Competitors

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.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.