Cigna Group 10-Q

Item 1. FINANCIAL STATEMENTS The Cigna Group Consolidated Statements of Income Unaudited Unaudited Three Months Ended June 30, Six Months Ended June 30, (In millions, except per share amounts) 2024 2023 2024 2023 Revenues Pharmacy revenues $ 45,101 $ 33,964 $ 87,137 $ 66,108 Premiums 11,454 11,039 23,057 22,064 Fees and other revenues 3,647 3,305 6,973 6,376 Net investment income 321 278 611 555 TOTAL REVENUES 60,523 48,586 117,778 95,103 Benefits and expenses Pharmacy and other service costs 44,492 33,442 85,923 64,901 Medical costs and other benefit expenses 9,515 9,034 18,955 18,080 Selling, general and administrative expenses 3,684 3,434 7,389 6,972 Amortization of acquired intangible assets 420 455 843 914 TOTAL BENEFITS AND EXPENSES 58,111 46,365 113,110 90,867 Income from operations 2,412 2,221 4,668 4,236 Interest expense and other ( 375 ) ( 363 ) ( 697 ) ( 721 ) Loss on sale of businesses — — ( 19 ) — Net realized investment (losses) gains ( 48 ) 26 ( 1,884 ) ( 30 ) Income before income taxes 1,989 1,884 2,068 3,485 TOTAL INCOME TAXES 360 374 651 669 Net income 1,629 1,510 1,417 2,816 Less: Net income attributable to noncontrolling interests 81 50 146 89 SHAREHOLDERS’ NET INCOME $ 1,548 $ 1,460 $ 1,271 $ 2,727 Shareholders' net income per share Basic $ 5.51 $ 4.96 $ 4.48 $ 9.24 Diluted $ 5.45 $ 4.92 $ 4.43 $ 9.15 The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements. 3 The Cigna Group Consolidated Statements of Comprehensive Income Unaudited Unaudited Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Net income $ 1,629 $ 1,510 $ 1,417 $ 2,816 Other comprehensive income (loss), net of tax Net unrealized appreciation on securities and derivatives 108 20 229 214 Net long-duration insurance and contractholder liabilities measurement adjustments ( 212 ) ( 117 ) ( 772 ) ( 448 ) Net translation (losses) on foreign currencies ( 5 ) ( 19 ) ( 31 ) ( 3 ) Postretirement benefits liability adjustment ( 9 ) 7 ( 4 ) 17 Other comprehensive loss, net of tax ( 118 ) ( 109 ) ( 578 ) ( 220 ) Total comprehensive income 1,511 1,401 839 2,596 Comprehensive income (loss) attributable to noncontrolling interests Net income attributable to redeemable noncontrolling interests — 45 — 79 Net income attributable to other noncontrolling interests 81 5 146 10 Total comprehensive income attributable to noncontrolling interests 81 50 146 89 SHAREHOLDERS' COMPREHENSIVE INCOME $ 1,430 $ 1,351 $ 693 $ 2,507 The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements. 4 The Cigna Group Consolidated Balance Sheets Unaudited As of June 30, As of December 31, (In millions) 2024 2023 Assets Cash and cash equivalents $ 6,788 $ 7,822 Investments 1,068 925 Accounts receivable, net 25,111 17,722 Inventories 5,173 5,645 Other current assets 2,664 2,169 Assets of businesses held for sale 5,411 3,068 Total current assets 46,215 37,351 Long-term investments 15,944 17,985 Reinsurance recoverables 4,595 4,835 Property and equipment 3,551 3,695 Goodwill 44,258 44,259 Other intangible assets 30,176 30,863 Other assets 3,276 3,421 Separate account assets 7,431 7,430 Assets of businesses held for sale, non-current — 2,922 TOTAL ASSETS $ 155,446 $ 152,761 Liabilities Current insurance and contractholder liabilities $ 5,616 $ 5,514 Pharmacy and other service costs payable 27,503 19,815 Accounts payable 9,275 8,553 Accrued expenses and other liabilities 9,003 9,955 Short-term debt 1,717 2,775 Liabilities of businesses held for sale 2,259 2,104 Total current liabilities 55,373 48,716 Non-current insurance and contractholder liabilities 10,449 10,904 Deferred tax liabilities, net 6,953 7,173 Other non-current liabilities 3,538 3,441 Long-term debt 30,175 28,155 Separate account liabilities 7,431 7,430 Liabilities of businesses held for sale, non-current — 591 TOTAL LIABILITIES 113,919 106,410 Contingencies — Note 16 Redeemable noncontrolling interests — 107 Shareholders' equity Common stock (1) 4 4 Additional paid-in capital 31,048 30,669 Accumulated other comprehensive loss ( 2,442 ) ( 1,864 ) Retained earnings 42,132 41,652 Less: Treasury stock, at cost ( 29,410 ) ( 24,238 ) TOTAL SHAREHOLDERS' EQUITY 41,332 46,223 Other noncontrolling interests 195 21 Total equity 41,527 46,244 Total liabilities and equity $ 155,446 $ 152,761 (1) Par value per share, $ 0.01 ; shares issued, 402 million as of June 30, 2024 and 400 million as of December 31, 2023; authorized shares, 600 million. The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements. 5 The Cigna Group Consolidated Statements of Changes in Total Equity Unaudited Three Months Ended June 30, 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 March 31, 2024 $ 4 $ 30,292 $ ( 2,324 ) $ 40,978 $ ( 27,769 ) $ 41,181 $ 169 $ 41,350 $ — Effects of issuing stock for employee benefit plans 116 ( 1 ) 115 115 Other comprehensive loss ( 118 ) ( 118 ) ( 118 ) — Net income 1,548 1,548 81 1,629 — Common dividends declared (per share: $ 1.40 ) ( 394 ) ( 394 ) ( 394 ) Repurchase of common stock 640 ( 1,640 ) ( 1,000 ) ( 1,000 ) Other transactions impacting noncontrolling interests — — ( 55 ) ( 55 ) — Balance at June 30, 2024 $ 4 $ 31,048 $ ( 2,442 ) $ 42,132 $ ( 29,410 ) $ 41,332 $ 195 $ 41,527 $ — Three Months Ended June 30, 2023 (In millions) Common Stock Additional Paid-in Capital Accumulated Other Comprehensive (Loss) Retained Earnings Treasury Stock Shareholders' Equity Other Non- controlling Interests Total Equity Redeemable Noncontrolling Interests Balance at March 31, 2023 $ 4 $ 30,332 $ ( 1,769 ) $ 38,841 $ ( 22,906 ) $ 44,502 $ 16 $ 44,518 $ 78 Effect of issuing stock for employee benefit plans 106 ( 1 ) 105 105 Other comprehensive loss ( 109 ) ( 109 ) ( 109 ) — Net income 1,460 1,460 5 1,465 45 Common dividends declared (per share: $ 1.23 ) ( 365 ) ( 365 ) ( 365 ) Repurchase of common stock — ( 146 ) ( 146 ) ( 146 ) Other transactions impacting noncontrolling interests ( 2 ) ( 2 ) ( 2 ) ( 4 ) ( 61 ) Balance at June 30, 2023 $ 4 $ 30,436 $ ( 1,878 ) $ 39,936 $ ( 23,053 ) $ 45,445 $ 19 $ 45,464 $ 62 The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements. 6 The Cigna Group Consolidated Statements of Changes in Total Equity Unaudited Six Months Ended June 30, 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 December 31, 2023 $ 4 $ 30,669 $ ( 1,864 ) $ 41,652 $ ( 24,238 ) $ 46,223 $ 21 $ 46,244 $ 107 Effect of issuing stock for employee benefit plans 379 ( 115 ) 264 264 Other comprehensive loss ( 578 ) ( 578 ) ( 578 ) — Net income 1,271 1,271 146 1,417 — Common dividends declared (per share: $ 2.80 ) ( 791 ) ( 791 ) ( 791 ) Repurchase of common stock — ( 5,057 ) ( 5,057 ) ( 5,057 ) Other transactions impacting noncontrolling interests — — 28 28 ( 107 ) Balance at June 30, 2024 $ 4 $ 31,048 $ ( 2,442 ) $ 42,132 $ ( 29,410 ) $ 41,332 $ 195 $ 41,527 $ — Six Months Ended June 30, 2023 (In millions) Common Stock Additional Paid-in Capital Accumulated Other Comprehensive (Loss) Retained Earnings Treasury Stock Shareholders' Equity Other Non- controlling Interests Total Equity Redeemable Noncontrolling Interests Balance at December 31, 2022 $ 4 $ 30,233 $ ( 1,658 ) $ 37,940 $ ( 21,844 ) $ 44,675 $ 13 $ 44,688 $ 66 Effect of issuing stock for employee benefit plans 205 ( 105 ) 100 100 Other comprehensive loss ( 220 ) ( 220 ) ( 220 ) — Net income 2,727 2,727 10 2,737 79 Common dividends declared (per share: $ 2.46 ) ( 731 ) ( 731 ) ( 731 ) Repurchase of common stock — ( 1,104 ) ( 1,104 ) ( 1,104 ) Other transactions impacting noncontrolling interests ( 2 ) ( 2 ) ( 4 ) ( 6 ) ( 83 ) Balance at June 30, 2023 $ 4 $ 30,436 $ ( 1,878 ) $ 39,936 $ ( 23,053 ) $ 45,445 $ 19 $ 45,464 $ 62 The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements. 7 The Cigna Group Consolidated Statements of Cash Flows Unaudited Six Months Ended June 30, (In millions) 2024 2023 Cash Flows from Operating Activities Net income $ 1,417 $ 2,816 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization 1,479 1,504 Realized investment losses, net 1,884 30 Deferred income tax benefit ( 199 ) ( 207 ) Loss on sale of businesses 19 — Net changes in assets and liabilities, net of non-operating effects: Accounts receivable, net ( 7,313 ) ( 1,144 ) Inventories 472 263 Reinsurance recoverable and Other assets ( 559 ) 109 Insurance liabilities ( 125 ) 1,727 Pharmacy and other service costs payable 7,820 1,547 Accounts payable and Accrued expenses and other liabilities ( 15 ) 638 Other, net 225 237 NET CASH PROVIDED BY OPERATING ACTIVITIES 5,105 7,520 Cash Flows from Investing Activities Proceeds from investments sold: Debt securities and equity securities 393 646 Investment maturities and repayments: Debt securities and equity securities 414 502 Commercial mortgage loans 37 82 Other sales, maturities and repayments (primarily short-term and other long-term investments) 451 313 Investments purchased or originated: Debt securities and equity securities ( 493 ) ( 3,339 ) Commercial mortgage loans ( 52 ) ( 59 ) Other (primarily short-term and other long-term investments) ( 865 ) ( 685 ) Property and equipment purchases, net ( 670 ) ( 805 ) Divestitures, net of cash sold — 27 Other, net ( 350 ) ( 79 ) NET CASH USED IN INVESTING ACTIVITIES ( 1,135 ) ( 3,397 ) Cash Flows from Financing Activities Deposits and interest credited to contractholder deposit funds 84 96 Withdrawals and benefit payments from contractholder deposit funds ( 135 ) ( 100 ) Net change in short-term debt ( 467 ) 183 Repayment of long-term debt ( 3,000 ) ( 80 ) Net proceeds on issuance of long-term debt 4,462 1,491 Repurchase of common stock ( 5,012 ) ( 1,116 ) Issuance of common stock 221 59 Common stock dividend paid ( 793 ) ( 730 ) Other, net ( 198 ) ( 275 ) NET CASH USED IN FINANCING ACTIVITIES ( 4,838 ) ( 472 ) Effect of foreign currency rate changes on cash, cash equivalents and restricted cash ( 12 ) 9 Net (decrease) increase in cash, cash equivalents and restricted cash ( 880 ) 3,660 Cash, cash equivalents and restricted cash January 1, (1) 8,337 5,976 Cash, cash equivalents and restricted cash, June 30, (2) 7,457 9,636 Cash and cash equivalents reclassified to assets of businesses held for sale ( 625 ) — Cash, cash equivalents and restricted cash June 30, per Consolidated Balance Sheets (2) $ 6,832 $ 9,636 Supplemental Disclosure of Cash Information: Income taxes paid, net of refunds $ 567 $ 926 Interest paid $ 643 $ 632 (1) Includes $ 467 million reported in Assets of businesses held for sale as of January 1, 2024. (2) Restricted cash and cash equivalents were reported in other long-term investments. The accompanying Notes to the Consolidated Financial Statements (unaudited) are an integral part of these statements . 8 THE CIGNA GROUP NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED) TABLE OF CONTENTS Note Number Footnote Page B USINESS AND C APITAL S TRUCTURE 1 Description of Business 10 2 Summary of Significant Accounting Policies 10 3 Accounts Receivable, Net 11 4 Supplier Finance Program 11 5 Assets and Liabilities of Businesses Held for Sale 12 6 Earnings Per Share 12 7 Debt 14 8 Common and Preferred Stock 16 I NSURANCE I NFORMATION 9 Insurance and Contractholder Liabilities 17 10 Reinsurance 21 I NVESTMENTS 11 Investments 22 12 Fair Value Measurements 26 13 Variable Interest Entities 29 14 Accumulated Other Comprehensive Income (Loss) 29 C OMPLIANCE , R EGULATION AND C ONTINGENCIES 15 Income Taxes 30 16 Contingencies and Other Matters 31 R ESULTS D ETAILS 17 Segment Information 32 9 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 committed to creating a better future for every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. Powered by our people and our brands, we advance our mission to improve the health and vitality of those we serve. Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services. The majority of these products and services are offered through employers and other entities 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 select international markets. In addition to these operations, The Cigna Group also has certain run-off operations. A full description of our segments follows: The Evernorth Health Services reportable segment includes 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 Evernorth Health Services' 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. U.S. 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. Note 2 – Summary of Significant Accounting Policies Basis of Presentation The Consolidated Financial Statements include the accounts of The Cigna Group and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP"). 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 10 these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment. These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2023 Annual Report on Form 10-K ("2023 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations. Recent Accounting Pronouncements The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. 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) June 30, 2024 December 31, 2023 Pharmaceutical manufacturers receivables $ 12,555 $ 8,169 Noninsurance customer receivables 10,946 8,044 Insurance customer receivables 2,325 2,359 Other receivables 289 272 Total $ 26,115 $ 18,844 Accounts receivable, net classified as assets of businesses held for sale ( 1,004 ) ( 1,122 ) Total $ 25,111 $ 17,722 These accounts receivable are reported net of our allowances of $ 4.4 billion as of June 30, 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 $ 95 million as of June 30, 2024 and $ 90 million as of December 31, 2023. Accounts Receivable Factoring Facility 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 began in July 2023 with an initial term of two years , followed by automatic one year renewal terms unless terminated by either party. The Facility's total capacity at inception was $ 1.0 billion and was amended to $ 1.5 billion during the three months ended June 30, 2024. 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 and six months ended June 30, 2024, we sold $ 1.3 billion and $ 3.2 billion of accounts receivable under the Facility and factoring fees paid were not material. As of June 30, 2024, there were $ 322 million of sold accounts receivable that have not been collected from pharmaceutical manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from pharmaceutical manufacturers. As of June 30, 2024 and December 31, 2023, there were $ 713 million and $ 515 million, respectively, of collections from pharmaceutical 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 11 order to be paid earlier than our payment terms require. Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K. As of June 30, 2024 and December 31, 2023, $ 1.7 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 June 30, 2024, we have been informed by the financial institution that $ 348 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) June 30, 2024 December 31, 2023 Cash and cash equivalents $ 625 $ 467 Investments 1,401 1,438 Accounts receivable, net 1,004 1,122 Other assets, including Goodwill (1) 2,381 2,963 Total assets of businesses held for sale 5,411 5,990 Insurance and contractholder liabilities 1,557 1,636 All other liabilities 702 1,059 Total liabilities of businesses held for sale $ 2,259 $ 2,695 (1) Includes Goodwill of $ 396 million as of June 30, 2024 and December 31, 2023. Integration and Transaction-related Costs In 2024 and 2023, the Company incurred transaction-related costs associated with the HCSC transaction. In 2023, the Company also incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). These costs incurred in both 2024 and 2023 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 $ 63 million pre-tax ($ 47 million after-tax) for the three months ended and $ 100 million pre-tax ($ 76 million after-tax) for the six months ended June 30, 2024, compared with $ 6 million pre-tax ($ 5 million after-tax) for the three months ended and $ 7 million pre-tax ($ 6 million after-tax) for the six months ended June 30, 2023. Note 6 – Earnings Per Share Basic and diluted earnings per share were computed as follows: Three Months Ended June 30, 2024 June 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Dilution Diluted Basic Effect of Dilution Diluted Shareholders' net income $ 1,548 $ 1,548 $ 1,460 $ 1,460 Shares: Weighted average 281,133 281,133 294,512 294,512 Common stock equivalents 2,919 2,919 2,367 2,367 Total shares 281,133 2,919 284,052 294,512 2,367 296,879 Earnings per share $ 5.51 $ ( 0.06 ) $ 5.45 $ 4.96 $ ( 0.04 ) $ 4.92 12 Six Months Ended June 30, 2024 June 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Dilution Diluted Basic Effect of Dilution Diluted Shareholders' net income $ 1,271 $ 1,271 $ 2,727 $ 2,727 Shares: Weighted average 283,799 283,799 295,105 295,105 Common stock equivalents 3,085 3,085 2,831 2,831 Total shares 283,799 3,085 286,884 295,105 2,831 297,936 Earnings per share $ 4.48 $ ( 0.05 ) $ 4.43 $ 9.24 $ ( 0.09 ) $ 9.15 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 June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Anti-dilutive options 0.8 0.9 1.2 0.9 The Company held approximately 122.5 million shares of common stock in treasury at June 30, 2024, 107.4 million shares as of December 31, 2023 and 103.3 million shares as of June 30, 2023. The increase in Treasury stock as of June 30, 2024 and the reduction in weighted average shares outstanding for the six months ended June 30, 2024 was driven in part by 9.3 million shares of our common stock repurchased under the accelerated share repurchase agreements (the "ASR agreements"), approximately 1.7 million of which were received in the three months ended June 30, 2024. S ee Note 8 for additional information. 13 Note 7 – Debt The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows: (In millions) June 30, 2024 December 31, 2023 Short-term debt Commercial paper $ 790 $ 1,237 $ 500 million, 0.613 % Notes due March 2024 — 500 $ 790 million, 3.500 % Notes due June 2024 (1) — 996 $ 900 million, 3.250 % Notes due April 2025 (2) 885 — Other, including finance leases 42 42 Total short-term debt $ 1,717 $ 2,775 Long-term debt $ 900 million, 3.250 % Notes due April 2025 (2) — 882 $ 1,216 million, 4.125 % Notes due November 2025 (1) 1,215 2,197 $ 1,284 million, 4.500 % Notes due February 2026 (1) 1,285 1,502 $ 550 million, 1.250 % Notes due March 2026 (1) 549 798 $ 700 million, 5.685 % Notes due March 2026 698 698 $ 1,500 million, 3.400 % Notes due March 2027 1,459 1,450 $ 259 million, 7.875 % Debentures due May 2027 259 259 $ 600 million, 3.050 % Notes due October 2027 598 597 $ 3,800 million, 4.375 % Notes due October 2028 3,790 3,787 $ 1,000 million, 5.000 % Notes due May 2029 994 — $ 1,400 million, 2.400 % Notes due March 2030 (1) (2) 1,394 1,493 $ 1,500 million, 2.375 % Notes due March 2031 (2) 1,383 1,397 $ 750 million, 5.125 % Notes due May 2031 745 — $ 45 million, 8.080 % Step Down Notes due January 2033 45 45 $ 800 million, 5.400 % Notes due March 2033 795 794 $ 1,250 million, 5.250 % Notes due February 2034 (2) 1,242 — $ 190 million, 6.150 % Notes due November 2036 190 190 $ 2,200 million, 4.800 % Notes due August 2038 2,193 2,193 $ 750 million, 3.200 % Notes due March 2040 744 744 $ 121 million, 5.875 % Notes due March 2041 119 119 $ 448 million, 6.125 % Notes due November 2041 486 487 $ 317 million, 5.375 % Notes due February 2042 315 315 $ 1,500 million, 4.800 % Notes due July 2046 1,467 1,467 $ 1,000 million, 3.875 % Notes due October 2047 990 989 $ 3,000 million, 4.900 % Notes due December 2048 2,970 2,970 $ 1,250 million, 3.400 % Notes due March 2050 1,237 1,237 $ 1,500 million, 3.400 % Notes due March 2051 1,479 1,479 $ 1,500 million, 5.600 % Notes due February 2054 1,482 — Other, including finance leases 52 66 Total long-term debt $ 30,175 $ 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 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments. Short-term and Credit Facilities Debt Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including providing liquidity support if necessary under our commercial paper program discussed below. As of June 30, 2024, there were no outstanding balances under these revolving credit agreements. 14 In April 2024, The Cigna Group replaced its previous revolving credit agreements and entered into the following (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. The Company can borrow up to $ 5.0 billion under the credit agreement for general corporate purposes, with up to $ 500 million available for issuance of letters of credit. • a $ 1.5 billion 364-day revolving credit agreement that will mature in April 2025. The Company can borrow up to $ 1.5 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion. Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $ 1.5 billion across both facilities for a maximum total commitment of $ 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 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 June 30, 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. Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $ 5.0 billion. In July 2024, our commercial paper program size was increased to $ 6.5 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The weighted average interest rate of our commercial paper was 5.47 % at June 30, 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 that 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 Redeemable Date (1) "Make whole" premium basis points over U.S. Treasury rate (2) $ 1,000 million May 15, 2029 5.000 % $ 995 million April 15, 2029 15 $ 750 million May 15, 2031 5.125 % $ 746 million March 15, 2031 15 $ 1,250 million February 15, 2034 5.250 % $ 1,244 million November 15, 2033 20 $ 1,500 million February 15, 2054 5.600 % $ 1,485 million August 15, 2053 20 (1) Redeemable at any time prior to this date at a "make whole" premium, defined below. Redeemable at par on or after this date. (2) "Make whole" premium calculated using the most directly comparable U.S. Treasury rate plus the amount of basis points set forth in this column. 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 $ 378 million for the three months ended and $ 747 million for the six months ended June 30, 2024, compared with $ 350 million for the three months ended and $ 695 million for the six months ended June 30, 2023. Debt Covenants The Company was in compliance with its debt covenants as of June 30, 2024. 15 Note 8 – Common and Preferred Stock Dividends The following table provides details of the Company's dividend payments: Record Date Payment Date Amount per Share Total Amount Paid (in millions) 2024 March 6, 2024 March 21, 2024 $ 1.40 $ 401 June 4, 2024 June 20, 2024 $ 1.40 $ 392 2023 March 8, 2023 March 23, 2023 $ 1.23 $ 368 June 7, 2023 June 22, 2023 $ 1.23 $ 362 On July 24, 2024, the Board of Directors declared the third quarter cash dividend of $ 1.40 per share of The Cigna Group common stock to be paid on September 19, 2024 to shareholders of record on September 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. The total number of shares of our common stock repurchased under the agreements was approximately 9.3 million, at $ 344.98 per share. The per share amount was calculated based on the daily volume-weighted average share price of our common stock over the term of the agreements, less a discount. 16 Note 9 – Insurance and Contractholder Liabilities A. Account Balances – Insurance and Contractholder Liabilities The Company's insurance and contractholder liabilities were comprised of the following: June 30, 2024 December 31, 2023 June 30, 2023 (In millions) Current Non-current Total Current Non-current Total Total Unpaid claims and claim expenses Cigna Healthcare $ 5,124 $ 78 $ 5,202 $ 5,017 $ 75 $ 5,092 $ 5,336 Other Operations 165 151 316 99 154 253 297 Future policy benefits Cigna Healthcare 90 506 596 97 518 615 595 Other Operations 162 3,200 3,362 163 3,375 3,538 3,587 Contractholder deposit funds Cigna Healthcare 10 125 135 12 133 145 158 Other Operations 360 6,021 6,381 362 6,178 6,540 6,647 Market risk benefits 25 840 865 37 966 1,003 1,069 Unearned premiums 737 28 765 846 22 868 1,425 Total 6,673 10,949 17,622 6,633 11,421 18,054 Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1) ( 1,057 ) ( 500 ) ( 1,557 ) ( 1,119 ) ( 517 ) ( 1,636 ) Total insurance and contractholder liabilities $ 5,616 $ 10,449 $ 16,065 $ 5,514 $ 10,904 $ 16,418 $ 19,114 (1) Amounts classified as liabilities of businesses held for sale include $ 900 million of Unpaid claims, $ 417 million of Future policy benefits, $ 129 million of Unearned premiums and $ 111 million of Contractholder deposit funds as of June 30, 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. B. Unpaid Claims and Claim Expenses – Cigna Healthcare This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, 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 $ 4.8 billion at June 30, 2024 and $ 5.0 billion at June 30, 2023. 17 Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows: Six Months Ended June 30, (In millions) 2024 (1) 2023 Beginning balance $ 5,092 $ 4,176 Less: Reinsurance and other amounts recoverable 236 221 Beginning balance, net 4,856 3,955 Incurred costs related to: Current year 18,821 17,974 Prior years ( 284 ) ( 202 ) Total incurred 18,537 17,772 Paid costs related to: Current year 14,397 13,408 Prior years 3,960 3,199 Total paid 18,357 16,607 Ending balance, net 5,036 5,120 Add: Reinsurance and other amounts recoverable 166 216 Ending balance $ 5,202 $ 5,336 (1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of June 30, 2024 and December 31, 2023, $ 900 million and $ 823 million classified as liabilities of businesses held for sale, respectively. Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance. Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows: Six Months Ended June 30, 2024 2023 (Dollars in millions) $ % (1) $ % (2) Actual completion factors $ 83 0.2 % $ 29 0.1 % Medical cost trend 201 0.6 173 0.5 Total favorable variance $ 284 0.8 % $ 202 0.6 % (1) Percentage of current year incurred costs as reported for the year ended December 31, 2023. (2) Percentage of current year incurred costs as reported for the year ended December 31, 2022. Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions. C. Future Policy Benefits Cigna Healthcare The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows: As of June 30, 2024 June 30, 2023 Interest accretion rate 2.70 % 2.20 % Current discount rate 5.31 % 5.36 % Weighted average duration 7.8 years 7.8 years 18 The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses. The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows: Six Months Ended June 30, (In millions) 2024 (1) 2023 Present value of expected net premiums Beginning balance $ 9,233 $ 8,557 Reversal of effect of beginning of period discount rate assumptions 1,154 1,537 Effect of assumption changes and actual variances from expected experience (2) ( 90 ) 51 Issuances and lapses 848 570 Net premiums collected ( 699 ) ( 658 ) Interest and other (3) 142 106 Ending balance at original discount rate 10,588 10,163 Effect of end of period discount rate assumptions ( 1,357 ) ( 1,491 ) Ending balance (4) $ 9,231 $ 8,672 Present value of expected policy benefits Beginning balance $ 9,633 $ 8,945 Reversal of effect of discount rate assumptions 1,220 1,611 Effect of assumption changes and actual variances from expected experience (2) ( 87 ) 54 Issuances and lapses 855 558 Benefit payments ( 725 ) ( 661 ) Interest and other (3) 147 121 Ending balance at original discount rate 11,043 10,628 Effect of discount rate assumptions ( 1,432 ) ( 1,565 ) Ending balance (5) $ 9,611 $ 9,063 Liability for future policy benefits $ 380 $ 391 Other (6) 216 204 Total liability for future policy benefits (1)(7) $ 596 $ 595 (1) Includes $ 417 million and $ 429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023, respectively. (2) Includes the effect of actual variances from expectations, which (decreased) increased the total liability for future policy benefits by $( 2 ) million and $ 2 million, respectively, for the six months ended June 30, 2024 and June 30, 2023. (3) Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate. (4) As of June 30, 2024 and June 30, 2023 undiscounted expected future gross premiums were $ 18.9 billion and $ 17.7 billion, respectively. As of June 30, 2024 and June 30, 2023 discounted expected future gross premiums were $ 13.2 billion and $ 12.3 billion, respectively. (5) As of June 30, 2024 and June 30, 2023, undiscounted expected future policy benefits were $ 13.7 billion and $ 12.9 billion, respectively. (6) The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off. (7) $ 73 million and $ 154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of June 30, 2024 and June 30, 2023, respectively, relate to the liability for future policy benefits. Additionally, $ 80 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of June 30, 2024. Other Operations The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows: As of June 30, 2024 June 30, 2023 Interest accretion rate 5.64 % 5.64 % Current discount rate 5.38 % 5.02 % Weighted average duration 11.2 years 11.7 years Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations ' traditional insurance contracts, which are in run-off, have no premium remaining to be collected; 19 therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability. Future policy benefits for Other Operations includes deferred profit liability of $ 0.4 billion as of both June 30, 2024 and June 30, 2023. Future policy benefits excluding deferred profit liability were $ 3.0 billion as of June 30, 2024 and $ 3.2 billion as of December 31, 2023, June 30, 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 June 30, 2024 and $ 4.5 billion as of June 30, 2023. As of June 30, 2024 and June 30, 2023, $ 0.9 billion and $ 1.0 billion, respectively, of the future policy benefit reserve was recoverable through treaties with external reinsurers. D. Contractholder Deposit Funds Contractholder deposit fund liabilities within Other Operations were $ 6.4 billion as of June 30, 2024, $ 6.5 billion as of December 31, 2023, $ 6.6 billion as of June 30, 2023 and $ 6.7 billion as of December 31, 2022. Approximately 38 % of the balance is reinsured externally. Activity in these liabilities is presented net of reinsurance in the Consolidated Statements of Cash Flows. The net year-to-date decrease in contractholder deposit fund liabilities generally relates to withdrawals and benefit payments from contractholder deposit funds, partially offset by deposits and interest credited to contractholder deposit funds. As of June 30, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.25 %, $ 2.9 billion and $ 2.8 billion, respectively. The comparative amounts as of June 30, 2023 were 3.26 %, $ 3.2 billion and $ 2.8 billion, respectively. More than 99 % of the $ 4.0 billion liability as of June 30, 2024 and the $ 4.1 billion liability as of June 30, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3 % - 4 %, and approximately $ 1.1 billion and $ 1.2 billion, as of June 30, 2024 and June 30, 2023, respectively, represented contracts with policies at the guarantee. As of both June 30, 2024 and June 30, 2023, $ 1.2 billion was 50 - 150 basis points ("bps") above the guarantee and the remaining $ 1.7 billion represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. As of both June 30, 2024 and June 30, 2023, more than 90 % of these contracts have actual cash values of at least 110% of the guaranteed cash value. E. Market Risk Benefits Liabilities for market risk benefits consist of variable annuity reinsurance contracts in Other Operations. These liabilities arise under annuities and riders to annuities written by ceding companies that guarantee the benefit received at death and, for a subset of policies, also provide contractholders the option, within 30 days of a policy anniversary after the appropriate waiting period, to elect minimum income payments. The Company's capital market risk exposure on variable annuity reinsurance contracts arises when the reinsured guaranteed minimum benefit exceeds the contractholder's account value in the related underlying mutual funds at the time the insurance benefit is payable under the respective contract. The Company receives and pays premium periodically based on the terms of the reinsurance agreements. Market risk benefits activity was as follows: Six Months Ended June 30, (Dollars in millions) 2024 2023 Balance, beginning of year $ 1,003 $ 1,268 Balance, beginning of year, before the effect of nonperformance risk (own credit risk) 1,085 1,379 Changes due to expected run-off ( 6 ) ( 14 ) Changes due to capital markets versus expected ( 133 ) ( 194 ) Changes due to policyholder behavior versus expected ( 17 ) 8 Assumption changes — ( 32 ) Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 929 1,147 Nonperformance risk (own credit risk), end of period ( 64 ) ( 78 ) Balance, end of period $ 865 $ 1,069 Reinsured market risk benefit, end of period $ 927 $ 1,143 20 The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements. (Dollars in millions, excludes impact of reinsurance ceded) June 30, 2024 June 30, 2023 Net amount at risk $ 1,391 $ 1,871 Average attained age of contractholders (weighted by exposure) 77.8 years 76.3 years Note 10 – Reinsurance The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk. A. Reinsurance Recoverables The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses. The Company's reinsurance recoverables as of June 30, 2024 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value: (In millions) Fair value of collateral contractually required to meet or exceed carrying value of recoverable Collateral provisions exist that may mitigate risk of credit loss (1) No collateral Total Ongoing Operations A- equivalent and higher current ratings (2) $ — $ 8 $ 80 $ 88 BBB- to BBB+ equivalent current credit ratings (2) — — 61 61 Not rated 151 8 224 383 Total recoverables related to ongoing operations 151 16 365 532 Acquisition, disposition or run-off activities BBB+ equivalent and higher current ratings (2) Lincoln National Life and Lincoln Life & Annuity of New York — 2,568 — 2,568 Empower Annuity Insurance Company — — 127 127 Prudential Insurance Company of America 335 — — 335 Life Insurance Company of North America — 318 — 318 Other 161 22 14 197 Not rated — 6 4 10 Total recoverables related to acquisition, disposition or run-off activities 496 2,914 145 3,555 Total reinsurance recoverables before market risk benefits $ 647 $ 2,930 $ 510 $ 4,087 Allowance for uncollectible reinsurance ( 34 ) Market risk benefits 927 Total reinsurance recoverables (3) $ 4,980 (1) Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level. (2) Certified by an NRSRO. (3) Includes $ 182 million of current reinsurance recoverables that are reported in Other current assets and $ 203 million of reinsurance recoverables classified as assets of businesses held for sale. 21 Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value. B. Effective Exit of Variable Annuity Reinsurance Business The Company entered into an agreement with Berkshire to effectively exit the variable annuity reinsurance business via a reinsurance transaction in 2013. Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 9 to the Consolidated Financial Statements. Berkshire reinsured 100 % of the Company's future cash flows in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall limit with approximately $ 3.0 billion remaining at June 30, 2024. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit. (In millions) Reinsurer (1) June 30, 2024 December 31, 2023 Collateral and Other Terms at June 30, 2024 Berkshire $ 762 $ 873 90 % were secured by assets in a trust. Sun Life Assurance Company of Canada 75 92 Liberty Re (Bermuda) Ltd. 85 104 100 % were secured by assets in a trust. SCOR SE 27 31 75 % were secured by a letter of credit. Market risk benefits (2) $ 949 $ 1,100 (1) All reinsurers are rated A- equivalent and higher by an NRSRO. (2) Includes incurred but not reported ("IBNR") and outstanding claims of $ 22 million as of June 30, 2024 and $ 19 million as of December 31, 2023. These amounts are excluded from market risk benefits as of June 30, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements. The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three and six months ended June 30, 2024 and June 30, 2023. Note 11 – Investments The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 to the Consolidated Financial Statements for information about the valuation of the Company's investment portfolio. Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K. The following table summarizes the Company's investments by category and current or long-term classification: June 30, 2024 December 31, 2023 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 621 $ 8,729 $ 9,350 $ 590 $ 9,265 $ 9,855 Equity securities 26 1,582 1,608 31 3,331 3,362 Commercial mortgage loans 191 1,318 1,509 182 1,351 1,533 Policy loans — 1,176 1,176 — 1,211 1,211 Other long-term investments — 4,446 4,446 — 4,181 4,181 Short-term investments 324 — 324 206 — 206 Total $ 1,162 $ 17,251 $ 18,413 $ 1,009 $ 19,339 $ 20,348 Investments classified as assets of businesses held for sale (1) ( 94 ) ( 1,307 ) ( 1,401 ) ( 84 ) ( 1,354 ) ( 1,438 ) Investments per Consolidated Balance Sheets $ 1,068 $ 15,944 $ 17,012 $ 925 $ 17,985 $ 18,910 (1) Investments related to the HCSC transaction that were held for sale as of June 30, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments. 22 A. Investment Portfolio Debt Securities The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of June 30, 2024: (In millions) Amortized Cost Fair Value Due in one year or less $ 666 $ 643 Due after one year through five years 3,732 3,497 Due after five years through ten years 3,175 2,945 Due after ten years 2,137 1,913 Mortgage and other asset-backed securities 387 352 Total $ 10,097 $ 9,350 Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties. Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below: (In millions) Amortized Cost Allowance for Credit Loss Unrealized Appreciation Unrealized Depreciation Fair Value June 30, 2024 Federal government and agency $ 288 $ — $ 18 $ ( 10 ) $ 296 State and local government 37 — 1 ( 1 ) 37 Foreign government 353 — 6 ( 14 ) 345 Corporate 9,032 ( 90 ) 99 ( 721 ) 8,320 Mortgage and other asset-backed 387 — — ( 35 ) 352 Total $ 10,097 $ ( 90 ) $ 124 $ ( 781 ) $ 9,350 December 31, 2023 Federal government and agency $ 251 $ — $ 24 $ ( 8 ) $ 267 State and local government 37 — 2 ( 1 ) 38 Foreign government 355 — 10 ( 13 ) 352 Corporate 9,338 ( 33 ) 158 ( 630 ) 8,833 Mortgage and other asset-backed 398 — 1 ( 34 ) 365 Total $ 10,379 $ ( 33 ) $ 195 $ ( 686 ) $ 9,855 Review of declines in fair value. Management reviews debt securities in an unrealized loss position to determine whether a credit loss allowance is needed based on criteria that include: • severity of decline; • financial health and specific prospects of the issuer; and • changes in the regulatory, economic or general market environment of the issuer's industry or geographic region. 23 The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased. June 30, 2024 December 31, 2023 (Dollars in millions) Fair Value Amortized Cost Unrealized Depreciation Number of Issues Fair Value Amortized Cost Unrealized Depreciation Number of Issues One year or less Investment grade $ 718 $ 730 $ ( 12 ) 301 $ 330 $ 338 $ ( 8 ) 142 Below investment grade 123 127 ( 4 ) 334 161 170 ( 9 ) 135 More than one year Investment grade 5,273 5,971 ( 698 ) 1,530 5,441 6,036 ( 595 ) 1,590 Below investment grade 598 665 ( 67 ) 326 701 775 ( 74 ) 486 Total $ 6,712 $ 7,493 $ ( 781 ) 2,491 $ 6,633 $ 7,319 $ ( 686 ) 2,353 Equity Securities The following table provides the values of the Company's equity security investments: June 30, 2024 December 31, 2023 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 655 $ 46 $ 656 $ 51 Equity securities with no readily determinable fair value 3,313 1,562 3,248 3,311 Total $ 3,968 $ 1,608 $ 3,904 $ 3,362 We are a minority owner in VillageMD, a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in equity securities with no readily determinable fair value in the above table. In the first quarter of 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) gains 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. Commercial Mortgage Loans Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties. The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. The annual review performed in the second quarter of 2024 confirmed ongoing strong overall credit quality in line with the previous year's results. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K. The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio: (Dollars in millions) June 30, 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 Below 60% $ 685 2.15 $ 802 2.13 60% to 79% 619 1.76 574 1.77 80% to 100% 205 1.02 157 0.65 Total $ 1,509 1.82 65 % $ 1,533 1.82 64 % 24 Other Long-Term Investments Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments. Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flow estimates indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments: Carrying Value as of (In millions) June 30, 2024 December 31, 2023 Real estate investments $ 1,724 $ 1,606 Securities partnerships 2,504 2,400 Other 218 175 Total $ 4,446 $ 4,181 B. Derivative Financial Instruments The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt. As of June 30, 2024, the notional value of interest rate swap contracts increased to $ 1.9 billion compared to $ 1.5 billion as of December 31, 2023. There have been no other material changes to the Company's derivative financial instruments during the six months ended June 30, 2024. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of June 30, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements. C. Realized Investment Gains and Losses The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders: Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Net realized investment gains (losses), excluding credit (loss)/recovery and other investment write-downs $ 13 $ 31 $ 7 $ ( 20 ) Credit (loss)/recovery and other investment write-downs ( 61 ) ( 5 ) ( 1,891 ) ( 10 ) Net realized investment (losses) gains, before income taxes $ ( 48 ) $ 26 $ ( 1,884 ) $ ( 30 ) Net realized investment losses for the three months ended June 30, 2024 were primarily due to expected credit loss charges on debt securities. Net realized investment losses for the six months ended June 30, 2024 were primarily driven by the impairment of equity securities in 2024. 25 Note 12 – Fair Value Measurements The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value. Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor. The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3). For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K. A. Financial Assets and Financial Liabilities Carried at Fair Value The following table provides information about the Company's financial assets and liabilities carried at fair value. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 9E to the Consolidated Financial Statements. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders: (In millions) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 Financial assets at fair value Debt securities Federal government and agency $ 162 $ 130 $ 134 $ 137 $ — $ — $ 296 $ 267 State and local government — — 37 38 — — 37 38 Foreign government — — 345 352 — — 345 352 Corporate — — 7,968 8,432 352 401 8,320 8,833 Mortgage and other asset-backed — — 308 319 44 46 352 365 Total debt securities 162 130 8,792 9,278 396 447 9,350 9,855 Equity securities (1) 1 4 44 47 1 — 46 51 Short-term investments — — 324 206 — — 324 206 Derivative assets — — 161 131 — 1 161 132 Financial liabilities at fair value Derivative liabilities $ — $ — $ 2 $ 4 $ — $ — $ 2 $ 4 (1) Excludes certain equity securities that have no readily determinable fair value. Level 3 Financial Assets and Financial Liabilities Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. Additionally, as discussed in Note 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy. 26 Quantitative Information about Unobservable Inputs The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security. The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values. Fair Value as of Unobservable Adjustment Range (Weighted Average by Quantity) as of (Fair value in millions) June 30, 2024 December 31, 2023 Unobservable Input June 30, 2024 June 30, 2024 December 31, 2023 Debt securities Corporate $ 352 $ 401 Liquidity 60 - 1340 ( 270 ) bps 70 - 1235 ( 310 ) bps Mortgage and other asset-backed securities 44 46 Liquidity 115 - 595 ( 300 ) bps 95 - 640 ( 310 ) bps Total Level 3 debt securities $ 396 $ 447 An increase in liquidity spread adjustments would result in a lower fair value measurement, while a decrease would result in a higher fair value measurement. Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs. Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Debt and Equity Securities Beginning balance $ 422 $ 471 $ 447 $ 447 Losses included in Shareholders' net income ( 40 ) ( 1 ) ( 61 ) — Losses included in Other comprehensive loss ( 2 ) ( 5 ) ( 5 ) — Purchases, sales and settlements Purchases 11 — 11 4 Settlements ( 1 ) ( 18 ) ( 15 ) ( 27 ) Total purchases, sales and settlements 10 ( 18 ) ( 4 ) ( 23 ) Transfers into / (out of) Level 3 Transfers into Level 3 15 32 31 71 Transfers out of Level 3 ( 8 ) ( 25 ) ( 11 ) ( 41 ) Total transfers into / (out of) Level 3 7 7 20 30 Ending balance $ 397 $ 454 $ 397 $ 454 Total losses included in Shareholders' net income attributable to instruments held at the reporting date $ ( 41 ) $ ( 1 ) $ ( 61 ) $ — Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period $ ( 2 ) $ ( 6 ) $ ( 6 ) $ ( 5 ) 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) gains 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. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads . Transfers between Level 2 and Level 3 during 2024 and 2023 27 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. See discussion under Quantitative Information about Unobservable Inputs above for more information. Separate Accounts The investment income and fair value gains and losses of Separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. The separate account activity for the six months ended June 30, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments. Fair values of Separate account assets were as follows: Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total (In millions) June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 Guaranteed separate accounts (See Note 16) $ 229 $ 226 $ 343 $ 352 $ — $ — $ 572 $ 578 Non-guaranteed separate accounts (1) 160 158 5,819 5,797 222 217 6,201 6,172 Subtotal $ 389 $ 384 $ 6,162 $ 6,149 $ 222 $ 217 6,773 6,750 Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1) 658 680 Total $ 7,431 $ 7,430 (1) Non-guaranteed separate accounts include $ 3.9 billion as of June 30, 2024 and $ 4.0 billion as of December 31, 2023 in assets supporting the Company's pension plans, including $ 0.2 billion classified in Level 3 as of both June 30, 2024 and December 31, 2023. Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three and six months ended June 30, 2024 or 2023. Separate account investments in securities partnerships, real estate, real estate funds and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments: Fair Value as of Unfunded Commitment as of June 30, 2024 Redemption Frequency (if currently eligible) Redemption Notice Period (In millions) June 30, 2024 December 31, 2023 Securities partnerships $ 412 $ 419 $ 234 Not applicable Not applicable Real estate and real estate funds 245 258 3 Quarterly 30 - 90 days Hedge funds 1 3 — Up to annually, varying by fund 30 - 90 days Total $ 658 $ 680 $ 237 As of June 30, 2024, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception. B. Assets and Liabilities Measured at Fair Value under Certain Conditions Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value. In the first quarter of 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) gains in the Company's Consolidated Statements of Income. For the three months ended June 30, 2024 and six months ended June 30, 2023, impairments recognized requiring the assets 28 and liabilities described above to be measured at fair value were not material. Observable price changes for equity securities with no readily determinable fair value were not material for the three and six months ended June 30, 2024 and June 30, 2023. C. Fair Value Disclosures for Financial Instruments Not Carried at Fair Value The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table: Classification in Fair Value Hierarchy June 30, 2024 December 31, 2023 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,402 $ 1,509 $ 1,430 $ 1,533 Long-term debt, including current maturities, excluding finance leases Level 2 $ 28,560 $ 31,008 $ 28,033 $ 29,585 Note 13 – Variable Interest Entities We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined that it was no t a primary beneficiary in any material variable interest entity as of June 30, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure. Note 14 – Accumulated Other Comprehensive Income (Loss) Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized. Shareholders' other comprehensive loss, net of tax, for the three and six months ended June 30, 2024 and June 30, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method. Changes in the components of AOCI were as follows: Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Securities and Derivatives Beginning balance $ 292 $ ( 138 ) $ 171 $ ( 332 ) Unrealized appreciation on securities and derivatives 106 7 249 259 Tax (expense) ( 29 ) ( 12 ) ( 68 ) ( 66 ) Net unrealized appreciation (depreciation) on securities and derivatives 77 ( 5 ) 181 193 Reclassification adjustment for losses included in Shareholders' net income (Net realized investment (losses) gains) 39 31 61 26 Reclassification adjustment for tax (benefit) included in Shareholders' net income ( 8 ) ( 6 ) ( 13 ) ( 5 ) Net losses reclassified from AOCI to Shareholders' net income 31 25 48 21 Other comprehensive income, net of tax 108 20 229 214 Ending balance $ 400 $ ( 118 ) $ 400 $ ( 118 ) 29 Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Net long-duration insurance and contractholder liabilities measurement adjustments Beginning balance $ ( 1,531 ) $ ( 587 ) $ ( 971 ) $ ( 256 ) Current period change in discount rate for certain long-duration liabilities ( 288 ) ( 147 ) ( 1,020 ) ( 558 ) Tax benefit 76 36 262 137 Net current period change in discount rate for certain long-duration liabilities ( 212 ) ( 111 ) ( 758 ) ( 421 ) Current period change in instrument-specific credit risk for market risk benefits — ( 7 ) ( 18 ) ( 33 ) Tax benefit — 1 4 6 Net current period change in instrument-specific credit risk for market risk benefits — ( 6 ) ( 14 ) ( 27 ) Other comprehensive (loss), net of tax ( 212 ) ( 117 ) ( 772 ) ( 448 ) Ending balance $ ( 1,743 ) $ ( 704 ) $ ( 1,743 ) $ ( 704 ) Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Translation of foreign currencies Beginning balance $ ( 175 ) $ ( 138 ) $ ( 149 ) $ ( 154 ) Translation of foreign currencies ( 4 ) ( 20 ) ( 28 ) ( 5 ) Tax (expense) benefit ( 1 ) 1 ( 3 ) 2 Shareholders' other comprehensive income (loss), net of tax ( 5 ) ( 19 ) ( 31 ) ( 3 ) Ending balance $ ( 180 ) $ ( 157 ) $ ( 180 ) $ ( 157 ) Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Postretirement benefits liability Beginning balance $ ( 910 ) $ ( 906 ) $ ( 915 ) $ ( 916 ) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 7 11 15 24 Reclassification adjustment for tax (benefit) included in Shareholders' net income — ( 3 ) ( 3 ) ( 6 ) Net adjustments reclassified from AOCI to Shareholders' net income 7 8 12 18 Valuation update ( 20 ) ( 2 ) ( 20 ) ( 2 ) Tax benefit 4 1 4 1 Net change due to valuation update ( 16 ) ( 1 ) ( 16 ) ( 1 ) Other comprehensive (loss) income, net of tax ( 9 ) 7 ( 4 ) 17 Ending balance $ ( 919 ) $ ( 899 ) $ ( 919 ) $ ( 899 ) Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Total Accumulated other comprehensive loss Beginning balance $ ( 2,324 ) $ ( 1,769 ) $ ( 1,864 ) $ ( 1,658 ) Shareholders' other comprehensive (loss), net of tax ( 118 ) ( 109 ) ( 578 ) ( 220 ) Ending balance $ ( 2,442 ) $ ( 1,878 ) $ ( 2,442 ) $ ( 1,878 ) Note 15 – Income Taxes Income Tax Expense The 18.1 % effective tax rate for the three months ended June 30, 2024 was lower than the 19.9 % rate for the three months ended June 30, 2023, primarily as a result of decreases in state taxes following a favorable state audit resolution. The 31.5 % effective tax rate for the six months ended June 30, 2024 was higher than the 19.2 % rate for the six months ended June 30, 2023 largely driven by an increase for a valuation allowance relative to the impairment of equity securities, partially offset by decreases in state taxes and a decrease relative to the businesses held for sale. 30 As of June 30, 2024, we had approximately $ 689 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 $ 422 million, established in the six months ended June 30, 2024, drove the higher effective tax rate and was almost entirely related to the impairment of equity securities discussed in Note 11. 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 The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business. A. Financial Guarantees: Retiree and Life Insurance Benefits The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of June 30, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $ 410 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of June 30, 2024. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy. The Company does not expect that these financial guarantees will have a material effect on the Company's consolidated results of operations, liquidity or financial condition. B. Certain Other Guarantees The Company had indemnification obligations as of June 30, 2024 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with laws or regulations or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a stated dollar amount or a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no recorded liabilities for these indemnification obligations as of June 30, 2024. C. Guaranty Fund Assessments The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions. There were no material charges or credits resulting from existing or new guaranty fund assessments for the six months ended June 30, 2024. D. Legal and Regulatory Matters The Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator's filing of a complaint under court seal, and other legal matters arising, for the most part, in the ordinary course of managing a global health services business. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions. Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information 31 cannot be estimated. The Company's accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in this ongoing litigation matter or any future claims or litigation. Litigation Matters Express Scripts Litigation with Elevance . In March 2016, Elevance filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Elevance also requested that the court enter declaratory judgment that Express Scripts is required to provide Elevance competitive benchmark pricing, that Elevance can terminate the agreement and that Express Scripts is required to provide Elevance with post-termination services at competitive benchmark pricing for one year following any termination by Elevance. Elevance claimed it is entitled to $ 13 billion in additional pricing concessions over the remaining term of the agreement, as well as $ 1.8 billion for one year following any contract termination by Elevance and $ 150 million damages for service issues ("Elevance's Allegations"). On April 19, 2016, in response to Elevance's complaint, Express Scripts filed its answer denying Elevance's Allegations in their entirety and asserting affirmative defenses and counterclaims against Elevance. The court subsequently granted Elevance's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Elevance completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. On March 31, 2022, the court granted summary judgment in favor of Express Scripts on all of Elevance's pricing claims for damages totaling $ 14.8 billion and on most of Elevance's claims relating to service issues. Elevance's only remaining service claims relate to the review or processing of prior authorizations, with alleged damages over $ 100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retained the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retained the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance filed its opening appellate brief on April 24, 2024. Express Scripts filed its answering appellate brief on July 24, 2024. Note 17 – Segment Information See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments. The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income (loss) from operations as income (loss) before income taxes excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets and special items. The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results. The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business. The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance. 32 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 June 30, Six Months Ended June 30, 2024 2023 2024 2023 (In millions) Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Integration and transaction-related costs (Selling, general and administrative expenses) $ 63 $ 47 $ 6 $ 5 $ 100 $ 76 $ 7 $ 6 Loss (gain) on sale of businesses — — — — 19 ( 43 ) — — Deferred tax expenses, net (Income taxes, less amount attributable to noncontrolling interests) — 17 — — — 34 — — Total impact from special items $ 63 $ 64 $ 6 $ 5 $ 119 $ 67 $ 7 $ 6 33 Summarized segment financial information was as follows: (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Three months ended June 30, 2024 Revenues from external customers $ 48,251 $ 11,821 $ 130 $ — $ 60,202 Intersegment revenues 1,232 1,203 20 ( 2,455 ) Net investment income 65 172 77 7 321 Total revenues 49,548 13,196 227 ( 2,448 ) 60,523 Net realized investment results from certain equity method investments — ( 53 ) — — ( 53 ) Adjusted revenues $ 49,548 $ 13,143 $ 227 $ ( 2,448 ) $ 60,470 Income (loss) before income taxes $ 1,299 $ 1,205 $ ( 17 ) $ ( 498 ) $ 1,989 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests ( 95 ) — — — ( 95 ) Net realized investment (gains) losses (1) ( 1 ) ( 5 ) 1 — ( 5 ) Amortization of acquired intangible assets 416 4 — — 420 Special items Integration and transaction-related costs — — — 63 63 Pre-tax adjusted income (loss) from operations $ 1,619 $ 1,204 $ ( 16 ) $ ( 435 ) $ 2,372 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Three months ended June 30, 2023 Revenues from external customers $ 36,721 $ 11,505 $ 82 $ — $ 48,308 Intersegment revenues 1,422 1,044 — ( 2,466 ) Net investment income 62 135 76 5 278 Total revenues 38,205 12,684 158 ( 2,461 ) 48,586 Net realized investment results from certain equity method investments — 30 — — 30 Adjusted revenues $ 38,205 $ 12,714 $ 158 $ ( 2,461 ) $ 48,616 Income (loss) before income taxes $ 1,128 $ 1,156 $ 29 $ ( 429 ) $ 1,884 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests ( 54 ) ( 1 ) — — ( 55 ) Net realized investment (gains) losses (1) ( 1 ) 5 — — 4 Amortization of acquired intangible assets 443 12 — — 455 Special items Integration and transaction-related costs — — — 6 6 Pre-tax adjusted income (loss) from operations $ 1,516 $ 1,172 $ 29 $ ( 423 ) $ 2,294 (1) Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income. 34 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Six months ended June 30, 2024 Revenues from external customers $ 93,137 $ 23,833 $ 196 $ 1 $ 117,167 Intersegment revenues 2,513 2,327 45 ( 4,885 ) Net investment income 124 321 152 14 611 Total revenues 95,774 26,481 393 ( 4,870 ) 117,778 Net realized investment results from certain equity method investments — ( 61 ) — — ( 61 ) Adjusted revenues $ 95,774 $ 26,420 $ 393 $ ( 4,870 ) $ 117,717 Income (loss) before income taxes $ 863 $ 2,148 $ 1 $ ( 944 ) $ 2,068 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests ( 172 ) — — — ( 172 ) Net realized investment losses (1) 1,455 367 1 — 1,823 Amortization of acquired intangible assets 833 10 — — 843 Special items Integration and transaction-related costs — — — 100 100 Loss on sale of businesses — 19 — — 19 Pre-tax adjusted income (loss) from operations $ 2,979 $ 2,544 $ 2 $ ( 844 ) $ 4,681 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Six months ended June 30, 2023 Revenues from external customers $ 71,232 $ 23,155 $ 161 $ — $ 94,548 Intersegment revenues 3,040 2,007 — ( 5,047 ) Net investment income 112 278 154 11 555 Total revenues 74,384 25,440 315 ( 5,036 ) 95,103 Net realized investment results from certain equity method investments — ( 8 ) — — ( 8 ) Adjusted revenues $ 74,384 $ 25,432 $ 315 $ ( 5,036 ) $ 95,095 Income (loss) before income taxes $ 2,046 $ 2,233 $ 50 $ ( 844 ) $ 3,485 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests ( 96 ) ( 2 ) — — ( 98 ) Net realized investment (gains) losses (1) ( 1 ) 29 ( 6 ) — 22 Amortization of acquired intangible assets 887 27 — — 914 Special items Integration and transaction-related costs — — — 7 7 Pre-tax adjusted income (loss) from operations $ 2,836 $ 2,287 $ 44 $ ( 837 ) $ 4,330 (1) Includes Net realized investment losses/gains as presented in our Consolidated Statements of Income, as well as the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting, which are presented within Fees and other revenues in our Consolidated Statements of Income. 35 Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type: Three Months Ended June 30, Six Months Ended June 30, (In millions) 2024 2023 2024 2023 Products (Pharmacy revenues) (ASC 606) Network revenues $ 25,276 $ 16,406 $ 49,442 $ 32,154 Home delivery and specialty revenues 18,017 16,594 34,475 32,619 Other revenues 2,897 2,249 5,443 4,116 Total Evernorth Health Services 46,190 35,249 89,360 68,889 Total Other Operations 16 — 33 — Intercompany eliminations ( 1,105 ) ( 1,285 ) ( 2,256 ) ( 2,781 ) Total Pharmacy revenues 45,101 33,964 87,137 66,108 Insurance premiums (ASC 944) Cigna Healthcare (1) U.S. Healthcare Employer insured 4,350 4,091 8,743 8,171 Medicare Advantage 2,207 2,180 4,494 4,416 Stop loss 1,665 1,514 3,333 3,017 Individual and Family Plans 975 1,293 2,015 2,501 Other 1,220 1,047 2,478 2,164 U.S. Healthcare 10,417 10,125 21,063 20,269 International Health 891 820 1,776 1,606 Total Cigna Healthcare 11,308 10,945 22,839 21,875 Other 115 76 163 155 Intercompany eliminations 31 18 55 34 Total Premiums 11,454 11,039 23,057 22,064 Services (Fees) (ASC 606) Evernorth Health Services 3,251 2,838 6,194 5,337 Cigna Healthcare 1,608 1,602 3,179 3,208 Other Operations 17 1 42 2 Other revenues 152 63 242 129 Intercompany eliminations ( 1,381 ) ( 1,199 ) ( 2,684 ) ( 2,300 ) Total Fees and other revenues 3,647 3,305 6,973 6,376 Total revenues from external customers $ 60,202 $ 48,308 $ 117,167 $ 94,548 (1) Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. Information presented for the three and six months ended June 30, 2023 has been restated to conform to the new operating segment presentation. Financial and performance guarantees. Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $ 1.7 billion as of June 30, 2024 and $ 1.6 billion as of December 31, 2023. Major customers. Revenues from a single pharmacy benefit client were approximately 16 % of consolidated revenues for both the three and six months ended June 30, 2024. These amounts were reported in the Evernorth Health Services segment. Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 10 % and 12 % of consolidated revenues for the three and six months ended June 30, 2024, respectively. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information. 36