TAXES 291 295

Net income 1,449 2,778 4,265 5,560

Net (loss) income ( 212 ) 1,306

Net income attributable to noncontrolling interests 65 39

SHAREHOLDERS' NET INCOME $ 1,408 $ 2,757 $ 4,135 $ 5,511

Shareholders' net income per share

SHAREHOLDERS' NET (LOSS) INCOME $ ( 277 ) $ 1,267

Shareholders' net (loss) income per share

Basic $ ( 0.97 ) $ 4.28

Diluted $ ( 0.97 ) $ 4.24

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

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

1 unchanged sentence

Consolidated Statements of Comprehensive Income

Unaudited Unaudited

Three Months Ended September 30, Nine Months Ended September 30,

Three Months Ended March 31,

(In millions) 2024

2023 2022 (1)

Net income $ 1,449 $ 2,778 $ 4,265 $ 5,560

Net (loss) income $ ( 212 ) $ 1,306

Other comprehensive income (loss), net of tax

Net unrealized (depreciation) appreciation on securities and derivatives

( 192 ) ( 150 ) 22 ( 1,663 )

Net unrealized appreciation on securities and derivatives

Net long-duration insurance and contractholder liabilities measurement adjustments ( 560 ) ( 331 )

Net translation (losses) gains on foreign currencies

( 29 ) 175 ( 32 ) ( 95 )

Postretirement benefits liability adjustment 5 10

Other comprehensive (loss) income, net of tax

Other comprehensive loss, net of tax

( 460 ) ( 111 )

Total comprehensive income 1,208 2,794 3,804 4,298

Total comprehensive (loss) income

( 672 ) 1,195

Comprehensive income (loss) attributable to noncontrolling interests

1 unchanged sentence

Net income attributable to other noncontrolling interests 65 5

Other comprehensive loss attributable to redeemable noncontrolling interests — 1 — ( 2 )

Total comprehensive income attributable to noncontrolling interests 65 39

SHAREHOLDERS' COMPREHENSIVE INCOME $ 1,167 $ 2,772 $ 3,674 $ 4,251

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

SHAREHOLDERS' COMPREHENSIVE (LOSS) INCOME

$ ( 737 ) $ 1,156

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

1 unchanged sentence

Consolidated Balance Sheets

September 30, As of

March 31, As of

(In millions) 2024 2023

4 unchanged sentences

Other current assets 2,263 2,169

Assets of businesses held for sale 6,354 3,068

Total current assets 43,357 37,351

6 unchanged sentences

Separate account assets 7,416 7,430

Assets of businesses held for sale, non-current — 2,922

TOTAL ASSETS $ 153,119 $ 152,761

4 unchanged sentences

Short-term debt 1,715 2,775

Liabilities of businesses held for sale 3,215 2,104

Total current liabilities 51,977 48,716

4 unchanged sentences

Separate account liabilities 7,416 7,430

Liabilities of businesses held for sale, non-current — 591

TOTAL LIABILITIES 111,769 106,410

11 unchanged sentences

Total liabilities and equity $ 153,119 $ 152,761

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

(1) Par value per share, $ 0.01 ;

shares issued, 399 million as of September 30, 2023 and 398 million as of December 31, 2022;

shares issued, 402 million as of March 31, 2024 and 400 million as of December 31, 2023;

authorized shares, 600 million.

2 unchanged sentences

Consolidated Statements of Changes in Total Equity

Three Months Ended September 30, 2023

Three Months Ended March 31, 2024

(In millions) Common Stock Additional Paid-in Capital Accumulated Other Comprehensive (Loss) Retained Earnings Treasury Stock Shareholders' Equity Other Non- controlling Interests Total Equity Redeemable Noncontrolling Interests

Balance at June 30, 2023 $ 4 $ 30,436 $ ( 1,878 ) $ 39,936 $ ( 23,053 ) $ 45,445 $ 19 $ 45,464 $ 62

Balance at December 31, 2023 $ 4 $ 30,669 $ ( 1,864 ) $ 41,652 $ ( 24,238 ) $ 46,223 $ 21 $ 46,244 $ 107

Effects of issuing stock for employee benefits plans 263 ( 114 ) 149 149

Other comprehensive loss ( 460 ) ( 460 ) ( 460 ) —

Net income 1,408 1,408 4 1,412 37

Common dividends declared (per share:

( 362 ) ( 362 ) ( 362 )

Repurchase of common stock — ( 681 ) ( 681 ) ( 681 )

Other transactions impacting noncontrolling interests — — ( 12 ) ( 12 ) ( 35 )

Balance at September 30, 2023 $ 4 $ 30,563 $ ( 2,119 ) $ 40,982 $ ( 23,739 ) $ 45,691 $ 11 $ 45,702 $ 64

Three Months Ended September 30, 2022 (1)

Balance at June 30, 2022, as retrospectively restated (1)

4 29,930 ( 2,343 ) 34,668 ( 16,588 ) 45,671 30 45,701 45

Effect of issuing stock for employee benefit plans 165 ( 2 ) 163 163

Other comprehensive income 15 15 15 1

Net income 2,757 2,757 18 2,775 3

Common dividends declared (per share:

( 342 ) ( 342 ) ( 342 )

Repurchase of common stock ( 700 ) ( 2,800 ) ( 3,500 ) ( 3,500 )

Other transactions impacting noncontrolling interests — — ( 6 ) ( 6 ) 1

Balance at September 30, 2022 $ 4 $ 29,395 $ ( 2,328 ) $ 37,083 $ ( 19,390 ) $ 44,764 $ 42 $ 44,806 $ 50

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information .

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

The Cigna Group

Consolidated Statements of Changes in Total Equity

Nine Months Ended September 30, 2023

Balance at December 31, 2022, as retrospectively restated (1)

Net (loss) income

( 277 ) ( 277 ) 65 ( 212 ) —

Effect of issuing stock for employee benefit plans 332 ( 110 ) 222 222

Other comprehensive loss ( 461 ) ( 461 ) ( 461 ) —

Net income 4,135 4,135 14 4,149 116

Common dividends declared (per share:

2 unchanged sentences

Other transactions impacting noncontrolling interests — — 83 83 ( 107 )

Balance at September 30, 2023 $ 4 $ 30,563 $ ( 2,119 ) $ 40,982 $ ( 23,739 ) $ 45,691 $ 11 $ 45,702 $ 64

Nine Months Ended September 30, 2022 (1)

Balance at March 31, 2024 $ 4 $ 30,292 $ ( 2,324 ) $ 40,978 $ ( 27,769 ) $ 41,181 $ 169 $ 41,350 $ —

Three Months Ended March 31, 2023

Balance at December 31, 2021, as retrospectively restated (1)

Balance at December 31, 2022

$ 4 $ 30,233 $ ( 1,658 ) $ 37,940 $ ( 21,844 ) $ 44,675 $ 13 $ 44,688 $ 66

6 unchanged sentences

Other transactions impacting noncontrolling interests — — ( 2 ) ( 2 ) ( 22 )

Balance at September 30, 2022 $ 4 $ 29,395 $ ( 2,328 ) $ 37,083 $ ( 19,390 ) $ 44,764 $ 42 $ 44,806 $ 50

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

Balance at March 31, 2023 $ 4 $ 30,332 $ ( 1,769 ) $ 38,841 $ ( 22,906 ) $ 44,502 $ 16 $ 44,518 $ 78

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

1 unchanged sentence

Consolidated Statements of Cash Flows

Nine Months Ended September 30,

Three Months Ended March 31,

(In millions) 2024

Cash Flows from Operating Activities

Net income $ 4,265 $ 5,560

Adjustments to reconcile net income to net cash provided by operating activities:

Net (loss) income $ ( 212 ) $ 1,306

Adjustments to reconcile net (loss) income to net cash provided by operating activities:

Depreciation and amortization 741 749

2 unchanged sentences

( 102 ) ( 108 )

Loss (gain) on sale of businesses

Loss on sale of businesses

Net changes in assets and liabilities, net of non-operating effects:

20 unchanged sentences

Property and equipment purchases, net ( 300 ) ( 408 )

Acquisitions, net of cash acquired ( 443 ) —

Divestitures, net of cash sold — 22

Other, net ( 112 ) ( 43 )

NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES ( 4,734 ) 3,714

NET CASH USED IN INVESTING ACTIVITIES ( 495 ) ( 2,983 )

Cash Flows from Financing Activities

12 unchanged sentences

Cash, cash equivalents and restricted cash January 1, 8,337 5,976

Cash, cash equivalents and restricted cash, September 30, (3)

Cash, cash equivalents and restricted cash, March 31, (1)

Cash and cash equivalents reclassified to assets of businesses held for sale

Cash, cash equivalents and restricted cash March 31, per Consolidated Balance Sheets (1)

$ 8,484 $ 7,989

Supplemental Disclosure of Cash Information:

1 unchanged sentence

Interest paid $ 336 $ 322

(1) Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

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

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

8 unchanged sentences

Supplier Finance Program

Mergers, Acquisitions and Divestitures

Assets and Liabilities of Businesses Held for Sale

Earnings Per Share

10 unchanged sentences

Note 1 – Description of Business

The Cigna Group, together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our"), is a global health company with a mission of helping those we serve improve their health and vitality.

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 committed to creating a better future built on the vitality of every individual and every community.

We relentlessly challenge ourselves to partner and innovate solutions for better health.

Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services.

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations.

Cigna Healthcare also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets.

In addition to these ongoing operations, The Cigna Group also has certain run-off operations.

The majority of these products and services are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations.

Cigna Healthcare also offers health and dental insurance and Medicare products to individuals in the United States and selected international markets.

In addition to these operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

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

Cigna Healthcare includes the U.S.

Commercial, U.S.

Government and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers.

Commercial products and services include medical, pharmacy, behavioral health, dental and other products and services for insured and self-insured clients.

Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans.

International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exited businesses.

Our ongoing businesses include continuing business (corporate-owned life insurance ("COLI")) and our run-off businesses.

Our run-off businesses include (i) variable annuity reinsurance business (also referred to as guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business) that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses comprised of deferred gains from the sales of these businesses.

Our exited businesses include our interest in a joint venture in Türkiye, which was sold in December 2022 and the international life, accident and supplemental benefits businesses sold in July 2022 (the "Chubb transaction").

The Evernorth Health Services reportable segment now presents the Pharmacy Benefit Services and the Specialty and Care Services operating segments, which partner with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.

Pharmacy Benefit Services drives high-quality, cost-effective pharmacy care through various services such as drug claim adjudication, retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and access to our home delivery pharmacy.

Specialty and Care Services provides specialty drugs for the treatment of complex and rare diseases, specialty distribution of pharmaceuticals and medical supplies, as well as clinical programs to help our clients drive better whole-person health outcomes through Care Delivery and Management Solutions.

The Company's reporting units remain aligned with its operating segments and goodwill was allocated on a relative fair value basis.

The Cigna Healthcare reportable segment includes the U.S.

Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers.

Healthcare provides medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Stand-Alone Prescription Drug Plans for seniors and individual health insurance plans.

International Health provides health care solutions in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

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") for approximately $ 3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction").

See Note 5 to the Consolidated Financial Statements for further information.

Other Operations comprises the remainder of our business operations, which includes our continuing business (corporate-owned life insurance ("COLI")) and our run-off and other non-strategic businesses.

Our run-off businesses include (i) variable annuity reinsurance business that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses which were sold through reinsurance agreements.

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.

4 unchanged sentences

These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP").

Certain amounts in prior years related to the adoption of Targeted Improvements for the Accounting of Long-Duration Contracts, have been reclassified to conform to the current year presentation.

See "Recent Accounting Pronouncements" below.

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors.

Significant estimates are discussed throughout these Notes;

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax and receivable valuations, interest rates and other factors.

Significant estimates are discussed throughout

however, actual results could differ from those estimates.

3 unchanged sentences

The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates.

This and other factors, including the seasonal nature of portions of the health care

and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.

This and other factors, including the seasonal nature of portions of the health care and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.

Recent Accounting Pronouncements

The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future.

The following information provides updates on recently adopted accounting pronouncements that have occurred since the Company filed its 2022 Form 10-K.

There are no significant accounting pronouncements not yet adopted as of September 30, 2023.

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

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

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

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

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

The upper-medium grade fixed income instrument yield is interpreted to mean A-rated.

• Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts are amortized on a constant-level basis over the expected term of the related contracts.

Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.

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

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

• The transition methods applied at adoption were:

• The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings.

The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.

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

• Market risk benefits were remeasured at fair value at the beginning of the earliest period presented.

The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in accumulated other comprehensive income.

Effects of adoption:

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

• The cumulative effects of adopting the new standard were immaterial.

The impacts were a decrease to January 1, 2021 Shareholders' equity of $ 139 million and an increase to Shareholders' net income for the year ended December 31, 2022 and December 31, 2021 of $ 36 million and $ 5 million, respectively.

The corresponding impact to diluted earnings per share was an increase of $ 0.11 and $ 0.02 for the year ended December 31, 2022 and December 31, 2021, respectively.

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

• Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard.

Refer to Note 9 to the Consolidated Financial Statements for the Company's updated accounting policies.

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

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

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

Additionally, in December 2022, the Financial Accounting Standards Board ("FASB") published ASU 2022-05, which simplified the retrospective adoption of LDTI by permitting companies to make an accounting policy election to exclude contracts that are sold and removed from the balance sheet prior to the effective date of the standard from the retrospective adoption of LDTI.

The Cigna Group made this policy election for the contracts sold in the Chubb transaction and our divested interest in a joint venture in Türkiye.

There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions) September 30, 2023 December 31, 2022

(In millions) March 31, 2024 December 31, 2023

Noninsurance customer receivables $ 9,735 $ 8,044

3 unchanged sentences

Total $ 21,522 $ 18,844

These accounts receivable are reported net of our allowances of $ 3.3 billion as of September 30, 2023 and $ 1.9 billion as of December 31, 2022.

Accounts receivable, net classified as assets of businesses held for sale

( 959 ) ( 1,122 )

Total $ 20,563 $ 17,722

These accounts receivable are reported net of our allowances of $ 4.5 billion as of March 31, 2024 and $ 3.7 billion as of December 31, 2023.

These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain accounts receivable from third-party payors, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments.

The Company's allowance for current expected credit losses was $ 96 million as of September 30, 2023 and $ 86 million as of December 31, 2022.

The Company's allowance for current expected credit losses was $ 91 million as of March 31, 2024 and $ 90 million as of December 31, 2023.

Accounts Receivable Factoring Facility

In July 2023, the Company entered into an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution .

The Facility's total capacity is $ 1.0 billion with an initial term of two years , followed by automatic one year renewal terms unless terminated by either party.

The transactions under the Facility are accounted for as a sale and recorded as a reduction to accounts receivable in the Consolidated Balance Sheets because control of, and risk related to, the accounts receivable are transferred to the financial institution .

Although the sale is made without recourse, we provide collection services related to the transferred assets.

Amounts associated with this Facility are reflected within Net cash provided by operating activities in the Company's Consolidated Statements of Cash Flows.

Factoring fees paid under this Facility are reflected in Interest expense and other in the Consolidated Statements of Income.

During the three months ended September 30, 2023 we sold $ 1.0 billion and factoring fees paid were not material.

As of September 30, 2023, there were $ 253 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets.

There were $ 512 million of amounts received from manufacturers but not yet remitted to the financial institution.

Such amounts are recorded within Accrued expenses and other liabilities on the Consolidated Balance Sheets.

The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution.

The Facility's total capacity is $ 1.0 billion and began in July 2023 with an initial term of two years , followed by automatic one year renewal terms unless terminated by either party.

Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.

For the three months ended March 31, 2024, we sold $ 1.9 billion of accounts receivable under the Facility and factoring fees paid were not material.

As of March 31, 2024, there were $ 93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets.

At December 31, 2023, all sold accounts receivable had been collected from manufacturers.

As of March 31, 2024 and December 31, 2023, there were $ 722 million and $ 515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution.

Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.

Note 4 – Supplier Finance Program

The Company facilitates a voluntary supplier finance program (the "Program") that provides suppliers the opportunity to sell their accounts receivable due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require.

The Cigna Group is not a party to the Program and agrees to commercial terms with its suppliers independently of their participation in the Program.

Amounts due to suppliers that participate in the Program are generally paid within one month following the invoice date.

A supplier's participation in the Program has no impact on the Company's payment terms and the Company has no economic interest in a supplier's decision to participate in the Program.

The suppliers, at their sole discretion, determine which invoices, if any, to sell to the financial institution.

No guarantees or pledged assets are provided by the Company or any of our subsidiaries under the Program.

As of September 30, 2023 and December 31, 2022, $ 1.6 billion and $ 1.3 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the Program by the financial institution and are reflected in Accounts payable in the

Consolidated Balance Sheets.

Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K.

As of March 31, 2024 and December 31, 2023, $ 1.6 billion and $ 1.5 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the Program by the financial institution and are reflected in Accounts payable in the Consolidated Balance Sheets.

The amounts confirmed as valid for both periods are predominately associated with one supplier.

As of September 30, 2023, we have been informed by the financial institution that $ 378 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.

Note 5 – Mergers, Acquisitions and Divestitures

Investment in CarepathRx Health Systems Solutions

In July 2023, Evernorth Health, Inc.

acquired a minority interest in CarepathRx Health Systems Solutions ("CHSS"), a provider of integrated hospital pharmacy solutions to support patients across their complete health care journey.

This equity method investment is reported in Other assets and the Company's share of CHSS' net income or loss is reported in Fees and other revenues.

The purchase price has been allocated to the acquired tangible and intangible assets, including customer relationships, trade names, internal-use software and goodwill.

Amortization of the acquired intangibles is included in Fees and other revenues.

The Company's share of CHSS' net loss and amortization of acquired intangibles was immaterial for the three months ended September 30, 2023.

The Company guaranteed $ 125 million of CHSS' credit facilities through July 2026.

The fair value of the guarantee is reflected in other liabilities and is not material.

The acquisition also includes separate put and call options to increase our ownership which become exercisable annually beginning as early as April 2025.

The net fair value of the options, determined using a Monte Carlo simulation, are not material and are included in Accrued expenses and other liabilities and Other assets, respectively.

Divestiture of International Businesses

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

In 2023, we recorded immaterial adjustments to the sales price reflecting resolution of certain contractual matters.

In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.

As of March 31, 2024, we have been informed by the financial institution that $ 327 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.

Note 5 – Assets and Liabilities of Businesses Held for Sale

In January 2024, the Company entered into the HCSC transaction for a total purchase price of approximately $ 3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions.

The transaction is expected to close in the first quarter of 2025.

The assets and liabilities of businesses held for sale were as follows:

(In millions) March 31, 2024 December 31, 2023

Cash and cash equivalents $ 1,660 $ 467

Investments 1,341 1,438

Accounts receivable, net 959 1,122

Other assets, including Goodwill (1)

Total assets of businesses held for sale 6,354 5,990

Insurance and contractholder liabilities 2,081 1,636

All other liabilities 1,134 1,059

Total liabilities of businesses held for sale $ 3,215 $ 2,695

(1) Includes Goodwill of $ 396 million as of March 31, 2024 and December 31, 2023.

Integration and Transaction-related Costs

In the first nine months of 2023 and 2022, the Company incurred net costs related to the Chubb transaction and continued strategic realignment initiatives.

In 2022, the Company also incurred net costs primarily related to the sale of the Group Disability and Life business and acquisition of MDLIVE, Inc.

These net costs were $ 13 million pre-tax ($ 9 million after-tax) for the three months ended and $ 20 million pre-tax ($ 15 million after-tax) for the nine months ended September 30, 2023, compared with $ 24 million pre-tax ($ 23 million after-tax) for the three months ended and $ 112 million pre-tax ($ 86 million after-tax) for the nine months ended September 30, 2022.

In 2024, the Company incurred costs related to the HCSC transaction.

In 2023, the Company incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction").

These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.

These costs were $ 37 million pre-tax ($ 29 million after-tax) for the three months ended March 31, 2024 and $ 1 million pre-tax ($ 1 million after-tax) for the three months ended March 31, 2023.

Note 6 – Earnings Per Share

1 unchanged sentence

Three Months Ended

September 30, 2023 September 30, 2022

(Shares in thousands, dollars in millions, except per share amounts) Basic Effect of

Dilution Diluted Basic Effect of

Dilution Diluted

Shareholders' net income $ 1,408 $ 1,408 $ 2,757 $ 2,757

Weighted average 294,058 294,058 303,854 303,854

Common stock equivalents 3,073 3,073 3,663 3,663

Total shares 294,058 3,073 297,131 303,854 3,663 307,517

Earnings per share $ 4.79 $ ( 0.05 ) $ 4.74 $ 9.07 $ ( 0.10 ) $ 8.97

Nine Months Ended

September 30, 2023 September 30, 2022

March 31, 2024 March 31, 2023

(Shares in thousands, dollars in millions, except per share amounts) Basic Effect of

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Dilution Diluted

Shareholders' net income $ 4,135 $ 4,135 $ 5,511 $ 5,511

Shareholders' net (loss) income

$ ( 277 ) $ ( 277 ) $ 1,267 $ 1,267

Weighted average 286,465 286,465 295,706 295,706

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Earnings per share $ ( 0.97 ) $ — $ ( 0.97 ) $ 4.28 $ ( 0.04 ) $ 4.24

Amounts reflected above for the three and nine months ended September 30, 2022 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).

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

Three Months Ended September 30, Nine Months Ended September 30,

(In millions) 2023 2022 2023 2022

Anti-dilutive options 0.9 — 0.9 1.3

The Company held approximately 105.7 million shares of common stock in treasury at September 30, 2023, 99.1 million shares as of December 31, 2022 and 91.8 million shares as of September 30, 2022.

Due to the Shareholders' net loss for the three months ended March 31, 2024, 8.2 million outstanding employee stock options, unvested restricted stock grants and units and strategic performance shares were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.

For the three months ended March 31, 2023, 0.9 million outstanding employee stock options were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.

The Company held approximately 117.8 million shares of common stock in treasury at March 31, 2024, 107.4 million shares as of December 31, 2023 and 102.7 million shares as of March 31, 2023.

The increase in Treasury stock as of March 31, 2024 and the reduction in weighted average shares outstanding for the three months ended March 31, 2024 was driven in part by 7.6 million shares of our common stock repurchased in February 2024 under the accelerated share repurchase agreements (the "ASR agreements").

Additionally, we expect final settlement of the ASR agreements to occur in the second quarter of 2024.

S ee Note 8 for additional information.

Note 7 – Debt

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

(In millions) September 30, 2023 December 31, 2022

(In millions) March 31, 2024 December 31, 2023

Short-term debt

Commercial paper $ 884 $ 1,237

$ 17 million, 8.300 % Notes due January 2023

$ 500 million, 0.613 % Notes due March 2024

$ 700 million, Floating Rate Notes due July 2023

$ 1,000 million, 3.000 % Notes due July 2023

$ 1,187 million, 3.750 % Notes due July 2023

$ 500 million, 0.613 % Notes due March 2024

$ 790 million, 3.500 % Notes due June 2024 (1)

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Long-term debt

$ 500 million, 0.613 % Notes due March 2024

$ 1,000 million, 3.500 % Notes due June 2024

$ 900 million, 3.250 % Notes due April 2025 (2)

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$ 3,800 million, 4.375 % Notes due October 2028

$ 1,000 million, 5.000 % Notes due May 2029

$ 1,400 million, 2.400 % Notes due March 2030 (1)

$ 1,500 million, 2.375 % Notes due March 2031 (2)

$ 750 million, 5.125 % Notes due May 2031

$ 45 million, 8.080 % Step Down Notes due January 2033 (3)

$ 800 million, 5.400 % Notes due March 2033

$ 1,250 million, 5.250 % Notes due February 2034

$ 190 million, 6.150 % Notes due November 2036

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$ 1,500 million, 3.400 % Notes due March 2051

$ 1,500 million, 5.600 % Notes due February 2054

Other, including finance leases 59 66

Total long-term debt $ 31,053 $ 28,155

(1) Included in the February 2024 debt tender offers discussed below.

(2) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments.

See Note 11 in the Company's 2022 Form 10-K for further information about the Company's interest rate risk management and these derivative instruments.

See Note 11 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.

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

Long-term debt

Debt Issuance.

On March 7, 2023, the Company issued $ 1.5 billion of new senior notes.

The proceeds of this issuance were used for general corporate purposes, and included repayment of outstanding debt securities.

Interest on this debt is paid semi-annually.

Principal Maturity Date Interest Rate Net Proceeds

$ 700 million (1)

March 15, 2026 5.685 % $ 698 million

$ 800 million (2)

March 15, 2033 5.400 % $ 796 million

(1) Redeemable at any time discounted at the U.S.

Treasury rate plus 20 basis points.

Redeemable at par on or after March 15, 2024.

(2) Redeemable at any time discounted at the U.S.

Treasury rate plus 25 basis points.

Redeemable at par on or after December 15, 2032.

Short-term and Credit Facilities Debt

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Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including providing liquidity support if necessary under our commercial paper program discussed below.

As of September 30, 2023, there were no outstanding balances under these revolving credit agreements.

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

As of March 31, 2024, there were no outstanding balances under these revolving credit agreements.

In April 2024, The Cigna Group replaced our existing $ 4.0 billion five-year revolving credit and letter of credit agreement maturing in April 2028 and a $ 1.0 billion 364-day revolving credit agreement maturing in April 2024 by entering into the following revolving credit agreements (the "Credit Agreements"):

• a $ 5.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2029 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks.

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This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.

The increase in the aggregate size of our revolving credit agreements from $ 5.0 billion to $ 6.5 billion will provide enhanced liquidity to support the continued growth of our business.

Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $ 1.5 billion across both facilities for a maximum total commitment of $ 8.0 billion.

The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the two facilities is diversified among 21 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of September 30, 2023.

Each of the two facilities is diversified among 22 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of March 31, 2024.

Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60 % subject to certain exceptions upon the consummation of an acquisition.

The Credit Agreements replaced a prior $ 3.0 billion five-year revolving credit and letter of credit agreement maturing in April 2027;

a $ 1.0 billion three-year revolving credit agreement maturing in April 2025;

and a $ 1.0 billion 364-day revolving credit agreement maturing in April 2023.

Commercial Paper.

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

The weighted average interest rate of our commercial paper was 5.50 % at September 30, 2023.

Debt Covenants.

The Company was in compliance with its debt covenants as of September 30, 2023.

The weighted average interest rate of our commercial paper was 5.54 % at March 31, 2024.

Long-term debt

Debt Issuance and Debt Tender Offers.

In February 2024, we issued $ 4.5 billion of new senior notes, as detailed in the table below.

The proceeds from this debt were used to pay the consideration for the cash tender offers as described below.

We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock.

Interest on this debt is paid semi-annually.

Principal Maturity Date Interest Rate Net Proceeds

$ 1,000 million (1)

May 15, 2029 5.000 % $ 995 million

$ 750 million (2)

May 15, 2031 5.125 % $ 746 million

$ 1,250 million (3)

February 15, 2034 5.250 % $ 1,244 million

$ 1,500 million (4)

February 15, 2054 5.600 % $ 1,485 million

(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S.

Treasury rate plus 15 basis points.

Redeemable at par on or after April 15, 2029.

(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S.

Treasury rate plus 15 basis points.

Redeemable at par on or after March 15, 2031.

(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S.

Treasury rate plus 20 basis points.

Redeemable at par on or after November 15, 2033.

(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S.

Treasury rate plus 20 basis points.

Redeemable at par on or after August 15, 2053.

In the first quarter of 2024, the Company completed the repurchase of a total of $ 1.8 billion in aggregate principal amount of existing senior notes that were tendered to the Company pursuant to cash tender offers.

Interest Expense

Interest expense on corporate financing was $ 353 million for the three months ended and $ 1,048 million for the nine months ended September 30, 2023, compared with $ 317 million for the three months ended and $ 947 million for the nine months ended September 30, 2022.

Interest expense on long-term and short-term debt was $ 369 million for the three months ended March 31, 2024 and $ 345 million for the three months ended March 31, 2023.

Debt Covenants

The Company was in compliance with its debt covenants as of March 31, 2024.

Note 8 – Common and Preferred Stock

During the first nine months of 2023, The Cigna Group declared quarterly cash dividends of $ 1.23 per share of the Company's common stock.

During the first nine months of 2022, The Cigna Group declared quarterly cash dividends of $ 1.12 per share of the Company's common stock.

In the first quarter of 2024, The Cigna Group declared quarterly cash dividends of $ 1.40 per share of the Company's common stock.

In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $ 1.23 per share of the Company's common stock.

The following table provides details of the Company's dividend payments:

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March 6, 2024 March 21, 2024 $ 1.40 $ 401

June 7, 2023 June 22, 2023 $ 1.23 $ 362

September 6, 2023 September 21, 2023 $ 1.23 $ 362

March 8, 2023 March 23, 2023 $ 1.23 $ 368

June 8, 2022 June 23, 2022 $ 1.12 $ 352

September 7, 2022 September 22, 2022 $ 1.12 $ 341

On October 25, 2023, the Board of Directors declared the fourth quarter cash dividend of $ 1.23 per share of The Cigna Group common stock to be paid on December 21, 2023 to shareholders of record on December 6, 2023.

On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $ 1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 2024.

The Company currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of The Cigna Group and its shareholders.

The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board may deem relevant.

Accelerated Share Repurchase Agreements

In February 2024, as part of our share repurchase program, we entered into separate accelerated share repurchase agreements with Deutsche Bank AG and Bank of America, N.A.

(collectively, the "Counterparties") to repurchase $ 3.2 billion of common stock in aggregate.

We remitted $ 3.2 billion to the Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024, representing $ 2.6 billion of the total remitted.

The final number of shares to be received under the ASR agreements will be determined based on the daily volume-weighted average share price ("VWAP") of our common stock over the term of the agreements, less a discount and subject to adjustments pursuant to the terms and conditions of the ASR agreements.

We recorded the payment to the Counterparties as a reduction to Total shareholders' equity, consisting of a $ 2.6 billion increase in Treasury stock, which reflects the value of the initial 7.6 million shares received, and a $ 640 million decrease in Additional paid-in capital, which reflects the value of the stock hold-back by the Counterparties pending final settlement of the ASR agreements.

The $ 640 million recorded in Additional paid-in capital will be reclassified to Treasury stock upon settlement of the ASR agreements in the second quarter of 2024.

The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted earnings per share.

Note 9 – Insurance and Contractholder Liabilities

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The Company's insurance and contractholder liabilities were comprised of the following:

September 30, 2023 December 31, 2022 September 30, 2022

March 31, 2024 December 31, 2023 March 31, 2023

(In millions) Current Non-current Total Current Non-current Total Total

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Unearned premiums 815 21 836 846 22 868 1,440

Total 7,357 11,153 18,510 6,633 11,421 18,054

Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)

( 1,569 ) ( 512 ) ( 2,081 ) ( 1,119 ) ( 517 ) ( 1,636 )

Total insurance and contractholder liabilities $ 5,788 $ 10,641 $ 16,429 $ 5,514 $ 10,904 $ 16,418 $ 18,956

(1) Amounts classified as liabilities of businesses held for sale include $ 1,378 million of Unpaid claims, $ 427 million of Future policy benefits, $ 161 million of Unearned premiums and $ 115 million of Contractholder deposit funds as of March 31, 2024 and $ 823 million of Unpaid claims, $ 429 million of Future policy benefits, $ 261 million of Unearned premiums and $ 123 million of Contractholder deposit funds as of December 31, 2023.

Insurance and contractholder liabilities expected to be paid within one year are classified as current.

The Company adopted amended accounting guidance for long-duration insurance contracts on January 1, 2023, discussed further in Note 2 to the Consolidated Financial Statements, which resulted in restatement of prior period amounts.

Additionally, see below updated accounting policies and incremental disclosures associated with future policy benefits (Note 9C), contractholder deposit funds (Note 9D), and market risk benefits (Note 9E).

Unpaid Claims and Claim Expenses – Cigna Healthcare

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

The total of incurred but not reported liabilities plus expected development on reported claims, including reported claims in process, was $ 5.0 billion at September 30, 2023 and $ 4.0 billion at September 30, 2022.

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

The total of incurred but not reported liabilities plus expected development on reported claims and reported claims in process was $ 5.4 billion at March 31, 2024 and $ 4.6 billion at March 31, 2023.

This increase was primarily due to claim submission and payment process disruptions related to a third-party cyber incident.

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

Nine Months Ended

(In millions) September 30, 2023 September 30, 2022

Three Months Ended March 31,

(In millions) 2024 (1)

Beginning balance $ 5,092 $ 4,176

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Ending balance $ 5,863 $ 4,959

(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale.

As of March 31, 2024 and December 31, 2023, $ 1,378 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.

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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, 2023 September 30, 2022

Three Months Ended March 31,

(Dollars in millions) $ % (1)

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Future Policy Benefits

Accounting Policy.

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

Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency.

Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders.

Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require.

Interest rate

assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed income instrument").

For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss.

For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach.

For contracts issued by foreign operating entities with functional currencies other than the U.S.

dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low credit risk fixed income instrument.

For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.

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

DPL is amortized based on expected future benefit payments.

Cigna Healthcare

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:

September 30, 2023 September 30, 2022

March 31, 2024 March 31, 2023

Interest accretion rate 2.56 % 2.59 %

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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 are as follows:

Nine Months Ended

(In millions) September 30, 2023 September 30, 2022

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

Three Months Ended March 31,

(In millions) 2024 (1)

Present value of expected net premiums

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Reversal of effect of beginning of period discount rate assumptions 1,154 1,537

Effect of assumption changes and actual variances from expected experience (1)

Issuances and lapses 446 306

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Reversal of effect of discount rate assumptions 1,220 1,611

Effect of assumption changes and actual variances from expected experience (1)

Issuances and lapses 457 307

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Total liability for future policy benefits (6)(7)

(1) Includes the effect of actual variances from expectations, which (decreased)/increased the total liability for future policy benefits by $( 12 ) million and $ 58 million, respectively, for the nine months ended September 30, 2023 and September 30, 2022.

(1) Includes future policy benefits amounts classified as liabilities of businesses held for sale.

(2) 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.

(3) As of September 30, 2023 and September 30, 2022, respectively, undiscounted expected future gross premiums were $ 18.5 billion and $ 17.1 billion.

As of September 30, 2023 and September 30, 2022, respectively, discounted expected future gross premiums were $ 12.5 billion and $ 11.8 billion.

(4) As of September 30, 2023 and September 30, 2022, respectively, undiscounted expected future policy benefits were $ 13.1 billion and $ 12.4 billion.

(3) As of March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $ 19.0 billion and $ 17.6 billion, respectively.

As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $ 13.3 billion and $ 12.5 billion, respectively.

(4) As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $ 13.6 billion and $ 12.8 billion, respectively.

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

(6) $ 154 million and $ 156 million of reinsurance recoverable asset reported in the Consolidated Balance Sheets as of September 30, 2023 and September 30, 2022, respectively, relate to the liability for future policy benefits.

(6) $ 72 million and $ 154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits.

Additionally, $ 81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

(7) Includes $ 427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 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:

September 30, 2023 September 30, 2022

March 31, 2024 March 31, 2023

Interest accretion rate 5.64 % 5.64 %

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Other Operations ' traditional insurance contracts, which are in run-off, have no premium remaining to be collected;

therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate and the remaining amortizable DPL.

Future policy benefits for Other Operations includes DPL of $ 390 million as of September 30, 2023 and $ 380 million as of September 30, 2022.

Future policy benefits excluding DPL were $ 3.0 billion as of September 30, 2023, $ 3.2 billion as of each of December 31, 2022 and September 30, 2022, and $ 4.3 billion as of December 31, 2021.

These balances exclude amounts classified as Liabilities of businesses held for sale of $ 3.8 billion as of December 31, 2021.

The change in future policy benefits reserves year-to-date was primarily driven by changes in the current discount rate.

Undiscounted expected future policy benefits were $ 4.5 billion as of September 30, 2023 and $ 4.7 billion as of September 30, 2022.

As of September 30, 2023 and September 30, 2022, $ 1.0 billion and $ 1.1 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

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 $ 379 million as of March 31, 2024 and $ 392 million as of March 31, 2023.

Future policy benefits excluding deferred profit liability were $ 3.1 billion as of March 31, 2024 and $ 3.2 billion as

of each of December 31, 2023, March 31, 2023, and December 31, 2022.

The change in future policy benefits reserves year-to-date was primarily driven by benefit payments, as well as changes in the current discount rate.

Undiscounted expected future policy benefits were $ 4.4 billion as of March 31, 2024 and $ 4.6 billion as of March 31, 2023.

As of both March 31, 2024 and March 31, 2023, $ 1.0 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

Contractholder Deposit Funds

Accounting Policy.

Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products as well as investment earnings on their fund balances in Other Operations.

These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges.

Interest credited on these funds is accrued ratably over the contract period.

Contractholder deposit fund liabilities within Other Operations were $ 6.6 billion as of September 30, 2023 and $ 6.7 billion as of each of December 31, 2022 and September 30, 2022, and $ 6.9 billion as of December 31, 2021.

Contractholder deposit fund liabilities within Other Operations were $ 6.5 billion as of March 31, 2024 and December 31, 2023 and $ 6.7 billion as of March 31, 2023 and December 31, 2022.

Approximately 38 % of the balance is reinsured externally.

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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, 2023, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not externally reinsured were 3.27 %, $ 3.1 billion and $ 2.8 billion, respectively.

The comparative amounts as of September 30, 2022 were 3.14 %, $ 3.3 billion and $ 2.8 billion, respectively.

As of both September 30, 2023 and September 30, 2022, more than 99 % of the $ 4.1 billion liability not reinsured externally is for contracts with guaranteed interest rates of 3 % - 4 %, and approximately $ 1.2 billion represented contracts with policies at the guarantee.

At both of these same period ends, $ 1.2 billion was 50 - 150 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 March 31, 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 %, $ 3.0 billion and $ 2.8 billion, respectively.

The comparative amounts as of March 31, 2023 were 3.25 %, $ 3.2 billion and $ 2.8 billion, respectively.

More than 99 % of the $ 4.0 billion liability as of March 31, 2024 and the $ 4.1 billion liability as of March 31, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3 % - 4 %, and approximately $ 1.2 billion represented contracts with policies at the guarantee.

At both of these same period ends, $ 1.2 billion was 50 - 150 basis points ("bps") above the guarantee and the remaining $ 1.6 billion as of March 31, 2024 and $ 1.7 billion as of March 31, 2023 represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value.

More than 90 % of these contracts have actual cash values of at least 110% of the guaranteed cash value.

Market Risk Benefits

Liabilities for market risk benefits consist of variable annuity reinsurance contracts (also referred to as GMDB and GMIB contracts) in Other Operations.

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.

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The Company receives and pays premium periodically based on the terms of the reinsurance agreements.

Accounting Policy.

Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefit expenses while fluctuations in the Company's own nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss.

Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e.

nonpayment risk).

The nonperformance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral.

The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable.

As discussed further in Note 10 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefit expenses and does not offset the nonperformance risk valuation on the liability.

Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates).

Market risk benefits activity was as follows:

Nine Months Ended

(In millions) September 30, 2023 September 30, 2022

Three Months Ended March 31,

(Dollars in millions) 2024 2023

Balance, beginning of year $ 1,003 $ 1,268

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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, 2023 September 30, 2022

(Dollars in millions, excludes impact of reinsurance ceded) March 31, 2024 March 31, 2023

Net amount at risk $ 1,441 $ 2,183

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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, 2023 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:

The Company's reinsurance recoverables as of March 31, 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

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Total reinsurance recoverables (3)

(1) Certified by a NRSRO.

(2) Includes $ 238 million of current reinsurance recoverables that are reported in Other current assets.

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

(4) Total Berkshire and certain Other recoverables reflected under acquisition, disposition or run-off activities in the Company's 2022 Form 10-K that relate to the Company's variable annuity reinsurance products discussed in section B below are now reported at fair market value as MRBs, as further discussed in Note 9 to the Consolidated Financial Statements.

At December 31, 2022, we reported $ 711 million of recoverables related to the GMDB variable annuity reinsurance product.

The restated December 31, 2022 variable annuity reinsurance recoverable balance is $ 1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.

(2) Certified by an NRSRO.

(3) Includes $ 166 million of current reinsurance recoverables that are reported in Other current assets and $ 209 million of reinsurance recoverables classified as assets of businesses held for sale.

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.

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Berkshire reinsured 100 % of the Company's future cash flows in this business, net of other reinsurance arrangements existing at that time.

The reinsurance agreement is subject to an overall limit with approximately $ 3.1 billion remaining at September 30, 2023.

The reinsurance agreement is subject to an overall

limit with approximately $ 3.1 billion remaining at March 31, 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.

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Reinsurer (1)

September 30, 2023 December 31, 2022 Collateral and Other Terms

at September 30, 2023

March 31, 2024 December 31, 2023 Collateral and Other Terms

at March 31, 2024

Berkshire $ 777 $ 873 100 % were secured by assets in a trust.

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

(2) Includes IBNR and outstanding claims of $ 21 million.

These amounts are excluded from market risk benefits at September 30, 2023 in Note 9 and Note 10A to the Consolidated Financial Statements.

At December 31, 2022, IBNR and outstanding claims of $ 27 million offset by premium due of $ 3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

The impact of nonperformance risk (i.e.

the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three and nine months ended September 30, 2023 and September 30, 2022.

(2) Includes incurred but not reported ("IBNR") and outstanding claims of $ 23 million as of March 31, 2024 and $ 19 million as of December 31, 2023.

These amounts are excluded from market risk benefits at of March 31, 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 months ended March 31, 2024 and March 31, 2023.

Note 11 – Investments

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

September 30, 2023 December 31, 2022

March 31, 2024 December 31, 2023

(In millions) Current Long-term Total Current Long-term Total

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Total $ 1,193 $ 17,281 $ 18,474 $ 1,009 $ 19,339 $ 20,348

Investments classified as assets of businesses held for sale (1)

( 85 ) ( 1,256 ) ( 1,341 ) ( 84 ) ( 1,354 ) ( 1,438 )

Investments per Consolidated Balance Sheets $ 1,108 $ 16,025 $ 17,133 $ 925 $ 17,985 $ 18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024.

These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

Investment Portfolio

Debt Securities

Accounting policy.

Our accounting policy for debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) remains materially consistent with the policy disclosed in the Company's 2022 Form 10-K.

However, with the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is no longer reported in Non-current insurance and contractholder liabilities but rather is reported in Accumulated other comprehensive loss.

See Note 14 to the Consolidated Financial Statements for the retrospectively restated Accumulated other comprehensive loss.

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of September 30, 2023:

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:

(In millions) Amortized

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Depreciation Fair

September 30, 2023

March 31, 2024

Federal government and agency $ 289 $ — $ 21 $ ( 10 ) $ 300

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Review of declines in fair value.

Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include:

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;

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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, 2023 December 31, 2022

March 31, 2024 December 31, 2023

(Dollars in millions) Fair

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Equity Securities

The following table provides the values of the Company's equity security investments as of September 30, 2023 and December 31, 2022:

September 30, 2023 December 31, 2022

The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:

March 31, 2024 December 31, 2023

(In millions) Cost Carrying Value Cost Carrying Value

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Total $ 3,928 $ 1,571 $ 3,904 $ 3,362

In 2023, we became a minority owner in VillageMD by investing $ 2.7 billion in VillageMD preferred equity.

VillageMD is a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc.

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.

A compounding dividend of 5.5 % accrues annually on $ 2.2 billion of our cost basis in these shares.

As of March 31, 2024, we determined our investment in VillageMD was impaired and wrote down the carrying value to an estimated fair value of $ 0.9 billion, resulting in a $ 1.8 billion loss recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 90 % of our investments in equity securities are in the health care sector.

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

(Dollars in millions) September 30, 2023 December 31, 2022

(Dollars in millions) March 31, 2024 December 31, 2023

Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio

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Carrying Value as of

(In millions) September 30, 2023 December 31, 2022

(In millions) March 31, 2024 December 31, 2023

Real estate investments $ 1,696 $ 1,606

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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, 2023, there have been no material changes to the Company's derivative financial instruments.

As of March 31, 2024, there have been no material changes to the Company's derivative financial instruments.

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, 2023 and December 31, 2022.

The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2024 and December 31, 2023.

The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

Realized Investment Gains and Losses

Accounting policy.

Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments.

With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business.

Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.

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

Three Months Ended September 30, Nine Months Ended September 30,

(In millions) 2023 2022 2023 2022

Net realized investment (losses) gains, excluding credit loss expense and asset write-downs

$ ( 9 ) $ ( 67 ) $ ( 29 ) $ ( 454 )

Credit loss (expense)

( 5 ) ( 15 ) ( 3 ) ( 39 )

Other investment asset write-downs — — ( 12 ) —

Net realized investment (losses), before income taxes

$ ( 14 ) $ ( 82 ) $ ( 44 ) $ ( 493 )

Net realized investment losses for the nine months ended September 30, 2023 and September 30, 2022 were primarily due to mark-to-market losses on a strategic health care equity securities investment.

Net realized investment losses, before income taxes were $ 1,836 million for the three months ended March 31, 2024 and $ 56 million for the three months ended March 31, 2023.

This increase was primarily driven by the impairment of equity securities in 2024.

These amounts exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders.

Note 12 – Fair Value Measurements

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(Level 3) Total

September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022

March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023

Financial assets at fair value

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Derivative assets — — 147 131 — 1 147 132

Financial liabilities at fair value

Derivative liabilities $ — $ — $ 4 $ 4 $ — $ — $ 4 $ 4

(1) Excludes certain equity securities that have no readily determinable fair value.

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Fair Value as of Unobservable Adjustment Range (Weighted Average by Quantity) as of

(Fair value in millions) September 30, 2023 December 31, 2022 Unobservable Input September 30, 2023 September 30, 2023 December 31, 2022

(Fair value in millions) March 31, 2024 December 31, 2023 Unobservable Input March 31, 2024 March 31, 2024 December 31, 2023

Debt securities

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Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.

For the Three Months Ended

September 30, For the Nine Months Ended

September 30,

Three Months Ended March 31,

(In millions) 2024 2023

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Beginning balance $ 447 $ 447

(Losses) gains included in Shareholders' net income

( 1 ) 4 ( 1 ) 14

Losses included in Other comprehensive (loss) income

( 5 ) ( 11 ) ( 5 ) ( 62 )

(Losses) gains included in Shareholders' net (loss) income

(Losses) gains included in Other comprehensive loss

Purchases, sales and settlements

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Ending balance $ 422 $ 471

Total losses included in Shareholders' net income attributable to instruments held at the reporting date

$ ( 1 ) $ — $ ( 1 ) $ ( 2 )

Change in unrealized gain or (loss) included in Other comprehensive (loss) income for assets held at the end of the reporting period

$ ( 4 ) $ ( 33 ) $ ( 9 ) $ ( 60 )

Total gains and losses included in Shareholders' net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income.

Gains and losses included in Other comprehensive (loss) income, net of tax in the tables above are reflected in Net unrealized (depreciation) appreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.

Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date

Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period

Total gains and losses included in Shareholders' net (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income.

Gains and losses included in Other comprehensive loss, net of tax in the tables above are reflected in Net unrealized appreciation 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.

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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, 2023 and 2022 was primarily driven by changes in the market values of the underlying separate account investments.

The separate account activity for the three months ended March 31, 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:

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(Level 3) Total

(In millions) September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022 September 30, 2023 December 31, 2022

(In millions) March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023

Guaranteed separate accounts (See Note 16)

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Total $ 7,416 $ 7,430

(1) Non-guaranteed separate accounts include $ 3.8 billion as of September 30, 2023 and $ 4.0 billion as of December 31, 2022 in assets supporting the Company's pension plans, including $ 0.2 billion classified in Level 3 as of September 30, 2023 and December 31, 2022.

(1) Non-guaranteed separate accounts include $ 4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $ 0.2 billion classified in Level 3 as of both March 31, 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, 2023 or 2022.

Activity, including transfers into and out of Level 3, was not material for the three months ended March 31, 2024 or 2023.

Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments .

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The following table provides additional information on these investments:

Fair Value as of Unfunded Commitment as of September 30, 2023 Redemption Frequency

Fair Value as of Unfunded Commitment as of March 31, 2024 Redemption Frequency

(if currently eligible) Redemption Notice

(In millions) September 30, 2023 December 31, 2022

(In millions) March 31, 2024 December 31, 2023

Securities partnerships $ 412 $ 419 $ 252 Not applicable Not applicable

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Total $ 666 $ 680 $ 252

As of September 30, 2023, the Company does not have plans to sell any of these assets at less than fair value.

As of March 31, 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.

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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, 2023 and 2022, impairments recognized requiring these assets to be measured at fair value were not material.

Realized investment gains and losses from these observable price changes for the three and nine months ended September 30, 2023 and September 30, 2022 were not material.

For the three months ended March 31, 2024, our equity investment in VillageMD was written down to an estimated fair value of $ 0.9 billion resulting in an investment loss of $ 1.8 billion recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

For the three months ended March 31, 2023, impairments recognized requiring these assets to be measured at fair value were not material.

Observable price changes for other equity securities with no readily determinable fair value were not material for the three months ended March 31, 2024 and March 31, 2023.

Fair Value Disclosures for Financial Instruments Not Carried at Fair Value

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In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:

Classification in Fair Value Hierarchy September 30, 2023 December 31, 2022

Classification in Fair Value Hierarchy March 31, 2024 December 31, 2023

(In millions) Fair Value Carrying Value Fair Value Carrying Value

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We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required.

The Company determined that it was no t a primary beneficiary in any material variable interest entity as of September 30, 2023 or December 31, 2022.

The Company determined that it was no t a primary beneficiary in any material variable interest entity as of March 31, 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.

The Company's maximum exposure to loss from securities limited partnerships and real estate limited partnerships is $ 5.1 billion as of September 30, 2023 compared to $ 4.8 billion as of December 31, 2022 and the maximum exposure from real estate joint ventures is $ 0.9 billion as of September 30, 2023 compared to $ 0.6 billion as of December 31, 2022.

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

AOCI includes net unrealized (depreciation) appreciation on securities and derivatives, change in discount rate and instrument specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment.

Note 14 – Accumulated Other Comprehensive Income (Loss)

Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment.

AOCI includes the Company's share from unconsolidated entities reported on the equity method.

Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive (loss) income, net of tax, for both the three and nine months ended September 30, 2023 and 2022, is primarily driven by the change in discount rates for certain long-duration liabilities 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, including the restatement for amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements), are as follows:

Three Months Ended September 30, Nine Months Ended September 30,

Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive loss, net of tax, for the three months ended March 31, 2024 and March 31, 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 March 31,

(In millions) 2024 2023

Securities and Derivatives

Beginning balance, as retrospectively restated $ ( 118 ) $ ( 247 ) $ ( 332 ) $ 1,266

Unrealized (depreciation) appreciation on securities and derivatives

( 257 ) ( 325 ) 2 ( 2,259 )

Tax benefit (expense)

57 ( 7 ) ( 9 ) 393

Net unrealized (depreciation) on securities and derivatives

( 200 ) ( 332 ) ( 7 ) ( 1,866 )

Reclassification adjustment for losses included in Shareholders' net income ((Loss) gain on sale of businesses)

Reclassification adjustment for losses included in Shareholders' net income (Net realized investment losses)

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

( 3 ) ( 3 ) ( 8 ) ( 9 )

Net losses reclassified from AOCI to Shareholders' net income

Other comprehensive (loss) income, net of tax

Beginning balance $ 171 $ ( 332 )

Unrealized appreciation on securities and derivatives

Tax (expense)

( 39 ) ( 54 )

Net unrealized appreciation on securities and derivatives

Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)

Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income

Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income

Other comprehensive income, net of tax

Ending balance $ 292 $ ( 138 )

Three Months Ended March 31,

(In millions) 2024 2023

Net long-duration insurance and contractholder liabilities measurement adjustments

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Current period change in discount rate for certain long-duration liabilities ( 732 ) ( 411 )

Tax benefit (expense)

12 23 149 ( 98 )

Net current period change in discount rate for certain long-duration liabilities ( 546 ) ( 310 )

Current period change in instrument-specific credit risk for market risk benefits ( 18 ) ( 26 )

Tax benefit (expense)

Net current period change in instrument-specific credit risk for market risk benefits ( 14 ) ( 21 )

Other comprehensive (loss) income, net of tax

Other comprehensive (loss), net of tax

( 560 ) ( 331 )

Ending balance $ ( 1,531 ) $ ( 587 )

Translation of foreign currencies

Beginning balance, as retrospectively restated $ ( 157 ) $ ( 500 ) $ ( 154 ) $ ( 233 )

Three Months Ended March 31,

(In millions) 2024 2023

Translation of foreign currencies

Tax benefit (expense)

Net translation of foreign currencies ( 29 ) ( 90 ) ( 32 ) ( 360 )

Reclassification adjustment for losses included in Net income ((Loss) gain on sale of businesses)

Reclassification adjustment for tax expense included in Net income

Net translation losses reclassified from AOCI to Net income

Beginning balance $ ( 149 ) $ ( 154 )

Translation of foreign currencies ( 24 ) 15

Tax (expense) benefit

Other comprehensive (loss) income, net of tax

( 29 ) 175 ( 32 ) ( 95 )

Net translation gain (loss) on foreign currencies attributable to noncontrolling interests

Shareholders' other comprehensive (loss) income, net of tax

( 29 ) 174 ( 32 ) ( 93 )

Ending balance $ ( 175 ) $ ( 138 )

Three Months Ended March 31,

(In millions) 2024 2023

Postretirement benefits liability

1 unchanged sentence

Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 8 13

Reclassification adjustment for (gains) included in Shareholders' net income ((Loss) gain on sale of businesses)

— ( 2 ) — ( 2 )

Reclassification adjustment for tax (benefit) included in Shareholders' net income

( 3 ) ( 5 ) ( 9 ) ( 12 )

Net adjustments reclassified from AOCI to Shareholders' net income

Valuation update — — ( 2 ) 18

Tax benefit (expense)

Net change due to valuation update — — ( 1 ) 14

Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income

Other comprehensive income, net of tax 5 10

Ending balance $ ( 910 ) $ ( 906 )

Three Months Ended March 31,

(In millions) 2024 2023

Total Accumulated other comprehensive loss

Beginning balance, as retrospectively restated $ ( 1,878 ) $ ( 2,343 ) $ ( 1,658 ) $ ( 1,068 )

Shareholders' other comprehensive (loss) income, net of tax

Beginning balance $ ( 1,864 ) $ ( 1,658 )

Shareholders' other comprehensive (loss), net of tax

( 460 ) ( 111 )

Ending balance $ ( 2,324 ) $ ( 1,769 )

(1) Established upon the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

See Note 2 to the Consolidated Financial Statements for further information.

Note 15 – Income Taxes

Income Tax Expense

The 21.3 % effective tax rate for the three months ended September 30, 2023 was higher than the 20.4 % rate for the three months ended September 30, 2022, primarily as a result of increases for the remeasurement of deferred tax liabilities and the Medicare Advantage litigation settlement, partially offset by favorable results relative to the Company's foreign operations.

The 19.9 % effective tax rate for the nine months ended September 30, 2023 is lower than the 21.0 % rate for the nine months ended September 30, 2022.

The decrease is driven largely by favorable results relative to the Company's foreign operations and the release of uncertain tax positions resulting from favorable audit developments, partially offset by an increase for the remeasurement of deferred tax liabilities.

As of September 30, 2023, we had approximately $ 331 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are partially recorded in Accumulated other comprehensive loss.

We have determined that a valuation allowance against the DTAs is not currently required based on the Company's ability to carry back losses and our ability and intent to hold certain securities until recovery.

We continue to monitor and evaluate the need for any valuation allowance in the future.

The effective tax rate for the three months ended March 31, 2024 increased due to a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution.

The 368.4 % effective tax rate for the three months ended March 31, 2024 was higher than the 18.4 % rate for the three months ended March 31, 2023.

As of March 31, 2024, we had approximately $ 664 million in deferred tax assets ("DTAs") associated with the impairment of equity securities, as well as unrealized investment losses that are partially recorded in Accumulated other comprehensive loss.

A valuation allowance of $ 427 million, which drove the higher effective tax rate, was established in the three months ended March 31, 2024, almost entirely related to the impairment of equity securities.

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 our 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

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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, 2023, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $ 420 million.

As of March 31, 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, 2023.

there were no additional liabilities required for these guarantees, net of reinsurance, as of March 31, 2024.

Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.

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Certain Other Guarantees

The Company had indemnification obligations as of September 30, 2023 in connection with acquisition and disposition transactions.

These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with law or identification of outstanding litigation.

The Company had indemnification obligations as of March 31, 2024 in connection with acquisition and disposition transactions.

These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation.

In some cases, the maximum potential amount due is subject to contractual limitations based on a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable.

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 liabilities for these indemnification obligations as of September 30, 2023.

There were no recorded liabilities for these indemnification obligations as of March 31, 2024.

Guaranty Fund Assessments

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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, 2023.

There were no material charges or credits resulting from existing or new guaranty fund assessments for the three months ended March 31, 2024.

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.

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For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated.

The Company's accruals for the matters discussed below under "Litigation Matters" and "Regulatory Matters" are not material.

Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if any) for these matters at this time.

In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company.

An adverse outcome in one or more of these matters could be material to the Company's results of operations, financial condition or liquidity for any particular period.

The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in these ongoing litigation matters or any future claims or litigation.

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

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The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries.

Following the settlement, Elevance would retain the right to appeal the pricing-related claims that were previously dismissed by the court, while Express Scripts would retain the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful.

Medicare Advantage.

A qui tam action that was filed by a private individual (the "relator") on behalf of the government in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020.

The action asserts claims related to risk adjustment practices arising from certain health exams conducted as part of the Company's Medicare Advantage business.

In September 2021, the qui tam action was transferred to the United States District Court for the Middle District of Tennessee.

On January 11, 2022, the U.S.

Department of Justice ("DOJ") (U.S.

Attorney's Offices for the Southern District of New York and the Middle District of Tennessee) filed a motion to partially intervene, which was granted on August 2, 2022.

On October 14, 2022, the DOJ filed its complaint-in-intervention alleging that certain diagnoses made during in-home exams were invalid for risk adjustment purposes, seeking unspecified damages and penalties under the federal False Claims Act.

The Company's motion to dismiss the DOJ's complaint is fully briefed and pending before the court.

The Company's motion to dismiss relator's complaint was denied as moot after relator asked for and was granted permission to amend his complaint.

Relator filed an amended complaint on July 28, 2023, which the Company moved to dismiss on September 11, 2023.

On September 29, 2023, the Company, the relator and the DOJ settled the matter for $ 37 million plus interest and attorney’s fees.

Regulatory Matters

Civil Investigative Demand .

The DOJ is conducting industry-wide investigations of Medicare Advantage organizations' risk adjustment practices.

For certain Medicare Advantage organizations, including The Cigna Group, those investigations have resulted in litigation (see "Litigation Matters—Medicare Advantage" above).

As part of these investigations, the Company responded to information requests (civil investigative demands) from the DOJ (U.S.

Attorney's Office for the Eastern District of Pennsylvania) regarding its risk adjustment submissions.

On September 29, 2023, the Company settled the DOJ’s investigation for approximately $ 135 million plus interest.

In connection with this settlement and the settlement of the litigation (see "Litigation Matters—Medicare

Advantage" above), The Cigna Group also entered into a Corporate Integrity Agreement with the U.S.

Department of Health and Human Services Office of the Inspector General, which contains certain auditing and governance requirements for a period of five years from the settlement date.

Following the settlement, Elevance retains the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retains 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.

Note 17 – Segment Information

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The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability.

We define pre-tax adjusted income from operations as income before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets, and special items.

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.

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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,

2023 2022 2023 2022

(In millions) Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax

Charges (benefits) associated with litigation matters

(Selling, general and administrative expenses) $ 201 $ 171 $ — $ — $ 201 $ 171 $ ( 28 ) $ ( 20 )

Loss (gain) on sale of businesses 21 19 ( 1,735 ) ( 1,388 ) 21 19 ( 1,735 ) ( 1,388 )

Three Months Ended March 31,

(In millions) Pre-tax After-tax Pre-tax After-tax

Integration and transaction-related costs

(Selling, general and administrative expenses) $ 37 $ 29 $ 1 $ 1

Charge for organizational efficiency plan

(Selling, general and administrative expenses) — — — — — — 22 17

Loss (gain) on sale of businesses 19 ( 43 ) — —

Deferred tax expenses, net

(Income taxes, less amount attributable to noncontrolling interests) — 17 — —

Total impact from special items $ 56 $ 3 $ 1 $ 1

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts.

See Note 2 to the Consolidated Financial Statements for further information.

Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting.

Summarized segment financial information was as follows:

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Corporate and Eliminations

Three months ended September 30, 2023

Three months ended March 31, 2024

Revenues from external customers $ 44,886 $ 12,012 $ 66 $ 1 $ 56,965

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Net realized investment results from certain equity method investments

Adjusted revenues $ 38,596 $ 12,768 $ 147 $ ( 2,433 ) $ 49,078

Income (loss) before income taxes

— ( 8 ) — — ( 8 )

Pre-tax adjustments to reconcile to adjusted income from operations

(Income) attributable to noncontrolling interests

( 44 ) — — — ( 44 )

Net realized investment losses (1)

Amortization of acquired intangible assets 443 11 — — 454

Special items

Charges associated with litigation matters 44 157 — — 201

Loss on sale of businesses — — 21 — 21

Integration and transaction-related costs — — — 13 13

Pre-tax adjusted income (loss) from operations $ 1,716 $ 1,222 $ 26 $ ( 435 ) $ 2,529

(In millions) Evernorth Health Services

Cigna Healthcare

Other Operations

Corporate and Eliminations

Three months ended September 30, 2022

Revenues from external customers $ 34,670 $ 10,329 $ 78 $ — $ 45,077

Intersegment revenues 1,003 667 — ( 1,670 )

Net investment income

25 101 75 3 204

Total revenues 35,698 11,097 153 ( 1,667 ) 45,281

Net realized investment results from certain equity method investments — 80 — — 80

Adjusted revenues $ 46,226 $ 13,277 $ 166 $ ( 2,422 ) $ 57,247

Income (loss) before income taxes

(Loss) income before income taxes

$ ( 436 ) $ 943 $ 18 $ ( 446 ) $ 79

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Special items

(Gain) on sale of businesses — — ( 1,735 ) — ( 1,735 )

Integration and transaction-related costs — — — 37 37

Pre-tax adjusted income (loss) from operations $ 1,625 $ 1,050 $ 21 $ ( 316 ) $ 2,380

(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.

(In millions) Evernorth Health Services

Cigna Healthcare

Other Operations

Corporate and Eliminations

Nine months ended September 30, 2023

Revenues from external customers $ 108,462 $ 34,581 $ 232 $ — $ 143,275

Intersegment revenues 4,343 3,143 — ( 7,486 )

Net investment income

175 454 230 17 876

Total revenues 112,980 38,178 462 ( 7,469 ) 144,151

Net realized investment results from certain equity method investments

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)

Amortization of acquired intangible assets 1,330 38 — — 1,368

Special items

Charges associated with litigation matters 44 157 — — 201

Loss on sale of businesses — 19 — — 19

Integration and transaction-related costs — — — 20 20

Pre-tax adjusted income (loss) from operations $ 1,360 $ 1,340 $ 18 $ ( 409 ) $ 2,309

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Corporate and Eliminations

Nine months ended September 30, 2022

Three months ended March 31, 2023

Revenues from external customers

11 unchanged sentences

( 42 ) ( 1 ) — — ( 43 )

Net realized investment losses (1)

Net realized investment losses (gains) (1)

— 24 ( 6 ) — 18

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Special items

(Benefits) associated with litigation matters — — — ( 28 ) ( 28 )

(Gain) on sale of businesses — — ( 1,735 ) — ( 1,735 )

Integration and transaction-related costs — — — 1 1

Charge for organizational efficiency plan — — — 22 22

Pre-tax adjusted income (loss) from operations $ 1,320 $ 1,115 $ 15 $ ( 414 ) $ 2,036

(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.

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

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues.

Prior period amounts have been retrospectively adjusted to reflect adoption of amended accounting guidance for long-duration insurance contracts, as discussed in Note 2 to the Consolidated Financial Statements.

The following table presents these revenues by product, premium and service type:

Three Months Ended September 30, Nine Months Ended September 30,

Three Months Ended March 31,

(In millions) 2024 2023

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Other revenues 2,546 1,867

Total Evernorth Health Services

43,170 33,640

Total Other Operations

Intercompany eliminations ( 1,151 ) ( 1,496 )

Total Pharmacy revenues

42,036 32,144

Insurance premiums (ASC 944)

Cigna Healthcare (1)

Commercial (1)

Insured 4,144 3,821 12,315 11,312

Employer insured 4,393 4,080

Medicare Advantage 2,287 2,236

Stop loss 1,668 1,503

Individual and Family Plans 1,040 1,208

Other 1,258 1,117

Government (1)

Medicare Advantage 2,189 1,949 6,605 6,080

Medicare Part D 224 240 984 986

Short-duration (Individual and family plans) 1,266 697 3,767 2,014

Long-duration (2) (Individual Medicare supplement and limited benefit health products)

10,646 10,144

International Health 885 786

Short-duration (Group medical insurance) 743 655 2,174 1,911

Long-duration (2) (Individual private medical insurance)

91 77 266 235

Total Cigna Healthcare 11,531 10,930

Divested International businesses — — — 1,500

Other 70 76 225 219

Intercompany eliminations 24 16

Total Premiums

11,603 11,025

Services (Fees) (ASC 606)

Evernorth Health Services

2,862 1,875 8,199 5,289

Cigna Healthcare

1,639 1,530 4,847 4,504

Other Operations

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Total revenues from external customers $ 56,965 $ 46,240

(1) Other than the long-duration products referenced in the table, U.S.

(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 insurance contracts are short-duration.

Government's and International Health's long-duration premium revenues are associated with contracts that provide coverage greater than one year or are guaranteed to be renewed at the option of the policyholder beyond one year.

Government operating segments merged to form the U.S.

Healthcare operating segment.

Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.

Financial and performance guarantees.

Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels.

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Historically, adjustments to original estimates have not been material.

This guarantee liability was $ 1.3 billion as of each of September 30, 2023 and December 31, 2022.

This guarantee liability was $ 1.9 billion as of March 31, 2024 and $ 1.6 billion as of December 31, 2023.

Major customers.

Revenues from a single pharmacy benefit client were approximately 15 % of consolidated revenues for the three months ended March 31, 2024.

These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S.

Federal Government agencies, under a number of contracts, were approximately 13 % of consolidated revenues for the three months ended March 31, 2024.

These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments.

See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.

Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-Q

Item 1. Financial Statements