☒ | ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 | ||||
For the fiscal year ended December 31, 2020
|
|||||
OR | |||||
☐ | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
Delaware | 82-4991898 | ||||
(State or other jurisdiction of incorporation or organization) | (I.R.S. Employer Identification No.) | ||||
900 Cottage Grove Road, Bloomfield, Connecticut
|
06002 | ||||
(Address of principal executive offices) | (Zip Code) | ||||
(860) 226-6000
|
|||||
Registrant’s telephone number, including area code |
Securities registered pursuant to Section 12(b) of the Act:
|
||||||||
Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Common Stock, Par Value $0.01 | CI |
New York Stock Exchange, Inc.
|
Securities registered pursuant to Section 12(g) of the Act:
|
||
NONE |
FREQUENTLY REQUESTED 10-K INFORMATION
|
|||||
Page | |||||
Risk Factors | |||||
Executive Overview | |||||
Industry Developments and Other Matters | |||||
Liquidity and Capital Resources | |||||
Critical Accounting Estimates | |||||
Segment Information | |||||
Revenues by Product Type |
Page | ||||||||
|
|||||||||||
|
|||||||||||
A. Directors of the Registrant | |||||||||||
B. Executive Officers of the Registrant | |||||||||||
C. Code of Ethics and Other Corporate Governance Disclosures | |||||||||||
D. Delinquent Section 16(a) Reports | |||||||||||
FS-1
|
|||||||||||
Exhibits |
Our Purpose and Mission
To improve the health, well-being and peace of mind of those we serve
|
||||||||
Our Strategy | ||||||||
Champions for affordable, predictable, and simple health care | ||||||||
Making it affordable: We build on our leading, differentiated position to lower the total cost of care.
|
||||||||
Making it predictable: We take the surprise out of the system and help people make informed health care choices.
|
||||||||
Making it simple: We make it easier for the people we serve to get the care they need.
|
HOW WE WIN | ||
Evernorth accelerates delivery of innovative and flexible solutions to create value and meet the diverse needs of health plans, employers, health care providers and government organizations by:
·Partnering in unconventional ways to solve complex problems across a fragmented health care ecosystem, fueled by connected data and expertise that drives purposeful innovation
·Creating flexible and focused solutions tailored to client needs, using Evernorth's combined strengths and capabilities, as well as strategic partnerships, to deliver: better, more efficient care for patients; better experiences for clients, providers and customers; and enhanced choices for clients and customers through our open architecture model
·Evaluating medicines, digital therapeutics and other health solutions for efficacy, adherence, value and price to assist clients in selecting a cost-effective formulary
·Offering home delivery and specialty customer-centric solutions that meet the needs of our clients and customers in ways that unlock greater value and better health services while providing better and specialized clinical care
·Aggregating purchasing volume to deliver discounts and drive risk-sharing and value-based care across the pharmaceutical supply chain
·Promoting the use of generics and lowest-cost, clinically effective brands of medications
|
Principal Products & Services |
Brands/
Subsidiaries |
Key Relationships | Primary Competitors | |||||||||||
Pharmacy Solutions |
Express Scripts Pharmacy, Accredo®, Freedom Fertility Pharmacy®,, Therapeutic Resource Center®
|
Clients, Customers, Health Care Providers | Independent Pharmacy Benefit Managers (“PBMs”), Managed Care PBMs, Retail Pharmacies, Specialty Pharmacies | |||||||||||
Benefits Management Solutions | Pharmacy and Medical Benefits Management |
eviCore Healthcare®, Express Scripts PBM, myMatrixx®, Care Continuum®, Evernorth Embarc Benefit ProtectionSM, Evernorth FamilyPathSM
|
Clients, Customers, Health Care Providers, Consultants, Health Plans, Commercial and Government Payors | Health Plans, Independent PBMs, Managed Care PBMs, Third-Party Benefit Administrators, Group Purchasing Organizations, Clinical Solutions and Health Care Data Analytics Companies | ||||||||||
Supply Chain Administration and Network Management |
Value Based Programs (Express Scripts SafeGuardRx®, Patient AssuranceSM), National Preferred Formulary, SaveOnSP, Express Scripts MedRx ManagementSM, Express Scripts Parachute RxSM, Ascent Health Services, Econdisc, Inside Rx®
|
Clients, Self-paying customers (InsideRx only), Pharmacy Providers | Health Plans, Independent PBMs, Managed Care PBMs, Third Party Benefit Administrators, Group Purchasing Organizations | |||||||||||
Care Solutions |
Evernorth Healthy Ways to WorkSM, inMyndSM, Health Connect 360SM, Evernorth Digital Health FormularySM, Advanced Utilization Management, Enhanced Fraud, Waste & Abuse, Advanced Opioid Management®, ScreenRx®, Behavioral Health
|
Clients, Customers | Independent PBMs, Managed Care PBMs, Third-Party Benefit Administrators | |||||||||||
Evernorth Intelligence Solutions |
Express Scripts Lab, RationalMed®, MediCUBE®, Express Scripts ScriptVisionSM
|
Health Care Providers, Clients | Health Care Data Analytics Companies | |||||||||||
Provider Services |
CuraScript SD®
|
Health Care Providers, Clinics, Hospitals | Specialty Drug Distributors |
HOW WE WIN | ||
·Broad and deep portfolio of solutions across U.S. Commercial and U.S. Government segments
·Commitment to highest-quality health outcomes and customer experiences
·Collaborative physician engagement models emphasizing value over volume of services
·Integrated and coordinated benefit solutions that deliver value for our customers, clients and partners
·Technology and data analytics powering actionable insights and affordable, predictable solutions
·Talented and caring people embracing change and putting customers at the center of all we do
|
Principal Products & Services | Major Brand(s) | Geography | Funding Solution(s) | Market Segment(s) | Primary Distribution Channel(s) | Primary Competitors | ||||||||||||||
U.S. Commercial Medical
|
||||||||||||||||||||
Managed Care | Cigna HealthCare | Nationwide | GC, ER, ASO |
U.S. Commercial
|
Brokers, Private Exchanges, Direct | National Insurers, Local Healthplans, Third-Party Administrators (“TPAs”) | ||||||||||||||
Preferred Provider Organization (“PPO”) | Cigna | Nationwide | National Insurers, TPAs | |||||||||||||||||
Consumer-Driven | Cigna | Nationwide | National Insurers, Local Health Maintenance Organizations (“HMOs”) | |||||||||||||||||
U.S. Government Medical
|
||||||||||||||||||||
Individual and Family Plans | Cigna |
11 states(1)
|
GC | Individual | Public Exchanges, Brokers, Direct | Local Healthplans, Start-ups, National Insurers | ||||||||||||||
Medicare Advantage | Cigna |
18 states(2) & District of Columbia
|
GC |
U.S. Government
|
Direct, Brokers | National Insurers, Local Healthplans | ||||||||||||||
Medicare Stand –Alone Prescription Drug Plans | Cigna, Express Scripts | Nationwide | GC, ASO |
U.S. Government
|
Direct, Brokers | National Insurers | ||||||||||||||
Medicare Supplement | Cigna |
48 states(3) & District of Columbia
|
GC |
U.S. Government
|
Brokers, Direct, Private Exchanges | National Insurers | ||||||||||||||
Medicaid | Cigna |
Texas
|
GC |
U.S. Government
|
Direct, Brokers | National Insurers | ||||||||||||||
Specialty Products and Services | ||||||||||||||||||||
Stop-Loss | Cigna | Nationwide | GC |
U.S. Commercial
|
Brokers, Direct | National Insurers, Specialty Companies | ||||||||||||||
Cost Containment | Cigna | Nationwide | GC, ER, ASO |
U.S. Commercial
|
Direct | National Insurers, Specialty Companies | ||||||||||||||
Consumer Health Engagement | Cigna | Nationwide | GC, ER, ASO |
U.S. Commercial, U.S. Government
|
Brokers, Direct | National Insurers, Specialty Companies | ||||||||||||||
Pharmacy Management | Cigna | Nationwide | GC, ER, ASO |
U.S. Commercial, U.S. Government
|
Brokers, Direct | National PBMs | ||||||||||||||
Behavioral Health | Cigna Behavioral Health | Nationwide | GC, ER, ASO |
U.S. Commercial
|
Brokers, Direct | National Insurers, Specialty Companies | ||||||||||||||
Dental & Vision | Cigna Dental HealthCare | Nationwide |
GC, ER, ASO |
U.S. Commercial, U.S. Government
|
Brokers, Direct | Dental Insurers, National Insurers |
HOW WE WIN | ||
·Offering a broad range of health and protection-related solutions to meet the needs of the growing
middle class and globally mobile
·Leveraging deep consumer insights to drive product and service innovation
·Maintaining leading innovative, direct-to-consumer distribution capabilities
·Providing access to quality, affordable care through one of the largest global provider networks
·Implementing locally-licensed and compliant solutions managed by strong, locally-developed talent
|
Principal Products & Services | Major Brand(s) | Geography | Funding Solution(s) | Key Relationships | Primary Distribution Channel(s) | Primary Competitors | ||||||||||||||
Global Health Care | Cigna Global Health Benefits, Cigna Global Individual Health | Worldwide (except as limited by applicable law) | ER, GC, ASO |
Multinational Companies, Inter-governmental and Non-governmental Organizations
Globally mobile individuals |
Brokers, Agents, Direct-to-Consumer | Global insurers | ||||||||||||||
Local Health Care |
Cigna,
ManipalCigna, CignaCMB |
United Kingdom, Spain, Hong Kong, India, China, Singapore, Middle East, Thailand | ER, GC, ASO |
Employer Groups
Individuals |
Brokers, Agents, Direct-to-Consumer | Global insurers and local non-U.S. insurers | ||||||||||||||
Supplemental Health, Life, & Accident |
Cigna
LINA Korea, CignaCMB, ManipalCigna, CignaFinans |
Asia Pacific, India, Turkey | GC | Individuals | Affinity, Bancassurance, Brokers, Agents, Direct-to-Consumer | Global insurers and local non-U.S. insurers |
Period |
Total # of shares purchased (1)
|
Average price paid per share |
Total # of shares purchased as part of
publicly announced program (2)
|
Approximate dollar value of shares
that may yet be purchased as part
of publicly announced program (3)
|
||||||||||||||||||||||
October 1-31, 2020 | 2,513,269 | $ | 174.20 | 2,511,898 | $ | 3,154,849,988 | ||||||||||||||||||||
November 1-30, 2020 | 2,264,316 | $ | 208.21 | 2,263,127 | $ | 2,683,607,700 | ||||||||||||||||||||
December 1-31, 2020 | 3,933,971 | $ | 206.97 | 3,915,223 | $ | 3,873,160,092 | ||||||||||||||||||||
Total | 8,711,556 | $ | 197.84 | 8,690,248 | N/A |
Financial highlights by segment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
For the Years Ended December 31, | Increase (Decrease) | Increase (Decrease) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Dollars in millions, except per share amounts) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Revenues | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues by segment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Evernorth | $ | 116,130 | $ | 96,447 | $ | 6,606 | 20 | % | N/M | |||||||||||||||||||||||||||||||||||||||||||||||
U.S. Medical | 38,451 | 36,519 | 32,791 | 5 | 11 | % | ||||||||||||||||||||||||||||||||||||||||||||||||||
International Markets | 5,877 | 5,615 | 5,366 | 5 | 5 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Group Disability and Other | 5,264 | 5,182 | 5,061 | 2 | 2 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Corporate, net of eliminations | (5,655) | (3,588) | (1,713) | (58) | (109) | |||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues | 160,067 | 140,175 | 48,111 | 14 | 191 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Revenue contribution from transitioning clients | — | 13,347 | 459 | N/M | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Net realized investment results from certain equity method investments | 130 | 44 | (43) | 195 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Special items | 204 | — | 123 | N/M | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Total revenues | $ | 160,401 | $ | 153,566 | $ | 48,650 | 4 | % | 216 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Shareholders’ net income | $ | 8,458 | $ | 5,104 | $ | 2,637 | 66 | % | 94 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Adjusted income from operations | $ | 6,795 | $ | 6,476 | $ | 3,557 | 5 | % | 82 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Earnings per share (diluted) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Shareholders’ net income | $ | 22.96 | $ | 13.44 | $ | 10.54 | 71 | % | 28 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Adjusted income from operations | $ | 18.45 | $ | 17.05 | $ | 14.22 | 8 | % | 20 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted income from operations by segment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Evernorth | $ | 5,363 | $ | 5,092 | $ | 380 | 5 | % | N/M | |||||||||||||||||||||||||||||||||||||||||||||||
U.S. Medical | 3,807 | 3,831 | 3,502 | (1) | 9 | % | ||||||||||||||||||||||||||||||||||||||||||||||||||
International Markets | 900 | 762 | 735 | 18 | 4 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Group Disability and Other | 290 | 501 | 529 | (42) | (5) | |||||||||||||||||||||||||||||||||||||||||||||||||||
Corporate, net of eliminations | (1,552) | (1,824) | (403) | 15 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Consolidated pre-tax adjusted income from operations | 8,808 | 8,362 | 4,743 | 5 | 76 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Adjustment for transitioning clients | — | 1,726 | 62 | N/M | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Income attributable to noncontrolling interests | 37 | 20 | 14 | 85 | 43 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Net realized investment gains (losses) | 279 | 221 | (124) | 26 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | (1,982) | (2,949) | (235) | 33 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||
Special items | 3,726 | (810) | (879) | N/M | 8 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Income before income taxes | $ | 10,868 | $ | 6,570 | $ | 3,581 | 65 | % | 83 | % | ||||||||||||||||||||||||||||||||||||||||||||||
Consolidated Results of Operations (GAAP basis) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
For the Years Ended December 31, | Increase (Decrease) | Increase (Decrease) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Dollars in millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pharmacy revenues | $ | 107,769 | $ | 103,099 | $ | 5,479 | $ | 4,670 | 5 | % | $ | 97,620 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Premiums | 42,627 | 39,714 | 36,113 | 2,913 | 7 | 3,601 | 10 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Fees and other revenues | 8,761 | 9,363 | 5,578 | (602) | (6) | 3,785 | 68 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net investment income | 1,244 | 1,390 | 1,480 | (146) | (11) | (90) | (6) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total revenues | 160,401 | 153,566 | 48,650 | 6,835 | 4 | 104,916 | 216 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pharmacy and other service costs | 103,484 | 97,668 | 4,793 | 5,816 | 6 | 92,875 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Medical costs and other benefit expenses | 32,710 | 30,819 | 27,528 | 1,891 | 6 | 3,291 | 12 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Selling, general and administrative expenses | 14,072 | 14,053 | 11,934 | 19 | — | 2,119 | 18 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | 1,982 | 2,949 | 235 | (967) | (33) | 2,714 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total benefits and expenses | 152,248 | 145,489 | 44,490 | 6,759 | 5 | 100,999 | 227 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Income from operations | 8,153 | 8,077 | 4,160 | 76 | 1 | 3,917 | 94 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Interest expense and other | (1,438) | (1,682) | (498) | 244 | 15 | (1,184) | (238) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Debt extinguishment costs | (199) | (2) | — | (197) | N/M | (2) | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gain (loss) on sale of business | 4,203 | — | — | 4,203 | N/M | — | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net realized investment gains (losses) | 149 | 177 | (81) | (28) | (16) | 258 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Income before income taxes | 10,868 | 6,570 | 3,581 | 4,298 | 65 | 2,989 | 83 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total income taxes | 2,379 | 1,450 | 935 | 929 | 64 | 515 | 55 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net income | 8,489 | 5,120 | 2,646 | 3,369 | 66 | 2,474 | 93 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Less: Net income attributable to noncontrolling interests | 31 | 16 | 9 | 15 | 94 | 7 | 78 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Shareholders' net income | $ | 8,458 | $ | 5,104 | $ | 2,637 | $ | 3,354 | 66 | % | $ | 2,467 | 94 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Consolidated effective tax rate | 21.9 | % | 22.1 | % | 26.1 | % | (20) | bps | (400) | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Medical customers (in thousands) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
U.S. Medical | 15,013 | 15,548 | 15,389 | (535) | (3) | % | 159 | 1 | % | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
International Markets | 1,660 | 1,597 | 1,572 | 63 | 4 | 25 | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total | 16,673 | 17,145 | 16,961 | (472) | (3) | % | 184 | 1 | % |
Reconciliation of Shareholders’ Net Income (GAAP) to Adjusted Income from Operations | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dollars in Millions | Diluted Earnings Per Share | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
For the Years Ended December 31, | For the Years Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
2020 | 2019 | 2018 | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Shareholders’ net income | $ | 8,458 | $ | 5,104 | $ | 2,637 | $ | 22.96 | $ | 13.44 | $ | 10.54 | ||||||||||||||||||||||||||||||||||||||||||||||||||
After-tax adjustments required to reconcile to adjusted income from operations | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net realized investment (gains) losses | (244) | (190) | 104 | (0.66) | (0.50) | 0.42 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | 1,431 | 2,248 | 177 | 3.88 | 5.92 | 0.71 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjustment for transitioning clients | — | (1,316) | (47) | — | (3.46) | (0.19) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Special items | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Integration and transaction-related costs | 404 | 427 | 669 | 1.10 | 1.11 | 2.67 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Debt extinguishment costs | 151 | — | — | 0.41 | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Charge for organizational efficiency plan | 24 | 162 | — | 0.07 | 0.43 | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Charges associated with litigation matters | 19 | 41 | 19 | 0.05 | 0.11 | 0.08 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Risk corridors recovery | (76) | — | — | (0.21) | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Contractual adjustment for a former client | (155) | — | — | (0.42) | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Gain) on sale of business | (3,217) | — | — | (8.73) | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Charges (benefits) associated with tax reform | — | — | (2) | — | — | (0.01) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total special items | (2,850) | 630 | 686 | (7.73) | 1.65 | 2.74 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted income from operations | $ | 6,795 | $ | 6,476 | $ | 3,557 | $ | 18.45 | $ | 17.05 | $ | 14.22 |
Item
|
Description
|
||||
Medicare Advantage ("MA") |
Medicare Star Quality Ratings ("Star Ratings"): CMS uses a Star Rating system to measure how well MA plans perform and scores performance in several categories, including quality of care and customer service. Star Ratings range from one to five stars. CMS recognizes plans with Star Ratings of four stars or greater with quality bonus payments and the ability to offer enhanced benefits. Approximately 77% of our MA customers were in four star or greater plans for bonus payments received in 2020 and 87% for bonus payments to be received in 2021. In October 2020, CMS announced the Star Ratings for bonus payments to be received in 2022. We expect the percentage of our MA customers in four star or greater plans will increase to 88% for bonus payments to be received in 2022.
|
||||
MA Rates: Final MA reimbursement rates for 2021 were published by CMS in April 2020, and final rates for 2022 were published by CMS in January 2021. We do not expect the new rates to have a material impact on our consolidated results of operations in 2021 or 2022.
|
|||||
Risk Adjustment: As discussed in the “Regulation” and “Risk Factors” sections of this Form 10-K, our MA business is subject to reviews, including risk adjustment data validation (“RADV”) audits by CMS and the Office of the Inspector General (“OIG”). We expect that CMS, OIG and other federal agencies will continue to closely scrutinize components of the Medicare program.
|
|||||
The “Regulation” section of this Form 10-K also discusses a proposed rule issued by CMS in 2018 for RADV audits of contract year 2011 and all subsequent years that included, among other things, extrapolation of the error rate related to RADV audit findings without applying the adjustment for underlying fee-for-service data errors as currently contemplated by CMS’ RADV audit methodology. RADV audits for our contract years 2011 through 2015 are currently in process. CMS has announced its intent to use third-party auditors to audit all Medicare Advantage contracts by either a comprehensive or a targeted RADV review for each contract year. If the proposed rule is adopted in its current form, it could result in some combination of degraded plan benefits, higher monthly premiums and reduced choice for the population served by all MA insurers. The Company, along with other MA organizations and additional interested parties, submitted comments to CMS on the proposed rule as part of the notice-and-comment rulemaking process. The comment period concluded on August 28, 2019 and CMS is expected to act by November 2021. If CMS adopts the rule as proposed, there could be a material impact on the Company’s future results of operations, though we expect the rule would be subject to legal challenges. In addition, the Company is subject to OIG RADV audits that are in process.
|
|||||
Also, as described in Note 21 to the Consolidated Financial Statements, the U.S. Department of Justice is currently conducting an industry-wide investigation of risk adjustment data submission practices and business processes, which in the case of certain other MA organizations has resulted in litigation.
|
|||||
Item
|
Description
|
||||
Affordable Care Act
|
Cost-Sharing Reduction Subsidies: The ACA provides for cost-sharing reductions that offset the amount that qualifying customers pay for deductibles, copays and coinsurance. The federal government stopped funding insurers for the cost-sharing reduction ("CSR”) subsidies in 2017. Certain insurers have sued the federal government for failure to pay cost-sharing reduction subsidies and the matter remains unresolved. In the first set of consolidated appeals, the Court of Appeals for the Federal Circuit issued a decision on August 14, 2020, finding that (i) the CSR reimbursement provision of the ACA imposes an obligation on the government to pay, but (ii) the insurers' damages must be reduced by the amount of additional premium tax credit payments that each insurer received as a result of the government’s termination of CSR payments. On September 28 and October 2, 2020, the insurers filed petitions for rehearing en banc in the Federal Circuit. The court denied those petitions on November 10 and December 16, 2020, respectively. On February 19, 2021 two insurers filed a petition seeking Supreme Court review. As described in Note 21 to the Consolidated Financial Statements, we filed a lawsuit in May 2020 against the federal government seeking payment of these subsidies. Our case is stayed until either the Federal Circuit’s judgments in the CSR appeals become final and non-appealable or the Supreme Court resolves any petition for writ of certiorari. Our premium rates for the 2018, 2019 and 2020 plan years reflected a lack of government funding for cost-sharing reduction subsidies.
|
||||
ACA Litigation: As described in the “Business - Regulation” section of this Form 10-K, a federal district court ruled that the “individual mandate” in the ACA is unconstitutional and that the entire law must be struck down. On appeal, the Court of Appeals for the Fifth Circuit agreed that the “individual mandate” is unconstitutional but ordered the district court to reexamine whether the other provisions of the ACA can remain in effect, thereby leaving in doubt whether the entire ACA is unconstitutional until there is a final judicial determination on appeal. The California-led states and the U.S. House of Representatives filed petitions seeking to appeal the Fifth Circuit's ruling to the U.S. Supreme Court. On March 2, 2020, the Supreme Court agreed to hear the appeals. The case was argued before the Supreme Court on November 10, 2020, and a decision is expected by the end of June 2021.
|
(In millions) |
December 31,
2020 |
December 31,
2019 |
||||||||||||
Risk Adjustment | ||||||||||||||
Receivables (1)
|
$ | 80 | $ | 47 | ||||||||||
Payables (2)
|
(153) | (213) | ||||||||||||
Total risk adjustment balance | $ | (73) | $ | (166) |
(In millions) | ||||||||||||||||||||
Financial Summary | 2020 | 2019 | 2018 | |||||||||||||||||
Short-term investments | $ | 359 | $ | 423 | $ | 316 | ||||||||||||||
Cash and cash equivalents | $ | 10,182 | $ | 4,619 | $ | 3,855 | ||||||||||||||
Short-term debt | $ | 3,374 | $ | 5,514 | $ | 2,955 | ||||||||||||||
Long-term debt | $ | 29,545 | $ | 31,893 | $ | 39,523 | ||||||||||||||
Shareholders’ equity | $ | 50,321 | $ | 45,338 | $ | 41,028 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Net cash provided by operating activities | $ | 10,350 | $ | 9,485 | $ | 3,770 | ||||||||||||||
Net cash provided by (used in) investing activities: | ||||||||||||||||||||
Cash proceeds from sale of U.S. Group Disability and Life business, net of cash sold | 5,592 | — | — | |||||||||||||||||
Cash used to acquire Express Scripts, net of cash acquired | — | — | (24,062) | |||||||||||||||||
Other acquisitions | (139) | (153) | (393) | |||||||||||||||||
Net investment sales (purchases) | (1,406) | 480 | (1,383) | |||||||||||||||||
Purchases of property and equipment and other | (1,071) | (1,061) | (540) | |||||||||||||||||
Net investing activities | 2,976 | (734) | (26,378) | |||||||||||||||||
Net cash (used in) provided by financing activities: | ||||||||||||||||||||
Debt (repayments) issuances | (4,736) | (5,175) | 24,212 | |||||||||||||||||
Stock repurchase | (4,042) | (1,987) | (342) | |||||||||||||||||
Other, net | 245 | (25) | (355) | |||||||||||||||||
Net financing activities | (8,533) | (7,187) | 23,515 | |||||||||||||||||
Foreign currency effect on cash | 41 | (8) | (24) | |||||||||||||||||
Change in cash, cash equivalents and restricted cash | $ | 4,834 | $ | 1,556 | $ | 883 |
(In millions, on an undiscounted basis) | Total | 2021 | 2022 to 2023 | 2024 to 2025 | Thereafter | |||||||||||||||||||||||||||
On-Balance Sheet | ||||||||||||||||||||||||||||||||
Insurance liabilities | ||||||||||||||||||||||||||||||||
Contractholder deposit funds | $ | 5,430 | $ | 282 | $ | 502 | $ | 462 | $ | 4,184 | ||||||||||||||||||||||
Future policy benefits | 12,339 | 338 | 776 | 900 | 10,325 | |||||||||||||||||||||||||||
Health Care Medical claims payable | 3,041 | 3,041 | ||||||||||||||||||||||||||||||
Unpaid claims and claim expenses | 1,195 | 1,141 | 11 | 9 | 34 | |||||||||||||||||||||||||||
Long-term debt (1)
|
48,029 | 3,595 | 8,048 | 6,062 | 30,324 | |||||||||||||||||||||||||||
Other noncurrent liabilities | 623 | 156 | 104 | 99 | 264 | |||||||||||||||||||||||||||
Operating leases | 705 | 150 | 288 | 146 | 121 | |||||||||||||||||||||||||||
Off-Balance Sheet | ||||||||||||||||||||||||||||||||
Purchase Obligations | 3,197 | 1,399 | 1,283 | 493 | 22 | |||||||||||||||||||||||||||
Total | $ | 74,559 | $ | 10,102 | $ | 11,012 | $ | 8,171 | $ | 45,274 |
Balance Sheet Caption /
Nature of Critical Accounting Estimate |
Effect if Different Assumptions Used | ||||
Goodwill and other intangible assets
Goodwill represents the excess of the cost of businesses acquired over the fair value of their net assets at the acquisition date. Intangible assets primarily reflect the value of customer relationships and other intangibles acquired in business combinations.
Fair values of reporting units are estimated using models and assumptions that we believe a hypothetical market participant would use to determine a current transaction price. The significant assumptions and estimates used in determining fair value include the discount rate and future cash flows. A discount rate is selected to correspond with each reporting unit’s weighted average cost of capital, consistent with that used for investment decisions considering the specific and detailed operating plans and strategies within each reporting unit. Projections of future cash flows for each reporting unit are consistent with our annual planning process for revenues, pharmacy costs, benefits expenses, operating expenses, taxes, capital levels and long-term growth rates. In addition to these assumptions, we consider market data to evaluate the fair value of each reporting unit. The fair value of intangibles and the amortization method were determined using an income approach that relies on projected future cash flows including key assumptions for customer attrition and discount rates. Management revises amortization periods if it believes there has been a change in the length of time that an intangible asset will continue to have value.
The Company conducts its quantitative evaluation for goodwill impairment at least annually during the third quarter at the reporting unit level and performs qualitative impairment assessments on a quarterly basis to determine if events or changes in circumstances indicate that it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value.
Goodwill and other intangibles as of December 31 were as follows (in millions):
·2020 – Goodwill $44,648; Other intangible assets $35,179
·2019 – Goodwill $44,602; Other intangible assets $36,562
See Note 17 to the Consolidated Financial Statements for additional discussion of our goodwill and other intangible assets.
|
We completed our normal annual evaluations for impairment of goodwill and intangible assets during the third quarter of 2020. The evaluations indicated that the fair value estimates of our reporting units exceed their carrying values by significant margins. Changes in assumptions concerning future financial results or other underlying assumptions, including macroeconomic factors, government legislation, changes in the competitive landscape or other market conditions could impact our ability to achieve profitability projections. If we consistently do not achieve our earnings and cash flow projections or our cost of capital rises significantly, the assumptions and estimates underlying the goodwill and intangible asset impairment evaluations could be adversely affected and result in future impairment charges that would negatively impact our operating results and financial position.
|
Financial Summary | For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Total revenues | $ | 116,334 | $ | 109,794 | $ | 7,065 | $ | 6,540 | 6 | % | $ | 102,729 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Less: Transitioning clients | — | (13,347) | (459) | 13,347 | N/M | (12,888) | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Less: Contractual adjustment for a former client | (204) | — | — | (204) | N/M | — | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues(1)
|
$ | 116,130 | $ | 96,447 | $ | 6,606 | $ | 19,683 | 20 | $ | 89,841 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Gross profit | $ | 7,797 | $ | 8,908 | $ | 604 | $ | (1,111) | (12) | $ | 8,304 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted gross profit(1)
|
$ | 7,593 | $ | 6,984 | $ | 531 | $ | 609 | 9 | $ | 6,453 | N/M | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted income from operations | $ | 5,363 | $ | 5,092 | $ | 380 | $ | 271 | 5 | % | $ | 4,712 | N/M | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted margin | 4.6 | % | 5.3 | % | 5.8 | % | (70) | bps | (50) | bps |
For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
||||||||||||||||||||||||||||||||||||||||
(Dollars and adjusted scripts in millions) | 2020 | 2019 | |||||||||||||||||||||||||||||||||||||||
Selected Financial Information(1)
|
|||||||||||||||||||||||||||||||||||||||||
Pharmacy revenue by distribution channel | |||||||||||||||||||||||||||||||||||||||||
Adjusted network revenues | $ | 56,181 | $ | 41,483 | 35 | % | |||||||||||||||||||||||||||||||||||
Adjusted home delivery and specialty revenues | 49,886 | 45,836 | 9 | % | |||||||||||||||||||||||||||||||||||||
Other revenues | 5,403 | 4,900 | 10 | % | |||||||||||||||||||||||||||||||||||||
Total adjusted pharmacy revenues | $ | 111,470 | $ | 92,219 | 21 | % | |||||||||||||||||||||||||||||||||||
Pharmacy script volume | |||||||||||||||||||||||||||||||||||||||||
Adjusted network scripts(2)
|
1,206 | 941 | 28 | % | |||||||||||||||||||||||||||||||||||||
Adjusted home delivery and specialty scripts(2)
|
287 | 283 | 1 | % | |||||||||||||||||||||||||||||||||||||
Total adjusted scripts(2)
|
1,493 | 1,224 | 22 | % | |||||||||||||||||||||||||||||||||||||
Generic fill rate | |||||||||||||||||||||||||||||||||||||||||
Network | 87.4 | % | 87.1 | % | 30 | bps | |||||||||||||||||||||||||||||||||||
Home delivery | 85.2 | % | 84.3 | % | 90 | bps | |||||||||||||||||||||||||||||||||||
Overall generic fill rate | 87.2 | % | 86.8 | % | 40 | bps |
Financial Summary | For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 38,451 | $ | 36,519 | $ | 32,791 | $ | 1,932 | 5 | % | $ | 3,728 | 11 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted income from operations | $ | 3,807 | $ | 3,831 | $ | 3,502 | $ | (24) | (1) | % | $ | 329 | 9 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted margin | 9.9 | % | 10.5 | % | 10.7 | % | (60) | bps | (20) | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Medical care ratio | 79.4 | % | 80.8 | % | 78.9 | % | 140 | bps | (190) | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Expense ratio | 22.8 | % | 22.9 | % | 24.7 | % | 10 | bps | 180 | bps |
For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
|||||||||||||||||||||||||||||||||||||||||||||
(In thousands) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||
U.S. Medical Customers
|
|||||||||||||||||||||||||||||||||||||||||||||||
U.S. Commercial
|
2,141 | 2,114 | 1,911 | 27 | 1 | % | 203 | 11 | % | ||||||||||||||||||||||||||||||||||||||
U.S. Government
|
1,387 | 1,361 | 1,407 | 26 | 2 | % | (46) | (3) | % | ||||||||||||||||||||||||||||||||||||||
Insured | 3,528 | 3,475 | 3,318 | 53 | 2 | % | 157 | 5 | % | ||||||||||||||||||||||||||||||||||||||
Service | 11,485 | 12,073 | 12,071 | (588) | (5) | % | 2 | — | % | ||||||||||||||||||||||||||||||||||||||
Total | 15,013 | 15,548 | 15,389 | (535) | (3) | % | 159 | 1 | % |
As of December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
|||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||
Unpaid claims and claim expenses – U.S. Medical
|
$ | 3,184 | $ | 2,892 | $ | 2,697 | $ | 292 | 10 | % | $ | 195 | 7 | % |
Financial Summary | For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 5,877 | $ | 5,615 | $ | 5,366 | $ | 262 | 5 | % | $ | 249 | 5 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted income from operations | $ | 900 | $ | 762 | $ | 735 | $ | 138 | 18 | % | $ | 27 | 4 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted margin | 15.3 | % | 13.6 | % | 13.7 | % | 170 | bps | (10) | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Loss ratio | 56.5 | % | 57.3 | % | 57.4 | % | 80 | bps | 10 | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Acquisition cost ratio | 11.3 | % | 12.9 | % | 13.1 | % | 160 | bps | 20 | bps | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Expense ratio (excluding acquisition costs) | 20.2 | % | 19.5 | % | 18.9 | % | (70) | bps | (60) | bps |
Financial Summary | For the Years Ended December 31, |
Change Favorable
(Unfavorable) |
Change Favorable
(Unfavorable) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 5,264 | $ | 5,182 | $ | 5,061 | $ | 82 | 2 | % | $ | 121 | 2 | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted income from operations | $ | 290 | $ | 501 | $ | 529 | $ | (211) | (42) | % | $ | (28) | (5) | % | |||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted margin | 5.5 | % | 9.7 | % | 10.5 | % | (420) | bps | (80) | bps |
Financial Summary | For the Years Ended December 31, | Change Favorable (Unfavorable) | Change Favorable (Unfavorable) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | 2020 vs. 2019 | 2019 vs. 2018 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pre-tax adjusted loss from operations | $ | (1,552) | $ | (1,824) | $ | (403) | $ | 272 | 15 | % | $ | (1,421) | N/M | % |
(In millions) |
December 31,
2020 |
December 31, 2019 | ||||||||||||
Debt securities | $ | 18,131 | $ | 23,755 | ||||||||||
Equity securities | 501 | 303 | ||||||||||||
Commercial mortgage loans | 1,419 | 1,947 | ||||||||||||
Policy loans | 1,351 | 1,357 | ||||||||||||
Other long-term investments | 2,832 | 2,403 | ||||||||||||
Short-term investments | 359 | 423 | ||||||||||||
Total | 30,188 | |||||||||||||
Investments classified as assets of business held for sale (1)
|
(7,709) | |||||||||||||
Investments per Consolidated Balance Sheets | $ | 24,593 | $ | 22,479 |
(In millions) |
December 31,
2020 |
December 31,
2019 |
||||||||||||
Federal government and agency | $ | 456 | $ | 733 | ||||||||||
State and local government | 167 | 810 | ||||||||||||
Foreign government | 2,511 | 2,256 | ||||||||||||
Corporate
|
14,562 | 19,420 | ||||||||||||
Mortgage and other asset-backed | 435 | 536 | ||||||||||||
Total | $ | 18,131 | $ | 23,755 |
Market scenario for certain non-insurance financial instruments | Loss in Fair Value | |||||||||||||
(in billions) | 2020 | 2019 | ||||||||||||
100 basis point increase in interest rates (excluding long-term debt) | $ | 1.4 | $ | 1.6 | ||||||||||
10% strengthening in U.S. dollar to foreign currencies | $ | 0.4 | $ | 0.3 |
Cigna Corporation
Consolidated Statements of Income
|
|||||||||||||||||||||||||||||
For the Years Ended December 31, | |||||||||||||||||||||||||||||
(In millions, except per share amounts) | 2020 | 2019 | 2018 | ||||||||||||||||||||||||||
Revenues | |||||||||||||||||||||||||||||
Pharmacy revenues | $ | 107,769 | $ | 103,099 | $ | 5,479 | |||||||||||||||||||||||
Premiums | 42,627 | 39,714 | 36,113 | ||||||||||||||||||||||||||
Fees and other revenues | 8,761 | 9,363 | 5,578 | ||||||||||||||||||||||||||
Net investment income | 1,244 | 1,390 | 1,480 | ||||||||||||||||||||||||||
TOTAL REVENUES | 160,401 | 153,566 | 48,650 | ||||||||||||||||||||||||||
Benefits and expenses | |||||||||||||||||||||||||||||
Pharmacy and other service costs | 103,484 | 97,668 | 4,793 | ||||||||||||||||||||||||||
Medical costs and other benefit expenses | 32,710 | 30,819 | 27,528 | ||||||||||||||||||||||||||
Selling, general and administrative expenses | 14,072 | 14,053 | 11,934 | ||||||||||||||||||||||||||
Amortization of acquired intangible assets | 1,982 | 2,949 | 235 | ||||||||||||||||||||||||||
TOTAL BENEFITS AND EXPENSES | 152,248 | 145,489 | 44,490 | ||||||||||||||||||||||||||
Income from operations | 8,153 | 8,077 | 4,160 | ||||||||||||||||||||||||||
Interest expense and other | (1,438) | (1,682) | (498) | ||||||||||||||||||||||||||
Debt extinguishment costs | (199) | (2) | — | ||||||||||||||||||||||||||
Gain (loss) on sale of business | 4,203 | — | — | ||||||||||||||||||||||||||
Net realized investment gains (losses) | 149 | 177 | (81) | ||||||||||||||||||||||||||
Income before income taxes | 10,868 | 6,570 | 3,581 | ||||||||||||||||||||||||||
TOTAL INCOME TAXES | 2,379 | 1,450 | 935 | ||||||||||||||||||||||||||
Net income | 8,489 | 5,120 | 2,646 | ||||||||||||||||||||||||||
Less: Net income attributable to noncontrolling interests | 31 | 16 | 9 | ||||||||||||||||||||||||||
SHAREHOLDERS' NET INCOME | $ | 8,458 | $ | 5,104 | $ | 2,637 | |||||||||||||||||||||||
Shareholders’ net income per share | |||||||||||||||||||||||||||||
Basic | $ | 23.17 | $ | 13.58 | $ | 10.69 | |||||||||||||||||||||||
Diluted | $ | 22.96 | $ | 13.44 | $ | 10.54 |
Cigna Corporation
Consolidated Statements of Comprehensive Income
|
|||||||||||||||||||||||||||||
For the Years Ended December 31, | |||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | ||||||||||||||||||||||||||
Net income | $ | 8,489 | $ | 5,120 | $ | 2,646 | |||||||||||||||||||||||
Other comprehensive income (loss), net of tax | |||||||||||||||||||||||||||||
Net unrealized (depreciation) appreciation on securities and derivatives | (75) | 957 | (365) | ||||||||||||||||||||||||||
Net translation gains (losses) on foreign currencies | 252 | (59) | (167) | ||||||||||||||||||||||||||
Postretirement benefits liability adjustment | (105) | (133) | 127 | ||||||||||||||||||||||||||
Other comprehensive income (loss), net of tax | 72 | 765 | (405) | ||||||||||||||||||||||||||
Total comprehensive income | 8,561 | 5,885 | 2,241 | ||||||||||||||||||||||||||
Comprehensive income (loss) attributable to noncontrolling interests | |||||||||||||||||||||||||||||
Net income attributable to redeemable noncontrolling interest | 14 | 11 | 9 | ||||||||||||||||||||||||||
Net income attributable to other noncontrolling interests | 17 | 5 | — | ||||||||||||||||||||||||||
Other comprehensive (loss) attributable to redeemable noncontrolling interest | (8) | (5) | (15) | ||||||||||||||||||||||||||
Total comprehensive income (loss) attributable to noncontrolling interests | 23 | 11 | (6) | ||||||||||||||||||||||||||
SHAREHOLDERS' COMPREHENSIVE INCOME | $ | 8,538 | $ | 5,874 | $ | 2,247 |
Cigna Corporation
Consolidated Balance Sheets
|
||||||||||||||
As of December 31, | ||||||||||||||
(In millions) | 2020 | 2019 | ||||||||||||
Assets | ||||||||||||||
Cash and cash equivalents | $ | 10,182 | $ | 4,619 | ||||||||||
Investments | 1,331 | 937 | ||||||||||||
Accounts receivable, net | 12,191 | 10,716 | ||||||||||||
Inventories | 3,165 | 2,661 | ||||||||||||
Other current assets | 930 | 1,400 | ||||||||||||
Assets of business held for sale | — | 9,512 | ||||||||||||
Total current assets | 27,799 | 29,845 | ||||||||||||
Long-term investments | 23,262 | 21,542 | ||||||||||||
Reinsurance recoverables | 5,200 | 5,100 | ||||||||||||
Deferred policy acquisition costs | 3,385 | 2,958 | ||||||||||||
Property and equipment | 4,205 | 4,417 | ||||||||||||
Goodwill | 44,648 | 44,602 | ||||||||||||
Other intangible assets | 35,179 | 36,562 | ||||||||||||
Other assets | 2,687 | 2,283 | ||||||||||||
Separate account assets | 9,086 | 8,465 | ||||||||||||
TOTAL ASSETS | $ | 155,451 | $ | 155,774 | ||||||||||
Liabilities | ||||||||||||||
Current insurance and contractholder liabilities | $ | 5,308 | $ | 4,921 | ||||||||||
Pharmacy and other service costs payable | 13,347 | 10,454 | ||||||||||||
Accounts payable | 5,478 | 5,090 | ||||||||||||
Accrued expenses and other liabilities | 8,515 | 7,347 | ||||||||||||
Short-term debt | 3,374 | 5,514 | ||||||||||||
Liabilities of business held for sale | — | 6,812 | ||||||||||||
Total current liabilities | 36,022 | 40,138 | ||||||||||||
Non-current insurance and contractholder liabilities | 16,844 | 16,052 | ||||||||||||
Deferred tax liabilities, net | 8,939 | 9,387 | ||||||||||||
Other non-current liabilities | 4,629 | 4,460 | ||||||||||||
Long-term debt | 29,545 | 31,893 | ||||||||||||
Separate account liabilities | 9,086 | 8,465 | ||||||||||||
TOTAL LIABILITIES | 105,065 | 110,395 | ||||||||||||
Contingencies — Note 21
|
||||||||||||||
Redeemable noncontrolling interests | 58 | 35 | ||||||||||||
Shareholders’ equity | ||||||||||||||
Common stock (1)
|
4 | 4 | ||||||||||||
Additional paid-in capital | 28,975 | 28,306 | ||||||||||||
Accumulated other comprehensive loss | (861) | (941) | ||||||||||||
Retained earnings | 28,575 | 20,162 | ||||||||||||
Less: treasury stock, at cost | (6,372) | (2,193) | ||||||||||||
TOTAL SHAREHOLDERS’ EQUITY | 50,321 | 45,338 | ||||||||||||
Other noncontrolling interests | 7 | 6 | ||||||||||||
Total equity | 50,328 | 45,344 | ||||||||||||
Total liabilities and equity | $ | 155,451 | $ | 155,774 |
Cigna Corporation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Consolidated Statements of Changes in Total Equity | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(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, 2017 | $ | 74 | $ | 2,940 | $ | (1,082) | $ | 15,800 | $ | (4,021) | $ | 13,711 | $ | — | $ | 13,711 | $ | 49 | ||||||||||||||||||||||||||||||||||||||
Cumulative effect of accounting for financial instruments and hedging | (10) | 68 | 58 | 58 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Reclassification adjustment related to U.S. tax reform legislation | (229) | 229 | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Retirement of treasury stock | (13) | (529) | (3,498) | 4,040 | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||
Exchange of Old Cigna common stock | (58) | 58 | — | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Acquisition of Express Scripts (see Note 5)
|
1 | 25,223 | 25,224 | 7 | 25,231 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Effect of issuing stock for employee benefit plans | 59 | (138) | 206 | 127 | 127 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Other comprehensive (loss) | (390) | (390) | (390) | (15) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Net income | 2,637 | 2,637 | 2,637 | 9 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Common dividends declared (per share: $0.04)
|
(10) | (10) | (10) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Repurchase of common stock | (329) | (329) | (329) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Other transactions impacting noncontrolling interests | — | — | (6) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Balance at December 31, 2018 | $ | 4 | $ | 27,751 | $ | (1,711) | $ | 15,088 | $ | (104) | $ | 41,028 | $ | 7 | $ | 41,035 | $ | 37 | ||||||||||||||||||||||||||||||||||||||
Cumulative effect of adopting new lease accounting guidance (ASU 2016-02) | (15) | (15) | (15) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Effect of issuing stock for employee benefit plans | 555 | (104) | 451 | 451 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Other comprehensive income (loss) | 770 | 770 | 770 | (5) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Net income | 5,104 | 5,104 | 5 | 5,109 | 11 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Common dividends declared (per share: $0.04)
|
(15) | (15) | (15) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Repurchase of common stock | (1,985) | (1,985) | (1,985) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Other transactions impacting noncontrolling interests | — | (6) | (6) | (8) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Balance at December 31, 2019 | $ | 4 | $ | 28,306 | $ | (941) | $ | 20,162 | $ | (2,193) | $ | 45,338 | $ | 6 | $ | 45,344 | $ | 35 | ||||||||||||||||||||||||||||||||||||||
Cumulative effect of adopting new credit loss guidance (ASU 2016-13) (1)
|
(30) | (30) | (30) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Effect of issuing stock for employee benefit plans | 672 | (90) | 582 | 582 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Other comprehensive income (loss) | 80 | 80 | 80 | (8) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Net income | 8,458 | 8,458 | 17 | 8,475 | 14 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Common dividends declared (per share: $0.04)
|
(15) | (15) | (15) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Repurchase of common stock | (4,089) | (4,089) | (4,089) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Other transactions impacting noncontrolling interests | (3) | (3) | (16) | (19) | 17 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Balance at December 31, 2020 | $ | 4 | $ | 28,975 | $ | (861) | $ | 28,575 | $ | (6,372) | $ | 50,321 | $ | 7 | $ | 50,328 | $ | 58 |
Cigna Corporation
Consolidated Statements of Cash Flows
|
||||||||||||||||||||
For the Years Ended December 31, | ||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Cash Flows from Operating Activities | ||||||||||||||||||||
Net income | $ | 8,489 | $ | 5,120 | $ | 2,646 | ||||||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||||||||||||||
Depreciation and amortization | 2,802 | 3,651 | 695 | |||||||||||||||||
Realized investment losses (gains), net | (149) | (177) | 81 | |||||||||||||||||
Deferred income tax (benefit) | (386) | (313) | (101) | |||||||||||||||||
Gain on sale of business | (4,203) | — | — | |||||||||||||||||
Debt extinguishment costs | 199 | 2 | — | |||||||||||||||||
Net changes in assets and liabilities, net of non-operating effects: | ||||||||||||||||||||
Accounts receivable | (1,496) | (713) | 705 | |||||||||||||||||
Inventories | (504) | 149 | (107) | |||||||||||||||||
Deferred policy acquisition costs | (307) | (242) | (237) | |||||||||||||||||
Reinsurance recoverable and Other assets | 230 | (277) | (234) | |||||||||||||||||
Insurance liabilities | 841 | 575 | 560 | |||||||||||||||||
Pharmacy and other service costs payable | 2,891 | (192) | (842) | |||||||||||||||||
Accounts payable and Accrued expenses and other liabilities | 1,346 | 1,343 | 332 | |||||||||||||||||
Other, net | 597 | 559 | 272 | |||||||||||||||||
NET CASH PROVIDED BY OPERATING ACTIVITIES | 10,350 | 9,485 | 3,770 | |||||||||||||||||
Cash Flows from Investing Activities | ||||||||||||||||||||
Proceeds from investments sold: | ||||||||||||||||||||
Debt securities and equity securities | 2,283 | 3,487 | 2,655 | |||||||||||||||||
Investment maturities and repayments: | ||||||||||||||||||||
Debt securities and equity securities | 1,519 | 1,825 | 2,151 | |||||||||||||||||
Commercial mortgage loans | 19 | 199 | 215 | |||||||||||||||||
Other sales, maturities and repayments (primarily short-term and other long-term investments) | 1,575 | 1,311 | 734 | |||||||||||||||||
Investments purchased or originated: | ||||||||||||||||||||
Debt securities and equity securities | (4,765) | (4,282) | (5,637) | |||||||||||||||||
Commercial mortgage loans | (113) | (307) | (312) | |||||||||||||||||
Other (primarily short-term and other long-term investments) | (1,924) | (1,753) | (1,189) | |||||||||||||||||
Property and equipment purchases, net | (1,094) | (1,050) | (528) | |||||||||||||||||
Acquisitions, net of cash acquired | (139) | (153) | (24,455) | |||||||||||||||||
Divestiture, net of cash sold | 5,592 | — | — | |||||||||||||||||
Other, net | 23 | (11) | (12) | |||||||||||||||||
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES | 2,976 | (734) | (26,378) | |||||||||||||||||
Cash Flows from Financing Activities | ||||||||||||||||||||
Deposits and interest credited to contractholder deposit funds | 1,023 | 955 | 1,040 | |||||||||||||||||
Withdrawals and benefit payments from contractholder deposit funds | (979) | (1,097) | (1,151) | |||||||||||||||||
Net change in short-term debt | 60 | (681) | 1,487 | |||||||||||||||||
Net proceeds on issuance of term loan | 1,398 | — | — | |||||||||||||||||
Repayment of term loan | (1,400) | — | — | |||||||||||||||||
Payments for debt extinguishment | (212) | (3) | — | |||||||||||||||||
Repayment of long-term debt | (8,047) | (4,491) | (131) | |||||||||||||||||
Net proceeds on issuance of long-term debt | 3,465 | — | 22,856 | |||||||||||||||||
Repurchase of common stock | (4,042) | (1,987) | (342) | |||||||||||||||||
Issuance of common stock | 376 | 224 | 68 | |||||||||||||||||
Other, net | (175) | (107) | (312) | |||||||||||||||||
NET CASH (USED IN) PROVIDED BY FINANCING ACTIVITIES | (8,533) | (7,187) | 23,515 | |||||||||||||||||
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash | 41 | (8) | (24) | |||||||||||||||||
Net increase in cash, cash equivalents and restricted cash | 4,834 | 1,556 | 883 | |||||||||||||||||
Cash, cash equivalents and restricted cash January 1, (1)
|
5,411 | 3,855 | 2,972 | |||||||||||||||||
Cash, cash equivalents and restricted cash, December 31, | 10,245 | 5,411 | 3,855 | |||||||||||||||||
Cash reclassified to assets of business held for sale | — | (743) | — | |||||||||||||||||
Cash, cash equivalents and restricted cash December 31, per Consolidated Balance Sheets (2)
|
$ | 10,245 | $ | 4,668 | $ | 3,855 | ||||||||||||||
Supplemental Disclosure of Cash Information: | ||||||||||||||||||||
Income taxes paid, net of refunds | $ | 1,837 | $ | 1,776 | $ | 1,019 | ||||||||||||||
Interest paid | $ | 1,439 | $ | 1,645 | $ | 267 |
As of December 31, | |||||||||||
(In millions) | 2020 | 2019 | |||||||||
Cash and cash equivalents | $ | 10,182 | $ | 4,619 | |||||||
Restricted cash and cash equivalents, included in other long-term investments | 63 | 49 | |||||||||
Total cash, cash equivalents, and restricted cash and cash equivalents | $ | 10,245 | $ | 4,668 |
(In millions) | December 31, 2020 | December 31, 2019 | |||||||||
Noninsurance customer receivables | $ | 5,534 | $ | 5,143 | |||||||
Pharmaceutical manufacturers receivable | 4,676 | 3,439 | |||||||||
Insurance customer receivables | 1,789 | 2,321 | |||||||||
Other receivables | 192 | 334 | |||||||||
Total | 11,237 | ||||||||||
Accounts receivable, net classified as assets of business held for sale | (521) | ||||||||||
Accounts receivable, net per Consolidated Balance Sheets | $ | 12,191 | $ | 10,716 |
(In millions) | December 31, 2019 | ||||
Cash and cash equivalents | $ | 743 | |||
Accounts receivable, net | 521 | ||||
Investments | 7,709 | ||||
Other assets | 539 | ||||
Total assets of business held for sale | 9,512 | ||||
Insurance and contractholder liabilities | 6,308 | ||||
Other liabilities | 504 | ||||
Total liabilities of business held for sale | $ | 6,812 |
2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||
(In millions) | Before-tax | After-tax | Before-tax | After-tax | Before-tax | After-tax | |||||||||||||||||||||||||||||
Interest expense on newly-issued debt | $ | — | $ | — | $ | — | $ | — | $ | 227 | $ | 179 | |||||||||||||||||||||||
Net investment income on debt proceeds | — | — | — | — | (123) | (97) | |||||||||||||||||||||||||||||
Charitable contributions | — | — | — | — | 200 | 158 | |||||||||||||||||||||||||||||
Legal and advisory fees | 48 | 36 | 53 | 41 | 204 | 185 | |||||||||||||||||||||||||||||
Bridge facility fees | — | — | — | — | 140 | 111 | |||||||||||||||||||||||||||||
All other integration and transaction-related costs | 479 | 368 | 499 | 386 | 204 | 133 | |||||||||||||||||||||||||||||
Integration and transaction-related costs, net | $ | 527 | $ | 404 | $ | 552 | $ | 427 | $ | 852 | $ | 669 |
2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||||||||||||||||||
(Shares in thousands, dollars in millions, except per share amounts) | Basic |
Effect of
Dilution |
Diluted | Basic |
Effect of
Dilution |
Diluted | Basic |
Effect of
Dilution |
Diluted | ||||||||||||||||||||||||||||||||||||||||||||
Shareholders’ net income | $ | 8,458 | $ | 8,458 | $ | 5,104 | $ | 5,104 | $ | 2,637 | $ | 2,637 | |||||||||||||||||||||||||||||||||||||||||
Shares: | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Weighted average | 364,979 | 364,979 | 375,919 | 375,919 | 246,652 | 246,652 | |||||||||||||||||||||||||||||||||||||||||||||||
Common stock equivalents | 3,410 | 3,410 | 3,898 | 3,898 | 3,573 | 3,573 | |||||||||||||||||||||||||||||||||||||||||||||||
Total shares | 364,979 | 3,410 | 368,389 | 375,919 | 3,898 | 379,817 | 246,652 | 3,573 | 250,225 | ||||||||||||||||||||||||||||||||||||||||||||
EPS | $ | 23.17 | $ | (0.21) | $ | 22.96 | $ | 13.58 | $ | (0.14) | $ | 13.44 | $ | 10.69 | $ | (0.15) | $ | 10.54 |
(In millions) | 2020 | 2019 | 2018 | ||||||||||||||||||||||||||
Anti-dilutive options | 4.1 | 3.5 | 0.9 |
(In millions) | December 31, 2020 | December 31, 2019 | |||||||||||||||
Short-term debt | |||||||||||||||||
$1,000 million, Floating Rate Notes due 3/2020
|
$ | — | $ | 999 | |||||||||||||
$300 million, 5.125% Notes due 6/2020
|
— | 300 | |||||||||||||||
$1,750 million, 3.2% Notes due 9/2020
|
— | 1,748 | |||||||||||||||
$349 million, 4.125% Notes due 9/2020
|
— | 351 | |||||||||||||||
$500 million, 2.6% Notes due 11/2020
|
— | 496 | |||||||||||||||
$400 million, Floating Rate Notes due 11/2020
|
— | 400 | |||||||||||||||
$250 million, 4.375% Notes due 12/2020
|
— | 249 | |||||||||||||||
$78 million, 6.37% Notes due 6/2021
|
78 | — | |||||||||||||||
$1,000 million, Floating Rate Notes due 9/2021
|
999 | — | |||||||||||||||
$1,250 million, 3.4% Notes due 9/2021
|
1,249 | — | |||||||||||||||
Commercial paper | 1,030 | 944 | |||||||||||||||
Other, including finance leases | 18 | 27 | |||||||||||||||
Total short-term debt | $ | 3,374 | $ | 5,514 | |||||||||||||
Long-term debt | |||||||||||||||||
$500 million, 3.3% Notes due 2021
|
$ | — | $ | 499 | |||||||||||||
$300 million, 4.5% Notes due 2021
|
— | 298 | |||||||||||||||
$78 million, 6.37% Notes due 2021
|
— | 78 | |||||||||||||||
$1,000 million, Floating Rate Notes due 2021
|
— | 998 | |||||||||||||||
$1,250 million, 3.4% Notes due 2021
|
— | 1,247 | |||||||||||||||
$1,248 million, 4.75% Notes due 2021
|
— | 1,272 | |||||||||||||||
$277 million, 4% Notes due 2022
|
276 | 747 | |||||||||||||||
$973 million, 3.9% Notes due 2022
|
972 | 999 | |||||||||||||||
$500 million, 3.05% Notes due 2022
|
490 | 485 | |||||||||||||||
$17 million, 8.3% Notes due 2023
|
17 | 17 | |||||||||||||||
$63 million, 7.65% Notes due 2023
|
63 | 100 | |||||||||||||||
$700 million, Floating Rate Notes due 2023
|
698 | 698 | |||||||||||||||
$1,000 million, 3% Notes due 2023
|
975 | 966 | |||||||||||||||
$2,187 million, 3.75% Notes due 2023
|
2,181 | 3,088 | |||||||||||||||
$1,000 million, 3.5% Notes due 2024
|
977 | 970 | |||||||||||||||
$900 million, 3.25% Notes due 2025
|
896 | 895 | |||||||||||||||
$2,200 million, 4.125% Notes due 2025
|
2,191 | 2,188 | |||||||||||||||
$1,500 million, 4.5% Notes due 2026
|
1,505 | 1,506 | |||||||||||||||
$1,500 million, 3.4% Notes due 2027
|
1,410 | 1,396 | |||||||||||||||
$259 million, 7.875% Debentures due 2027
|
259 | 259 | |||||||||||||||
$600 million, 3.05% Notes due 2027
|
595 | 595 | |||||||||||||||
$3,800 million, 4.375% Notes due 2028
|
3,780 | 3,776 | |||||||||||||||
$1,500 million, 2.4% Notes due 2030
|
1,489 | — | |||||||||||||||
$45 million, 8.3% Step Down Notes due 2033
|
45 | 45 | |||||||||||||||
$190 million, 6.15% Notes due 2036
|
190 | 190 | |||||||||||||||
$2,200 million, 4.8% Notes due 2038
|
2,180 | 2,178 | |||||||||||||||
$750 million, 3.2% Notes due 2040
|
742 | — | |||||||||||||||
$121 million, 5.875% Notes due 2041
|
119 | 119 | |||||||||||||||
$448 million, 6.125% Notes due 2041
|
490 | 491 | |||||||||||||||
$317 million, 5.375% Notes due 2042
|
315 | 315 | |||||||||||||||
$1,500 million, 4.8% Notes due 2046
|
1,465 | 1,465 | |||||||||||||||
$1,000 million, 3.875% Notes due 2047
|
988 | 988 | |||||||||||||||
$3,000 million, 4.9% Notes due 2048
|
2,966 | 2,964 | |||||||||||||||
$1,250 million, 3.4% Notes due 2050
|
1,235 | — | |||||||||||||||
Other, including finance leases | 36 | 61 | |||||||||||||||
Total long-term debt | $ | 29,545 | $ | 31,893 |
Principal | Maturity Date | Interest Rate | Net Proceeds | |||||||||||||||||
$1,500 million | March 15, 2030 | 2.4% | $1,491 million | |||||||||||||||||
$750 million | March 15, 2040 | 3.2% | $743 million | |||||||||||||||||
$1,250 million | March 15, 2050 | 3.4% | $1,237 million |
(in millions) |
Scheduled Maturities (1)
|
||||||||||
2021 | $ | 2,328 | |||||||||
2022 | $ | 1,749 | |||||||||
2023 | $ | 3,967 | |||||||||
2024 | $ | 1,000 | |||||||||
2025 | $ | 3,100 | |||||||||
Maturities after 2025 | $ | 19,981 |
(Shares in thousands) | 2020 | 2019 | 2018 | ||||||||||||||
Common: Par value $0.01; 600,000 shares authorized - Cigna
|
|||||||||||||||||
Outstanding- January 1, | 372,531 | 380,924 | — | ||||||||||||||
Shares issued to Old Cigna shareholders | 243,785 | ||||||||||||||||
Shares issued to Express Scripts shareholders | 137,337 | ||||||||||||||||
Issued for stock option exercises and other benefit plans | 4,142 | 3,413 | 91 | ||||||||||||||
Repurchased common stock | (21,902) | (11,806) | (289) | ||||||||||||||
Outstanding- December 31, | 354,771 | 372,531 | 380,924 | ||||||||||||||
Treasury stock | 35,505 | 13,012 | 570 | ||||||||||||||
Issued- December 31, | 390,276 | 385,543 | 381,494 | ||||||||||||||
Common: Par value $0.25; 600,000 shares authorized - Old Cigna
|
|||||||||||||||||
Outstanding- January 1, | 243,967 | ||||||||||||||||
Issued for stock option exercises and other benefit plans | 1,118 | ||||||||||||||||
Repurchased common stock | (1,300) | ||||||||||||||||
Balance, December 20, 2018 (Merger Date) | 243,785 | ||||||||||||||||
Exchange of Old Cigna shares for shares of Cigna | (243,785) | ||||||||||||||||
Outstanding- December 31, | — | ||||||||||||||||
Retirement of treasury stock on December 20, 2018 | (52,358) | ||||||||||||||||
Exchange of Old Cigna certificated treasury stock for new Cigna certificated treasury stock | (2) | ||||||||||||||||
Treasury stock- December 31, | — | ||||||||||||||||
Issued- December 31, | — |
December 31, 2020 | December 31, 2019 | ||||||||||||||||||||||||||||||||||||||||
(In millions) | Current | Non-current | Total | Current | Non-current | Total | |||||||||||||||||||||||||||||||||||
Contractholder deposit funds | $ | 350 | $ | 6,823 | $ | 7,173 | $ | 600 | $ | 7,139 | $ | 7,739 | |||||||||||||||||||||||||||||
Future policy benefits | 327 | 9,317 | 9,644 | 553 | 9,281 | 9,834 | |||||||||||||||||||||||||||||||||||
Unearned premiums | 485 | 394 | 879 | 453 | 360 | 813 | |||||||||||||||||||||||||||||||||||
Unpaid claims and claim expenses | |||||||||||||||||||||||||||||||||||||||||
U.S. Medical
|
3,166 | 18 | 3,184 | 2,875 | 17 | 2,892 | |||||||||||||||||||||||||||||||||||
Other segments | 980 | 292 | 1,272 | 2,529 | 3,474 | 6,003 | |||||||||||||||||||||||||||||||||||
Total | 7,010 | 20,271 | 27,281 | ||||||||||||||||||||||||||||||||||||||
Insurance and contractholder liabilities classified as liabilities of business held for sale (1)
|
(2,089) | (4,219) | (6,308) | ||||||||||||||||||||||||||||||||||||||
Total insurance and contractholder liabilities | $ | 5,308 | $ | 16,844 | $ | 22,152 | $ | 4,921 | $ | 16,052 | $ | 20,973 |
(In millions) | 2020 | 2019 | 2018 | ||||||||||||||
Beginning balance | $ | 2,892 | $ | 2,697 | $ | 2,420 | |||||||||||
Less: Reinsurance and other amounts recoverable | 303 | 264 | 262 | ||||||||||||||
Beginning balance, net | 2,589 | 2,433 | 2,158 | ||||||||||||||
Acquired, net | — | — | 40 | ||||||||||||||
Incurred costs related to: | |||||||||||||||||
Current year | 25,889 | 24,368 | 21,331 | ||||||||||||||
Prior years | (115) | (165) | (173) | ||||||||||||||
Total incurred | 25,774 | 24,203 | 21,158 | ||||||||||||||
Paid costs related to: | |||||||||||||||||
Current year | 23,005 | 21,851 | 18,978 | ||||||||||||||
Prior years | 2,398 | 2,196 | 1,945 | ||||||||||||||
Total paid | 25,403 | 24,047 | 20,923 | ||||||||||||||
Ending balance, net | 2,960 | 2,589 | 2,433 | ||||||||||||||
Add: Reinsurance and other amounts recoverable | 224 | 303 | 264 | ||||||||||||||
Ending balance | $ | 3,184 | $ | 2,892 | $ | 2,697 |
Year Ended | ||||||||||||||||||||||||||
(Dollars in millions) | December 31, 2020 | December 31, 2019 | ||||||||||||||||||||||||
$ |
%(1)
|
$ |
%(2)
|
|||||||||||||||||||||||
Actual completion factors | $ | 42 | 0.2 | % | $ | 90 | 0.4 | % | ||||||||||||||||||
Medical cost trend | 73 | 0.3 | 75 | 0.4 | ||||||||||||||||||||||
Total favorable variance | $ | 115 | 0.5 | % | $ | 165 | 0.8 | % |
Incurred Costs | |||||||||||||||||||||||
Incurral Year |
2019
(Unaudited) |
2020 | Unpaid Claims & Claim Expenses | Claims Frequency | |||||||||||||||||||
(In millions) | |||||||||||||||||||||||
2019 | $ | 23,306 | $ | 23,211 | 60 | 3.5 | million | ||||||||||||||||
2020 | 24,927 | 2,764 | 3.7 | million | |||||||||||||||||||
Cumulative incurred costs for the periods presented | $ | 48,138 | |||||||||||||||||||||
Cumulative Costs Paid | |||||||||||||||||||||||
Incurral Year |
2019
(Unaudited) |
2020 | |||||||||||||||||||||
2019 | $ | 20,920 | $ | 23,151 | |||||||||||||||||||
2020 | 22,163 | ||||||||||||||||||||||
Cumulative paid costs for the periods presented | $ | 45,314 | |||||||||||||||||||||
Outstanding liabilities for the periods presented, net of reinsurance | $ | 2,824 | |||||||||||||||||||||
Other long-duration liabilities not included in development table above | 136 | ||||||||||||||||||||||
Net unpaid claims and claims expenses - U.S. Medical
|
2,960 | ||||||||||||||||||||||
Reinsurance and other amounts recoverable | 224 | ||||||||||||||||||||||
Unpaid claims and claim expenses - U.S. Medical
|
$ | 3,184 |
(In billions) |
2019 (1)
|
|||||||||||||||||||||||||||||||||||||
Discounted liabilities | $ | 4.5 | ||||||||||||||||||||||||||||||||||||
Aggregate amount of discount | $ | 1.2 | ||||||||||||||||||||||||||||||||||||
Range of discount rates | 4.0 | % | — | 5.2 | % |
(In millions) |
2020
|
2019 (1)
|
2018 | ||||||||||||||
Beginning balance | $ | 5,816 | $ | 5,432 | $ | 5,274 | |||||||||||
Less: Reinsurance | 184 | 156 | 140 | ||||||||||||||
Beginning balance, net | 5,632 | 5,276 | 5,134 | ||||||||||||||
Incurred claims related to: | |||||||||||||||||
Current year | 5,810 | 5,616 | 5,350 | ||||||||||||||
Prior years: | |||||||||||||||||
Interest accretion | 154 | 152 | 156 | ||||||||||||||
All other incurred | 19 | (40) | (147) | ||||||||||||||
Total incurred | 5,983 | 5,728 | 5,359 | ||||||||||||||
Paid claims related to: | |||||||||||||||||
Current year | 3,595 | 3,488 | 3,391 | ||||||||||||||
Prior years | 2,015 | 1,873 | 1,808 | ||||||||||||||
Total paid | 5,610 | 5,361 | 5,199 | ||||||||||||||
Acquisitions | — | — | 23 | ||||||||||||||
Foreign currency | 42 | (11) | (41) | ||||||||||||||
Divestiture of Group Disability and Life business | (5,093) | — | — | ||||||||||||||
Ending balance, net | 954 | 5,632 | 5,276 | ||||||||||||||
Add: Reinsurance | 159 | 184 | 156 | ||||||||||||||
Ending balance | $ | 1,113 | $ | 5,816 | $ | 5,432 |
(Dollars 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(3)
|
No collateral | Total | ||||||||||||||||||||||
Ongoing Operations | ||||||||||||||||||||||||||
Upper-medium grade and higher (1)
|
$ | — | $ | — | $ | 173 | $ | 173 | ||||||||||||||||||
Lower-medium grade (2)
|
— | — | 64 | 64 | ||||||||||||||||||||||
Not rated | 92 | — | 29 | 121 | ||||||||||||||||||||||
Total recoverables related to ongoing operations | 92 | — | 266 | 358 | ||||||||||||||||||||||
Acquisition, disposition or runoff activities | ||||||||||||||||||||||||||
Upper-medium grade and higher (1)
|
||||||||||||||||||||||||||
Lincoln National Life and Lincoln Life & Annuity of New York | — | 3,033 | — | 3,033 | ||||||||||||||||||||||
Berkshire | 309 | 409 | — | 718 | ||||||||||||||||||||||
Prudential Retirement Insurance and Annuity | 625 | — | — | 625 | ||||||||||||||||||||||
Life Insurance Company of North America | — | 424 | — | 424 | ||||||||||||||||||||||
Other | 232 | 18 | 20 | 270 | ||||||||||||||||||||||
Not rated | — | 17 | 4 | 21 | ||||||||||||||||||||||
Total recoverables related to acquisition, disposition or runoff activities | 1,166 | 3,901 | 24 | 5,091 | ||||||||||||||||||||||
Total | $ | 1,258 | $ | 3,901 | $ | 290 | $ | 5,449 | ||||||||||||||||||
Allowance for uncollectible reinsurance | (32) | |||||||||||||||||||||||||
Total reinsurance recoverables | $ | 5,417 |
(In millions) | 2020 | 2019 | 2018 | ||||||||||||||
Premiums | |||||||||||||||||
Short-duration contracts | |||||||||||||||||
Direct | $ | 38,425 | $ | 35,690 | $ | 32,148 | |||||||||||
Assumed | 85 | 64 | 77 | ||||||||||||||
Ceded | (230) | (203) | (182) | ||||||||||||||
Total short-duration contract premiums | 38,280 | 35,551 | 32,043 | ||||||||||||||
Long-duration contracts | |||||||||||||||||
Direct | 4,517 | 4,352 | 4,268 | ||||||||||||||
Assumed | 99 | 105 | 116 | ||||||||||||||
Ceded | |||||||||||||||||
Individual life insurance and annuity business sold | (119) | (126) | (133) | ||||||||||||||
Other | (150) | (168) | (181) | ||||||||||||||
Total long-duration contract premiums | 4,347 | 4,163 | 4,070 | ||||||||||||||
Total premiums | $ | 42,627 | $ | 39,714 | $ | 36,113 | |||||||||||
Reinsurance recoveries | |||||||||||||||||
Individual life insurance and annuity business sold | $ | 240 | $ | 238 | $ | 249 | |||||||||||
Other | 191 | 157 | 203 | ||||||||||||||
Total reinsurance recoveries | $ | 431 | $ | 395 | $ | 452 |
(Dollars in millions, excludes impact of reinsurance ceded) | December 31, 2020 | December 31, 2019 | |||||||||
Account value | $ | 9,523 | $ | 9,110 | |||||||
Net amount at risk | $ | 1,570 | $ | 1,764 | |||||||
Average attained age of contractholders (weighted by exposure) | 77 | 76 | |||||||||
Number of contractholders (estimated) | 185,000 | 200,000 |
(In millions) |
Amortized
Cost |
Fair
Value |
||||||||||||
Due in one year or less | $ | 991 | $ | 1,001 | ||||||||||
Due after one year through five years | 5,412 | 5,699 | ||||||||||||
Due after five years through ten years | 5,581 | 6,178 | ||||||||||||
Due after ten years | 3,809 | 4,818 | ||||||||||||
Mortgage and other asset-backed securities | 427 | 435 | ||||||||||||
Total | $ | 16,220 | $ | 18,131 |
(In millions) |
Amortized
Cost |
Allowance for Credit Loss |
Unrealized
Appreciation |
Unrealized
Depreciation |
Fair
Value |
|||||||||||||||||||||||||||
December 31, 2020 | ||||||||||||||||||||||||||||||||
Federal government and agency | $ | 334 | $ | — | $ | 122 | $ | — | $ | 456 | ||||||||||||||||||||||
State and local government | 150 | — | 17 | — | 167 | |||||||||||||||||||||||||||
Foreign government | 2,201 | — | 318 | (8) | 2,511 | |||||||||||||||||||||||||||
Corporate | 13,108 | (19) | 1,506 | (33) | 14,562 | |||||||||||||||||||||||||||
Mortgage and other asset-backed | 427 | (7) | 27 | (12) | 435 | |||||||||||||||||||||||||||
Total | $ | 16,220 | $ | (26) | $ | 1,990 | $ | (53) | $ | 18,131 | ||||||||||||||||||||||
Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1)
|
$ | 2,282 | $ | (5) | $ | 838 | $ | (3) | $ | 3,112 | ||||||||||||||||||||||
December 31, 2019 | ||||||||||||||||||||||||||||||||
Federal government and agency | $ | 498 | $ | — | $ | 235 | $ | — | $ | 733 | ||||||||||||||||||||||
State and local government | 729 | — | 81 | — | 810 | |||||||||||||||||||||||||||
Foreign government | 2,027 | — | 230 | (1) | 2,256 | |||||||||||||||||||||||||||
Corporate | 18,149 | — | 1,299 | (28) | 19,420 | |||||||||||||||||||||||||||
Mortgage and other asset-backed | 506 | — | 31 | (1) | 536 | |||||||||||||||||||||||||||
Total | $ | 21,909 | $ | — | $ | 1,876 | $ | (30) | $ | 23,755 | ||||||||||||||||||||||
Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1)
|
$ | 2,229 | $ | — | $ | 740 | $ | (4) | $ | 2,965 |
December 31, 2020 | December 31, 2019 | |||||||||||||||||||||||||||||||||||||||||||||||||
(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 | $ | 1,026 | $ | 1,045 | $ | (19) | 300 | $ | 723 | $ | 729 | $ | (6) | 267 | ||||||||||||||||||||||||||||||||||||
Below investment grade | $ | 381 | $ | 405 | $ | (24) | 232 | $ | 340 | $ | 348 | $ | (8) | 355 | ||||||||||||||||||||||||||||||||||||
More than one year | ||||||||||||||||||||||||||||||||||||||||||||||||||
Investment grade | $ | 18 | $ | 18 | $ | — | 6 | $ | 366 | $ | 378 | $ | (12) | 118 | ||||||||||||||||||||||||||||||||||||
Below investment grade | $ | 90 | $ | 100 | $ | (10) | 33 | $ | 84 | $ | 88 | $ | (4) | 93 | ||||||||||||||||||||||||||||||||||||
Total | $ | 1,515 | $ | 1,568 | $ | (53) | 571 | $ | 1,513 | $ | 1,543 | $ | (30) | 833 |
(In millions) | 2020 | ||||||||||
Balance at beginning of period | $ | — | |||||||||
Additions for debt securities where no credit loss has previously been recognized | 82 | ||||||||||
Reductions for securities sold during the period | (15) | ||||||||||
Decrease for debt securities where credit losses have previously been recorded | (41) | ||||||||||
Balance December 31, | $ | 26 |
December 31, 2020 | December 31, 2019 | |||||||||||||||||||||||||
(In millions) | Cost | Carrying Value | Cost | Carrying Value | ||||||||||||||||||||||
Equity securities with readily determinable fair values | $ | 180 | $ | 202 | $ | 61 | $ | 64 | ||||||||||||||||||
Equity securities with no readily determinable fair value | $ | 225 | $ | 255 | $ | 183 | $ | 192 | ||||||||||||||||||
Hybrid equity securities | $ | 58 | $ | 44 | $ | 58 | $ | 47 | ||||||||||||||||||
Total | $ | 463 | $ | 501 | $ | 302 | $ | 303 |
(Dollars in millions) | December 31, 2020 | December 31, 2019 | |||||||||||||||||||||||||||||||||||||||
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% | $ | 533 | 2.28 | $ | 1,136 | 2.19 | |||||||||||||||||||||||||||||||||||
60% to 79% | 751 | 2.08 | 723 | 1.98 | |||||||||||||||||||||||||||||||||||||
80% to 100% | 141 | 1.33 | 88 | 1.62 | |||||||||||||||||||||||||||||||||||||
Allowance for credit losses | (6) | ||||||||||||||||||||||||||||||||||||||||
Total | $ | 1,419 | 2.08 | 61 | % | $ | 1,947 | 2.09 | 58 | % |
(In millions) | December 31, 2020 | December 31, 2019 | ||||||||||||
Corporate securities | $ | 2,669 | $ | 1,985 | ||||||||||
Federal government securities | $ | 158 | $ | 472 | ||||||||||
Foreign government securities | $ | 90 | $ | 65 | ||||||||||
Money market funds | $ | 5,134 | $ | 631 |
Notional Value as of | ||||||||||||||||||||
(In millions) | December 31, 2020 | December 31, 2019 | ||||||||||||||||||
Purpose | Type of Instrument | |||||||||||||||||||
Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds.
|
Foreign currency swap contracts
|
$ | 925 | $ | 817 | |||||||||||||||
Net investment hedge: To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in Euros, Korean Won and Taiwan Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets.
|
Foreign currency swap contracts
|
$ | 526 | $ | 438 | |||||||||||||||
Foreign currency forward contracts
|
$ | 636 | $ | 406 | ||||||||||||||||
Economic hedge: To hedge the foreign exchange-related changes in fair value of U.S. dollar-denominated investment assets to reflect the local currency for the Company’s foreign subsidiary in South Korea. The notional value of hedging instruments generally aligns with the fair value of the hedged investments.
|
Foreign currency forward contracts
|
$ | 538 | $ | 410 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Debt Securities | $ | 962 | $ | 986 | $ | 1,009 | ||||||||||||||
Equity securities | 11 | 5 | 28 | |||||||||||||||||
Commercial mortgage loans | 80 | 88 | 78 | |||||||||||||||||
Policy loans | 64 | 66 | 70 | |||||||||||||||||
Other long-term investments | 127 | 167 | 156 | |||||||||||||||||
Short-term investments and cash | 52 | 131 | 194 | |||||||||||||||||
Total investment income | 1,296 | 1,443 | 1,535 | |||||||||||||||||
Less investment expenses | 52 | 53 | 55 | |||||||||||||||||
Net investment income | $ | 1,244 | $ | 1,390 | $ | 1,480 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||
Net realized investment gains (losses), excluding credit loss expense and asset write-downs | $ | 186 | $ | 189 | $ | (34) | ||||||||||||||||||||||||||
Credit loss (expense) recoveries on invested assets | (27) | — | — | |||||||||||||||||||||||||||||
Other investment asset write-downs | (10) | (12) | (47) | |||||||||||||||||||||||||||||
Net realized investment gains (losses), before income taxes | $ | 149 | $ | 177 | $ | (81) |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||
Proceeds from sales | $ | 2,186 | $ | 3,077 | $ | 2,625 | ||||||||||||||||||||||||||
Gross gains on sales | $ | 89 | $ | 72 | $ | 28 | ||||||||||||||||||||||||||
Gross losses on sales | $ | (23) | $ | (19) | $ | (47) |
(In millions) |
Quoted Prices in Active Markets for Identical Assets
(Level 1) |
Significant Other Observable Inputs
(Level 2) |
Significant Unobservable Inputs
(Level 3) |
Total | ||||||||||||||||||||||||||||||||||||||||||||||
As of December 31, 2020 | As of December 31, 2019 | As of December 31, 2020 | As of December 31, 2019 | As of December 31, 2020 | As of December 31, 2019 | As of December 31, 2020 | As of December 31, 2019 | |||||||||||||||||||||||||||||||||||||||||||
Financial assets at fair value | ||||||||||||||||||||||||||||||||||||||||||||||||||
Debt securities | ||||||||||||||||||||||||||||||||||||||||||||||||||
Federal government and agency | $ | 207 | $ | 197 | $ | 249 | $ | 536 | $ | — | $ | — | $ | 456 | $ | 733 | ||||||||||||||||||||||||||||||||||
State and local government | — | — | 167 | 810 | — | — | 167 | 810 | ||||||||||||||||||||||||||||||||||||||||||
Foreign government | — | — | 2,498 | 2,228 | 13 | 28 | 2,511 | 2,256 | ||||||||||||||||||||||||||||||||||||||||||
Corporate
|
— | — | 13,878 | 19,063 | 684 | 357 | 14,562 | 19,420 | ||||||||||||||||||||||||||||||||||||||||||
Mortgage and other asset-backed | — | — | 309 | 398 | 126 | 138 | 435 | 536 | ||||||||||||||||||||||||||||||||||||||||||
Total debt securities | 207 | 197 | 17,101 | 23,035 | 823 | 523 | 18,131 | 23,755 | ||||||||||||||||||||||||||||||||||||||||||
Equity securities (1)
|
50 | 7 | 165 | 72 | 31 | 32 | 246 | 111 | ||||||||||||||||||||||||||||||||||||||||||
Short-term investments | — | — | 325 | 423 | — | — | 325 | 423 | ||||||||||||||||||||||||||||||||||||||||||
Derivative assets (3)
|
— | — | 72 | 83 | — | — | 72 | 83 | ||||||||||||||||||||||||||||||||||||||||||
Real estate funds priced at NAV as a practical expedient (2)
|
156 | 184 | ||||||||||||||||||||||||||||||||||||||||||||||||
Financial liabilities at fair value | ||||||||||||||||||||||||||||||||||||||||||||||||||
Derivative liabilities | $ | — | $ | — | $ | 108 | $ | 18 | $ | — | $ | — | $ | 108 | $ | 18 |
Fair Value as of | Unobservable Adjustment Range (Weighted Average by Quantity) as of | ||||||||||||||||||||||||||||||||||
(Fair value in millions ) | December 31, 2020 | December 31, 2019 | Unobservable input December 31, 2020 | December 31, 2020 | December 31, 2019 | ||||||||||||||||||||||||||||||
Debt securities | |||||||||||||||||||||||||||||||||||
Corporate and government debt securities | $ | 696 | $ | 385 | Liquidity |
60 - 1370 (470)
|
bps |
70 - 930 (280)
|
bps | ||||||||||||||||||||||||||
Mortgage and other asset-backed securities | 126 | 138 | Liquidity |
60 - 380 (80)
|
bps |
60 - 370 (70)
|
bps | ||||||||||||||||||||||||||||
Weighting of credit spreads |
300 - 670 (480)
|
bps |
240 - 460 (330)
|
bps | |||||||||||||||||||||||||||||||
Securities not priced by the Company (1)
|
1 | — | |||||||||||||||||||||||||||||||||
Total Level 3 debt securities | $ | 823 | $ | 523 |
(In millions) | 2020 | 2019 | ||||||||||||||||||||||||
Balance at beginning of period | $ | 555 | $ | 410 | ||||||||||||||||||||||
Total gains (losses) included in shareholders’ net income | (7) | (8) | ||||||||||||||||||||||||
Gains (losses) included in other comprehensive income | (12) | 22 | ||||||||||||||||||||||||
Gains (losses) required to adjust future policy benefits for settlement annuities (1)
|
7 | 2 | ||||||||||||||||||||||||
Purchases, sales and settlements | ||||||||||||||||||||||||||
Purchases | 107 | 72 | ||||||||||||||||||||||||
Sales (2)
|
(121) | — | ||||||||||||||||||||||||
Settlements | (89) | (19) | ||||||||||||||||||||||||
Total purchases, sales and settlements | $ | (103) | $ | 53 | ||||||||||||||||||||||
Transfers into/(out of) Level 3 | ||||||||||||||||||||||||||
Transfers into Level 3 | 774 | 170 | ||||||||||||||||||||||||
Transfers out of Level 3 | (360) | (94) | ||||||||||||||||||||||||
Total transfers into/(out of) Level 3 | $ | 414 | $ | 76 | ||||||||||||||||||||||
Balance at December 31,
|
$ | 854 | $ | 555 | ||||||||||||||||||||||
Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date | $ | (17) | $ | (8) | ||||||||||||||||||||||
Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period | $ | (6) | N/A |
(In millions) |
Quoted Prices in Active Markets for Identical Assets
(Level 1) |
Significant Other Observable Inputs
(Level 2) |
Significant Unobservable Inputs
(Level 3) |
Total | ||||||||||||||||||||||||||||||||||||||||||||||
2020 | 2019 | 2020 | 2019 | 2020 | 2019 | 2020 | 2019 | |||||||||||||||||||||||||||||||||||||||||||
Guaranteed separate accounts (See Note 21)
|
$ | 226 | $ | 219 | $ | 297 | $ | 271 | $ | — | $ | — | $ | 523 | $ | 490 | ||||||||||||||||||||||||||||||||||
Non-guaranteed separate accounts (1)
|
1,925 | 1,450 | 5,600 | 5,522 | 355 | 263 | 7,880 | 7,235 | ||||||||||||||||||||||||||||||||||||||||||
Subtotal | $ | 2,151 | $ | 1,669 | $ | 5,897 | $ | 5,793 | $ | 355 | $ | 263 | 8,403 | 7,725 | ||||||||||||||||||||||||||||||||||||
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)
|
683 | 756 | ||||||||||||||||||||||||||||||||||||||||||||||||
Total | 8,481 | |||||||||||||||||||||||||||||||||||||||||||||||||
Separate account assets of business classified as held for sale | (16) | |||||||||||||||||||||||||||||||||||||||||||||||||
Separate account assets per Consolidated Balance Sheets | $ | 9,086 | $ | 8,465 |
Fair Value as of | Unfunded Commitment as of December 31, 2020 |
Redemption Frequency
(if currently eligible) |
Redemption Notice
Period |
|||||||||||||||||||||||||||||
(In millions) | December 31, 2020 | December 31, 2019 | ||||||||||||||||||||||||||||||
Securities partnerships | $ | 463 | $ | 531 | $ | 272 | Not applicable | Not applicable | ||||||||||||||||||||||||
Real estate funds | 215 | 220 | — | Quarterly |
30 - 90 days
|
|||||||||||||||||||||||||||
Hedge funds | 5 | 5 | — | Up to annually, varying by fund |
30 - 90 days
|
|||||||||||||||||||||||||||
Total | $ | 683 | $ | 756 | $ | 272 |
December 31, 2020 | December 31, 2019 | |||||||||||||||||||||||||||||||
(In millions) | Classification in Fair Value Hierarchy | Fair Value | Carrying Value | Fair Value | Carrying Value | |||||||||||||||||||||||||||
Commercial mortgage loans | Level 3 | $ | 1,456 | $ | 1,419 | $ | 1,989 | $ | 1,947 | |||||||||||||||||||||||
Long-term debt, including current maturities, excluding finance leases | Level 2 | $ | 37,676 | $ | 31,835 | $ | 39,439 | $ | 36,375 |
For the Years Ended December 31, | ||||||||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||
Securities and Derivatives | ||||||||||||||||||||||||||||||||
Beginning balance | $ | 975 | $ | 18 | $ | 328 | ||||||||||||||||||||||||||
Reclassification adjustment to retained earnings related to U.S. tax reform legislation | — | — | 65 | |||||||||||||||||||||||||||||
Reclassification adjustment to retained earnings related to new financial instruments guidance | — | — | (4) | |||||||||||||||||||||||||||||
Reclassification adjustment from retained earnings related to new hedging guidance | — | — | (6) | |||||||||||||||||||||||||||||
Adjusted beginning balance | 975 | 18 | 383 | |||||||||||||||||||||||||||||
Appreciation (depreciation) on securities and derivatives | 776 | 1,266 | (512) | |||||||||||||||||||||||||||||
Tax (expense) benefit | (150) | (270) | 100 | |||||||||||||||||||||||||||||
Net appreciation (depreciation) on securities and derivatives | 626 | 996 | (412) | |||||||||||||||||||||||||||||
Reclassification adjustment for (gains) included in shareholders' net income ((gain) loss on sale of business) | (862) | — | — | |||||||||||||||||||||||||||||
Reclassification adjustment for (gains) losses included in shareholders' net income (net realized investment (gains) losses) | (26) | (49) | 60 | |||||||||||||||||||||||||||||
Reclassification adjustment for tax expense (benefit) included in shareholders’ net income | 187 | 10 | (13) | |||||||||||||||||||||||||||||
Net (gains) losses reclassified from AOCI to net income | (701) | (39) | 47 | |||||||||||||||||||||||||||||
Other comprehensive (loss) income, net of tax | (75) | 957 | (365) | |||||||||||||||||||||||||||||
Ending balance | $ | 900 | $ | 975 | $ | 18 | ||||||||||||||||||||||||||
Translation of foreign currencies | ||||||||||||||||||||||||||||||||
Beginning balance | $ | (275) | $ | (221) | $ | (65) | ||||||||||||||||||||||||||
Reclassification adjustment to retained earnings related to U.S. tax reform legislation | — | — | (4) | |||||||||||||||||||||||||||||
Adjusted beginning balance | (275) | (221) | (69) | |||||||||||||||||||||||||||||
Translation of foreign currencies | 232 | (57) | (167) | |||||||||||||||||||||||||||||
Tax (expense) benefit | 12 | (2) | — | |||||||||||||||||||||||||||||
Net translation of foreign currencies | 244 | (59) | (167) | |||||||||||||||||||||||||||||
Reclassification adjustment for losses included in shareholders' net income ((gain) loss on sale of business) | 11 | — | — | |||||||||||||||||||||||||||||
Reclassification adjustment for tax expense (benefit) included in shareholders’ net income | (3) | — | — | |||||||||||||||||||||||||||||
Net translation losses reclassified from AOCI to net income | 8 | — | — | |||||||||||||||||||||||||||||
Other comprehensive income (loss), net of tax | 252 | (59) | (167) | |||||||||||||||||||||||||||||
Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests | (8) | (5) | (15) | |||||||||||||||||||||||||||||
Shareholders' other comprehensive income (loss), net of tax | 260 | (54) | (152) | |||||||||||||||||||||||||||||
Ending balance | $ | (15) | $ | (275) | $ | (221) | ||||||||||||||||||||||||||
Postretirement benefits liability | ||||||||||||||||||||||||||||||||
Beginning balance | $ | (1,641) | $ | (1,508) | $ | (1,345) | ||||||||||||||||||||||||||
Reclassification adjustment to retained earnings related to U.S. tax reform legislation | — | — | (290) | |||||||||||||||||||||||||||||
Adjusted beginning balance | (1,641) | (1,508) | (1,635) | |||||||||||||||||||||||||||||
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (interest expense and other) | 70 | 62 | 69 | |||||||||||||||||||||||||||||
Reclassification adjustment for settlement (interest expense and other) | — | 10 | — | |||||||||||||||||||||||||||||
Reclassification adjustment for tax expense (benefit) included in shareholders’ net income | (17) | (15) | (15) | |||||||||||||||||||||||||||||
Net adjustments reclassified from AOCI to net income | 53 | 57 | 54 | |||||||||||||||||||||||||||||
Valuation update | (206) | (249) | 93 | |||||||||||||||||||||||||||||
Tax (expense) benefit | 48 | 59 | (20) | |||||||||||||||||||||||||||||
Net change due to valuation update | (158) | (190) | 73 | |||||||||||||||||||||||||||||
Other comprehensive (loss) income, net of tax | (105) | (133) | 127 | |||||||||||||||||||||||||||||
Ending balance | $ | (1,746) | $ | (1,641) | $ | (1,508) |
Pension Benefits | |||||||||||||||||
(In millions) | 2020 | 2019 | |||||||||||||||
Change in benefit obligation | |||||||||||||||||
Benefit obligation, January 1 | $ | 5,314 | $ | 4,741 | |||||||||||||
Service cost | 2 | 2 | |||||||||||||||
Interest cost | 168 | 194 | |||||||||||||||
Litigation settlement | — | 142 | |||||||||||||||
Actuarial losses, net (1)
|
416 | 574 | |||||||||||||||
Benefits paid from plan assets | (285) | (325) | |||||||||||||||
Benefits paid — other | (15) | (14) | |||||||||||||||
Benefit obligation, December 31 | 5,600 | 5,314 | |||||||||||||||
Change in plan assets | |||||||||||||||||
Fair value of plan assets, January 1 | 4,441 | 4,151 | |||||||||||||||
Actual return on plan assets | 449 | 594 | |||||||||||||||
Benefits paid | (285) | (325) | |||||||||||||||
Contributions | 18 | 21 | |||||||||||||||
Fair value of plan assets, December 31 | 4,623 | 4,441 | |||||||||||||||
Funded status | $ | (977) | $ | (873) | |||||||||||||
Liability in Consolidated Balance Sheets | |||||||||||||||||
Accrued expenses and other liabilities | $ | (15) | $ | (18) | |||||||||||||
Other non-current liabilities | $ | (962) | $ | (855) |
(In millions) | Pension Benefits | |||||||
2021 | $ | 328 | ||||||
2022 | $ | 313 | ||||||
2023 | $ | 316 | ||||||
2024 | $ | 316 | ||||||
2025 | $ | 315 | ||||||
2026-2030 | $ | 1,551 |
Pension Benefits | ||||||||||||||
(In millions) | 2020 | 2019 | ||||||||||||
Unrecognized net (losses) | $ | (2,277) | $ | (2,132) | ||||||||||
Unrecognized prior service cost | (5) | (5) | ||||||||||||
Postretirement benefits liability adjustment | $ | (2,282) | $ | (2,137) |
Pension Benefits | ||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Service cost | $ | 2 | $ | 2 | $ | 3 | ||||||||||||||
Interest cost | 168 | 194 | 169 | |||||||||||||||||
Expected long-term return on plan assets | (260) | (245) | (257) | |||||||||||||||||
Amortization of: | ||||||||||||||||||||
Prior actuarial losses, net | 78 | 59 | 70 | |||||||||||||||||
Prior service cost | — | — | — | |||||||||||||||||
Litigation settlement - plan amendment | — | 142 | 32 | |||||||||||||||||
Settlement loss | — | 10 | — | |||||||||||||||||
Net (benefit) cost | $ | (12) | $ | 162 | $ | 17 |
2020 | 2019 | ||||||||||||||||
Discount rate: | |||||||||||||||||
Pension benefit obligation | 2.49 | % | 3.30 | % | |||||||||||||
Pension benefit cost | 3.30 | % | 4.23 | % | |||||||||||||
Expected long-term return on plan assets: | |||||||||||||||||
Pension benefit cost | 6.75 | % | 6.75 | % | |||||||||||||
Mortality table for pension obligations | White Collar mortality table with MP 2020 projection scale | White Collar mortality table with MP 2019 projection scale |
(In millions) | 2020 | 2019 | ||||||||||||
Debt securities: | ||||||||||||||
Federal government and agency | $ | 9 | $ | — | ||||||||||
Corporate | 1,680 | 1,906 | ||||||||||||
Asset-backed | 53 | 41 | ||||||||||||
Fund investments | 380 | 460 | ||||||||||||
Total debt securities | 2,122 | 2,407 | ||||||||||||
Equity securities: | ||||||||||||||
Domestic | 978 | 582 | ||||||||||||
International, including funds and pooled separate accounts (1)
|
471 | 419 | ||||||||||||
Total equity securities | 1,449 | 1,001 | ||||||||||||
Securities partnerships | 463 | 531 | ||||||||||||
Real estate funds, including pooled separate accounts (1)
|
219 | 230 | ||||||||||||
Commercial mortgage loans | 95 | 96 | ||||||||||||
Hedge funds | 1 | 24 | ||||||||||||
Guaranteed deposit account contract | 98 | 100 | ||||||||||||
Cash equivalents and other current assets, net | 176 | 52 | ||||||||||||
Total pension assets at fair value | $ | 4,623 | $ | 4,441 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Expense | $ | 243 | $ | 256 | $ | 196 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Common shares available for award | 20.6 | 23.2 | 25.7 |
2020 | 2019 | 2018 | |||||||||||||||||||||
Dividend yield | — | % | — | % | — | % | |||||||||||||||||
Expected volatility | 30.0 | % | 30.0 | % | 35.0 | % | |||||||||||||||||
Risk-free interest rate | 1.4 | % | 2.5 | % | 2.5 | % | |||||||||||||||||
Expected option life | 4.5 years | 4.4 years | 4.4 years | ||||||||||||||||||||
Weighted average fair value of options | $ | 52.42 | $ | 53.10 | $ | 64.18 |
(Options in thousands) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||
Options | Weighted Average Exercise Price | Options | Weighted Average Exercise Price | Options | Weighted Average Exercise Price | |||||||||||||||||||||||||||||||||
Outstanding - January 1 | 11,438 | $ | 136.19 | 12,370 | $ | 125.46 | 6,156 | $ | 100.79 | |||||||||||||||||||||||||||||
Granted | 1,851 | $ | 191.86 | 1,569 | $ | 183.41 | 7,080 | $ | 143.62 | |||||||||||||||||||||||||||||
Exercised | (3,289) | $ | 115.38 | (2,297) | $ | 106.75 | (771) | $ | 88.35 | |||||||||||||||||||||||||||||
Expired or canceled | (258) | $ | 188.79 | (204) | $ | 180.08 | (95) | $ | 165.04 | |||||||||||||||||||||||||||||
Outstanding - December 31 | 9,742 | $ | 152.40 | 11,438 | $ | 136.19 | 12,370 | $ | 125.46 | |||||||||||||||||||||||||||||
Options exercisable at year-end | 6,837 | $ | 137.08 | 8,874 | $ | 123.87 | 9,446 | $ | 114.22 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Intrinsic value of options exercised | $ | 304 | $ | 180 | $ | 86 | ||||||||||||||
Cash received for options exercised | $ | 376 | $ | 224 | $ | 68 | ||||||||||||||
Tax benefit from options exercised | $ | 57 | $ | 34 | $ | 8 |
Options
Outstanding |
Options
Exercisable |
|||||||||||||
Number (in thousands) | 9,742 | 6,837 | ||||||||||||
Total intrinsic value (in millions) | $ | 543 | $ | 486 | ||||||||||
Weighted average exercise price | $ | 152.40 | $ | 137.08 | ||||||||||
Weighted average remaining contractual life | 5.8 years | 4.6 years |
(Awards in thousands) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||
Grants/Units | Weighted Average Fair Value at Award Date | Grants/Units | Weighted Average Fair Value at Award Date | Grants/Units | Weighted Average Fair Value at Award Date | |||||||||||||||||||||||||||||||||
Outstanding - January 1 | 1,945 | $ | 178.78 | 2,138 | $ | 168.12 | 1,295 | $ | 126.44 | |||||||||||||||||||||||||||||
Awarded | 791 | $ | 191.22 | 870 | $ | 183.86 | 1,451 | $ | 183.29 | |||||||||||||||||||||||||||||
Vested | (1,026) | $ | 161.58 | (964) | $ | 160.74 | (560) | $ | 112.53 | |||||||||||||||||||||||||||||
Forfeited | (110) | $ | 186.63 | (99) | $ | 168.68 | (48) | $ | 150.84 | |||||||||||||||||||||||||||||
Outstanding - December 31 | 1,600 | $ | 186.12 | 1,945 | $ | 178.78 | 2,138 | $ | 168.12 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Fair value of vested restricted stock | $ | 190 | $ | 171 | $ | 107 |
2020 | 2019 | 2018 | ||||||||||||||||||||||||||||||||||||
(Awards in thousands) | Shares | Weighted Average Fair Value at Award Date | Shares | Weighted Average Fair Value at Award Date | Shares | Weighted Average Fair Value at Award Date | ||||||||||||||||||||||||||||||||
Outstanding - January 1 | 818 | $ | 177.94 | 707 | $ | 160.74 | 778 | $ | 136.57 | |||||||||||||||||||||||||||||
Awarded | 362 | $ | 191.52 | 389 | $ | 184.72 | 221 | $ | 197.51 | |||||||||||||||||||||||||||||
Vested | (309) | $ | 159.67 | (244) | $ | 139.27 | (269) | $ | 121.57 | |||||||||||||||||||||||||||||
Forfeited | (63) | $ | 187.76 | (34) | $ | 178.98 | (23) | $ | 158.16 | |||||||||||||||||||||||||||||
Outstanding - December 31 | 808 | $ | 190.02 | 818 | $ | 177.94 | 707 | $ | 160.74 |
2020 | 2019 | 2018 | ||||||||||||||||||||||||||||||||||||
(Shares in thousands; $ in millions) | Shares | Fair Value | Shares | Fair Value | Shares | Fair Value | ||||||||||||||||||||||||||||||||
Shares of Cigna common stock distributed upon SPS vesting | 306 | $ | 55 | 254 | $ | 45 | 380 | $ | 73 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Total compensation cost for shared-based awards | $ | 289 | $ | 299 | $ | 180 | ||||||||||||||
Tax benefits recognized | $ | 63 | $ | 59 | $ | 36 |
(In millions) | 2020 | 2019 | ||||||||||||
Balance at January 1, | $ | 44,602 | $ | 44,505 | ||||||||||
Goodwill acquired, net | 29 | 103 | ||||||||||||
Impact of foreign currency translation | 17 | (6) | ||||||||||||
Balance at December 31, | $ | 44,648 | $ | 44,602 |
(In millions) | Cost | Accumulated Amortization | Net Carrying Value | |||||||||||||||||
2020 | ||||||||||||||||||||
Customer relationships | $ | 29,432 | 3,024 | 26,408 | ||||||||||||||||
Trade Name - Express Scripts | 8,400 | 8,400 | ||||||||||||||||||
Other | 475 | 104 | 371 | |||||||||||||||||
Other intangible assets | 38,307 | 3,128 | 35,179 | |||||||||||||||||
Value of business acquired (reported in Deferred policy acquisition costs) | 670 | 152 | 518 | |||||||||||||||||
Total | $ | 38,977 | 3,280 | 35,697 | ||||||||||||||||
2019 | ||||||||||||||||||||
Customer relationships | $ | 31,184 | 3,319 | 27,865 | ||||||||||||||||
Trade Name - Express Scripts | 8,400 | 8,400 | ||||||||||||||||||
Other | 383 | 86 | 297 | |||||||||||||||||
Other intangible assets | 39,967 | 3,405 | 36,562 | |||||||||||||||||
Value of business acquired (reported in Deferred policy acquisition costs) | 643 | 122 | 521 | |||||||||||||||||
Total | $ | 40,610 | 3,527 | 37,083 |
(In millions) | Cost | Accumulated Amortization | Net Carrying Value | |||||||||||||||||
2020 | ||||||||||||||||||||
Internal-use software | $ | 7,061 | $ | 4,048 | $ | 3,013 | ||||||||||||||
Other property and equipment | 2,719 | 1,527 | 1,192 | |||||||||||||||||
Total property and equipment | $ | 9,780 | $ | 5,575 | $ | 4,205 | ||||||||||||||
2019 | ||||||||||||||||||||
Internal-use software | $ | 6,578 | $ | 3,282 | $ | 3,296 | ||||||||||||||
Other property and equipment | 2,569 | 1,353 | 1,216 | |||||||||||||||||
Total property and equipment | 9,147 | 4,635 | 4,512 | |||||||||||||||||
Property and equipment classified as Assets held for sale | (226) | (131) | (95) | |||||||||||||||||
Total property and equipment per Consolidated Balance Sheet | $ | 8,921 | $ | 4,504 | $ | 4,417 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Internal-use software | $ | 971 | $ | 850 | $ | 323 | ||||||||||||||
Other property and equipment | 276 | 284 | 146 | |||||||||||||||||
Value of business acquired (reported in deferred policy acquisition costs) | 28 | 34 | 16 | |||||||||||||||||
Other intangibles | 1,527 | 2,483 | 210 | |||||||||||||||||
Total depreciation and amortization | $ | 2,802 | $ | 3,651 | $ | 695 |
(In millions) | Pre-tax Amortization | |||||||
2021 | $ | 2,719 | ||||||
2022 | $ | 2,236 | ||||||
2023 | $ | 2,014 | ||||||
2024 | $ | 1,821 | ||||||
2025 | $ | 1,760 | ||||||
ROU Asset | Current Lease Liability | Non-Current Lease Liability | ||||||||||||||||||
Operating lease | Other assets | Accrued expenses and other liabilities (current) | Other liabilities (non-current) | |||||||||||||||||
Finance lease | Property and equipment | Short-term debt | Long-term debt |
For the Years Ended December 31, | |||||||||||||||||
(In millions) | 2020 | 2019 | |||||||||||||||
Operating lease cost | $ | 190 | $ | 188 | |||||||||||||
Finance lease cost: | |||||||||||||||||
Amortization of ROU assets | 28 | 28 | |||||||||||||||
Interest on lease liabilities | 3 | 3 | |||||||||||||||
Total finance lease cost | 31 | 31 | |||||||||||||||
Variable lease cost | 48 | 50 | |||||||||||||||
Total lease cost | $ | 269 | $ | 269 |
For the Years Ended December 31, | ||||||||||||||
(In millions) | 2020 | 2019 | ||||||||||||
Cash paid for amounts included in the measurement of lease liabilities: | ||||||||||||||
Operating cash outflows from operating leases | $ | 189 | $ | 173 | ||||||||||
Operating cash outflows from finance leases | $ | 3 | $ | 3 | ||||||||||
Financing cash outflows from finance leases | $ | 26 | $ | 25 | ||||||||||
ROU assets obtained in exchange for lease obligations: | ||||||||||||||
Operating leases | $ | 189 | $ | 89 | ||||||||||
Finance leases | $ | 9 | $ | 68 |
(In millions) | December 31, 2020 | December 31, 2019 | ||||||||||||||||||
Operating leases: | ||||||||||||||||||||
Operating lease ROU assets | $ | 552 | $ | 536 | ||||||||||||||||
Accrued expenses and other liabilities | $ | 152 | $ | 166 | ||||||||||||||||
Other non-current liabilities | 491 | 465 | ||||||||||||||||||
Total operating lease liabilities | $ | 643 | $ | 631 | ||||||||||||||||
Finance leases: | ||||||||||||||||||||
Property and equipment, gross | $ | 98 | $ | 110 | ||||||||||||||||
Accumulated depreciation | (46) | (23) | ||||||||||||||||||
Property and equipment, net | $ | 52 | $ | 87 | ||||||||||||||||
Short-term debt | $ | 18 | $ | 27 | ||||||||||||||||
Long-term debt | 36 | 61 | ||||||||||||||||||
Total finance lease liabilities | $ | 54 | $ | 88 |
(In millions) | Operating Leases | Finance Leases | ||||||||||||
2021 | $ | 150 | $ | 20 | ||||||||||
2022 | 170 | 18 | ||||||||||||
2023 | 118 | 6 | ||||||||||||
2024 | 89 | 3 | ||||||||||||
2025 | 57 | 3 | ||||||||||||
Thereafter | 121 | 10 | ||||||||||||
Total lease payments | 705 | 60 | ||||||||||||
Less: imputed interest | 62 | 6 | ||||||||||||
Total | $ | 643 | $ | 54 |
(In billions) | 2020 | 2019 | 2018 | |||||||||||||||||
Net income | $ | 4.0 | $ | 3.8 | $ | 3.4 | ||||||||||||||
Surplus | $ | 12.9 | $ | 13.8 | $ | 12.2 | ||||||||||||||
(In billions) | 2020 | |||||||
Minimum statutory surplus required by regulators | $ | 4.9 | ||||||
Investments on deposit with regulatory bodies | $ | 0.4 | ||||||
Maximum dividend distributions permitted in 2021 without regulatory approval
|
$ | 2.5 | ||||||
Maximum loans to the parent company permitted without regulatory approval | $ | 0.8 | ||||||
Restricted GAAP net assets of Cigna Corporation's subsidiaries | $ | 13.5 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Current taxes | ||||||||||||||||||||
U.S. income taxes | $ | 2,128 | $ | 1,476 | $ | 804 | ||||||||||||||
Foreign income taxes | 334 | 173 | 185 | |||||||||||||||||
State income taxes | 303 | 114 | 47 | |||||||||||||||||
Total current taxes | 2,765 | 1,763 | 1,036 | |||||||||||||||||
Deferred taxes (benefits) | ||||||||||||||||||||
U.S. income taxes (benefits) | (217) | (236) | (75) | |||||||||||||||||
Foreign income taxes | 11 | 16 | 8 | |||||||||||||||||
State income tax (benefits) | (180) | (93) | (34) | |||||||||||||||||
Total deferred taxes (benefits) | (386) | (313) | (101) | |||||||||||||||||
Total income taxes | $ | 2,379 | $ | 1,450 | $ | 935 |
2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||||||
(In millions) | $ | % | $ | % | $ | % | |||||||||||||||||||||||||||||||||||
Tax expense at nominal rate | $ | 2,282 | 21.0 | % | $ | 1,380 | 21.0 | % | $ | 752 | 21.0 | % | |||||||||||||||||||||||||||||
Effect of U.S. tax reform legislation | — | — | — | — | (4) | (0.1) | |||||||||||||||||||||||||||||||||||
Impact of sale of business | 104 | 1.0 | — | — | — | — | |||||||||||||||||||||||||||||||||||
Effect of foreign earnings | (61) | (0.6) | 24 | 0.4 | 74 | 2.1 | |||||||||||||||||||||||||||||||||||
Health insurance industry tax | 93 | 0.9 | — | — | 78 | 2.2 | |||||||||||||||||||||||||||||||||||
State income tax (net of federal income tax benefit) | 24 | 0.2 | 32 | 0.5 | 10 | 0.3 | |||||||||||||||||||||||||||||||||||
Other | (63) | (0.6) | 14 | 0.2 | 25 | 0.6 | |||||||||||||||||||||||||||||||||||
Total income taxes | $ | 2,379 | 21.9 | % | $ | 1,450 | 22.1 | % | $ | 935 | 26.1 | % |
(In millions) | 2020 | 2019 | ||||||||||||
Deferred tax assets
|
||||||||||||||
Employee and retiree benefit plans | $ | 477 | $ | 511 | ||||||||||
Other insurance and contractholder liabilities | 278 | 282 | ||||||||||||
Loss carryforwards | 177 | 260 | ||||||||||||
Other accrued liabilities | 358 | 183 | ||||||||||||
Other | 209 | 218 | ||||||||||||
Deferred tax assets before valuation allowance | 1,499 | 1,454 | ||||||||||||
Valuation allowance for deferred tax assets | (207) | (196) | ||||||||||||
Deferred tax assets, net of valuation allowance | 1,292 | 1,258 | ||||||||||||
Deferred tax liabilities | ||||||||||||||
Depreciation and amortization | 660 | 630 | ||||||||||||
Acquisition-related basis differences | 8,989 | 9,386 | ||||||||||||
Policy acquisition expenses | 289 | 113 | ||||||||||||
Unrealized appreciation on investments and foreign currency translation | 171 | 223 | ||||||||||||
Other | 122 | 293 | ||||||||||||
Total deferred tax liabilities | 10,231 | 10,645 | ||||||||||||
Net deferred income tax (liabilities) assets | $ | (8,939) | $ | (9,387) |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Balance at January 1, | $ | 1,018 | $ | 928 | $ | 35 | ||||||||||||||
Increase due to prior year positions | 128 | 68 | 40 | |||||||||||||||||
Increase due to business combinations | — | — | 860 | |||||||||||||||||
Increase due to current year positions | 88 | 29 | 6 | |||||||||||||||||
Reduction related to settlements with taxing authorities | — | — | (1) | |||||||||||||||||
Reduction related to lapse of applicable statute of limitations | (24) | (7) | (12) | |||||||||||||||||
Balance at December 31, | $ | 1,210 | $ | 1,018 | $ | 928 |
Three Months Ended | ||||||||||||||||||||||||||
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||||||||
Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) | After-tax | Before-tax | After-tax | Before-tax | After-tax | Before-tax | ||||||||||||||||||||||||||||||||
Integration and transaction-related costs: | ||||||||||||||||||||||||||||||||||||||
- Selling, general and administrative expenses | $ | 404 | $ | 527 | $ | 427 | $ | 552 | $ | 587 | $ | 748 | ||||||||||||||||||||||||||
- Interest expense and other | — | — | — | — | 179 | 227 | ||||||||||||||||||||||||||||||||
- Net investment income | — | — | — | — | (97) | (123) | ||||||||||||||||||||||||||||||||
Integration and transaction-related costs | $ | 404 | $ | 527 | $ | 427 | $ | 552 | $ | 669 | $ | 852 | ||||||||||||||||||||||||||
Debt extinguishment costs | $ | 151 | $ | 199 | $ | — | $ | — | $ | — | $ | — | ||||||||||||||||||||||||||
Charge for organizational efficiency plan (Selling, general and administrative expenses) | 24 | 31 | 162 | 207 | — | — | ||||||||||||||||||||||||||||||||
Charges associated with litigation matters (Selling, general and administrative expenses) | 19 | 25 | 41 | 51 | 19 | 25 | ||||||||||||||||||||||||||||||||
Risk corridors recovery (Selling, general and administrative expenses) | (76) | (101) | — | — | — | — | ||||||||||||||||||||||||||||||||
Contractual adjustment for a former client (Pharmacy revenues) | (155) | (204) | — | — | — | — | ||||||||||||||||||||||||||||||||
(Gain) on sale of business | (3,217) | (4,203) | — | — | — | — | ||||||||||||||||||||||||||||||||
Charges (benefits) associated with tax reform: | ||||||||||||||||||||||||||||||||||||||
- Selling, general and administrative expenses | $ | — | $ | — | $ | — | $ | — | $ | 1 | $ | 2 | ||||||||||||||||||||||||||
- Tax (benefit) | — | — | — | — | (3) | — | ||||||||||||||||||||||||||||||||
Charges (benefits) associated with tax reform | $ | — | $ | — | $ | — | $ | — | $ | (2) | $ | 2 | ||||||||||||||||||||||||||
Total impact from special items | $ | (2,850) | $ | (3,726) | $ | 630 | $ | 810 | $ | 686 | $ | 879 |
(In millions) |
Evernorth
|
U.S. Medical
|
International Markets
|
Group Disability and Other
|
Corporate and Eliminations
|
Total | ||||||||||||||||||||||||||||||||
2020 | ||||||||||||||||||||||||||||||||||||||
Revenues from external customers | $ | 112,647 | $ | 36,027 | $ | 5,853 | $ | 4,630 | $ | — | $ | 159,157 | ||||||||||||||||||||||||||
Inter-segment revenues | 3,655 | 1,977 | — | 23 | (5,655) | |||||||||||||||||||||||||||||||||
Net investment income | 32 | 447 | 154 | 611 | — | 1,244 | ||||||||||||||||||||||||||||||||
Total revenues | $ | 116,334 | $ | 38,451 | $ | 6,007 | $ | 5,264 | $ | (5,655) | $ | 160,401 | ||||||||||||||||||||||||||
Net realized investment results from certain equity method investments
|
— | — | (130) | — | — | (130) | ||||||||||||||||||||||||||||||||
Special item related to contractual adjustment for a former client | (204) | — | — | — | — | (204) | ||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 116,130 | $ | 38,451 | $ | 5,877 | $ | 5,264 | $ | (5,655) | $ | 160,067 | ||||||||||||||||||||||||||
Depreciation and amortization | $ | 2,248 | $ | 426 | $ | 68 | $ | 35 | $ | 25 | $ | 2,802 | ||||||||||||||||||||||||||
Income (loss) before taxes | $ | 3,684 | $ | 3,956 | $ | 1,048 | $ | 4,514 | $ | (2,334) | $ | 10,868 | ||||||||||||||||||||||||||
Pre-tax adjustments to reconcile to adjusted income from operations | ||||||||||||||||||||||||||||||||||||||
(Income) attributable to noncontrolling interests | (17) | — | (20) | — | — | (37) | ||||||||||||||||||||||||||||||||
Net realized investment (gains) losses (1)
|
(17) | (77) | (161) | (24) | — | (279) | ||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | 1,917 | 29 | 33 | 3 | — | 1,982 | ||||||||||||||||||||||||||||||||
Special items | ||||||||||||||||||||||||||||||||||||||
Integration and transaction-related costs | — | — | — | — | 527 | 527 | ||||||||||||||||||||||||||||||||
Debt extinguishment costs | — | — | — | — | 199 | 199 | ||||||||||||||||||||||||||||||||
Charge for organizational efficiency plan | — | — | — | — | 31 | 31 | ||||||||||||||||||||||||||||||||
Charges associated with litigation matters | — | — | — | — | 25 | 25 | ||||||||||||||||||||||||||||||||
Risk corridors recovery | — | (101) | — | — | — | (101) | ||||||||||||||||||||||||||||||||
Contractual adjustment for a former client | (204) | — | — | — | — | (204) | ||||||||||||||||||||||||||||||||
(Gain) on sale of business | — | — | — | (4,203) | — | (4,203) | ||||||||||||||||||||||||||||||||
Pre-tax adjusted income (loss) from operations | $ | 5,363 | $ | 3,807 | $ | 900 | $ | 290 | $ | (1,552) | $ | 8,808 | ||||||||||||||||||||||||||
(In millions) |
Evernorth
|
U.S. Medical
|
International Markets
|
Group Disability and Other
|
Corporate and Eliminations
|
Total | ||||||||||||||||||||||||||||||||
2019 | ||||||||||||||||||||||||||||||||||||||
Revenues from external customers
|
$ | 107,354 | $ | 34,861 | $ | 5,500 | $ | 4,461 | $ | — | $ | 152,176 | ||||||||||||||||||||||||||
Inter-segment revenues | 2,380 | 1,180 | — | 26 | (3,586) | |||||||||||||||||||||||||||||||||
Net investment income (loss) | 60 | 478 | 159 | 695 | (2) | 1,390 | ||||||||||||||||||||||||||||||||
Total revenues | $ | 109,794 | $ | 36,519 | $ | 5,659 | $ | 5,182 | $ | (3,588) | $ | 153,566 | ||||||||||||||||||||||||||
Revenue contribution from transitioning clients | (13,347) | — | — | — | — | (13,347) | ||||||||||||||||||||||||||||||||
Net realized investment results from certain equity method investments | — | — | (44) | — | — | (44) | ||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 96,447 | $ | 36,519 | $ | 5,615 | $ | 5,182 | $ | (3,588) | $ | 140,175 | ||||||||||||||||||||||||||
Depreciation and amortization | $ | 3,071 | $ | 449 | $ | 87 | $ | 41 | $ | 3 | $ | 3,651 | ||||||||||||||||||||||||||
Income (loss) before taxes | $ | 3,983 | $ | 3,904 | $ | 785 | $ | 562 | $ | (2,664) | $ | 6,570 | ||||||||||||||||||||||||||
Pre-tax adjustments to reconcile to adjusted income from operations | ||||||||||||||||||||||||||||||||||||||
Adjustment for transitioning clients | (1,726) | — | — | — | — | (1,726) | ||||||||||||||||||||||||||||||||
(Income) attributable to noncontrolling interests | (4) | — | (16) | — | — | (20) | ||||||||||||||||||||||||||||||||
Net realized investment (gains) losses (1)
|
— | (112) | (43) | (66) | — | (221) | ||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | 2,839 | 69 | 36 | 5 | — | 2,949 | ||||||||||||||||||||||||||||||||
Special items | ||||||||||||||||||||||||||||||||||||||
Integration and transaction-related costs | — | — | — | — | 552 | 552 | ||||||||||||||||||||||||||||||||
Charge for organizational efficiency plan | — | — | — | — | 207 | 207 | ||||||||||||||||||||||||||||||||
Charges associated with litigation matters | — | (30) | — | — | 81 | 51 | ||||||||||||||||||||||||||||||||
Pre-tax adjusted income (loss) from operations | $ | 5,092 | $ | 3,831 | $ | 762 | $ | 501 | $ | (1,824) | $ | 8,362 | ||||||||||||||||||||||||||
(In millions) | Evernorth | U.S. Medical | International Markets | Group Disability and Other | Corporate and Eliminations | Total | ||||||||||||||||||||||||||||||||
2018 | ||||||||||||||||||||||||||||||||||||||
Revenues from external customers | $ | 5,902 | $ | 31,759 | $ | 5,174 | $ | 4,335 | $ | — | $ | 47,170 | ||||||||||||||||||||||||||
Inter-segment revenues | 1,154 | 573 | — | 14 | (1,741) | |||||||||||||||||||||||||||||||||
Net investment income (loss) | 9 | 459 | 149 | 712 | 151 | 1,480 | ||||||||||||||||||||||||||||||||
Total revenues | $ | 7,065 | $ | 32,791 | $ | 5,323 | $ | 5,061 | $ | (1,590) | $ | 48,650 | ||||||||||||||||||||||||||
Revenue contributions from transitioning clients | (459) | — | — | — | — | (459) | ||||||||||||||||||||||||||||||||
Net realized investment results from certain equity method investments | — | — | 43 | — | — | 43 | ||||||||||||||||||||||||||||||||
Special items reported in integration and transaction-related costs | — | — | — | — | (123) | (123) | ||||||||||||||||||||||||||||||||
Adjusted revenues | $ | 6,606 | $ | 32,791 | $ | 5,366 | $ | 5,061 | $ | (1,713) | $ | 48,111 | ||||||||||||||||||||||||||
Depreciation and amortization | $ | 120 | $ | 466 | $ | 55 | $ | 53 | $ | 1 | $ | 695 | ||||||||||||||||||||||||||
Income (loss) before taxes | $ | 329 | $ | 3,342 | $ | 670 | $ | 497 | $ | (1,257) | $ | 3,581 | ||||||||||||||||||||||||||
Pre-tax adjustments to reconcile to adjusted income from operations | ||||||||||||||||||||||||||||||||||||||
Adjustment for transitioning clients | (62) | — | — | — | — | (62) | ||||||||||||||||||||||||||||||||
(Income) attributable to noncontrolling interests | — | — | (14) | — | — | (14) | ||||||||||||||||||||||||||||||||
Net realized investment (gains) losses (1)
|
— | 36 | 61 | 25 | 2 | 124 | ||||||||||||||||||||||||||||||||
Amortization of acquired intangible assets | 113 | 99 | 18 | 5 | — | 235 | ||||||||||||||||||||||||||||||||
Special items | ||||||||||||||||||||||||||||||||||||||
Integration and transaction-related costs | — | — | — | — | 852 | 852 | ||||||||||||||||||||||||||||||||
Charges associated with litigation matters | — | 25 | — | — | — | 25 | ||||||||||||||||||||||||||||||||
Charges (benefits) associated with tax reform | — | — | — | 2 | — | 2 | ||||||||||||||||||||||||||||||||
Pre-tax adjusted income (loss) from operations | $ | 380 | $ | 3,502 | $ | 735 | $ | 529 | $ | (403) | $ | 4,743 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||||||||||||||
Products (Pharmacy revenues) (ASC 606) | ||||||||||||||||||||||||||||||||
Network revenues | $ | 53,574 | $ | 50,431 | $ | 1,415 | ||||||||||||||||||||||||||
Home delivery and specialty revenues | 48,792 | 47,768 | 3,997 | |||||||||||||||||||||||||||||
Other | 5,403 | 4,900 | 67 | |||||||||||||||||||||||||||||
Total pharmacy revenues | $ | 107,769 | $ | 103,099 | $ | 5,479 | ||||||||||||||||||||||||||
Insurance premiums (ASC 944) | ||||||||||||||||||||||||||||||||
U.S. Medical premiums
|
||||||||||||||||||||||||||||||||
U.S. Commercial
|
||||||||||||||||||||||||||||||||
Health Insurance | 13,389 | 12,523 | 10,710 | |||||||||||||||||||||||||||||
Stop loss | 4,614 | 4,328 | 4,008 | |||||||||||||||||||||||||||||
Other | 1,135 | 1,040 | 1,038 | |||||||||||||||||||||||||||||
U.S. Government
|
||||||||||||||||||||||||||||||||
Medicare Advantage | 7,565 | 6,314 | 5,832 | |||||||||||||||||||||||||||||
Medicare Part D | 1,593 | 1,699 | 764 | |||||||||||||||||||||||||||||
Other | 4,301 | 4,185 | 4,496 | |||||||||||||||||||||||||||||
Total U.S. Medical premiums
|
32,597 | 30,089 | 26,848 | |||||||||||||||||||||||||||||
International Markets premiums
|
5,511 | 5,266 | 5,043 | |||||||||||||||||||||||||||||
Domestic disability, life and accident premiums | 4,423 | 4,225 | 4,000 | |||||||||||||||||||||||||||||
Other premiums | 96 | 134 | 222 | |||||||||||||||||||||||||||||
Total premiums | 42,627 | 39,714 | 36,113 | |||||||||||||||||||||||||||||
Services (ASC 606) | ||||||||||||||||||||||||||||||||
Fees | 8,532 | 9,229 | 5,558 | |||||||||||||||||||||||||||||
Other external revenues | 229 | 134 | 20 | |||||||||||||||||||||||||||||
Total services | 8,761 | 9,363 | 5,578 | |||||||||||||||||||||||||||||
Total revenues from external customers | $ | 159,157 | $ | 152,176 | $ | 47,170 |
(In millions) | 2020 | 2019 | 2018 | |||||||||||||||||
United States | $ | 154,042 | $ | 147,332 | $ | 42,773 | ||||||||||||||
South Korea | 2,123 | 2,022 | 2,093 | |||||||||||||||||
All other foreign countries | 2,992 | 2,822 | 2,304 | |||||||||||||||||
Total | $ | 159,157 | $ | 152,176 | $ | 47,170 |
4.3(f) | Filed by CHC as Exhibit 99.2 to the Current Report on Form 8-K on December 9, 2010 and incorporated herein by reference. | |||||||
4.3(g) | Filed by CHC as Exhibit 99.2 to the Current Report on Form 8-K on March 8, 2011 and incorporated herein by reference. | |||||||
4.3(h) | Filed by CHC as Exhibit 4.1 to the Current Report on Form 8-K on November 14, 2011 and incorporated herein by reference. | |||||||
4.3(i) | Filed by CHC as Exhibit 4.1 to the Current Report on Form 8-K on March 26, 2015 and incorporated herein by reference. | |||||||
4.3(j) | Filed by CHC as Exhibit 4.1 to the Current Report on Form 8-K filed September 14, 2017 and incorporated herein by reference. | |||||||
4.3(k) | Filed by the registrant as Exhibit 4.1 to the Current Report on Form 8-K on December 20, 2018 and incorporated herein by reference. | |||||||
4.3(l) | Filed by the registrant as Exhibit 4.3 to the Current Report on Form 8-K on October 11, 2019 and incorporated herein by reference. | |||||||
4.4(a) | Filed by CHC as Exhibit 4.2 to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | |||||||
4.4(b) | Filed by the registrant as Exhibit 4.2 to the Current Report on Form 8-K on December 20, 2018 and incorporated herein by reference. | |||||||
4.4(c) | Filed by the registrant as Exhibit 4.4 to the Current Report on Form 8-K on October 11, 2019 and incorporated herein by reference. | |||||||
4.5(a) | Filed by CHC as Exhibit 4.3 to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | |||||||
4.5(b) | Filed by the registrant as Exhibit 4.3 to the Current Report on Form 8-K on December 20, 2018 and incorporated herein by reference. | |||||||
4.6(a) | Filed by Express Scripts, Inc. (“ESI”) as Exhibit 4.1 to the Current Report on Form 8-K filed November 25, 2011 and incorporated herein by reference. | |||||||
4.6(b) | Filed by ESI as Exhibit 4.4 to the Current Report on Form 8-K on November 25, 2011 and incorporated herein by reference. | |||||||
4.6(c) | Filed by ESI as Exhibit 4.5 to the Current Report on Form 8-K on November 25, 2011 and incorporated herein by reference. | |||||||
4.6(d) | Filed by ESI as Exhibit 4.3 to the Current Report on Form 8-K filed February 10, 2012 and incorporated herein by reference. |
4.6(e) | Filed by Express Scripts Holding Company (“ESRX”) as Exhibit 4.1 to the Current Report on Form 8-K on April 6, 2012 and incorporated herein by reference. | |||||||
4.6(f) | Filed by ESRX as Exhibit 4.1 to the Current Report on Form 8-K on June 5, 2014 and incorporated herein by reference. | |||||||
4.6(g) | Filed by ESRX as Exhibit 4.2 to the Current Report on Form 8-K on June 5, 2014 and incorporated herein by reference. | |||||||
4.6(h) | Filed by ESRX as Exhibit 4.3 to the Current Report on Form 8-K on June 5, 2014 and incorporated herein by reference. | |||||||
4.6(i) | Filed by ESRX as Exhibit 4.1 to the Current Report on Form 8-K on February 25, 2016 and incorporated herein by reference. | |||||||
4.6(j) | Filed by ESRX as Exhibit 4.2 to the Current Report on Form 8-K on February 25, 2016 and incorporated herein by reference. | |||||||
4.6(k) | Filed by ESRX as Exhibit 4.1 to the Current Report on Form 8-K on July 5, 2016 and incorporated herein by reference. | |||||||
4.6(l) | Filed by ESRX as Exhibit 4.2 to the Current Report on Form 8-K on July 5, 2016 and incorporated herein by reference. | |||||||
4.6(m) | Filed by ESRX as Exhibit 4.3 to the Current Report on Form 8-K on July 5, 2016 and incorporated herein by reference. | |||||||
4.6(n) | Filed by ESRX as Exhibit 4.1 to the Current Report on Form 8-K on November 30, 2017 and incorporated herein by reference. | |||||||
4.6(o) | Filed by ESRX as Exhibit 4.2 to the Current Report on Form 8-K on November 30, 2017 and incorporated herein by reference. | |||||||
4.6(p) | Filed by ESRX as Exhibit 4.3 to the Current Report on Form 8-K on November 30, 2017 and incorporated herein by reference. | |||||||
4.6(q) | Filed by the registrant as Exhibit 4.4 to the Current Report on Form 8-K on December 20, 2018 and incorporated herein by reference. | |||||||
4.6(r) | Filed by the registrant as Exhibit 4.5 to the Current Report on Form 8-K on October 11, 2019 and incorporated herein by reference. | |||||||
4.7(a) | Filed by ESI as Exhibit 4.1 to the Current Report on Form 8-K on June 10, 2009 and incorporated herein by reference. | |||||||
4.7(b) | Filed by ESI as Exhibit 4.4 to the Current Report on Form 8-K on June 10, 2009 and incorporated herein by reference. |
10.1(a) | Filed by the registrant as Exhibit 10.1 to the Current Report on Form 8-K on May 1, 2017 and incorporated herein by reference. | |||||||
10.1(b) | Filed by CHC as Exhibit 10.3 to the Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2018 and incorporated herein by reference. | |||||||
10.1(c) | Filed by CHC as Exhibit 10.21 to Form 10-K for the year ended December 31, 2011 and incorporated herein by reference. | |||||||
10.1(d) | Filed by CHC as Exhibit 10.2 to Form 10-Q for the period ended March 31, 2014 and incorporated herein by | |||||||
10.1(e) | Filed by CHC as Exhibit 10.3 to Form 10-Q for the period ended March 31, 2015 and incorporated herein by | |||||||
10.1(f) | Filed by CHC as Exhibit 10.3 to Form 10-Q for the period ended March 31, 2017 and incorporated herein by reference. | |||||||
10.1(g) | Filed by CHC as Exhibit 10.4 to Quarterly Report on Form 10-Q for the period ended March 31, 2018 and incorporated herein by reference. | |||||||
10.1(h) | Filed by CHC as Exhibit 10.6 to Quarterly Report on Form 10-Q for the period ended March 31, 2018 and incorporated herein by reference | |||||||
10.1(i) | Filed by CHC as Exhibit 10.5 to Quarterly Report on Form 10-Q for the period ended March 31, 2018 and incorporated herein by reference. | |||||||
10.1(j) | Filed by the registrant as Exhibit 10.1 to Quarterly Report on Form 10-Q for the period ended March 31, 2019 and incorporated herein by reference. | |||||||
10.1(k) |
|
Filed by the registrant as Exhibit 10.2 to Quarterly Report on Form 10-Q for the period ended March 31, 2019 and incorporated herein by reference. |
10.6(a) | Filed by the registrant as Exhibit 4.11 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. | |||||||
10.6(b) | Filed by Medco as Exhibit 10.2 to the Current Report on Form 8-K on February 8, 2005 and incorporated herein by reference. | |||||||
10.7 | Filed by the registrant as Exhibit 4.12 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. | |||||||
10.8 |
|
Filed by CHC as Exhibit 10.1 the Annual Report on Form 10-K for the year ended December 31, 2011 and incorporated herein by reference. | ||||||
10.9 |
|
Filed by CHC as Exhibit 10.14 to the Annual Report on Form 10-K for the year ended December 31, 2011 and incorporated herein by reference. | ||||||
10.10 | Filed by the registrant as Exhibit 4.6 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. | |||||||
10.11 | Filed by ESI as Exhibit No. 10.1 to the Current Report on Form 8-K on May 25, 2007 and incorporated herein by reference. | |||||||
10.12(a) | Filed by the registrant as Exhibit 4.13 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. | |||||||
10.12(b) |
Filed by the registrant as Exhibit 10.12(b) to the Annual Report on Form 10-K for the year ended December 31, 2019 and incorporated herein by reference.
|
|||||||
10.13(a) | Filed by CHC as Exhibit 10.15(a) to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | |||||||
10.13(b) | Filed by CHC as Exhibit 10.15(b) to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | |||||||
10.13(c) | Filed by CHC as Exhibit 10.16(c) to the Annual Report on Form 10-K for the year ended December 31, 2011 and incorporated herein by reference. | |||||||
10.14(a) | Filed by CHC as Exhibit 10.15 to the Annual Report on Form 10-K for the year ended December 31, 2007 and incorporated herein by reference. | |||||||
10.14(b) | Filed by CHC as Exhibit 10.1 to the Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2009 and incorporated herein by reference. | |||||||
10.15(a) | Filed by the registrant as Exhibit 4.7 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. |
10.15(b) |
Filed by the registrant as Exhibit 10.15(b) to the Annual Report on Form 10-K for the year ended December 31, 2019 and incorporated herein by reference.
|
|||||||
10.15(c) |
Filed by the registrant as Exhibit 10.15(c) to the Annual Report on Form 10-K for the year ended December 31, 2019 and incorporated herein by reference.
|
|||||||
10.15(d) |
Filed by the registrant as Exhibit 10.15(d) to the Annual Report on Form 10-K for the year ended December 31, 2019 and incorporated herein by reference.
|
|||||||
10.16 |
|
Filed by CHC as Exhibit 10.1 to the Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2014 and incorporated herein by reference. | ||||||
10.17 |
|
Filed by the registrant as Exhibit 10.18 to the Annual Report on Form 10-K for the year ended December 31, 2018 and incorporated herein by reference. | ||||||
10.18 | Filed herewith. | |||||||
10.19 | Filed by CHC as Exhibit 10.4 to the Annual Report on Form 10-K for the year ended December 31, 2012 and incorporated herein by reference. | |||||||
10.20 | Filed by the registrant as Exhibit 4.8 to the Registration Statement on Form S-8 (No. 333- 228930) on December 20, 2018 and incorporated herein by reference. | |||||||
10.21 | Filed by ESRX as Exhibit 10.1 to the Current Report on Form 8-K on March 5, 2014 and incorporated herein by reference. | |||||||
10.22 |
Filed by the registrant as Exhibit 10.1 to the Current Report on Form 8-K on October 30, 2020 and incorporated herein by reference.
|
|||||||
10.23 |
|
Filed by CHC as Exhibit 10.10 to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | ||||||
10.24 | Filed by CHC as Exhibit 10.1 to the Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2012 and incorporated herein by reference. | |||||||
10.25 | Filed by CHC as Exhibit 10.18 to the Annual Report on Form 10-K for the year ended December 31, 2009 and incorporated herein by reference. | |||||||
10.26 | Filed by CHC as Exhibit 10.1 to the Current Report on Form 8-K on June 19, 2017 and incorporated herein by reference. | |||||||
10.27 | Filed by CHC as Exhibit 10.2 to the Quarterly Report on Form 10-Q for the period ended March 31, 2012 and incorporated herein by reference. |
10.28 | Filed by CHC as Exhibit 10.1(a) to the Quarterly Report on Form 10-Q for the period ended March 31, 2015 and incorporated herein by reference. | |||||||
10.29 | Filed by CHC as Exhibit 10.1(b) to the Quarterly Report on Form 10-Q for the period ended March 31, 2015 and incorporated herein by reference. | |||||||
10.30 |
|
Filed by the registrant as Exhibit 10.1 to Amendment No. 1 to the Registration Statement on Form S-4 (No. 333-224960) on June 20, 2018 and incorporated herein by reference. | ||||||
10.31 | Filed by ESRX as Exhibit 10.1 to the Current Report on Form 8-K on May 4, 2016 and incorporated herein by reference. | |||||||
10.32 | Filed by CHC as Exhibit 10.20 to the Annual Report on Form 10-K for the year ended December 31, 2008 and incorporated herein by reference. | |||||||
10.33 | Filed by the registrant as Exhibit 10.34 to the Annual Report on Form 10-K for the year ended December 31, 2018 and incorporated herein by reference. | |||||||
10.34 | Filed by CHC as Exhibit 10.1 to the Current Report on Form 8-K on October 18, 2017 and incorporated herein by reference. | |||||||
10.35 | Filed herewith. | |||||||
10.36 | Filed herewith. | |||||||
10.37 | Filed herewith. | |||||||
10.38 | Filed by CHC as Exhibit 10.1 to Current Report on Form 8-K on April 12, 2018 and incorporated herein by reference. | |||||||
10.39
|
Master Transaction Agreement, dated February 4, 2013 among Connecticut General Life Insurance Company, Berkshire Hathaway Life Insurance Company of Nebraska and, solely for purposes of Sections 3.10, 6.1, 6.3, 6.4, 6.6, 6.9 and Articles II, V, VII and VIII, thereof, National Indemnity Company (including the Forms of Retrocession Agreement, the Collateral Trust Agreement, the Security and Control Agreement, the Surety Policy and the ALC Model Purchase Option Agreement as exhibits)
|
Filed by CHC as Exhibit 10.29 to the Annual Report on Form 10-K for the year ended December 31, 2012 and incorporated herein by reference. | ||||||
21 | Filed herewith. | |||||||
23 | Filed herewith. | |||||||
31.1 | Filed herewith. | |||||||
31.2 | Filed herewith. | |||||||
32.1 | Furnished herewith. | |||||||
32.2 | Furnished herewith. |
101 | The following materials from Cigna Corporation’s Annual Report on Form 10-K for the year ended December 31, 2020, formatted in inline XBRL (Extensible Business Reporting Language): (i) the Consolidated Balance Sheets; (ii) the Consolidated Statements of Income; (iii) the Consolidated Statements of Comprehensive Income; (iv) the Consolidated Statements of Cash Flows; (v) the Consolidated Statements of Changes in Total Equity; (vi) the Notes to Consolidated Financial Statements; and (vii) Financial Statement Schedules I and II. | Filed herewith. | ||||||
104 | Cover Page Interactive Data File (formatted as inline XBRL and contained in Exhibit 101) | Filed herewith. |
CIGNA CORPORATION | |||||||||||
|
|||||||||||
By: | /s/ Brian C. Evanko | ||||||||||
Brian C. Evanko | |||||||||||
Executive Vice President and
Chief Financial Officer |
|||||||||||
(Principal Financial Officer) | |||||||||||
Signature | Title | |||||||
/s/ David M. Cordani | ||||||||
David M. Cordani |
Chief Executive Officer and Director
(Principal Executive Officer) |
|||||||
/s/ Brian C. Evanko | ||||||||
Brian C. Evanko |
Executive Vice President and Chief Financial Officer
(Principal Financial Officer) |
|||||||
/s/ Mary T. Agoglia Hoeltzel | ||||||||
Mary T. Agoglia Hoeltzel |
Senior Vice President, Tax and Chief Accounting Officer
(Principal Accounting Officer) |
|||||||
/s/ William J. DeLaney | ||||||||
William J. DeLaney |
Director
|
|||||||
/s/ Eric J. Foss | ||||||||
Eric J. Foss | Director | |||||||
/s/ Elder Granger, M.D. | ||||||||
Elder Granger, M.D. | Director | |||||||
/s/ Isaiah Harris, Jr. | ||||||||
Isaiah Harris, Jr.
|
Chairman of the Board
|
/s/ Kathleen M. Mazzarella | ||||||||
Kathleen M. Mazzarella |
Director
|
|||||||
/s/ Mark McClellan, M.D. | ||||||||
Mark McClellan, M.D. |
Director
|
|||||||
/s/ John M. Partridge | ||||||||
John M. Partridge |
Director
|
|||||||
/s/ William L. Roper, M.D. | ||||||||
William L. Roper, M.D. |
Director
|
|||||||
/s/ Kimberly A. Ross | ||||||||
Kimberly A. Ross |
Director
|
|||||||
/s/ Eric C. Wiseman | ||||||||
Eric C. Wiseman
|
Director
|
|||||||
/s/ Donna F. Zarcone | ||||||||
Donna F. Zarcone
|
Director
|
PAGE | |||||||||||
Report of Independent Registered Public Accounting Firm on Financial Statement Schedules | FS-2 | ||||||||||
Schedules | |||||||||||
I | Condensed Financial Information of Cigna Corporation (Registrant) | FS-3 | |||||||||
Statements of Income for the Years Ended December 31, 2020, 2019 and 2018
|
FS-3 | ||||||||||
Balance Sheets as of December 31, 2020 and 2019 | FS-4 | ||||||||||
Statements of Cash Flows for the Years Ended December 31, 2020, 2019 and 2018
|
FS-5 | ||||||||||
Notes to Condensed Financial Statements | FS-6 | ||||||||||
II |
Valuation and Qualifying Accounts for the Years Ended December 31, 2020, 2019 and 2018
|
FS-8 |
For the years ended | ||||||||||||||||||||
December 31, | ||||||||||||||||||||
Cigna | Cigna | Cigna | ||||||||||||||||||
(in millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Revenues | ||||||||||||||||||||
Net investment income | $ | 1 | $ | — | $ | 123 | ||||||||||||||
Intercompany interest income | 475 | 6 | — | |||||||||||||||||
Total revenues | 476 | 6 | 123 | |||||||||||||||||
Operating expenses | ||||||||||||||||||||
Selling, general and administrative expenses | 4 | (85) | 200 | |||||||||||||||||
Total operating expenses | 4 | (85) | 200 | |||||||||||||||||
Income (loss) from operations | 472 | 91 | (77) | |||||||||||||||||
Interest and other (expense) | (1,324) | (1,032) | (244) | |||||||||||||||||
Intercompany interest (expense) | (48) | (127) | (5) | |||||||||||||||||
Debt extinguishment costs | (171) | — | — | |||||||||||||||||
Realized investment (loss) | — | — | (1) | |||||||||||||||||
Loss before taxes | (1,071) | (1,068) | (327) | |||||||||||||||||
Income tax (benefit) | (234) | (251) | (74) | |||||||||||||||||
Loss of Parent Company | (837) | (817) | (253) | |||||||||||||||||
Equity in income of subsidiaries | 9,295 | 5,921 | 2,890 | |||||||||||||||||
Shareholders' net income | 8,458 | 5,104 | 2,637 | |||||||||||||||||
Shareholders' other comprehensive income (loss), net of tax | ||||||||||||||||||||
Net unrealized appreciation (depreciation) on securities and derivatives | (75) | 957 | (365) | |||||||||||||||||
Net translation (losses) gains of foreign currencies | 260 | (54) | (152) | |||||||||||||||||
Postretirement benefits liability adjustment | (105) | (133) | 127 | |||||||||||||||||
Shareholders' other comprehensive income (loss), net of tax | 80 | 770 | (390) | |||||||||||||||||
Shareholders' comprehensive income | $ | 8,538 | $ | 5,874 | $ | 2,247 | ||||||||||||||
As of December 31, | ||||||||||||||
(in millions) | 2020 | 2019 | ||||||||||||
Assets | ||||||||||||||
Cash and cash equivalents | $ | 4,157 | $ | — | ||||||||||
Short-term investments | 49 | 30 | ||||||||||||
Other current assets | 4 | 4 | ||||||||||||
Total current assets | 4,210 | 34 | ||||||||||||
Intercompany receivable | 1,666 | 4,111 | ||||||||||||
Investments in subsidiaries | 76,040 | 77,380 | ||||||||||||
Other noncurrent assets | 22 | 19 | ||||||||||||
TOTAL ASSETS | $ | 81,938 | $ | 81,544 | ||||||||||
Liabilities | ||||||||||||||
Short-term debt | $ | 3,278 | $ | 4,043 | ||||||||||
Other current liabilities | 616 | 457 | ||||||||||||
Total current liabilities | 3,894 | 4,500 | ||||||||||||
Intercompany payable | 5 | 2,341 | ||||||||||||
Long-term debt | 27,718 | 29,365 | ||||||||||||
TOTAL LIABILITIES | 31,617 | 36,206 | ||||||||||||
Shareholders’ Equity | ||||||||||||||
Common stock (shares issued, 390 and 386; authorized, 600)
|
4 | 4 | ||||||||||||
Additional paid-in capital | 28,975 | 28,306 | ||||||||||||
Accumulated other comprehensive loss | (861) | (941) | ||||||||||||
Retained earnings | 28,575 | 20,162 | ||||||||||||
Less treasury stock, at cost | (6,372) | (2,193) | ||||||||||||
TOTAL SHAREHOLDERS’ EQUITY | 50,321 | 45,338 | ||||||||||||
TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY | $ | 81,938 | $ | 81,544 |
For the years ended | ||||||||||||||||||||
December 31, | ||||||||||||||||||||
Cigna | Cigna | Cigna | ||||||||||||||||||
(in millions) | 2020 | 2019 | 2018 | |||||||||||||||||
Cash Flows from Operating Activities | ||||||||||||||||||||
Shareholders’ net income | $ | 8,458 | $ | 5,104 | $ | 2,637 | ||||||||||||||
Adjustments to reconcile shareholders’ net income | ||||||||||||||||||||
to net cash provided by operating activities | ||||||||||||||||||||
Equity in income of subsidiaries | (9,295) | (5,921) | (2,890) | |||||||||||||||||
Debt extinguishment costs | 171 | — | — | |||||||||||||||||
Dividends received from subsidiaries | 8,627 | 2,457 | — | |||||||||||||||||
Other liabilities | 112 | 43 | 412 | |||||||||||||||||
Other, net | 500 | 20 | (14) | |||||||||||||||||
NET CASH PROVIDED BY OPERATING ACTIVITIES | 8,573 | 1,703 | 145 | |||||||||||||||||
Cash Flows from Investing Activities | ||||||||||||||||||||
Net change in loans due to (from) affiliates | (265) | — | — | |||||||||||||||||
Short-term investment purchased, net | (19) | (30) | — | |||||||||||||||||
Other, net | — | — | (27,115) | |||||||||||||||||
NET CASH (USED IN) INVESTING ACTIVITIES | (284) | (30) | (27,115) | |||||||||||||||||
Cash Flows from Financing Activities | ||||||||||||||||||||
Net change in amounts due to affiliates | 2,262 | 2,015 | 4,437 | |||||||||||||||||
Proceeds on issuance of commercial paper | 86 | 944 | — | |||||||||||||||||
Payments for debt extinguishment | (181) | — | — | |||||||||||||||||
Repayment of long-term debt | (5,996) | (3,002) | — | |||||||||||||||||
Net proceeds on issuance of long-term debt | 3,465 | — | 22,856 | |||||||||||||||||
Issuance of common stock | 376 | 224 | 1 | |||||||||||||||||
Common dividends paid | (15) | (15) | — | |||||||||||||||||
Repurchase of common stock | (4,042) | (1,987) | (32) | |||||||||||||||||
Tax withholding on stock compensation and other | (87) | (82) | (49) | |||||||||||||||||
Other | — | (13) | — | |||||||||||||||||
NET CASH (USED IN) PROVIDED BY FINANCING ACTIVITIES | (4,132) | (1,916) | 27,213 | |||||||||||||||||
Net increase (decrease) in cash and cash equivalents | 4,157 | (243) | 243 | |||||||||||||||||
Cash and cash equivalents, beginning of year | — | 243 | — | |||||||||||||||||
Cash and cash equivalents, end of year | 4,157 | — | 243 | |||||||||||||||||
Principal | Maturity Date | Interest Rate | Net Proceeds | |||||||||||||||||
$1,500 million | March 15, 2030 | 2.4% | $1,491 million | |||||||||||||||||
$750 million | March 15, 2040 | 3.2% | $743 million | |||||||||||||||||
$1,250 million | March 15, 2050 | 3.4% | $1,237 million |
(in millions) | ||||||||
2021 | $ | 2,250 | ||||||
2022 | $ | 1,378 | ||||||
2023 | $ | 3,754 | ||||||
2024 | $ | 714 | ||||||
2025 | $ | 2,957 | ||||||
Maturities after 2025 | $ | 19,182 | ||||||
(in millions) | Balance at beginning of year | Charged (Credited) to costs and expenses | Charged (Credited) to other accounts | Other deductions | Balance at end of year | |||||||||||||||||||||||||||
Description | ||||||||||||||||||||||||||||||||
2020 | ||||||||||||||||||||||||||||||||
Investment asset valuation reserves | ||||||||||||||||||||||||||||||||
Available-for-sale debt securities | $ | — | $ | 82 | $ | — | $ | (56) | $ | 26 | ||||||||||||||||||||||
Accounts receivable, net | $ | 252 | $ | (50) | $ | (12) | $ | (34) | $ | 156 | ||||||||||||||||||||||
Deferred tax asset valuation allowance | $ | 196 | $ | 10 | $ | 1 | $ | — | $ | 207 | ||||||||||||||||||||||
Reinsurance recoverables (1)
|
$ | 2 | $ | (1) | $ | 31 | $ | — | $ | 32 | ||||||||||||||||||||||
2019 | ||||||||||||||||||||||||||||||||
Accounts receivable, net | $ | 217 | $ | 51 | $ | — | $ | (16) | $ | 252 | ||||||||||||||||||||||
Deferred tax asset valuation allowance | $ | 199 | $ | (6) | $ | 3 | $ | — | $ | 196 | ||||||||||||||||||||||
Reinsurance recoverables | $ | 2 | $ | — | $ | — | $ | — | $ | 2 | ||||||||||||||||||||||
2018 | ||||||||||||||||||||||||||||||||
Accounts receivable, net | $ | 207 | $ | 18 | $ | (3) | $ | (5) | $ | 217 | ||||||||||||||||||||||
Deferred tax asset valuation allowance (2)
|
$ | 72 | $ | (5) | $ | 132 | $ | — | $ | 199 | ||||||||||||||||||||||
Reinsurance recoverables | $ | 3 | $ | (1) | $ | — | $ | — | $ | 2 |
Entity Name | Jurisdiction | ||||
Accredo Health Group, Inc. | Delaware | ||||
Accredo Health, Incorporated | Delaware | ||||
Allegiance Life & Health Insurance Company | Montana | ||||
American Retirement Life Insurance Company | Ohio | ||||
Bravo Health Mid-Atlantic, Inc. | Maryland | ||||
Bravo Health Pennsylvania, Inc. | Pennsylvania | ||||
Care Continuum, Inc. | Kentucky | ||||
CareCore National, LLC | New York | ||||
CareCore NJ, LLC | New Jersey | ||||
Chiro Alliance Corporation | Florida | ||||
Cigna & CMB Life Insurance Company Limited | China | ||||
Cigna Arbor Life Insurance Company | Connecticut | ||||
Cigna Brokerage & Marketing (Thailand) Limited | Thailand | ||||
Cigna Dental Health Of California, Inc. | California | ||||
Cigna Dental Health Of Colorado, Inc. | Colorado | ||||
Cigna Dental Health Of Delaware, Inc. | Delaware | ||||
Cigna Dental Health Of Florida, Inc. | Florida | ||||
Cigna Dental Health of Illinois, Inc. | Illinois | ||||
Cigna Dental Health Of Kansas, Inc. | Kansas | ||||
Cigna Dental Health Of Kentucky, Inc. | Kentucky | ||||
Cigna Dental Health Of Maryland, Inc. | Maryland | ||||
Cigna Dental Health Of Missouri, Inc. | Missouri | ||||
Cigna Dental Health Of New Jersey, Inc. | New Jersey | ||||
Cigna Dental Health Of North Carolina, Inc. | North Carolina | ||||
Cigna Dental Health Of Ohio, Inc. | Ohio | ||||
Cigna Dental Health Of Pennsylvania, Inc. | Pennsylvania | ||||
Cigna Dental Health Of Texas, Inc. | Texas | ||||
Cigna Dental Health Of Virginia, Inc. | Virginia | ||||
Cigna Dental Health Plan Of Arizona, Inc. | Arizona | ||||
Cigna Europe Insurance Company S.A.-N.V. | Belgium | ||||
Cigna Global Insurance Company Limited | Guernsey | ||||
Cigna Global Reinsurance Company, Ltd. | Bermuda | ||||
Cigna Health and Life Insurance Company | Connecticut | ||||
Cigna HealthCare Mid-Atlantic, Inc. | Maryland | ||||
Cigna HealthCare of Arizona, Inc. | Arizona | ||||
Cigna HealthCare of California, Inc. | California |
Cigna HealthCare of Colorado, Inc. | Colorado | ||||
Cigna HealthCare of Connecticut, Inc. | Connecticut | ||||
Cigna HealthCare of Florida, Inc. | Florida | ||||
Cigna HealthCare of Georgia, Inc. | Georgia | ||||
Cigna HealthCare of Illinois, Inc. | Illinois | ||||
Cigna HealthCare of Indiana, Inc. | Indiana | ||||
Cigna HealthCare of Maine, Inc. | Maine | ||||
Cigna HealthCare of Massachusetts, Inc. | Massachusetts | ||||
Cigna HealthCare of New Hampshire, Inc. | New Hampshire | ||||
Cigna HealthCare of New Jersey, Inc. | New Jersey | ||||
Cigna HealthCare of North Carolina, Inc. | North Carolina | ||||
Cigna HealthCare of Pennsylvania, Inc. | Pennsylvania | ||||
Cigna HealthCare of South Carolina, Inc. | South Carolina | ||||
Cigna HealthCare of St. Louis, Inc. | Missouri | ||||
Cigna HealthCare of Tennessee, Inc. | Tennessee | ||||
Cigna HealthCare of Texas, Inc. | Texas | ||||
Cigna HealthCare of Utah, Inc. | Utah | ||||
Cigna Holding Company | Delaware | ||||
Cigna Holdings, Inc. | Delaware | ||||
Cigna Insurance Middle East S.A.L. | Lebanon | ||||
Cigna Insurance Public Company Limited | Thailand | ||||
Cigna Insurance Services (Europe) Limited | United Kingdom | ||||
Cigna Life Insurance Company of Canada | Canada | ||||
Cigna Life Insurance Company of Europe S.A.-N.V. | Belgium | ||||
Cigna Life Insurance New Zealand Limited | New Zealand | ||||
Cigna National Health Insurance Company | Ohio | ||||
Cigna Saglik Hayat ve Emeklilik A.S. | Turkey | ||||
Cigna Taiwan Life Assurance Company Limited | Taiwan | ||||
Cigna Worldwide Life Insurance Company Limited | Hong Kong | ||||
Connecticut General Corporation | Connecticut | ||||
Connecticut General Life Insurance Company | Connecticut | ||||
CuraScript, Inc. | Delaware | ||||
ESI Mail Pharmacy Service, Inc. | Delaware | ||||
Evernorth Health, Inc. | Delaware | ||||
eviCore healthcare MSI, LLC | Tennessee | ||||
Express Reinsurance Company | Missouri | ||||
Express Scripts Administrators LLC | Delaware | ||||
Express Scripts Pharmaceutical Procurement, LLC | Delaware | ||||
Express Scripts Strategic Development, Inc. | New Jersey | ||||
Express Scripts Utilization Management Company | Delaware | ||||
Express Scripts, Inc. | Delaware | ||||
HealthSpring Life & Health Insurance Company, Inc. | Texas | ||||
HealthSpring of Florida, Inc. | Florida |
Inside RX, LLC | Delaware | ||||
LINA Life Insurance Company of Korea | South Korea | ||||
Loyal American Life Insurance Company | Ohio | ||||
ManipalCigna Health Insurance Company Limited | India | ||||
Matrix Healthcare Services, Inc. | Florida | ||||
Medco Containment Insurance Company of NY | New York | ||||
Medco Containment Life Insurance Company | Pennsylvania | ||||
Medco Health Services, Inc. | Delaware | ||||
Medco Health Solutions, Inc. | Delaware | ||||
MSI Health Organization of Texas, Inc. | Texas | ||||
Provident American Life & Health Insurance Company | Ohio | ||||
PT Asuransi Cigna | Indonesia | ||||
Sterling Life Insurance Company | Illinois | ||||
Temple Insurance Company Limited | Bermuda | ||||
United Benefit Life Insurance Company | Ohio |
Date: February 25, 2021
|
/s/ David M. Cordani | ||||
Chief Executive Officer |
Date: February 25, 2021
|
/s/ Brian C. Evanko | ||||
Chief Financial Officer |
/s/ David M. Cordani | ||
David M. Cordani | ||
Chief Executive Officer | ||
February 25, 2021
|
/s/ Brian C. Evanko | ||
Brian C. Evanko | ||
Chief Financial Officer | ||
February 25, 2021
|