Full Report
The Cigna Group's management explains the business in its own materials. The slides below do the most of that work, pulled from the documents preserved in Sources. Each source link opens the complete presentation at that slide in a new tab.
Investor Presentation — January 2025 — Q4 / FY2024
The latest, fullest deck: two-platform structure, the earnings algorithm, FY2024 segment results and FY2025 guidance. · Open the full document →
Investor Presentation — November 2023 — Q3 2023
Three slides later decks dropped: what each platform sells, how sub-businesses map to growth, and how the two sides reinforce each other. · Open the full document →
The Cigna Group's management answers for the business every quarter. These are the exchanges that explain it best — verbatim, from the call transcripts preserved in Sources. Each link opens the full transcript at that page in a new tab.
Q1 2026 Earnings Call — Q1 FY2026
David Cordani's final call: the leadership handoff, two portfolio exits, and the clearest map of where Cigna's earnings come from. · Open the full transcript →
Where the earnings come from: Specialty & Care ~35%, Pharmacy Benefit Services ~25%, Cigna Healthcare ~40%.
Scott Fidel (Analyst, Goldman Sachs); Brian Evanko (President and Chief Operating Officer): One is our Specialty and Care Services platform, which now represents about 35% of the company's income and is growing 8% to 12% per year, as Ann just referenced earlier. Secondly, our Pharmacy Benefit Services platform also within Evernorth, about 25% of the company's income is going through the transformation that I was alluding to earlier, and we're confident on the long-term durability of that. And then finally, our Cigna Healthcare business, which represents the other 40% of the company's income, which is our high-performing health plan business, underpinned by our flagship U.S. employer business, which has shown a long track record of growing at above market rates.
p. 10 · Read in context →
Guidance philosophy: priced for sustained elevated cost trend; deceleration would be upside, not baseline.
Brian Evanko (President and Chief Operating Officer): As Ann said, we continue to plan for and price for sustained elevated cost trends. On the positive side, they have not accelerated. They remained elevated. So to the extent we do eventually see some deceleration, that offers some upside to our outlook.
p. 14 · Read in context →
Q4 2025 Earnings Call — Q4 FY2025
The FTC settlement resolved and PBM reform passed — management lays out how the rebate-free model actually gets paid, margin profile intact. · Open the full transcript →
The FTC global settlement, framed: $7B in out-of-pocket relief over ten years, resolving insulin litigation and investigations.
David Cordani (Chairman and Chief Executive Officer): The settlement is a comprehensive resolution of all matters brought by the FTC regarding our pharmacy benefits business. It includes the industry-wide insulin lawsuit and ongoing investigations. […] The settlement noted $7 billion in out-of-pocket cost relief over the next ten years for the 100 million customers and patients we serve. The savings will be delivered through lower insulin prices and reduced costs for brand-name medications for consumers at the pharmacy counter.
p. 2 · Read in context →
How the rebate-free model makes money: a delinked per-member/per-script admin fee plus at-risk clinical programs, same profitability.
Scott Fidel (Analyst, Goldman Sachs); Brian Evanko (President and Chief Operating Officer): the core value creators in both our legacy models and our new rebate-free model really remain the same. Think about securing better unit pricing for prescription drugs, administering benefits for plan sponsors, and supporting patients with clinical safety checks and advanced clinical programs. […] So there's two primary ways we get paid in the future in this model. The first is a core admin fee. That'll be per member or per script, delinked from the price of the drug, that'll grow with inflation over time. And then the second category would be for clinical programs and other innovations that we bring to market. And we expect to take risk on this portion of compensation. But in aggregate, as David said earlier, we expect to achieve a comparable level of profitability between the legacy model and the new model, although the sources of profit will evolve as I outlined.
p. 8 · Read in context →
The specialty growth engine: a $400B+ market, 13% script growth, an 8–12% income algorithm, $100B of biosimilar competition by 2030.
Erin Wright (Analyst, Morgan Stanley); Brian Evanko (President and Chief Operating Officer): this is already a $400 billion plus addressable market growing at a high single-digit secular growth rate, and we're really well-positioned to capitalize on that over the longer run. […] the full year we had 13% growth in prescriptions, higher rate of growth in our Medicare book of business, but also strong growth in the commercial employer and the Medicaid portfolio […] We continue to expect long term average annual income growth of 8% to 12% in this business, benefiting from some of these strong secular tailwinds. […] we expect another $100 billion of specialty drug spend to be subject to competition from biosimilars and generics by 2030.
p. 11 · Read in context →
Q3 2025 Earnings Call — Q3 FY2025
Where the rebate-free model was first unveiled: the drug-pricing problem it solves and a three-part framework for modeling the PBM through the transition. · Open the full transcript →
The problem the model targets: generics are 90% of scripts but ~10% of spend; brands are 10% of volume but 88% of spend.
David Cordani (Chairman and CEO): generic drugs now account for 90% of all prescriptions, and on average, they are one-third cheaper than in other countries. […] On the other hand, prices for brand name medications continue to skyrocket, with those drugs that do not have a generic equivalent costing four times as much as the same drug in European markets. […] even though brand name drug medications comprise only 10% of overall pharmaceutical volumes in the United States, they account for 88% of the spend.
p. 2 · Read in context →
The new model, first unveiled: upfront discounts replacing post-purchase rebates, ~30% lower brand cost, standard by 2028.
David Cordani (Chairman and CEO): we've stepped forward with our new simple and transparent model for pharmacy benefit services, which will replace the complex post-purchase rebate process with a simple upfront discount that will enable customers and patients to automatically pay the lowest price at the counter, whether through their benefit or on a cash pay basis and apply their payments to the deductible. […] for Americans and health plans where they pay the full cost of medications, our new model will reduce the cost for a brand name drug prescription on average by 30%. […] Cigna Healthcare will adopt this model 100% for fully insured lives beginning in 2027, and it will become our standard offering broadly for the Cigna Group to the marketplace starting in January 2028.
p. 2 · Read in context →
A framework for the transition: $90B of renewed large-client revenue, temporary 2026–27 investment costs, and a stable core book.
Lisa Gill (Analyst, JPMorgan); Brian Evanko (President and COO): When considering how to model this business going forward, I suggest breaking it into three categories. The first category includes the three major clients we've mentioned, accounting for roughly $90 billion in annual revenue, with the margin profile for 2026 expected to sustain through the decade. […] The second category pertains to the costs associated with transitioning to the new rebate-free model, which will create margin pressures in 2026 and 2027 but should diminish afterward. The third category reflects the fundamental earnings profile from the remainder of our pharmacy benefit services book, which we expect will remain stable in terms of client level earnings contributions, ensuring comparable contributions from our rebate-free model as from our existing solutions.
p. 7 · Read in context →
Guidance philosophy through the pivot: two platforms on-algorithm in 2026, PBS off, enterprise back on-algorithm in 2027.
David Cordani (Chairman and CEO); Justin Lake (Analyst, Wolfe Research): As you think about the building blocks of the capabilities, our CHC are on algorithm in '26, Specialty & Care on algorithm in '26, PBS off algorithm in '26. […] while there are investments that will carry into 2027, it would be reasonable to assume we expect to be back on algorithm for the enterprise level for 2027 with the strength of the franchise.
p. 8 · Read in context →
Q4 2024 Earnings Call — Q4 FY2024
The stop-loss shock, explained: a cost miss and the two-year margin-recovery plan, alongside the post-Brian-Thompson push on transparency. · Open the full transcript →
Management addresses the moment: after the killing of UnitedHealth's Brian Thompson, accelerating transparency and accountability.
David Cordani (CEO): In early December, we all witnessed the tragic murder of Brian Thompson, a leader at the UnitedHealth Group. The past several weeks have further challenged us to listen more intensely to the public narrative about our industry. At the Cigna Group, we are further accelerating improvements and innovations to increase transparency, expand support, and drive even greater accountability.
p. 1 · Read in context →
What stop-loss is and why it missed: employers cap catastrophic-claim risk; high-cost claimants and specialty drugs drove Q4 variability.
Brian Evanko (CFO): stop loss is a unique product within our portfolio where employers limit their risk from unexpected high-cost claims by transferring that risk for medical costs above a specific individual or aggregate employer dollar amount. […] This year, variability was more pronounced in the fourth quarter as we had an increase in the number of high-cost claimants related to cost pressures from the continued acceleration in the prescribing and use of specialty medications, as well as elevated high-acuity surgical activity.
p. 3 · Read in context →
Why the miss is recoverable: stop-loss is only sold integrated with first-dollar coverage; 50%+ of those clients stay 5+ years.
Stephen Baxter (Analyst, Wells Fargo); Brian Evanko (CFO): we don't write standalone stop loss coverage. So our entire book of business reflects an integrated employer offering where we're providing the firstdollar coverage alongside. […] well over 50% of our employer clients who choose our stop loss products have been clients of Cigna Healthcare for five years or more.
p. 6 · Read in context →
Q4 2023 Earnings Call — Q4 FY2023
The portfolio-shaping landmark: exiting Medicare Advantage to double down on capital-light Evernorth services, funded by the Express Scripts payoff. · Open the full transcript →
The track record: 13%+ annualized EPS growth over a decade, every Express Scripts goal met, $27B returned to shareholders.
David Cordani (Chairman and Chief Executive Officer): As a result of our focus, discipline, and sustained execution, over the past decade, we've delivered adjusted EPS growth of more than 13% on an annualized basis. In the five years since our acquisition of Express Scripts, we've achieved or surpassed every goal we established for the combined company. Through 2023, we've grown revenue by over $50 billion and met or exceeded our adjusted EPS objectives each year. And we've returned $27 billion to shareholders through share repurchase as well as attractive dividend payments.
p. 5 · Read in context →
Why exit Medicare Advantage: an attractive market, but capital-intensive and heavily regulated relative to its size in the portfolio.
A.J. Rice (Analyst, UBS); David Cordani (Chairman and Chief Executive Officer): We see it as a win-win and it's a clarification to our strategy within our portfolio. As I noted in my prepared remarks, while we view the market as a attractive growth market, the required capital investment resources focus relative to its size within our portfolio, coupled with the continued elevated regulatory environment, our decision was it was best to enter this transaction.
p. 14 · Read in context →
The strategic pivot: grow government reach through capital-light Evernorth services rather than owning the health plan.
David Cordani (Chairman and Chief Executive Officer): We will continue in a long-term service relationship with HCSC that further expands our proven track record within Evernorth. We see the Evernorth service portfolio as an attractive, capital-light, high-visibility way to grow this portfolio. And as we have in the past, we will maintain very strong discipline for capital deployment, and our 2024 capital deployment priorities are quite clear.
p. 15 · Read in context →
More calls
Q2 2025 Earnings Call — Q2 FY2025 · 14 pages · Mid-2025 read on the stop-loss margin-recovery plan and specialty momentum — the quarter before the rebate-free model was unveiled. · Open →
Q1 2025 Earnings Call — Q1 FY2025 · 15 pages · First quarter after the Medicare divestiture closed and Evanko/Dennison were named to new roles — the reset earnings base and early stop-loss recovery signals. · Open →
Q2 2024 Earnings Call — Q2 FY2024 · 14 pages · Progress on the Medicare Advantage sale to HCSC and the Evernorth specialty and care build-out at mid-2024. · Open →
Q1 2023 Earnings Call — Q1 FY2023 · 40 pages · An early call under the newly renamed Cigna Group for baseline framing of the Evernorth and Cigna Healthcare two-platform model. · Open →
Q4 2021 Earnings Call — Q4 FY2021 · 49 pages · A pandemic-era annual call for fuller strategic framing of the Evernorth build-out and the long-term growth algorithm before the recent portfolio moves. · Open →
The Cigna Group's annual reports contain management's most considered account of the business. These are the sections, passages and visual pages worth opening in the originals preserved in Sources.
The Cigna Group — FY2025 Annual Report (Form 10-K) — FY2025
The latest 10-K: a pharmacy-services-plus-health-benefits company reshaped by the 2025 exit of Medicare Advantage. · Open the full document →
Item 1. Business — p. 5 · Read the full section →
Management's own framing of the two-segment model — Evernorth pharmacy services and Cigna Healthcare benefits.
How Cigna defines its two segments and the scale behind them.
At The Cigna Group our global workforce of approximately 67,700 colleagues strives to fulfill our mission to improve the health and vitality of more than 185 million customer relationships in more than 30 markets and jurisdictions (as of December 31, 2025). […] Evernorth Health Services includes our Pharmacy Benefit Services and Specialty and Care Services operating segments, which provide independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live healthier lives. […] Cigna Healthcare includes our U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers.
p. 5 · Read in context →
Item 1A. Risk Factors — p. 37 · Read the full section →
The risks specific to a PBM-led health company — drug-pricing benchmarks and the new front of AI/ML use.
Item 7. Management's Discussion and Analysis — p. 72 · Read the full section →
Where management explains what actually moved 2025 results — chiefly the HCSC (Medicare Advantage) divestiture.
Line-by-line drivers of the 2025-versus-2024 change, in management's words.
Shareholders' net income increased 73%, primarily reflecting the absence of the impairment of VillageMD equity securities that was recorded in 2024. […] Pharmacy revenues increased 17%, primarily reflecting higher utilization of prescription drugs from customer growth in Evernorth Health Services. […] Premiums decreased 12%, primarily driven by the impact of the HCSC transaction (-18%), partially offset by higher premium rate within our ongoing U.S. Healthcare businesses (+4%). […] Medical costs and other benefit expenses decreased 11%, primarily driven by the impact of the HCSC transaction (-18%), partially offset by higher medical costs within our ongoing U.S. Healthcare businesses (+7%).
p. 77 · Read in context →
Segment Reporting — p. 77 · Read the full section →
How each segment actually earns — the utilization, claims-mix and affordability-rebate levers behind Evernorth.
The levers that drive Evernorth revenue and income: utilization, claims mix, affordability.
The key factors that impact the segment's revenues and income from operations are claims utilization, claims composition and contract affordability services. […] Our client contract pricing is impacted by our ongoing ability to negotiate favorable contracts for pharmacy network, pharmaceutical and wholesaler purchasing, and manufacturer rebates (also referred to as affordability improvements or affordability services).
p. 79 · Read in context →
Critical Accounting Estimates — p. 90 · Read the full section →
The unpaid-claims reserve is the estimate that defines a managed-care income statement — small assumption shifts move net income.
Medical-cost reserves and the sensitivity of net income to trend and completion-factor assumptions.
Unpaid claims and claim expenses reflect 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 […] Unpaid claims and claim expenses in Cigna Healthcare are primarily impacted by assumptions related to completion factors and medical cost trend. […] A 100 basis point increase in the medical cost trend rate would increase this liability by approximately $115 million, resulting in a decrease in net income of approximately $90 million after-tax
p. 94 · Read in context →
Cigna Corporation — FY2021 Annual Report (Form 10-K) — FY2021
Featured for one section: the 2021 restructuring that created today's Evernorth / Cigna Healthcare segment map. · Open the full document →
Item 1. Business — p. 6 · Read the full section →
Captures the segment redefinition — International Markets folded in, Chubb divestiture pending — that reshaped reporting.
The 2021 segment realignment and the then-current Cigna Healthcare composition (U.S. Commercial, U.S. Government, International Health).
In connection with the pending Chubb Transaction, we revised our business reporting structure. […] we adjusted our segment reporting effective in the fourth quarter of 2021 so that the results previously reported in the International Markets segment are now reported as follows: […] Cigna Healthcare includes Cigna's U.S. Commercial, U.S. Government and International Health operating segments that provide comprehensive medical and coordinated solutions to clients and customers.
p. 8 · Read in context →
More annual reports
The Cigna Group — FY2024 Annual Report (Form 10-K) — FY2024 · 214 pages · The year before the Medicare Advantage exit; carries the VillageMD impairment that depressed 2024 net income. · Open →
The Cigna Group — FY2023 Annual Report (Form 10-K) — FY2023 · 269 pages · Baseline for the two-segment era before recent divestitures reshaped the top line. · Open →
The Cigna Group — FY2022 Annual Report (Form 10-K) — FY2022 · 257 pages · First full year under The Cigna Group name and the Evernorth / Cigna Healthcare structure. · Open →
Source: S&P Capital IQ consensus via Xpressfeed · Generated 2026-07-22.
Cigna's consensus tape pairs steady mid-single-digit revenue growth with normalized EPS that reaccelerates from under 2% in 2026 to low-double-digit gains through 2029 — a margin- and capital-return-driven earnings story. The beat record is consistent: revenue has topped consensus for eight straight quarters and normalized EPS in every quarter but a −15% Q4 2024 miss. Yet forward estimates have barely moved in six months, and the street sits bullish with no sell ratings and a $341 mean target. The main fault line is GAAP net income, where analysts disagree sharply while clustering tightly on adjusted EPS.
Forward estimates
Currency: USD · Scale: money in millions, absolute · YoY uses the prior fiscal year from the feed; analyst count and range use the first displayed period.
| Metric | FY2025A | FY2026E | FY2027E | FY2028E | FY2029E | YoY | Analysts | Low / high |
|---|---|---|---|---|---|---|---|---|
| Revenue | $269.86bn | $284.46bn | $296.83bn | $313.11bn | $322.06bn | — | 11 | $253.30bn / $277.15bn |
| EBITDA | $12.89bn | $13.34bn | $14.48bn | $15.21bn | $15.35bn | — | 14 | $11.33bn / $14.83bn |
| EPS (normalized) | $29.65 | $30.41 | $33.48 | $37.01 | $41.92 | — | 24 | $29.60 / $29.78 |
Beat / miss record
Current sequences by metric: Revenue: 8 consecutive beats; EPS (normalized): 5 consecutive beats.
Currency: USD · Scale: money in millions, absolute · Consensus is captured before each actual first became effective.
| Quarter | Metric | Consensus | Actual | Surprise | Outcome |
|---|---|---|---|---|---|
| Q1 FY2026 | Revenue | $66.20bn | $68.49bn | +3.5% | Beat |
| Q1 FY2026 | EPS (normalized) | $7.61 | $7.79 | +2.4% | Beat |
| Q4 FY2025 | Revenue | $69.08bn | $72.47bn | +4.9% | Beat |
| Q4 FY2025 | EPS (normalized) | $7.88 | $8.08 | +2.5% | Beat |
| Q3 FY2025 | Revenue | $66.74bn | $69.75bn | +4.5% | Beat |
| Q3 FY2025 | EPS (normalized) | $7.64 | $7.83 | +2.5% | Beat |
| Q2 FY2025 | Revenue | $62.51bn | $67.18bn | +7.5% | Beat |
| Q2 FY2025 | EPS (normalized) | $7.15 | $7.20 | +0.6% | Beat |
| Q1 FY2025 | Revenue | $60.53bn | $65.50bn | +8.2% | Beat |
| Q1 FY2025 | EPS (normalized) | $6.35 | $6.74 | +6.2% | Beat |
| Q4 FY2024 | Revenue | $63.18bn | $65.68bn | +4.0% | Beat |
| Q4 FY2024 | EPS (normalized) | $7.82 | $6.64 | -15.1% | Miss |
| Q3 FY2024 | Revenue | $59.59bn | $63.70bn | +6.9% | Beat |
| Q3 FY2024 | EPS (normalized) | $7.25 | $7.51 | +3.5% | Beat |
| Q2 FY2024 | Revenue | $58.32bn | $60.47bn | +3.7% | Beat |
| Q2 FY2024 | EPS (normalized) | $6.42 | $6.72 | +4.7% | Beat |
Forward estimates barely moved in six months — no line shifted more than ~1.3%
The largest six-month revision is FY2028 revenue, up about 1.3%; FY2027 revenue is down about 1%, and normalized EPS for both years is essentially flat. Consensus has not chased the recent beats into higher out-year numbers.
Currency: USD · Scale: money in millions, absolute · Point-in-time consensus; Δ90d is Now versus 90d.
| Metric | FY | 180d | 90d | 30d | Now | Δ90d |
|---|---|---|---|---|---|---|
| Revenue | FY2027 | $299.78bn | $297.38bn | $297.07bn | $296.83bn | -0.2% |
| Revenue | FY2028 | $309.01bn | $312.95bn | $312.31bn | $313.11bn | +0.1% |
| EPS (normalized) | FY2027 | $33.51 | $33.42 | $33.45 | $33.48 | +0.2% |
| EPS (normalized) | FY2028 | $37.00 | $37.14 | $36.89 | $37.01 | -0.4% |
Analysts split widely on GAAP net income even as normalized EPS stays tightly clustered
GAAP net income estimates diverge sharply — FY2027 spans roughly $6.5–10.3bn (13 analysts) and FY2028 $5.7–9.8bn (9) — reflecting uncertainty over below-the-line charges. EBITDA disagreement is also material in FY2028. Normalized EPS, by contrast, is tightly clustered.
Currency: USD · Scale: money in millions, absolute · Spread/mean is absolute high-low divided by absolute mean.
| Metric | Period | Mean | Low–high | Spread/mean | Analysts |
|---|---|---|---|---|---|
| Net income (GAAP) | FY2027E | $7.70bn | $6.46bn–$10.35bn | 50.5% | 13 |
| Net income (GAAP) | FY2028E | $7.82bn | $5.66bn–$9.82bn | 53.2% | 9 |
| EBITDA | FY2028E | $15.21bn | $12.88bn–$18.51bn | 37.0% | 11 |
Street snapshot
Currency: USD · Scale: money in millions, absolute · Analyst counts shown explicitly.
| Street view | Reading | Analysts |
|---|---|---|
| Recommendation mix | Buy 15, Outperform 5, Hold 4, Underperform 0, Sell 0 | 24 |
| Consensus score | 1.54 | 24 |
| Target price | mean $340.9; median $340.0; high $400.0; low $290.0 | 24 |
FY2029 rests on a handful of analysts
FY2029 consensus is built on very thin coverage — 2 analysts for revenue, EBITDA and GAAP net income, 4 for normalized EPS and 3 for GAAP EPS. The +13% FY2029 EPS growth and outer-year levels should be read as directional, not firm consensus.
Visible Alpha broker models via S&P Xpressfeed · 18 brokers · 478 line items · freshest revision 2026-07-09.
Cigna's modeled story is two businesses moving in opposite directions. Evernorth, the Express Scripts pharmacy-services engine, supplies the large majority of revenue and nearly all the growth, while Cigna Healthcare's top line runs roughly flat and its value rests on a bending medical-care ratio. The most differentiated signal in the broker models sits inside Evernorth, where pre-tax profit is rotating from legacy pharmacy benefits toward specialty and care services. Coverage is deep on the consolidated P&L and segment margins but thin and stale on international and group-disability lines.
Evernorth carries the top line; Cigna Healthcare revenue runs roughly flat
Evernorth's revenue rises every modeled year, whereas Cigna Healthcare's is roughly flat to slightly lower through FY-2027 before recovering. Consolidated growth is almost entirely Evernorth.
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Total revenue | $272.09bn | $286.09bn | $298.60bn | $316.63bn | +5.1% | 17 |
| Total revenue - Evernorth | $231.97bn | $246.78bn | $259.83bn | $273.99bn | +6.4% | 13 |
| Total revenue - Cigna Healthcare | $47.00bn | $46.06bn | $46.05bn | $49.15bn | -2.0% | 14 |
Inside Evernorth, pre-tax profit is rotating from legacy pharmacy benefits to specialty and care
Pharmacy-benefit-services pre-tax profit steps down in FY-2026 and stays below its FY-2025 level, while specialty and care services grows steadily to become the larger pre-tax contributor. Revenue growth in both is priced as much as volume-driven.
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Revenue | — | — | — | — | — | — |
| Revenue - Pharmacy benefit services - Operating | $130.17bn | $138.85bn | $144.81bn | $151.81bn | +6.7% | 9 |
| Revenue - Specialty and care services - Operating | $102.34bn | $109.35bn | $117.45bn | $125.85bn | +6.9% | 9 |
| Pre-tax profit | — | — | — | — | — | — |
| Income/(loss) before income tax - Pharmacy benefit services - Operating | $3.49bn | $2.74bn | $2.77bn | $2.87bn | -21.4% | 8 |
| Income/(loss) before income tax - Specialty and care services - Operating | $3.68bn | $4.15bn | $4.47bn | $4.85bn | +12.6% | 8 |
Cigna Healthcare's medical-care ratio peaks in FY-2026, then bends lower
The medical-care ratio is modeled to peak in FY-2026 before improving into FY-2028, lifting operating income even as segment revenue stays flat. This margin path, not membership, is the segment's value driver.
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Medical care ratio - Cigna Healthcare(%) | 84.2% | 84.2% | 83.8% | 83.6% | +0.0pt | 16 |
| Selling, general & admin. expenses ratio - Cigna Healthcare(%) | 20.1% | 20.1% | 20.0% | 20.0% | -0.0pt | 16 |
| Income from operations - Cigna Healthcare - Operating | $4.21bn | $4.53bn | $4.92bn | $5.26bn | +7.6% | 10 |
Membership growth is fee-based services, not risk
Total medical customers grow modestly, but the gain is in services-only (fee-based) lives; employer-insured (risk) membership is flat to lower. The model reads Cigna Healthcare growth as low-risk and fee-based.
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Total customers - Medical customers(K#) | 18.08m Number | 18.27m Number | 18.23m Number | 18.50m Number | +1.1% | 16 |
| Total customers - Services only(K#) | 13.81m Number | 14.07m Number | 14.29m Number | 14.50m Number | +1.9% | 17 |
| Total customers - Employer insured(K#) | 2.18m Number | 2.11m Number | 2.11m Number | 2.12m Number | -3.0% | 17 |
Where brokers disagree: medical-cost trend and PBM profit
Dispersion is widest on the FY-2027 medical-care ratio and Evernorth earnings, a medical-cost-trend and PBM-margin debate; headline EPS consensus (see CapIQ tab) is comparatively tight.
| Line | Period | Median | Q1–Q3 | Min–max | Brokers |
|---|---|---|---|---|---|
| Medical care ratio - Cigna Healthcare(%) | FY-2027E | 83.8% | 83.7%–84.2% | 82.7%–84.6% | 16 |
| Income from operations - Evernorth - Operating | FY-2027E | $7.91bn | $7.40bn–$8.25bn | $6.94bn–$8.89bn | 16 |
| Income/(loss) before income tax - Pharmacy benefit services - Operating | FY-2027E | $2.79bn | $2.71bn–$2.86bn | $2.51bn–$2.92bn | 8 |
| Total revenue - Cigna Healthcare | FY-2028E | $48.58bn | $48.04bn–$49.76bn | $45.96bn–$55.47bn | 12 |
Thin, stale coverage on international, group-disability and Medicare lines
Total revenue, EPS and segment margins carry up to 18 brokers with mid-2026 revisions, but International markets, Group disability & other and Medicare-advantage membership rest on a single broker with 2024-dated estimates. Treat those as one analyst's stale view, not consensus.
Headline P&L consensus, momentum and beat/miss live in the CapIQ tab.
Source: S&P Capital IQ transcripts via Xpressfeed · latest indexed call 2026-04-30 · generated 2026-07-22.
Latest call digest
The Cigna Group, Q1 2026 Earnings Call, Apr 30, 2026 · 2026-04-30T12:30:00
Q1 2026 (reported April 30, 2026) was David Cordani's final quarterly call as CEO before Brian Evanko succeeds him on July 1, with Cordani moving to Executive Chair. Prepared remarks led with strength and a raised outlook: total revenue of $68.5 billion, adjusted EPS of $7.79, and a full-year 2026 adjusted EPS guide lifted to at least $30.35. Management paired the beat with two new portfolio-shaping actions — a planned exit of the individual exchange business at the end of 2026 and a strategic review of eviCore — alongside continued progress on the rebate-free "Signature" pharmacy model and 20% adjusted-earnings growth in Specialty and Care Services.
The Q&A was less about the beat and more about the reshaping. Analysts pressed on how and when clients adopt Signature, the economics of the exchange exit and eviCore review, the drivers of specialty strength (biosimilars, Shields), and a sharp jump in the noncontrolling-interest line. Management framed both divestiture actions as proactive with no transaction to discuss, and reiterated that cost trends remain elevated but have not accelerated. Guidance actually stated: full-year adjusted EPS of at least $30.35, Evernorth adjusted income of at least $6.9 billion, Cigna Healthcare pretax adjusted earnings of at least $4.525 billion, and an unchanged full-year medical care ratio range of 83.7% to 84.7%.
Participant coverage from the latest call.
| Group | Participants | Count |
|---|---|---|
| Management | Operator; Ralph Giacobbe — Senior Vice President of Investor Relations, The Cigna Group; David Cordani — Executive Chairman of the Board, The Cigna Group; Brian Evanko — President, CEO & Director, The Cigna Group; Ann Dennison — Executive VP & CFO, The Cigna Group | 5 |
| Analysts | Albert Rice — Health Care Services Analyst, UBS Investment Bank, Research Division; Kevin Fischbeck — Managing Director in Equity Research, BofA Securities, Research Division; Lisa Gill — MD, Head of U.S. Healthcare Technology & Distribution Equity Research and Senior Research Analyst, JPMorgan Chase & Co, Research Division; Scott Fidel — Research Analyst, Goldman Sachs Group, Inc., Research Division; Charles Rhyee — MD & Senior Research Analyst, TD Cowen, Research Division; George Hill — MD & Equity Research Analyst, Deutsche Bank AG, Research Division; Justin Lake — MD & Senior Healthcare Services Analyst, Wolfe Research, LLC; Erin Wilson Wright — Equity Analyst, Morgan Stanley, Research Division; Jason Cassorla — VP & Equity Research Analyst, Guggenheim Securities, LLC, Research Division; David Windley — MD & Equity Analyst, Jefferies LLC, Research Division | 10 |
Curated latest-call exchanges; one row per analyst topic.
| Analyst | Firm | Topic | What changed in Q&A |
|---|---|---|---|
| Albert (A.J.) Rice | UBS | Signature PBM adoption and selling season | Pressed on transition mechanics, client lead times, and how much of the strong 2027 selling season is Signature versus the general market. Management said 2027 is largely the existing models, expects mid-90s retention, and Signature becomes the standard in 2028. |
| Kevin Fischbeck | BofA Securities | Exchange exit and eviCore economics | Asked about capital recaptured from the exchange exit and whether the eviCore review was inbound or strategic, and its accretion. Management called both proactive, said freed capital is not particularly material, and that there is no eviCore transaction to discuss. |
| Lisa Gill | JPMorgan | PBS cost cadence and specialty drivers | Sought the cadence of the roughly $150 million year-over-year PBS earnings step-down and the drivers of specialty strength. Management pointed to large-client renewals plus Signature investment weighted to the back half, and to volumes, biosimilars, and the Shields contribution. |
| Justin Lake | Wolfe Research | Noncontrolling-interest line jump | Dug into the $226 million NCI that more than doubled year-over-year. Management attributed it to a new joint venture with a large client where most economics pass through despite majority ownership, and said it was fully contemplated in guidance. |
| Jason Cassorla | Guggenheim Securities | Medical care ratio bridge | Questioned whether the 79.8% first-quarter MCR beat was fully explained by flu, weather, and exchange seasonality, and asked to bridge the second-quarter step-up. Management cited balanced favorability with no single outsized driver and left full-year MCR guidance unchanged. |
| Scott Fidel | Goldman Sachs | Growth-pillar continuity under new CEO | Asked how Evanko would treat the long-standing growth strategy. He reaffirmed the three core platforms and signaled intensification on data and AI, lower-cost care, and moving further upstream, with no change to the capital-deployment framework. |
| David Windley | Jefferies | GLP-1 program uptake | Asked about uptake across the GLP-1 programs. Management said weight-management coverage is roughly stable year-over-year, EnCircle enrollment continues to grow, and the demand-versus-affordability tension persists pending oral versions and easing supply. |
Theme tracker
Themes are curator-classified across supplied calls.
| Theme | Status | Quarters mentioned | Read-through |
|---|---|---|---|
| Specialty and Care Services / biosimilars | persisted | Q2 2024, Q3 2024, Q4 2024, Q1 2025, Q2 2025, Q3 2025, Q4 2025, Q1 2026 | The consistent growth engine across the window: specialty pharmacy plus biosimilars (HUMIRA, then STELARA at $0 patient out-of-pocket) and the CarepathRx and Shields additions. Specialty and Care Services grew 20% in Q1 2026 and is framed as about 35% of company income. |
| Rebate-free "Signature" pharmacy model | emerged | Q3 2025, Q4 2025, Q1 2026 | Announced on the Q3 2025 call and dominant since. It becomes the standard model in 2028, with a target of at least 50% of Evernorth Pharmacy Benefit Services members by year-end 2028, reframing the PBM story from transparency commitments to a full rebate-free redesign. |
| Elevated medical cost trend | persisted | Q4 2024, Q1 2025, Q2 2025, Q3 2025, Q4 2025, Q1 2026 | A standing planning assumption throughout. The language migrated from "broadly in line" in 2024 to "persistently elevated" across 2025; by Q1 2026 management adds that trend has not accelerated, offering potential upside if it decelerates. |
| Stop-loss margin pressure and recovery | persisted | Q4 2024, Q1 2025, Q2 2025, Q3 2025 | Stop-loss drove the Q4 2024 earnings miss and recurred through 2025 as management repriced. A roughly 100 basis point, two-year margin recapture (majority in 2026, remainder 2027) was laid out, and the topic receded from prominence by Q1 2026. |
| Medicare Advantage divestiture | dropped | Q4 2023, Q1 2024, Q2 2024, Q3 2024, Q4 2024, Q1 2025 | The sale of the Medicare businesses to HCSC dominated calls from late 2023 through the early-2025 close, then dropped out of the narrative once completed — a clean case of a theme running its course and disappearing after execution. |
| GLP-1 coverage and clinical programs | persisted | Q2 2024, Q3 2024, Q4 2024, Q1 2025, Q2 2025, Q3 2025, Q1 2026 | GLP-1s (EnCircle, EnReach, EnGuide) recur every year, consistently framed as a tension between employee demand and employer affordability, with oral versions and easing supply cited as the route to lower net cost. |
| Portfolio shaping and business exits | persisted | Q4 2023, Q3 2024, Q3 2025, Q4 2025, Q1 2026 | A recurring management discipline: group life and disability, then Medicare, and in Q1 2026 the planned individual-exchange exit plus a strategic review of eviCore — each framed as sharpening focus on core growth platforms. |
Guidance ledger
Quotes, calls, and speakers are source-verified; outcomes are curator-classified.
| Verbatim guidance | Call | Speaker | Curator outcome | Outcome note |
|---|---|---|---|---|
| “With the strong first half performance, we continue to have confidence in our full year 2024 adjusted earnings per share outlook of at least $28.40, which represents more than 13% year-over-year growth in EPS.” | The Cigna Group, Q2 2024 Earnings Call, Aug 01, 2024 · 2024-08-01T12:30:00 | Brian Evanko | missed | Full-year 2024 adjusted EPS was reported at $27.33 on the Q4 2024 call, below the reaffirmed at-least-$28.40 outlook; management attributed the shortfall to stop-loss. |
| “And we expect full year 2025 consolidated adjusted income from operations to be at least $7.9 billion or at least $29.50 per share.” | The Cigna Group, Q4 2024 Earnings Call, Jan 30, 2025 · 2025-01-30T13:30:00 | Brian Evanko | kept | The Q4 2025 call reported full-year 2025 adjusted EPS of $29.84, above the initial at-least-$29.50 outlook. |
| “we expect to recapture approximately 100 basis points of margin in the overall Cigna Healthcare segment over the next 2 years with the majority in 2026 and the remaining in 2027.” | The Cigna Group, Q4 2024 Earnings Call, Jan 30, 2025 · 2025-01-30T13:30:00 | Brian Evanko | pending | The stop-loss recovery was scoped across 2026 and 2027; the supplied call history does not extend far enough to confirm completion. |
| “With the first quarter results, we are raising our full year 2025 adjusted earnings per share outlook to at least $29.60.” | The Cigna Group, Q1 2025 Earnings Call, May 02, 2025 · 2025-05-02T12:30:00 | Ann Dennison | kept | Full-year 2025 adjusted EPS was reported at $29.84 on the Q4 2025 call, above the raised at-least-$29.60 outlook. |
| “Our performance through the first 3 quarters gives us the confidence to deliver on our full year 2025 adjusted earnings per share outlook of at least $29.60.” | The Cigna Group, Q3 2025 Earnings Call, Oct 30, 2025 · 2025-10-30T12:30:00 | Ann Dennison | kept | Reaffirmed at least $29.60 for 2025; the Q4 2025 call reported $29.84. |
| “We are confident in our ability to deliver full year 2026 adjusted earnings of at least $30.25 per share and our ability to deliver attractive long-term EPS growth.” | The Cigna Group, Q4 2025 Earnings Call, Feb 05, 2026 · 2026-02-05T13:30:00 | Ann Dennison | pending | 2026 is in progress; on the Q1 2026 call the outlook was raised to at least $30.35, tracking above this initial floor. |
| “With the first quarter results, we are raising our full year 2026 adjusted earnings per share outlook to at least $30.35.” | The Cigna Group, Q1 2026 Earnings Call, Apr 30, 2026 · 2026-04-30T12:30:00 | Ann Dennison | pending | Full-year 2026 results are not yet in the supplied call history. |
Q&A pressure map
Question counts and firms are curator tallies; analyst coverage shown above.
| Topic | Questions | Firms | Pressure / response |
|---|---|---|---|
| Signature model and the 2026 PBM income decline | 5 | JPMorgan, Wolfe Research, UBS, Barclays, BofA Securities | The Q3 2025 call, which introduced the rebate-free model and flagged a 2026 Pharmacy Benefit Services decline, drew the heaviest questioning. Analysts pushed for the magnitude of the decline and 2026 EPS; management gave only directional commentary and explicitly declined to quantify either. |
| Stop-loss margin miss and repricing | 6 | Wolfe Research, Wells Fargo, TD Cowen, Stephens, Barclays, Deutsche Bank | The Q4 2024 miss made stop-loss the dominant line of questioning, with analysts probing the size of the shortfall, the pace of repricing, and why the margin recovery extends into 2027. |
| Medicare Advantage divestiture rationale | 5 | UBS, Wells Fargo, Nephron Research, Stephens, Wolfe Research | When the HCSC sale was announced on the Q4 2023 call, analysts pressed the rationale for exiting a business management still described as attractive and the implications of ceding control of internal medical spend. |
| Exchange exit and eviCore review | 2 | BofA Securities, Morgan Stanley | On the Q1 2026 call, questions centered on capital freed by the exchange exit and whether the eviCore review was proactive or prompted. Management said both actions were proactive with no transaction to discuss. |
Language shifts
Only language evidence verified against the referenced component is shown.
| Observation | Verbatim evidence | Call ID | Component |
|---|---|---|---|
| A candid admission of a miss that broke from the steady "in line with expectations" cadence of the prior 2023–2024 calls, with the shortfall concentrated in stop-loss. | “we're disappointed by the shortfall that we reported in the fourth quarter.” | 1916608175 | 6 |
| Management framed elevated high-cost-claimant pressure as durable rather than transient, a more structural read of cost trend than earlier calls conveyed. | “So we see it as more of a structural shift than something that's temporary.” | 1916608175 | 49 |
| New forward caution specific to the PBM segment, introduced alongside the rebate-free Signature model and its transition costs. | “we expect margin pressure within our Pharmacy Benefit Service segment over the next 2 years.” | 1962900714 | 2 |
| By Q1 2026 the cost-trend language turns modestly more constructive — still elevated, but explicitly not accelerating and framed as potential upside. | “On the positive side, they have not accelerated. They remained elevated.” | 1993036685 | 34 |
Across the history, Cigna is steadily shifting its center of gravity from insurance toward services and specialty, executed through disciplined pruning — group life, then Medicare, and now exchanges and possibly eviCore. Execution against the EPS algorithm has been reliable apart from the stop-loss-driven 2024 miss; the open question the transcripts leave for the debate is whether the rebate-free Signature transition can absorb near-term PBM margin pressure without denting the long-run algorithm as Evanko takes over.
Competitors describe The Cigna Group's market in their own filings and calls. These verified passages and visual pages show where their strategies meet, using source documents preserved in Sources.
CVS Health (CVS)
Cigna's closest structural mirror: CVS pairs Aetna (health plans) with Caremark (PBM) exactly as Cigna pairs Cigna Healthcare with Evernorth's Express Scripts, and its 10-K names Cigna's Express Scripts by name as a PBM competitor.
CVS Health's FY2025 10-K lists the primary competitive factors in health services and names “the Express Scripts business of Cigna Corporation” among the PBM competitors to its Caremark segment.
The Company believes the primary competitive factors in the health services industry include: (i) the ability to negotiate favorable discounts from drug manufacturers as well as to negotiate favorable discounts from, and access to, retail pharmacy networks; (ii) the ability to identify and apply effective cost management programs utilizing clinical strategies, including the development and utilization of preferred formularies; (iii) the ability to market PBM and other health products and services […] The Health Services segment has a significant number of competitors offering PBM services, including large, national PBM companies (e.g., Prime Therapeutics and MedImpact), PBMs owned by large national health plans (e.g., the Express Scripts business of Cigna Corporation and the Optum Rx business of UnitedHealth Group) and smaller standalone PBMs.
p. 24 · Read in context →
CVS Health's pharmacy chief characterizes Caremark as “the leader in the PBM in the marketplace” with an “upper 90% retention rate” heading into the 2026 selling season Cigna's Express Scripts also bids in.
Prem Shah, Group President: We’re really pleased with the strong start to the 2026 PBM selling season. Caremark continues to be well positioned as the leader in the PBM in the marketplace. What I’d say is we’re continuing to be focused on driving what our clients value the most, which is making prescriptions and pharmacy costs more affordable and lowering the cost by increasing competition. On the retention side, we’re on track with where we normally are, with our historical upper 90% retention rate. The PBM industry has always been competitive. We remain to have the same discipline we’ve always had in our pricing and in the marketplace.
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CVS Health's CEO frames Caremark's TrueCost net-cost pricing model as a first move that “others are following,” citing more than 25 million members in point-of-sale rebate programs.
David Joyner, President and CEO: As the leading health care consumer company, we’ve been working diligently for years to lead with greater transparency and savings for consumers at the pharmacy counter. We were at the forefront of this transition with more than 25 million members who benefit at the pharmacy counter from our lowest net cost through point-of-sale rebates. […] Two years ago, we continued our innovation leadership when we introduced our new TrueCost model, which guarantees a net cost for each individual drug, delivering drug pricing transparency for our clients and consumers. We are encouraged by recent announcements that others are following us on this path.
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UnitedHealth Group (UNH)
The largest US health insurer and, through Optum Rx, Express Scripts' biggest head-to-head PBM rival; its own disclosures size the drug-spend pool and stake out the transparency/rebate-pass-through ground Cigna's Evernorth also competes on.
UnitedHealth's FY2025 10-K sizes Optum Rx at $188 billion of pharmaceutical spend managed in 2025, including nearly $87 billion of specialty — the same pool Cigna's Express Scripts and Accredo manage.
Optum Rx manages a broad range of prescription drug spend, including widely available retail drugs as well as limited and ultra-limited distribution drugs in oncology, human immunodeficiency virus, pain management and ophthalmology. Optum Rx serves the growing pharmacy needs of people with behavioral health and substance use disorders. In 2025, Optum Rx managed $188 billion in pharmaceutical spending, including nearly $87 billion in specialty pharmaceutical spending
p. 7 · Read in context →
Optum Rx's stated pivot to fee-based pricing and a commitment to pass through 100% of manufacturer rebates by 2027, with retention it describes as “high 90s.”
Patrick Conway, CEO, Optum: Turning to Optum Rx. For a few years now, we have been leading an industry-wide shift towards transparency and fee-based services, where we are delivering affordability and better outcomes regardless of pricing structure. That's why we continue to win new customers and retain existing ones, with retention rates in the high 90s. In May, we announced a new pharmacy care approach based on monthly per-member fees with full PBM and GPO fee transparency and enhanced consumer tools. Client feedback has been positive and focused on how greater transparency and clinical alignment can address trend challenges, shifting the conversation to affordable health outcomes versus economic guarantees. This all builds on our industry-leading commitment last year to pass through 100% of manufacturer rebates to customers by the end of 2027. We are well on our way, as we expect to end 2026 with more than 95% of clients on 100% pass-through.
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Optum Rx's stated first-quarter client wins (more than 800 new clients onboarded) and its claim that specialty drugs now exceed 50% of drug spend.
Patrick Conway, CEO, Optum: Moving to Optum Rx. We started the year by onboarding more than 800 new clients while reducing contact call center volume by 25% through enhanced digital and AI-enabled self-service, with member satisfaction over 95%. Our unique PreCheck Prior Authorization capability reduces prescription approval time from over 8 hours to under 30 seconds and provides a 68% reduction in denials due to missing information and an 88% reduction in appeals, easing interaction for clients, members, and providers. First quarter utilization and drug cost trends were as expected, with scripts down slightly year-over-year reflecting some membership mix and attrition. As manufacturers continue to implement significant drug price increases, and with more complex specialty drugs representing over 50% of drug spend, the role of pharmacy care is more important than ever in helping patients access affordable drugs.
p. 3 · Read in context →
Elevance Health (ELV)
A Blue Cross Blue Shield insurer building CarelonRx into a full PBM and an in-house specialty pharmacy pointed squarely at Express Scripts and Accredo; its filings also record a direct legal collision with Cigna's Express Scripts.
CarelonRx's stated 2026 selling-season national-account wins and a claimed $100 per-member-per-month saving from an integrated medical-pharmacy model — the same integration thesis Cigna markets across Evernorth and Cigna Healthcare.
Mark Kaye, Chief Financial Officer: Carelon Rx delivered a strong ASO selling season for 2026. We had several national account wins and improved win rates across both the middle market and large group. That performance reflects growing demand for a more integrated medical-pharmacy model and for some of the differentiated value Carelon Rx brings to employers and our health plan partners. Sales momentum remains strong. Total sales to date are running ahead of plan including two marquee national wins, highlighting our ability to compete upmarket successfully for large sophisticated clients. […] For clients with aligned medical-pharmacy benefits we have seen savings upwards of $100 per member per month as well as significantly fewer ER visits and a reduction in some high-cost specialty drug administration.
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Carelon's stated specialty-pharmacy build-out on the BioPlus platform, including migrating Kroger Specialty Pharmacy prescriptions — volume it is capturing in Accredo's specialty niche.
Peter Haytaian, President of Carelon: Our specialty strategy is a key part of the diversification strategy we're implementing in pharmacy, and we're very excited about it. We are committed to promoting whole health, enhancing affordability and simplicity, and focusing on the patient experience. This strategy is vital for our long-term growth. We're making significant progress with it. We began with the BioPlus platform and are continuing to shift prescriptions to that platform. Last year, we acquired Kroger Specialty Pharmacy, and we're on track to transition those prescriptions by the end of this year, which is progressing well.
p. 9 · Read in context →
Elevance's FY2024 10-K recounts Anthem, Inc. v. Express Scripts, its suit seeking over $14,800 (thousands) for pharmacy pricing above competitive benchmarks — a direct dispute with the PBM Cigna now owns.
In March 2016, we filed a lawsuit against Express Scripts, Inc. (“Express Scripts”), our vendor at the time for pharmacy benefit management services, captioned Anthem, Inc. v. Express Scripts, Inc., in the U.S. District Court for the Southern District of New York (the “District Court”). The lawsuit sought to recover over $14,800 in damages for pharmacy pricing that is higher than competitive benchmark pricing under the agreement between the parties (the “ESI Agreement”), over $158 in damages related to operational breaches
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Humana (HUM)
The leading Medicare Advantage insurer, now pushing CenterWell specialty pharmacy and GLP-1 distribution into Evernorth's and Accredo's turf while defending the senior-market share Cigna Healthcare's government business contests.
Humana's stated CenterWell specialty-pharmacy growth, including new GLP-1 direct-to-consumer partnerships with Ro and Weight Watchers — encroaching on the specialty-pharmacy niche Evernorth's Accredo serves.
Celeste Mellet, Chief Financial Officer: In the Specialty Pharma sector, specifically within the CenterWell Pharmacy business, our strong performance this year is largely due to strategic changes in how we organize and market that business. We have made significant investments in establishing robust partnerships with pharmaceutical companies, which has led to new opportunities through our direct-to-consumer model. For example, we have formed new partnerships with Ro and Weight Watchers to sell some GLP-1 products, and we anticipate seeing more of this type of business in the future.
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Humana's stated 2026 AEP Medicare Advantage growth of roughly 1 million members (20%), with over 70% of new sales switchers from competitor plans.
James Rechtin, President and CEO: Third, let me provide an overview of our growth and why we like the growth. We grew by approximately 1,000,000 members or 20% in AEP. Our retention rate improved over 500 basis points year over year. And I'm going to keep emphasizing that that is good growth. Over 70% of our new sales were switchers from competitor plans. On average, switchers have better economics.
p. 2 · Read in context →
Humana's FY2025 10-K states its scale at roughly 15 million medical members and 4.7 million specialty members, with 83% of revenue from federal government contracts concentrated in Medicare Advantage.
As of December 31, 2025, we had approximately 15 million members in our medical benefit plans, as well as approximately 4.7 million members in our specialty products. During 2025, 83% of our total premiums and services revenue were derived from contracts with the federal government, including 14% derived from our individual Medicare Advantage contracts in Florida with the Centers for Medicare and Medicaid Services, or CMS, under which we provided health insurance coverage to approximately 1.0 million members as of December 31, 2025.
p. 4 · Read in context →
Centene (CNC)
The nation's largest ACA Marketplace and Medicaid insurer; Cigna's clearest overlap with Centene is the individual-exchange line, where Centene's leadership and post-subsidy pricing choices reshape the risk pool Cigna also sells into.
Centene's FY2025 10-K claims the largest ACA Marketplace position — 5.5 million Ambetter members across 29 states — while flagging the year-end 2025 expiration of enhanced APTC subsidies.
Temporary enhanced subsidies were made available by the American Rescue Plan Act (ARPA), which were further extended through 2025 pursuant to the IRA. The enhanced eligibility extended by the IRA expired at the end of 2025. While enhanced eligibility has expired, APTCs are still in force and provide meaningful subsidies to eligible members. We are the largest Marketplace carrier, serving 5.5 million members across 29 states as of December 31, 2025, under the brand name Ambetter Health. Revenues from CMS are significant to the segment.
p. 13 · Read in context →
Centene's stated exchange-pricing posture — a deliberate decision not to price as aggressively as competitors — and its claim to retain higher-acuity Silver members after enhanced-APTC expiration.
Sarah London, Chief Executive Officer: It also, as we've seen, drove a shift across the market from Silver membership into Bronze products as consumers looked for more affordable plans. And so as a result, the Silver tier remaining membership really follows the golden rule of risk pools that when it strengthens, it becomes more and more concentrated in higher acuity members. And so given our market size, our Silver footprint and, frankly, our intentional decision not to go as hard on aggressive pricing strategy, which we still very much stand by, we were positioned to retain and attract more Silver members who are now more acute in that overall post-APTC environment.
p. 6 · Read in context →
Molina Healthcare (MOH)
A government-programs managed-care insurer (Medicaid, D-SNP, Marketplace); its collision with Cigna is in the ACA exchange, where Molina is deliberately ceding share, and in Medicaid procurement scale.
Molina's stated ACA Marketplace retrenchment — repricing up ~30% and cutting its #1/#2 county footprint from 50% to 15% — with membership expected to fall from 650,000 toward the low-200,000s.
Joseph Zubretsky, Chief Executive Officer: But as you recall, we ended the year with 650,000 members. We priced up 30% on average, ranging from 15% to 45%, consciously reduced our #1 and #2 position from 50% of our counties to 15% and reduced our footprint by 20%, a conscious effort as we will not allocate capital to an unstable risk pool. Our speculation or forecast at the time was we would come down into the 200,000 zone, 200,000 to 300,000 and reduce our revenue to $2.2 billion.
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Molina's stated Medicaid procurement record — 90% renewal and 80% new-contract RFP win rates, over $9 billion of recent wins, and a $50 billion pipeline.
Joseph Zubretsky, Chief Executive Officer: The significant win in Florida in our previously announced Georgia and Texas star ship wins represent over $9 billion of Medicaid premium and significantly contribute to our embedded earnings. Since we embarked on this growth strategy, we have achieved an RFP win rate of 90% on renewal contracts, representing $14 billion in retained revenue and 80% on new contracts representing $20 billion of new revenue. We are engaged in active RFPs in several states and have an active pipeline of $50 billion of new opportunities over the next few years.
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More peer documents
Q4_FY2025 — 13 pages · CEO quantifies over $280 billion of combined Aetna network and Caremark drug-negotiation savings, and details the Cordavis biosimilar unit — the dual-engine scale claim that parallels Cigna's structure. · Open →
CVS_annual_report_FY2024 — 340 pages · Prior-year 10-K carries the same Health Services competition paragraph naming “the Express Scripts business of Cigna Corporation,” for a year-over-year read. · Open →
UNH_annual_report_FY2024 — 118 pages · Prior-year 10-K with Optum Rx managed-spend and adjusted-script figures for a year-over-year benchmark against Express Scripts' scale. · Open →
Q4_FY2025 — 13 pages · Fuller-year Optum Rx commentary on PBM transparency, specialty mix and drug-cost trend around the 2026 selling season. · Open →
ELV_annual_report_FY2025 — 230 pages · Latest 10-K describes CarelonRx's full PBM service portfolio (formulary, rebate administration, specialty, home delivery) sold to affiliated and external clients, plus updated medical membership. · Open →
Q3_FY2025 — 12 pages · CEO describes extending CenterWell GLP-1 pharmacy from direct-to-consumer into direct-to-employer, and PDP growth from below-benchmark bids capturing competitor reassignments. · Open →
Q2_FY2025 — 14 pages · CEO answers analysts on exchange competition, claiming the largest combined Medicaid and Marketplace book and signaling intent to use that scale on market-wide pricing rules. · Open →
MOH_annual_report_FY2025 — 102 pages · 10-K lays out the OBBBA Medicaid-expansion cuts and expiring ACA subsidies reshaping the public-program and exchange risk pools Cigna also serves. · Open →