Item 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

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Item 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

Report of Independent Registered Public Accounting Firm

To the Board of Directors and Shareholders of Cigna Corporation

Opinions on the Financial Statements and Internal Control over Financial Reporting

We have audited the accompanying consolidated balance sheets of Cigna Corporation and its subsidiaries (the "Company") as of December 31, 2021 and 2020, and the related consolidated statements of income, comprehensive income, changes in total equity and cash flows for each of the three years in the period ended December 31, 2021, including the related notes (collectively referred to as the "consolidated financial statements"). We also have audited the Company's internal control over financial reporting as of December 31, 2021, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2021 and 2020, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2021 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2021, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.

Basis for Opinions

The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in Management's Annual Report on Internal Control over Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company's consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.

Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.

Definition and Limitations of Internal Control over Financial Reporting

A company's internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company's internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company's assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Critical Audit Matters

The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.

Goodwill Impairment Assessment - Evernorth and U.S. Government Reporting Units

As described in Note 18 to the consolidated financial statements, as of December 31, 2021, goodwill is primarily reported in the Evernorth segment ($35.1 billion) and the Cigna Healthcare segment ($10.7 billion), of which a portion of the goodwill balance for the Cigna Healthcare segment relates to the U.S. Government reporting unit. Management conducts its annual quantitative evaluation for goodwill impairment during the third quarter at the reporting unit level and writes it down through shareholders' net income if impaired. On a quarterly basis, management performs a qualitative impairment assessment 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. Fair value of a reporting unit is generally estimated based on both a discounted cash flow analysis and a market approach using assumptions that management believes a hypothetical market participant would use to determine a current transaction price. The significant assumptions and estimates used in determining fair value primarily 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. Future cash flows for Evernorth are primarily driven by the forecasted gross margins of the business, as well as operating expenses and long-term growth rates. Future cash flows for the U.S. Government reporting unit is primarily driven by forecasted revenues, benefit expenses, operating expenses and long-term growth rates.

The principal considerations for our determination that performing procedures relating to the goodwill impairment assessment of the Evernorth and the U.S. Government reporting units is a critical audit matter are the significant judgment by management when estimating the fair value of the reporting units. This in turn led to a high degree of auditor judgment, subjectivity, and effort in performing procedures and evaluating management's estimate of the reporting units' fair value determined using significant assumptions related to the discount rate, forecasted gross margins, and long-term growth rates for the Evernorth reporting unit and the discount rate, forecasted revenues, benefit expenses, operating expenses, and long-term growth rates for the U.S. Government reporting unit (collectively referred to as the "significant assumptions"). In addition, the audit effort involved the use of professionals with specialized skill and knowledge.

Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to management's goodwill impairment assessment, including controls over management's methodology, inputs and assumptions used in its goodwill impairment assessment of the Evernorth and the U.S. Government reporting units. These procedures also included, among others (i) testing management's process for determining the fair value estimate of the reporting units; (ii) evaluating the appropriateness of the discounted cash flow analysis and market approach; (iii) testing the completeness and accuracy of underlying data used in the discounted cash flow analysis and market approach and (iv) evaluating the reasonableness of the significant assumptions. Evaluating the reasonableness of the significant assumptions involved consideration of (i) the current and past performance of the reporting units; (ii) the consistency with external market and industry data; and (iii) whether these assumptions were consistent with evidence obtained in other areas of the audit, as applicable. Professionals with specialized skill and knowledge were used to assist in the evaluation of the reasonableness of the discount rate and long-term growth rate significant assumptions.

/s/ PricewaterhouseCoopers LLP

Hartford, Connecticut

February 24, 2022

We have served as the Company's auditor since 1983.


Cigna Corporation Consolidated Statements of Income

	For the Years Ended December 31,
(In millions, except per share amounts)		2021		2020		2019
Revenues
Pharmacy revenues		$	121,413	$	107,769	$	103,099
Premiums		41,154		42,627		39,714
Fees and other revenues		9,962		8,761		9,363
Net investment income		1,549		1,244		1,390
TOTAL REVENUES		174,078		160,401		153,566
Benefits and expenses
Pharmacy and other service costs		117,553		103,484		97,668
Medical costs and other benefit expenses		33,562		32,710		30,819
Selling, general and administrative expenses		13,030		14,072		14,053
Amortization of acquired intangible assets		1,998		1,982		2,949
TOTAL BENEFITS AND EXPENSES		166,143		152,248		145,489
Income from operations		7,935		8,153		8,077
Interest expense and other		(1,208)		(1,438)		(1,682)
Debt extinguishment costs		(141)		(199)		(2)
Gain (loss) on sale of business		—		4,203		—
Net realized investment gains (losses)		196		149		177
Income before income taxes		6,782		10,868		6,570
TOTAL INCOME TAXES		1,367		2,379		1,450
Net income		5,415		8,489		5,120
Less: Net income attributable to noncontrolling interests		50		31		16
SHAREHOLDERS' NET INCOME		$	5,365	$	8,458	$	5,104
Shareholders' net income per share
Basic		$	15.87	$	23.17	$	13.58
Diluted		$	15.73	$	22.96	$	13.44

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


Cigna Corporation Consolidated Statements of Comprehensive Income

	For the Years Ended December 31,
(In millions)		2021		2020		2019
Net income		$	5,415	$	8,489	$	5,120
Other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives		(215)		(75)		957
Net translation gains (losses) on foreign currencies		(232)		252		(59)
Postretirement benefits liability adjustment		410		(105)		(133)
Other comprehensive income (loss), net of tax		(37)		72		765
Total comprehensive income		5,378		8,561		5,885

Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests		19		14		11
Net income attributable to other noncontrolling interests		31		17		5
Other comprehensive (loss) attributable to redeemable noncontrolling interests		(14)		(8)		(5)
Total comprehensive income attributable to noncontrolling interests		36		23		11
SHAREHOLDERS' COMPREHENSIVE INCOME		$	5,342	$	8,538	$	5,874

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


Cigna Corporation Consolidated Balance Sheets


	As of December 31,
(In millions)	2021		2020
Assets
Cash and cash equivalents	$	5,081	$	10,182
Investments	920		1,331
Accounts receivable, net	15,071		12,191
Inventories	3,722		3,165
Other current assets	1,283		930
Assets of businesses held for sale	10,057		—
Total current assets	36,134		27,799
Long-term investments	18,438		23,262
Reinsurance recoverables	4,970		5,200
Deferred policy acquisition costs	677		3,385
Property and equipment	3,692		4,205
Goodwill	45,811		44,648
Other intangible assets	34,102		35,179
Other assets	2,728		2,687
Separate account assets	8,337		9,086
TOTAL ASSETS	$	154,889	$	155,451
Liabilities
Current insurance and contractholder liabilities	$	5,318	$	5,308
Pharmacy and other service costs payable	15,309		13,347
Accounts payable	6,655		5,478
Accrued expenses and other liabilities	7,322		8,515
Short-term debt	2,545		3,374
Liabilities of businesses held for sale	6,423		—
Total current liabilities	43,572		36,022
Non-current insurance and contractholder liabilities	12,563		16,844
Deferred tax liabilities, net	8,346		8,939
Other non-current liabilities	3,762		4,629
Long-term debt	31,125		29,545
Separate account liabilities	8,337		9,086
TOTAL LIABILITIES	107,705		105,065
Contingencies — Note 22
Redeemable noncontrolling interests	54		58
Shareholders' equity
Common stock (1)	4		4
Additional paid-in capital	29,574		28,975
Accumulated other comprehensive loss	(884)		(861)
Retained earnings	32,593		28,575
Less: Treasury stock, at cost	(14,175)		(6,372)
TOTAL SHAREHOLDERS' EQUITY	47,112		50,321
Other noncontrolling interests	18		7
Total equity	47,130		50,328
Total liabilities and equity	$	154,889	$	155,451

(1) Par value per share, $0.01; shares issued, 394 million as of December 31, 2021 and 390 million as of December 31, 2020; authorized shares, 600 million.

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


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, 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)							(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

Effect of issuing stock for employee benefit plans			604						(93)		511				511
Other comprehensive income (loss)					(23)						(23)				(23)		(14)
Net income							5,365				5,365		31		5,396		19
Common dividends declared (per share: $4.00)							(1,347)				(1,347)				(1,347)
Repurchase of common stock									(7,710)		(7,710)				(7,710)
Other transactions impacting noncontrolling interests			(5)								(5)		(20)		(25)		(9)
Balance at December 31, 2021	$	4	$	29,574	$	(884)	$	32,593	$	(14,175)	$	47,112	$	18	$	47,130	$	54

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

Cigna Corporation

Consolidated Statements of Cash Flows




	For the Years Ended December 31,
(In millions)	2021		2020		2019
Cash Flows from Operating Activities
Net income	$	5,415	$	8,489	$	5,120
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	2,923		2,802		3,651
Realized investment (gains) losses, net	(196)		(149)		(177)
Deferred income tax (benefit)	(220)		(386)		(313)
Gain on sale of business	—		(4,203)		—
Debt extinguishment costs	141		199		2
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable	(2,843)		(1,496)		(713)
Inventories	(557)		(504)		149
Deferred policy acquisition costs	(267)		(307)		(242)
Reinsurance recoverable and Other assets	(389)		230		(277)
Insurance liabilities	967		841		575
Pharmacy and other service costs payable	1,961		2,891		(192)
Accounts payable and Accrued expenses and other liabilities	(77)		1,346		1,343
Other, net	333		597		559
NET CASH PROVIDED BY OPERATING ACTIVITIES	7,191		10,350		9,485
Cash Flows from Investing Activities
Proceeds from investments sold:
Debt securities and equity securities	2,030		2,283		3,487
Investment maturities and repayments:
Debt securities and equity securities	1,628		1,519		1,825
Commercial mortgage loans	180		19		199
Other sales, maturities and repayments (primarily short-term and other long-term investments)	1,936		1,575		1,311
Investments purchased or originated:
Debt securities and equity securities	(3,553)		(4,765)		(4,282)
Commercial mortgage loans	(327)		(113)		(307)
Other (primarily short-term and other long-term investments)	(2,554)		(1,924)		(1,753)
Property and equipment purchases, net	(1,154)		(1,094)		(1,050)
Acquisitions, net of cash acquired	(1,833)		(139)		(153)
Divestiture, net of cash sold	(61)		5,592		—
Other, net	97		23		(11)
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES	(3,611)		2,976		(734)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds	153		1,023		955
Withdrawals and benefit payments from contractholder deposit funds	(168)		(979)		(1,097)
Net change in short-term debt	975		60		(681)
Net proceeds on issuance of term loan	—		1,398		—
Repayment of term loan	—		(1,400)		—
Payments for debt extinguishment	(136)		(212)		(3)
Repayment of long-term debt	(4,578)		(8,047)		(4,491)
Net proceeds on issuance of long-term debt	4,260		3,465		—
Repurchase of common stock	(7,742)		(4,042)		(1,987)
Issuance of common stock	326		376		224
Common stock dividend paid	(1,341)		(15)		(15)
Other, net	39		(160)		(92)
NET CASH (USED IN) FINANCING ACTIVITIES	(8,212)		(8,533)		(7,187)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash	(65)		41		(8)
Net (decrease) increase in cash, cash equivalents and restricted cash	(4,697)		4,834		1,556
Cash, cash equivalents and restricted cash January 1, (1)	10,245		5,411		3,855
Cash, cash equivalents and restricted cash, December 31,	5,548		10,245		5,411
Cash reclassified to assets of businesses held for sale	(425)		—		(743)
Cash, cash equivalents and restricted cash December 31, per Consolidated Balance Sheets (2)	$	5,123	$	10,245	$	4,668
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds	$	2,240	$	1,837	$	1,776
Interest paid	$	1,253	$	1,439	$	1,645

(1) Includes $743 million reported in Assets of businesses held for sale as of January 1, 2020.

(2) Restricted cash and cash equivalents were reported in Other long-term investments as of December 31, 2021 and December 31, 2020 and were reported in Other long-term investments and Other assets as of December 31, 2019.

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

CIGNA CORPORATION

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS

TABLE OF CONTENTS



Note Number	Footnote	Page

BUSINESS AND CAPITAL STRUCTURE
1	Description of Business	85
2	Summary of Significant Accounting Policies	86
3	Accounts Receivable, Net	92
4	Mergers, Acquisitions and Divestitures	94
5	Assets and Liabilities of Businesses Held for Sale	95
6	Earnings Per Share	96
7	Debt	97
8	Common and Preferred Stock	99
INSURANCE INFORMATION
9	Insurance and Contractholder Liabilities	100
10	Reinsurance	104
INVESTMENTS
11	Investments	108
12	Fair Value Measurements	114
13	Variable Interest Entities	119
14	Accumulated Other Comprehensive Income (Loss)	121
WORKFORCE MANAGEMENT AND COMPENSATION
15	O rganizational Efficiency Plan	122
16	Pension	122
17	Employee Incentive Plans	126
PROPERTY, LEASES AND OTHER ASSET BALANCES
18	Goodwill, Other Intangibles and Property and Equipment	129
19	Leases	132
COMPLIANCE, REGULATION AND CONTINGENCIES
20	Shareholders ' Equity and Dividend Restrictions	133
21	Income Taxes	134
22	Contingencies and Other Matters	137
RESULTS DETAILS
23	Segment Information	138

Note 1 – Description of Business

Cigna Corporation, together with its subsidiaries (either individually or collectively referred to as "Cigna," the "Company," "we," "our" or "us") is a global health services organization with a mission of helping those we serve improve their health, well-being and peace of mind by making health care affordable, predictable and simple. Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and supplemental products and services.

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these ongoing operations, Cigna also has certain run-off operations.

Details of the Company's reporting segments and recent changes are provided below:

We entered into a definitive agreement in October 2021 to sell our life, accident and supplemental benefits businesses in seven countries to Chubb INA Holdings, Inc. ("Chubb") for $5.75 billion cash (the "Chubb Transaction"). See Note 5 for further information on the classification of these businesses as held for sale. In connection with the pending Chubb Transaction, we revised our business reporting structure. As such, we adjusted our segment reporting effective in the fourth quarter of 2021 so that the results previously reported in the International Markets segment are now reported as follows:

The businesses to be retained by Cigna are now reported in the newly created International Health operating segment that will be aggregated with our existing U.S. Commercial and U.S. Government operating segments in the renamed Cigna Healthcare reporting segment (previously named U.S. Medical segment).
The businesses to be sold pursuant to the Chubb Transaction are now reported in Other Operations.

Segment results for the years ended December 31, 2020 and 2019 have been restated to conform to the new segment presentation (see Note 23). A full description of our segments follows:

Evernorth includes a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in pharmacy solutions, benefits management solutions, care delivery and care management solutions and intelligence solutions, which are provided to health plans, employers, government organizations and health care providers.

Cigna Healthcare includes U.S. Commercial, U.S. Government and International Health operating segments that provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental, vision, health advocacy programs and other products and services for insured and self-insured customers. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans both on and off the public exchanges. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations. The Cigna Healthcare segment is comprised of the previously named U.S. Medical segment and the businesses to be retained from the previous International Markets segment.

Other Operations contains the remainder of our business operations, consisting of the following:

Ongoing business:**
Corporate-Owned Life Insurance ("COLI")** offers permanent insurance contracts sold to corporations to provide coverage on the lives of certain employees for the purpose of financing employer-paid future benefit obligations.
Exiting businesses:**
International Life, Accident and Supplemental Benefits Businesses** in seven countries to be sold pursuant to the Chubb Transaction.
Group Disability and Life**. Prior to the sale of the U.S. Group Disability and Life business on December 31, 2020, this operating segment provided group long-term and short-term disability, group life, accident, voluntary and specialty insurance products and related services.
Run-off businesses:
Reinsurance: predominantly comprised of guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013.
Settlement Annuity business in run-off.
Individual Life Insurance and Annuity and Retirement Benefits businesses: deferred gains from the sales of these businesses.

Other Operations was previously named Group Disability and Other.

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate debt less net investment income on investments not supporting segment and other operations), certain litigation matters, expense associated with our frozen pension plans, charitable contributions, severance, certain overhead and enterprise-wide project costs and intersegment eliminations for products and services sold between segments.

Note 2 – Summary of Significant Accounting Policies

Basis of Presentation

The Consolidated Financial Statements include the accounts of Cigna Corporation and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP").

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

Recent Accounting Pronouncements

There were no new accounting standards adopted during the year ended December 31, 2021 that had a material impact on our consolidated financial statements.

Accounting Guidance Not Yet Adopted

Facilitation of the Effects of Reference Rate Reform on Financial Reporting (ASU 2020-04) and related amendments

Permits optional expedients and exceptions to simplify the accounting for contract modifications, hedging arrangements and held-to-maturity investments, when certain changes are made to a contract or instrument to facilitate reference rate reform and the discontinuation of reference interbank offered rates, including LIBOR.
An entity may elect to apply the amendments, by topic or subsection, at any point prospectively through December 31, 2022. When elected, the optional expedients must be applied consistently for all eligible contracts or transactions.

The Company has performed a comprehensive evaluation of our exposures and does not believe the cessation of LIBOR will materially impact our operations or financial results, primarily because many of the Company's contracts contain contractual fallback language for a new benchmark rate or the underlying exposure is minimal.

Targeted Improvements to the Accounting for Long-Duration Contracts (ASU 2018-12) and related amendments

Effective date of January 1, 2023 for Cigna (early adoption permitted) and requires the following key provisions (for insurance entities that issue long-duration contracts):

Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:
Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) to be updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
Discount rate assumptions to be updated quarterly based on market level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.
Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts to be amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.
Market risk benefits (defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk) to be measured at fair value, with changes in fair value recognized in net income each period, except for the effect of changes in the insurance entity's credit risk to be recognized in other comprehensive income.
Additional disclosures, including disaggregated rollforwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
Transition methods at adoption vary:
Changes to the liability for future policy benefits to use a modified retrospective approach applied to all outstanding contracts on the basis of their existing carrying amounts as of the beginning of the earliest period presented, with an option to elect a full retrospective transition under certain criteria. Remeasuring the future policy benefits liability for the discount rate to be recorded through accumulated other comprehensive income at transition.
DAC to follow the transition method used for future policyholder benefits.
Market risk benefits to be transitioned retrospectively and measured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value to be recognized in the opening balance of retained earnings, excluding the effect of credit risk changes that are to be recognized in accumulated other comprehensive income.

Expected effects:

The new guidance will apply to our long-duration insurance products predominantly within the Other Operations and Cigna Healthcare segments.
The Company developed a cross-functional implementation project plan and is executing on the necessary significant changes to our systems, processes and controls.
The Company will adopt the standard on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and DAC. We currently do not expect the impact of adoption to be material to shareholder's equity.
Although we continue to evaluate the new requirements of the standard and model their impacts across various products, we are unable to project or estimate the magnitude or frequency of expected changes to our financial results. However, it is possible that our income recognition pattern could change for several reasons:
Applying periodic assumption updates, versus the current locked-in model, may change our timing of profit or loss recognition.
DAC amortization will be on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.
Features, such as the Company's GMDB product, that provide market-risk benefits are not currently measured at fair value, so these liabilities and related reinsurance recoverables will become subject to market sensitivity, notably to interest rates.

Significant Accounting Policies

The Company's accounting policies are described either in this Note or in the applicable Notes to the Consolidated Financial Statements as listed in the table of contents.

**A.**Cash and Cash Equivalents

Cash and cash equivalents are carried at cost that approximates fair value. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase. The Company reclassifies cash overdraft positions to liabilities when the legal right of offset does not exist.

**B.**Inventories

Inventories consist of prescription drugs and medical supplies and are stated at the lower of first-in-first-out cost or net realizable value.

**C.**Deferred Policy Acquisition Costs

Costs eligible for deferral include incremental, direct costs of acquiring new or renewal insurance and investment contracts and other costs directly related to successful contract acquisition. Examples of deferrable costs include commissions, sales compensation and benefits, policy issuance and underwriting costs. The Company records acquisition costs differently depending on the product line. Acquisition costs for:

Supplemental health, life and accident insurance products** (primarily individual products) that comprise the majority of the Company's deferred policy acquisition costs and group health and accident insurance products are deferred and amortized, generally in proportion to the ratio of periodic revenue to the estimated total revenues over the contract periods. See Note 5 for Deferred policy acquisition costs reclassified to Assets of businesses held for sale.
Universal life products** are deferred and amortized in proportion to the present value of total estimated gross profits over the expected lives of the contracts.
Other products** are expensed as incurred.

Deferred policy acquisition costs also include the value of business acquired ("VOBA") for certain acquisitions with material long-duration insurance contracts. The Company recorded amortization of deferred policy acquisition costs of $478 million in 2021, $502 million in 2020 and $483 million in 2019 primarily in Selling, general and administrative expenses.

Each year, deferred policy acquisition costs are tested for recoverability. For universal life and other individual products, management estimates the present value of future revenues less expected payments. For group health and accident insurance products, management estimates the sum of unearned premiums and anticipated net investment income less future expected claims and related costs. If management's estimates of these sums are less than the deferred costs, the Company reduces deferred policy acquisition costs and records an additional expense.

**D.**Other Assets (Current and Non-Current)

Other current assets consist primarily of prepaid expenses, accrued investment income, the current portion of reinsurance recoverables and income tax receivables. Other non-current assets consist primarily of GMIB assets, operating lease right-of-use assets and various other insurance-related assets. See Note 10 for the Company's accounting policy for GMIB assets and Note 19 for the Company's accounting policy related to leases. Additionally, other non-current assets include the carrying value of our equity-method investments in business-related joint ventures in China, India, the U.S. and other foreign jurisdictions. Earnings or losses from these equity-method investments in joint ventures are recorded in Fees and other revenues.

**E.**Redeemable Noncontrolling Interests

Redeemable noncontrolling interests on our Consolidated Balance Sheets represents the noncontrolling shareholders' preferred and common stock interests of the Company's consolidated less than fully owned subsidiaries. Those shareholders may choose to require the Company to purchase their redeemable noncontrolling interest. We also have the right to require those shareholders to sell their redeemable noncontrolling interest to us. The redeemable noncontrolling interest was recorded at fair value as of the date of purchase. When the estimated redemption value for a redeemable noncontrolling interest exceeds its carrying value, an adjustment to increase the redeemable noncontrolling interest is recorded with an offsetting reduction to retained earnings or additional paid-in capital in the

absence of retained earnings. When an adjustment is made to the carrying value of the redeemable noncontrolling interest, the calculation of shareholders' net income per share will be adjusted if the redemption value exceeds fair value.

**F.**Accrued Expenses and Other Current and Non-Current Liabilities

Accrued expenses (current) primarily includes financial and performance guarantee liabilities under pharmacy contracts (see section H), management compensation and various insurance-related liabilities, including experience-rated refunds, reinsurance contracts and the risk adjustment and minimum medical loss ratio rebate accruals under The Patient Protection and Affordable Care Act (the "ACA"). Other non-current liabilities primarily include obligations for pension (see Note 16), GMIB contract liabilities (see Note 10), lease liabilities (see Note 19), uncertain tax positions (see Note 21) and self-insured exposures not expected to be settled within one year.

The Company accrues for legal and regulatory matters when a loss contingency is both probable and estimable. The estimated loss is generally recorded in Selling, general and administrative expenses and represents the Company's best estimate of the loss contingency. If the loss estimate is a range, the Company accrues the minimum amount in the range if no amount is better than any other estimated amount in the range. Legal costs to defend the Company's litigation and arbitration matters are expensed as incurred in cases that the Company cannot reasonably estimate the ultimate cost to defend. If the Company can reasonably estimate the cost to defend, a liability for these costs is accrued when the claim is reported. Litigation and legal or regulatory matters that the Company has identified with a reasonable possibility of material loss are described in Note 22.

**G.**Translation of Foreign Currencies

The Company generally conducts its international business through foreign operating entities that maintain assets and liabilities in local currencies that are their functional currencies. The Company uses exchange rates as of the balance sheet date to translate assets and liabilities into U.S. dollars. Translation gains or losses on functional currencies, net of applicable taxes, are recorded in Accumulated other comprehensive income (loss). The Company uses average monthly exchange rates during the year to translate revenues and expenses into U.S. dollars.

**H.**Pharmacy Revenues and Costs

Pharmacy revenues**.** Pharmacy revenues are primarily derived from providing pharmacy benefit management services to clients and customers. Pharmacy revenues are recognized when control of the promised goods or services is transferred to clients and customers, in an amount that reflects the consideration the Company expects to receive for those goods or services.

The Company provides or makes available various services supporting benefit management and claims administration and is generally obligated to provide prescription drugs to clients' members using multiple distribution methods including retail networks, home delivery and specialty pharmacies. These goods and services are integrated into a single performance obligation to process claims, dispense prescription drugs and provide other services over the contract period (generally three years). This performance obligation is satisfied as the business stands ready to fulfill its obligation.

Revenues for dispensing prescription drugs through retail pharmacies are reported gross and consist of the prescription price (ingredient cost and dispensing fee) contracted with clients, including the customer copayment and any associated fees for services, because the Company acts as the principal in these arrangements. When a prescription is presented to a retail network pharmacy, the Company is solely responsible for customer eligibility, drug utilization review, drug-to-drug interaction review, any required clinical intervention, plan provision information, payment to the pharmacy and client billing. These revenues are recognized based on the full prescription price when the pharmacy claim is processed and approved for payment. The Company also provides benefit design and formulary consultation services to clients and negotiates separate contractual relationships with clients and network pharmacies. These factors indicate that the Company has control over these transactions until the prescription is processed. Revenues are billed, due and recognized at contract rates either on a periodic basis or as services are provided (such as based on volume of claims processed). This recognition pattern aligns with the benefits from services provided.

Home delivery and specialty pharmacy revenues are due and recognized as each prescription is shipped, net of reserves for discounts and contractual allowances estimated based on historical experience. Any differences between estimates and actual collections are reflected in operations when payments are received. Historically, adjustments to original estimates and returns have not been material. The Company has elected the practical expedient to account for shipping and handling as a fulfillment activity.

We may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue

for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted at the end of the guarantee period. Historically, adjustments to original estimates have not been material. The performance guarantee liability was $1.1 billion as of December 31, 2021 and December 31, 2020.

The Company administers programs through which we may receive rebates and other vendor consideration from pharmaceutical manufacturers. The amounts of such rebates or other vendor consideration shared with pharmacy benefit management services clients vary based on the contractual arrangement with the client and in some cases the type of consideration received from the pharmaceutical manufacturer. Rebates and other vendor consideration payable to pharmacy benefit management services clients are recorded as a reduction of Pharmacy revenues. Estimated amounts payable to clients are based on contractual sharing arrangements between the Company and the client and these amounts are adjusted when amounts are collected from pharmaceutical manufacturers in accordance with the contractual arrangement between the Company and the client. Historically, these adjustments have not been material.

In retail, home delivery and specialty transactions, amounts may be collected from third-party payors. These are billed and collected subject to normal account receivable collections procedures.

Other pharmacy service revenues are earned by distributing specialty pharmaceuticals and medical supplies to providers, clinics and hospitals. These revenues are billed, due and recognized at contracted rates as prescriptions and supplies are shipped and services are provided.

Pharmacy costs**.** Pharmacy costs include the cost of prescriptions sold, network pharmacy claim costs and copayments. Also included are direct costs of dispensing prescriptions including supplies, shipping and handling and direct costs associated with clinical programs, such as drug utilization management and medication adherence counseling. Home delivery and specialty pharmacy costs are recognized when the drug is shipped and retail network costs are recognized when the drug is processed and approved for payment. Rebates and other vendor consideration received when providing pharmacy benefit management services are recorded as a reduction of pharmacy costs. Rebates are recognized as prescriptions are shipped or processed and approved for payment. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected, net of contractual allowances, has not been material. The Company maintains reimbursement guarantees with certain retail network pharmacies. For each such guarantee, the Company records a pharmacy and other service costs payable or prepaid asset for applicable retail network claims based on our actual performance throughout the period against the contractual reimbursement rate. The Company's contracts with certain retail pharmacies give the Company the right to adjust reimbursement rates during the annual guarantee period.

Other**.** Incremental costs of obtaining service and pharmacy contracts for short-term arrangements are expensed as incurred.

**I.**Premiums and Related Expenses

Premiums for group life, accident and health insurance and managed care coverages are recognized as revenue on a pro rata basis over the contract period. Benefits and expenses are recognized when incurred and, for our Cigna Healthcare insured business, are presented net of pharmaceutical manufacturer rebates. For experience-rated contracts, premium revenue includes an adjustment for experience-rated refunds based on contract terms and calculated using the customer's experience (including estimates of incurred but not reported claims).

Premiums received for the Company's Medicare Advantage plans, Medicare Part D products and Individual and Family Plans from the Centers for Medicare and Medicaid Services ("CMS") and customers are recognized as revenue ratably over the contract period.

CMS provides risk-adjusted premium payments for Medicare Advantage Plans and Medicare Part D products based on our customer demographics and medical diagnoses, which may change from period to period based on the underlying health of our customers. The Company recognizes changes to risk-adjusted premiums as revenue when the amounts are determinable and collection is reasonably assured. Revenue adjustments are generally settled semi-annually with CMS. The final revenue adjustment is generally settled with CMS in the year following the contract year.

Medicare Part D premiums include payments from CMS for risk-sharing adjustments that are estimated quarterly based on claim experience by comparing actual incurred prescription drug costs to the estimated costs submitted in the original contracts. These adjustments may result in more or less revenue from CMS. Final revenue adjustments generally occur in the year following the contract year.

The ACA prescribed a risk-adjustment program to mitigate the risk for participating health insurance companies selling coverage on the public exchanges. The risk-adjustment program reallocates funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our receivable or payable based on the risk of our

customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and the United States Department of Health and Human Services ("HHS"). Receivables or payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.

Premium revenue may also include an adjustment to reflect the estimated effect of rebates due to customers under medical loss ratio provisions of the ACA. These rebate liabilities are settled in the subsequent year.

Premiums for individual life, accident and supplemental health insurance and annuity products, excluding universal life and investment-related products, are recognized as revenue when due. Benefits and expenses are matched with premiums.

Revenue for universal life products is recognized as follows:

Investment income on assets supporting universal life products is recognized in Net investment income as earned.
Charges for mortality, administration and policy surrender are recognized in Premiums as earned. Administrative fees are considered earned when services are provided.

Benefits and expenses for universal life products consist of benefit claims in excess of policyholder account balances and income earned by policyholders. Expenses are recognized when claims are incurred and income is credited to policyholders in accordance with contract provisions.

The unrecognized portion of premiums received is recorded as unearned premiums included in insurance and contractholder liabilities (see Note 9 for further information).

**J.**Fees and Related Expenses

The majority of the Company's service fees are derived from administrative services only ("ASO") arrangements, fee-for-service clinical solutions, administration of certain rebate arrangements, health benefit management services and administration of services to specialty pharmacy manufacturers.

ASO arrangements allow plan sponsors to self-fund claims and assume the risk of medical or other benefit costs. Most of the Company's ASO arrangements are for medical and specialty services, including pharmacy benefits. Generally, the Company's ASO arrangements are short-term. Contract modifications typically occur on renewal and are prospective in nature.

In return for fees from these clients, the Company provides access to our participating provider networks and other services supporting benefit management, including claims administration, behavioral health services, disease management, utilization management and cost containment programs. In general, the Company considers these services to be a combined performance obligation to provide cost effective administration of plan benefits over the contract period. Fees are billed, due and recognized monthly at contracted rates based on current membership or utilization. This recognition pattern aligns with the benefits from services provided to clients. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income.

The Company may also provide performance guarantees that provide potential refunds to clients if certain service standards, clinical outcomes or financial metrics are not met. If these standards, outcomes and metrics are not met, the Company may be financially at risk up to a stated percentage of the contracted fee or a stated dollar amount. The Company defers revenue by recording a liability for estimated payouts associated with these guarantees within Accrued expenses and other liabilities. The amount of revenue deferred is estimated for each type of guarantee using either a most likely amount or expected value method depending on the nature of the guarantee and the information available to estimate refunds. Estimates are refined each reporting period as additional information on the Company's performance becomes available and upon final reconciliation and settlement following the guarantee period. Amounts accrued and paid for these performance guarantees during the reporting periods were not material.

Rebates from pharmaceutical manufacturers for ASO client purchases at retail pharmacies, net of amounts payable to ASO clients, were considered compensation for use of the manufacturer's products and recorded in Fees and other revenues prior to transitioning U.S. Commercial customers to Express Scripts' retail pharmacy network in the third quarter of 2019. After this transition, these rebates are reflected as a reduction to pharmacy costs (see "Pharmacy costs" above).

Expenses associated with administrative programs and services are recognized as incurred in Selling, general and administrative expenses.

The Company also earns revenue, as part of its integrated pharmacy benefits performance obligation, by offering fee-for-service clinical solutions to our clients, such as drug utilization management and medication adherence counseling. These clinical programs help clients to drive better health outcomes at a lower cost by identifying and addressing potentially unsafe or wasteful prescribing, dispensing and utilization of prescription drugs and communicating with, or supporting communications with physicians, pharmacies and patients. Fees are billed, due and recognized at contracted rates either on a periodic basis or as services are provided. This recognition pattern aligns with the benefits from services provided. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded as incurred in Selling, general and administrative expenses.

The Company earns fees from our Pharmacy Rebate Program services. These services include either our formulary rebate administrative service arrangements or our formulary processing arrangements. Formulary rebate administrative services may include formulary consultation, administration of rebate contracts, rebate submission, collection from drug manufacturers and the distribution of rebates to clients. Services may also include facilitating audits of data submissions and reporting of rebates to clients. Clients agree to pay administrative fees that are billed, due and recognized at contracted rates as services are performed. These revenues are reported gross in Fees and other revenues and associated costs are reported in Pharmacy and other service costs in the Consolidated Statements of Income. For certain other clients in our formulary processing arrangements, the Company does not control the right to retain rebates before they are transferred to the client for services performed. Clients agree to allow the Company to retain a portion of each rebate collected in exchange for formulary processing services provided. These rebate and administrative fee revenues are reported net in Fees and other revenues in the Consolidated Statements of Income. Revenue is recognized as rebates are processed.

The Company also earns fees by providing health benefit management solutions that drive cost reductions and improve quality outcomes. Clients are primarily sponsors of health benefit plans and fees may be stated as a per-member-per-month fee or as a per-claim fee. The Company considers the services to be a single performance obligation to stand ready to provide utilization management services over the contract period (generally three years). In certain arrangements, the Company assumes the financial obligation for third-party provider costs for medical services provided to the health plan's customers. Fees are recorded gross in Fees and other revenues in the Consolidated Statements of Income because the Company is acting as a principal in arranging for and controlling the services provided by third-party network providers. Contractual fees vary based on enrollment and provider costs and are billed, due and recognized monthly. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded in Selling, general and administrative expenses as incurred.

Certain health benefit management contracts require the Company to share the results of medical cost experience that differ from specified targets. This variable consideration is estimated at contract inception and adjusted through the contract period. The estimated profits and costs are recognized net in Fees and other revenues.

The Company also earns other service fees related to administrating services to specialty pharmacy manufacturers that are recorded in Fees and other revenues in the Consolidated Statements of Income. These revenues are billed, due and recognized at contracted rates as services are provided.

Note 3 – Accounts Receivable, Net

Accounting policy. The allowance for expected credit losses for current accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due; however, when available evidence reasonably supports an assumption that counterparty credit risk over the expected payment period will differ from current and historical payment collections, a forecasting adjustment is reflected in the allowance for expected credit losses.

All other (non-credit) allowances are based on the current status of each customer's receivable balance, current economic and market conditions and a variety of other factors, including the length of time the receivables are past due, the financial health of customers and our past experience.

We bill pharmaceutical manufacturers based on management's interpretation of contractual terms and estimate a contractual allowance based on the best information available at the time a claim is processed. Contractual allowances for certain rebates receivable from pharmaceutical manufacturers are determined by reviewing payment experience and specific known items that could be adjusted under

contract terms. The Company's estimation process for contractual allowances for pharmaceutical manufacturer receivables generally results in an allowance for balances outstanding greater than 90 days.

Contractual allowances for certain receivables from third-party payors are based on their contractual terms and are estimates based on the Company's best information available at the time revenue is recognized.

Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.

The Company's accounts receivable include amounts due from clients, third-party payors, customers and pharmaceutical manufacturers, and are presented net of allowances. These balances include:

Noninsurance customer receivables - amounts due from customers for noninsurance services, primarily pharmacy benefit management and ASO contracts.
Pharmaceutical manufacturers receivable - amounts due from pharmaceutical manufacturers.
Insurance customer receivables - amounts due from customers under insurance contracts, primarily premiums receivable and amounts due from CMS.
Other receivables - all other accounts receivable not defined in the categories above.

The following amounts were included within Accounts receivable, net:


(In millions)	December 31, 2021		December 31, 2020
Noninsurance customer receivables	$	6,274	$	5,534
Pharmaceutical manufacturers receivable	5,463		4,676
Insurance customer receivables	2,932		1,789
Other receivables	456		192
Total	15,125
Accounts receivable, net classified as Assets of businesses held for sale	(54)
Accounts receivable, net per Consolidated Balance Sheets	$	15,071	$	12,191

These receivables are reported net of our allowances of $1.4 billion as of December 31, 2021 and $1.2 billion as of December 31, 2020 as follows:

Included in our Pharmaceutical manufacturers receivable are contractual allowances for certain rebates receivable with pharmaceutical manufacturers of $926 million as of December 31, 2021 and $757 million as of December 31, 2020.
Included in our Noninsurance customer receivables are contractual allowances from third-party payors of $321 million as of December 31, 2021 and $208 million as of December 31, 2020 based upon the contractual payment terms.
The remaining allowances of $186 million as of December 31, 2021 and $224 million as of December 31, 2020 include allowances, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments.
The Company's allowance for current expected credit losses was $60 million as of December 31, 2021 and $65 million as of December 31, 2020.

Note 4 – Mergers, Acquisitions and Divestitures

**A.**Acquisition of MDLIVE

On April 19, 2021, Cigna acquired 97% of MDLIVE, Inc. ("MDLIVE"), a 24/7 virtual care platform. Combined with Cigna's previously held equity investment, Cigna now owns 100% of MDLIVE. The acquisition of MDLIVE will enable Cigna's Evernorth segment to continue expanding access to virtual care and delivering a more affordable, convenient and connected care experience for consumers.

The purchase price of $2.0 billion consisted of cash consideration. In accordance with GAAP, the total consideration transferred has been allocated to the tangible and intangible net assets acquired based on management's preliminary estimates of their fair values and may change as additional information becomes available over the next several months. As of December 31, 2021, the Company made immaterial measurement period adjustments to the purchase price allocation. The estimated fair values of assets acquired and liabilities assumed as of the closing date were as follows:


(In millions)
Goodwill	$	1,438
Acquired intangible assets	627
Tangible assets acquired net of liabilities assumed	17
Total consideration transferred	2,082
Less: Fair value to Cigna's previously held equity interest	(55)
Total purchase price	$	2,027

Substantially all of the goodwill is assigned to the Evernorth segment ($1.3 billion). Goodwill is not deductible for federal income tax purposes. The acquired intangible assets primarily consist of customer relationships ($577 million) as well as internal-use software, provider networks and a trade name. The fair value of the customer relationships and the amortization period were determined using an income approach that relies heavily on projected future net cash flows including key assumptions for customer attrition, margins and discount rates. The customer relationship intangible asset is amortized over a period of 17 years in a pattern that reflects when Cigna expects to receive the benefits of the related cash flows.

The results of MDLIVE have been included in the Company's Consolidated Financial Statements from the date of the acquisition. Revenues from MDLIVE and their results of operations were not material to Cigna's consolidated results of operations for the year ended December 31, 2021. The pro forma effects of this acquisition for current and prior periods were not material to our consolidated results of operations.

**B.**Divestiture of U.S. Group Disability and Life business

On December 31, 2020, Cigna completed the sale of its U.S. Group Disability and Life business to New York Life Insurance Company for cash proceeds of $6.2 billion. The Company recognized a gain of $4.2 billion pre-tax ($3.2 billion after-tax), which included recognition of previously unrealized capital gains on investments sold (see Note 14 for further information).

**C.**Integration and Transaction-related Costs

In 2021, the Company incurred costs related to the acquisition of MDLIVE, the sale of the U.S. Group Disability and Life business, the terminated merger with Anthem, Inc. ("Anthem") and the pending Chubb Transaction (see Note 5 for further information on assets and liabilities of businesses held for sale). In 2020 and 2019, the Company incurred costs related to the acquisition and integration of Express Scripts Holding Company ("Express Scripts"), the terminated merger with Anthem, the sale of the U.S. Group Disability and Life insurance business and other transactions. These costs were $169 million pre-tax ($71 million after-tax) for the year ended December 31, 2021, compared with $527 million pre-tax ($404 million after-tax) for the year ended December 31, 2020 and $552 million pre-tax ($427 million after-tax) for the year ended December 31, 2019. These costs consisted primarily of certain projects to integrate or separate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs. After-tax costs for the year ended December 31, 2021 included a tax benefit from the resolution of a tax matter related to the sold Group Disability and Life business.

Note 5 – Assets and Liabilities of Businesses Held for Sale

Accounting Policy. The Company classifies assets and liabilities as held for sale ("disposal group") when management commits to a plan to sell the disposal group, the sale is probable within one year and the disposal group is available for immediate sale in its present condition. The Company considers various factors, particularly whether actions required to complete the plan indicate it is unlikely that significant changes to the plan will be made or the plan will be withdrawn. Assets held for sale are measured at the lower of carrying value or fair value less costs to sell. Any loss resulting from the measurement is recognized in the period the held-for-sale criteria are met. Conversely, gains are not recognized until the date of the sale. When the disposal group is classified as held for sale, depreciation and amortization for most long-lived assets ceases and the Company tests the assets for impairment. Deferred policy acquisition costs continue to be amortized.

Cigna entered into a definitive agreement in October 2021 to sell its life, accident and supplemental benefits businesses in seven countries to Chubb for $5.75 billion cash. Subject to applicable regulatory approvals and customary closing conditions, we expect to complete the sale of our life, accident and supplemental benefits businesses in Hong Kong, Indonesia, New Zealand, South Korea, Taiwan, Thailand and our interest in a joint venture in Turkey in the second quarter of 2022. The Company believes this sale is probable and has aggregated and classified the assets and liabilities directly associated with the pending sale as held for sale and has reported them separately on our Consolidated Balance Sheets as of December 31, 2021. The assets and liabilities of businesses held for sale were as follows:


(In millions)	December 31, 2021
Cash and cash equivalents	$	406
Investments	5,109
Deferred policy acquisition costs	2,755
Separate account assets	878
Goodwill, other intangible assets and all other assets	909
Total assets of business held for sale	10,057
Insurance and contractholder liabilities	4,644
Accounts payable, accrued expenses and other liabilities	452
Deferred tax liabilities, net	449
Separate account liabilities	878
Total liabilities of business held for sale	$	6,423

The held for sale businesses reported Redeemable noncontrolling interests of $24 million, Gross unrealized appreciation on securities and derivatives of $137 million and Gross translation loss on foreign currencies of $209 million on our Consolidated Balance Sheets as of December 31, 2021.

Note 6 – Earnings Per Share ("EPS")

Accounting policy. The Company computes basic earnings per share using the weighted-average number of unrestricted common and deferred shares outstanding. Diluted earnings per share also includes the dilutive effect of outstanding employee stock options and restricted stock using the treasury stock method and the effect of strategic performance shares.

Basic and diluted earnings per share were computed as follows:




	2021						2020						2019
(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	$	5,365			$	5,365	$	8,458			$	8,458	$	5,104			$	5,104
Shares:
Weighted average	337,962				337,962		364,979				364,979		375,919				375,919
Common stock equivalents			3,004		3,004				3,410		3,410				3,898		3,898
Total shares	337,962		3,004		340,966		364,979		3,410		368,389		375,919		3,898		379,817
EPS	$	15.87	$	(0.14)	$	15.73	$	23.17	$	(0.21)	$	22.96	$	13.58	$	(0.14)	$	13.44

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



(In millions)	2021	2020	2019
Anti-dilutive options	1.5	4.1	3.5

Note 7 – Debt

The outstanding amounts of debt and finance leases were as follows:


(In millions)	December 31, 2021		December 31, 2020
Short-term debt
Commercial paper	$	2,027	$	1,030
$500 million, 3.05% Notes due 11/2022	495		—
Other, including finance leases	23		18


$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
Total short-term debt	$	2,545	$	3,374
Long-term debt
$277 million, 4% Notes due 2022	$	—	$	276
$973 million, 3.9% Notes due 2022	—		972
$500 million, 3.05% Notes due 2022	—		490
$17 million, 8.3% Notes due 2023	17		17
$63 million, 7.65% Notes due 2023	63		63
$700 million, Floating Rate Notes due 2023	699		698
$1,000 million, 3% Notes due 2023	985		975
$1,187 million, 3.75% Notes due 2023	1,185		2,181
$500 million, 0.613% Notes due 2024	498		—
$1,000 million, 3.5% Notes due 2024	983		977
$900 million, 3.25% Notes due 2025	897		896
$2,200 million, 4.125% Notes due 2025	2,193		2,191
$1,500 million, 4.5% Notes due 2026	1,504		1,505
$800 million, 1.25% Notes due 2026	796		—
$1,500 million, 3.4% Notes due 2027	1,423		1,410
$259 million, 7.875% Debentures due 2027	259		259
$600 million, 3.05% Notes due 2027	596		595
$3,800 million, 4.375% Notes due 2028	3,782		3,780
$1,500 million, 2.4% Notes due 2030	1,490		1,489
$1,500 million, 2.375% Notes due 2031 (1)	1,500		—
$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	2,192		2,180
$750 million, 3.2% Notes due 2040	743		742
$121 million, 5.875% Notes due 2041	119		119
$448 million, 6.125% Notes due 2041	490		490
$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	2,967		2,966
$1,250 million, 3.4% Notes due 2050	1,236		1,235
$1,500 million , 3.4% Notes due 2051	1,477		—
Other, including finance leases	28		36
Total long-term debt	$	31,125	$	29,545

(1) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 for further information about the Company's interest rate risk management and these derivative instruments.

Debt Issuance and Redemption. In order to decrease future interest expense, mitigate future refinancing risk and raise proceeds for general corporate purposes, the Company entered into the following transactions during 2021:

Debt issuance: On March 3, 2021, the Company issued $4.3 billion of new senior notes. The proceeds of this issuance were mainly used to redeem outstanding debt securities. The remaining proceeds are available for general corporate purposes. Interest on this debt is paid semi-annually.


Principal	Maturity Date	Interest Rate	Net Proceeds
$500 million (1)	March 15, 2024	0.613%	$499 million
$800 million (2)	March 15, 2026	1.250%	$797 million
$1,500 million (3)	March 15, 2031	2.375%	$1,492 million
$1,500 million (4)	March 15, 2051	3.400%	$1,479 million

(1) Redeemable at any time discounted at the U.S. Treasury rate plus 7.5 basis points. Redeemable at par on or after March 15, 2022.

(2) Redeemable at any time discounted at the U.S. Treasury rate plus 10 basis points. Redeemable at par on or after February 15, 2026.

(3) Redeemable at any time discounted at the U.S. Treasury rate plus 15 basis points. Redeemable at par on or after December 15, 2030.

(4) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after September 15, 2050.

Debt redemption: During 2021, the Company completed the redemption of a total of $4.5 billion in aggregate principal amount of certain of its outstanding debt securities. The Company recorded a pre-tax loss of $141 million ($110 million after-tax), consisting primarily of premium payments.

Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including for the purpose of providing liquidity support if necessary under our commercial paper program discussed below. As of December 31, 2021, there were no outstanding balances under these revolving credit agreements.

In April 2021, Cigna entered into a $3.0 billion five-year revolving credit and letter of credit agreement that matures in April 2026 and a $1.0 billion three-year revolving credit agreement that matures in April 2024, which are diversified among 23 banks and replaced the five-year revolving credit and letter of credit agreement that was scheduled to mature in April 2023. Under the current agreements, Cigna can borrow up to $3.0 billion and $1.0 billion, respectively, for general corporate purposes, with up to $500 million available under the five-year facility for issuance of letters of credit. The revolving credit agreements also include an option to extend the termination date for an additional one-year period, subject to consent of the banks.

Additionally, in April 2021, Cigna entered into a $1.0 billion 364-day revolving credit agreement that will mature in April 2022 and is diversified among 23 banks. This agreement replaced the prior $1.0 billion 364-day revolving credit agreement that was scheduled to expire in October 2021. Pursuant to this revolving credit agreement, Cigna can borrow up to $1.0 billion for general corporate purposes. The agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.

Each of the five-year facility, the three-year facility and the 364-day facility include an option to increase commitments in an aggregate amount of up to $1.5 billion across all three facilities. Each of the three facilities also contain customary covenants and restrictions including a financial covenant that the Company's leverage ratio, as defined in the credit agreements, may not exceed 60%, subject to certain exceptions upon the consummation of an acquisition.

Commercial Paper. Under our commercial paper program we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The commercial paper average interest rate was 0.26% at December 31, 2021.

The Company was in compliance with its debt covenants as of December 31, 2021.

Maturities of outstanding long-term debt are as follows:


(In millions)	Scheduled Maturities (1)
2022	$	500
2023	$	2,967
2024	$	1,500
2025	$	3,100
2026	$	2,300
Maturities after 2026	$	21,481

(1) Long-term debt maturity amounts include current maturities of long-term debt.

Interest expense on long-term and short-term debt was $1.3 billion in 2021, $1.4 billion in 2020 and $1.6 billion in 2019.

Note 8 – Common and Preferred Stock

Cigna has a total of 25 million shares of $1 par value preferred stock authorized for issuance. No shares of preferred stock were outstanding at December 31, 2021, 2020 or 2019.

The following table presents the share activity of Cigna for the years ended December 31, 2021, 2020 and 2019:


(Shares in thousands)	2021	2020	2019
Common: Par value $0.01; 600,000 shares authorized
Outstanding- January 1,	354,771	372,531	380,924
Net issued for stock option exercises and other benefit plans	3,375	4,142	3,413
Repurchased common stock	(35,198)	(21,902)	(11,806)
Outstanding- December 31,	322,948	354,771	372,531
Treasury stock	71,246	35,505	13,012
Issued- December 31,	394,194	390,276	385,543

Dividends

In 2021, Cigna initiated and declared quarterly cash dividends of $1.00 per share of Cigna common stock. Cigna currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of Cigna and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board of Directors may deem relevant. On February 3, 2022, the Board of Directors declared a quarterly cash dividend of $1.12 per share of Cigna common stock to be paid on March 27, 2022 to shareholders of records on March 9, 2022.

The following table provides details of Cigna's dividend payments:


Record Date	Payment Date	Amount per Share	Total Amount Paid (in millions)
2021
March 10, 2021	March 25, 2021	$1.00	$345
June 8, 2021	June 23, 2021	$1.00	$342
September 8, 2021	September 23, 2021	$1.00	$330
December 7, 2021	December 22, 2021	$1.00	$324
2020
March 10, 2020	April 9, 2020	$0.04	$15
2019
March 11, 2019	April 10, 2019	$0.04	$15

Accelerated Share Repurchase Agreements

On August 23, 2021, as part of our existing share repurchase program, we entered into separate accelerated share repurchase agreements ("ASR agreements") with Morgan Stanley & Co. LLC and JP Morgan Chase Bank, N.A. (collectively, the "Counterparties") to repurchase $2.0 billion of common stock in aggregate. On August 24, 2021, in accordance with the ASR agreements we remitted $2.0 billion to the Counterparties and received an initial delivery of 7.7 million shares of our common stock. We recorded the payments to the Counterparties as a reduction to stockholders' equity, consisting of a $1.6 billion increase in treasury stock, which reflects the value of the initial 7.7 million shares received upon initial settlement and a $400 million decrease in Additional paid-in capital, which reflects the value of the stock held back by the Counterparties pending final settlement of the agreements.

Upon final settlement of the ASR agreements on November 29, 2021 and December 1, 2021, we received an additional 1.8 million shares of our common stock for no additional consideration as the value of this stock was held back by the Counterparties pending final settlement of the agreements. The total number of shares of our common stock repurchased under the ASR agreements was 9.5 million based on an average daily volume weighted-average share price of our common stock during the term of the agreements, less a discount, of $209.53. In addition, we reclassified the $400 million recorded in Additional paid-in capital to Treasury stock upon settlement.

Note 9 – Insurance and Contractholder Liabilities

**A.**Account Balances – Insurance and Contractholder Liabilities

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


	December 31, 2021						December 31, 2020
(In millions)	Current		Non-current		Total		Current		Non-current		Total
Contractholder deposit funds	$	352	$	6,702	$	7,054	$	350	$	6,823	$	7,173
Future policy benefits	312		9,194		9,506		327		9,317		9,644
Unearned premiums	558		418		976		485		394		879
Unpaid claims and claim expenses
Cigna Healthcare	4,159		102		4,261		3,608		87		3,695
Other Operations	548		180		728		538		223		761
Total	5,929		16,596		22,525
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)	(611)		(4,033)		(4,644)
Total insurance and contractholder liabilities	$	5,318	$	12,563	$	17,881	$	5,308	$	16,844	$	22,152

(1) Amounts classified as Liabilities of businesses held for sale primarily include $3.8 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of December 31, 2021.

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

Accounting Policy - Contractholder Deposit Funds. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. In addition, this caption includes: 1) premium stabilization reserves under group health insurance contracts representing experience refunds left with the Company to pay future premiums; 2) deposit administration funds used to fund non-pension retiree insurance programs; 3) retained asset accounts and 4) annuities or supplementary contracts without significant life contingencies. Interest credited on these funds is accrued ratably over the contract period.

Accounting Policy - Future Policy Benefits. Future policy benefits represent the present value of estimated future obligations under long-term life and supplemental health insurance policies and annuity products currently in force. These obligations are estimated using actuarial methods and consist primarily of reserves for annuity contracts, life insurance benefits, GMDB contracts (GMDB contracts are fully reinsured, see Note 10 for additional information) and certain life and accident insurance products of our international businesses to be sold.

Obligations for annuities represent specified periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Obligations for life insurance policies and GMDB contracts represent benefits expected to be paid to policyholders, net of future premiums expected to be received. Management estimates these obligations based on assumptions as to premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders, allowing for adverse deviation as appropriate. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables. Interest rate

assumptions are based on management's judgment considering the Company's experience and future expectations and range from 1% to 9%. Obligations for the direct and assumed run-off settlement annuity business include adjustments for realized and unrealized investment returns consistent with GAAP when a premium deficiency exists. As of December 31, 2021, approximately 18% of the liability for future policy benefits was supported by assets held in trust for the benefit of the ceding company under reinsurance agreements.

Accounting Policy - Unearned Premium. The unrecognized portion of premiums received is recorded as unearned premiums included in insurance and contractholder liabilities.

**B.**Unpaid Claims and Claim Expenses – Cigna Healthcare

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities. This liability includes amounts from the International Health businesses now reported in Cigna Healthcare following our change in segment reporting in 2021. Prior year rollforwards have been updated to reflect this segment change.

Accounting policy. The Company uses actuarial principles and assumptions that are consistently applied each reporting period and recognizes the actuarial best estimate of the ultimate liability along with a margin for adverse deviation. This approach is consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions.

The Company compares key assumptions used to establish the medical costs payable to actual experience for each reporting period. The unpaid claims liability is adjusted through current period shareholders' net income when actual experience differs from these assumptions. Additionally, the Company evaluates expected future developments and emerging trends that may impact key assumptions. The process used to determine this liability requires the Company to make critical accounting estimates that involve considerable judgment, reflecting the variability inherent in forecasting future claim payments. These estimates are highly sensitive to changes in the Company's key assumptions, specifically completion factors and medical cost trend.

The liability is primarily calculated using "completion factors" developed by comparing the claim incurral date to the date claims were paid. Completion factors are impacted by several key items including changes in: 1) electronic (auto-adjudication) versus manual claim processing; 2) frequency and timeliness of provider claims submissions; 3) number of customers and 4) the mix of products. The Company uses historical completion factors combined with an analysis of current trends and operational factors to develop current estimates of completion factors. The Company estimates the liability for claims incurred in each month by applying the current estimates of completion factors to the current paid claims data. This approach implicitly assumes that historical completion rates will be a useful indicator for the current period.

The Company relies more heavily on medical cost trend analysis that reflects expected claim payment patterns and other relevant operational considerations for more recent months. Medical cost trend is primarily impacted by medical service utilization and unit costs that are affected by changes in the level and mix of health benefits offered, including inpatient, outpatient and pharmacy, the impact of copays and deductibles, changes in provider practices and changes in consumer demographics and consumption behavior.

The total of incurred but not reported liabilities plus expected development on reported claims, including reported claims in process, was $4.0 billion at December 31, 2021 and $3.4 billion at December 31, 2020.

Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment for the years ended December 31 was as follows:



(In millions)	2021		2020		2019
Beginning balance	$	3,695	$	3,336	$	3,090
Less: Reinsurance and other amounts recoverable	237		318		280
Beginning balance, net	3,458		3,018		2,810

Incurred costs related to:
Current year	31,755		27,494		26,026
Prior years	(219)		(144)		(180)
Total incurred	31,536		27,350		25,846
Paid costs related to:
Current year	27,929		24,187		23,176
Prior years	3,065		2,723		2,462
Total paid	30,994		26,910		25,638

Ending balance, net	4,000		3,458		3,018
Add: Reinsurance and other amounts recoverable	261		237		318
Ending balance	$	4,261	$	3,695	$	3,336

Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 for additional information on reinsurance.

Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions for the years ended December 31 were as follows:



(Dollars in millions)	2021				2020
	$		% (1)		$		% (2)
Actual completion factors	$	81	0.3	%	$	57	0.2	%
Medical cost trend	138		0.5		87		0.4

Total favorable variance	$	219	0.8	%	$	144	0.6	%

(1) Percentage of current year incurred costs as reported for the year ended December 31, 2020.

(2) Percentage of current year incurred costs as reported for the year ended December 31, 2019.

Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions.

The following table depicts the incurred and paid claims development as of December 31, 2021 (net of reinsurance), claims frequency metrics and incurred but not reported liabilities reported in the Cigna Healthcare segment. The information about incurred and paid claims development for the year ended December 31, 2020 is presented as supplementary information and is unaudited.


	Incurred Costs
Incurral Year	2020 (Unaudited)		2021		Unpaid Claims & Claim Expenses	Claims Frequency
(In millions)
2020	$	26,532	$	26,332	156	4.7	million
2021			30,735		3,696	5.1	million
Cumulative incurred costs for the periods presented			$	57,067

	Cumulative Costs Paid
Incurral Year	2020 (Unaudited)		2021
(In millions)
2020	$	23,347	$	26,176
2021			27,039
Cumulative paid costs for the periods presented			$	53,215

Outstanding liabilities for the periods presented, net of reinsurance			$	3,852
Other long-duration liabilities not included in development table above			148
Net unpaid claims and claims expenses - Cigna Healthcare			4,000
Reinsurance and other amounts recoverable			261
Unpaid claims and claim expenses - Cigna Healthcare			$	4,261

More than 95% of health claims incurred in a calendar year are paid within one year of their incurred date.

There is no single or common claim frequency metric used in the health care industry. The Company believes a relevant metric for its health insurance business is the number of customers for whom an insured medical claim was paid. Customers for whom no insured medical claim was paid are excluded from the calculation. Claims that did not result in a liability are not included in the frequency metric.

**C.**Unpaid Claims and Claim Expenses – Other Operations

Accounting policy. Liabilities for unpaid claims and claim expenses are established by book of business within Other Operations including the international businesses to be sold. Unpaid claims and claim expenses within the Other Operations consist of (1) case or claims reserves for reported claims that are unpaid as of the balance sheet date; (2) incurred but not reported reserves for claims when the insured event has occurred but has not been reported to the Company and (3) loss adjustment expense reserves for the expected costs of settling these claims. The Company consistently estimates incurred but not yet reported losses using actuarial principles and assumptions based on historical and projected claim incidence patterns, claim size and the expected payment period. The Company recognizes the actuarial best estimate of the ultimate liability within a level of confidence, consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions. The Company immediately records an adjustment in Medical costs and other benefit expenses when estimates of these liabilities change.

See Note 4 for a discussion of the divestiture of the Group Disability and Life business on December 31, 2020. Prior to the sale, the liabilities for unpaid claims and claim expenses in the Group Disability and Life business reflected reserves for long-term and short-term disability, life insurance and accident products. The majority of the unpaid claim liability related to disability claims that was measured as the present value of estimated future benefit payments, including expected development, for each reported claim that was receiving benefit payments over the expected disability period or pending a decision on eligibility for benefits.

Liability balance details. The liability details for unpaid claims and claim expenses are as follows. The liability no longer includes the International Health businesses now reported in Cigna Healthcare following our change in segment reporting. Prior year rollforwards have been updated to reflect the segment change.


(In millions)	December 31, 2021		December 31, 2020
Other Operations
International businesses to be sold	$	447	$	452
Other Operations	281		309
Unpaid claims and claim expenses Other Operations	728		761

Activity in the unpaid claims and claim expenses for international businesses held for sale and, prior to the sale, Group Disability and Life (see Note 4 for further information) is presented in the following table. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been largely reinsured.


(In millions)	2021 (1)		2020		2019
Beginning balance	$	452	$	5,372	$	5,039
Less: Reinsurance	45		169		140
Beginning balance, net	407		5,203		4,899
Incurred claims related to:
Current year	982		4,205		3,958
Prior years:
Interest accretion	—		154		152
All other incurred	11		48		(25)
Total incurred	993		4,407		4,085
Paid claims related to:
Current year	738		2,392		2,163
Prior years	227		1,690		1,607
Total paid	965		4,082		3,770

Foreign currency	(34)		21		(11)
Divestiture of Group Disability and Life business (2)	—		(5,142)		—
Ending balance, net	401		407		5,203
Add: Reinsurance	46		45		169
Ending balance	$	447	$	452	$	5,372

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

(2) Includes Group Disability and Life reserves sold or reinsured to New York Life Insurance Company as part of the sale of the Group Disability and Life business and immaterial retained balances which are now excluded from this table.

Reinsurance in the table above reflects amounts due from reinsurers related to unpaid claims liabilities. See Note 10 for additional information on reinsurance.

Note 10 – Reinsurance

The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.

**A.**Reinsurance Recoverables

Accounting policy. Reinsurance recoverables represent amounts due from reinsurers for both paid and unpaid claims of the Company's insurance businesses. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. Most reinsurance recoverables are classified as non-current assets. The current portion of reinsurance recoverables is reported in Other current assets and consists primarily of recoverables on paid claims expected to be settled within one year. Reinsurance recoverables are presented net of allowances, consisting primarily of an allowance for expected credit losses which is recognized on reinsurance recoverable balances each period and adjusted through benefits expense. Estimates of the allowance for expected credit losses are based on internal and external data used to develop expected loss rates over the anticipated duration of the recoverable asset that vary by external credit rating and collateral level.

The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. Included in the table below are $129 million of current reinsurance recoverables that are reported in Other current assets as of December 31, 2021; as of December 31, 2020 there were $217 million of current reinsurance recoverables reported in Other current assets. The Company's reinsurance recoverables as of December 31, 2021 are presented in the following table by range of external credit rating and collateral level:


(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 (2)		No collateral		Total
Ongoing Operations
A-A A- equivalent and higher current ratings (1)	$	—	$	—	$	172	$	172
BBB BBB- to BBB+ equivalent current credit ratings (1)	—		—		61		61
Not rated	103		1		35		139
Total recoverables related to ongoing operations (3)	103		1		268		372
Acquisition, disposition or runoff activities
A- equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York	—		2,935		—		2,935
Berkshire Hathaway Life Insurance Company of Nebraska	276		370		—		646
Prudential Retirement Insurance and Annuity	565		—		—		565
Life Insurance Company of North America	—		437		—		437
Other	220		17		17		254

Not rated	—		12		3		15
Total recoverables related to acquisition, disposition or runoff activities	1,061		3,771		20		4,852
Total	$	1,164	$	3,772	$	288	$	5,224
Allowance for uncollectible reinsurance							(30)
Total reinsurance recoverables (3)							$	5,194

(1) Certified by a nationally recognized statistical rating organization ("NRSRO").

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

(3) Includes $95 million of recoverables classified as Assets of businesses held for sale.

Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.

**B.**Effects of Reinsurance

The following table presents direct, assumed and ceded premiums for both short-duration and long-duration insurance contracts. It also presents reinsurance recoveries that have been netted against benefit expenses in the Company's Consolidated Statements of Income.


(In millions)	2021		2020		2019
Premiums
Short-duration contracts
Direct	$	36,513	$	38,425	$	35,690
Assumed	335		85		64
Ceded	(148)		(230)		(203)
Total short-duration contract premiums	36,700		38,280		35,551
Long-duration contracts
Direct	4,753		4,517		4,352
Assumed	99		99		105
Ceded	(398)		(269)		(294)
Total long-duration contract premiums	4,454		4,347		4,163
Total premiums	$	41,154	$	42,627	$	39,714
Total reinsurance recoveries	$	552	$	431	$	395

**C.**Effective Exit of GMDB and GMIB Business

The Company entered into an agreement with Berkshire to effectively exit the GMDB and GMIB business via a reinsurance transaction in 2013. Berkshire reinsured 100% of the Company's future claim payments in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall limit with approximately $3.2 billion remaining at December 31, 2021.

GMDB is accounted for as assumed and ceded reinsurance and GMIB assets and liabilities are reported as derivatives at fair value as discussed below. GMIB assets are reported in Other current assets and Other assets and GMIB liabilities are reported in Accrued expenses and other liabilities and Other non-current liabilities.

GMDB

The GMDB exposure arises under annuities written by ceding companies that guarantee the benefit received at death. The Company's exposure arises when the guaranteed minimum death benefit exceeds the fair value of the related mutual fund investments at the time of a contractholder's death.

Accounting policy. The Company estimates the gross liability and reinsurance recoverable with an internal model based on the Company's experience and future expectations over an extended period, consistent with the long-term nature of this product. As a result of the reinsurance transaction, reserve increases have a corresponding increase in the recorded reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit (including the GMIB asset presented below).

The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded.


(Dollars in millions, excludes impact of reinsurance ceded)	December 31, 2021		December 31, 2020
Account value	$	9,795	$	9,523
Net amount at risk	$	1,392	$	1,570
Average attained age of contractholders (weighted by exposure)	77		77
Number of contractholders (estimated)	170,000		185,000

GMIB

The Company reinsured contracts with issuers of GMIB products. The Company's exposure represents the excess of a contractually guaranteed amount over the level of variable annuity account values. Payment by the Company depends on the actual account value in the related underlying mutual funds and the level of interest rates when the contractholders elect to receive minimum income payments that can only occur within 30 days of a policy anniversary after the appropriate waiting period. The Company has purchased retrocessional coverage ("GMIB assets") for these contracts including retrocessional coverage from Berkshire.

Accounting policy. The Company reports GMIB liabilities and assets as derivatives at fair value because cash flows of these liabilities and assets are affected by equity markets and interest rates, but are without significant life insurance risk and are settled in lump sum payments. The Company receives and pays fees periodically based on either contractholders' account values or deposits increased at a contractual rate. The Company will also pay and receive cash depending on changes in account values and interest rates when contractholders first elect to receive minimum income payments. Cash flows on these contracts are reported in operating activities.

Assumptions used in fair value measurement. GMIB assets and liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates). The Company classifies GMIB assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 because assumptions related to future annuitant behavior are largely unobservable.

The only assumption expected to impact future shareholders' net income is non-performance risk. The non-performance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the GMIB liabilities to be paid by the Company and (b) the GMIB assets to be paid by the reinsurers, after considering collateral. The impact of non-performance risk was immaterial for the years ended December 31, 2021 and December 31, 2020.

GMIB liabilities totaling $572 million as of December 31, 2021 and $729 million as of December 31, 2020 are classified as Level 3 because fair value inputs are largely unobservable. The GMIB liabilities reflect the Company's credit risk, while the reinsurance recoverable reflects the credit risk of the reinsurers. There were three reinsurers covering 100% of the GMIB exposures as of December 31, 2021 and December 31, 2020 as follows:


(In millions)
Line of Business	Reinsurer	December 31, 2021		December 31, 2020		Collateral and Other Terms at December 31, 2021
GMIB	Berkshire	$	283	$	353	100% were secured by assets in a trust.
	Sun Life Assurance Company of Canada	167		215
	Liberty Re (Bermuda) Ltd.	151		190		100% were secured by assets in a trust.
Total GMIB recoverables reported in Other current assets and Other assets		$	601	$	758

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

Note 11 – Investments

Cigna's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 for information about the valuation of the Company's investment portfolio.

Debt securities, commercial mortgage loans, derivative financial instruments and short-term investments with contractual maturities during the next twelve months are classified on the balance sheet as current investments, unless they are held as statutory deposits or restricted for other purposes and then they are classified in Long-term investments. Equity securities may include funds that are used in our cash management strategy and are classified as current investments. All other investments are classified as Long-term investments.

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


	December 31, 2021						December 31, 2020
(In millions)	Current		Long-term		Total		Current		Long-term		Total
Debt securities	$	796	$	16,162	$	16,958	$	959	$	17,172	$	18,131
Equity securities	—		603		603		—		501		501
Commercial mortgage loans	40		1,526		1,566		13		1,406		1,419
Policy loans	—		1,338		1,338		—		1,351		1,351
Other long-term investments	—		3,574		3,574		—		2,832		2,832
Short-term investments	428		—		428		359		—		359
Total	1,264		23,203		24,467
Investments classified as assets of businesses held for sale (1)	(344)		(4,765)		(5,109)
Investments per Consolidated Balance Sheets	$	920	$	18,438	$	19,358	$	1,331	$	23,262	$	24,593

(1) Investments related to the international life, accident and supplemental benefits businesses that are held for sale. These investments are primarily comprised of debt securities and other long-term investments, and to a lesser extent, equity securities and short-term investments. See Note 5 to the Consolidated Financial Statements for additional information.

**A.**Investment Portfolio

Debt Securities

Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive income (loss) within Shareholders' equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive income (loss). When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Realized investment gains and losses. Certain asset-backed securities are considered variable interest entities, see Note 13 for additional information.

The Company reviews declines in fair value from a debt security's amortized cost basis to determine whether a credit loss exists, and when appropriate, recognizes a credit loss allowance with a corresponding charge to credit loss expense, presented in Realized investment gains and losses in the Company's Consolidated Statements of Income. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted as needed through credit loss expense.

The Company does not measure an allowance for credit losses for accrued interest receivables. When interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income and interest income is recognized on a cash basis.

The amortized cost and fair value by contractual maturity periods for debt securities were as follows at December 31, 2021:


(In millions)	Amortized Cost		Fair Value
Due in one year or less	$	812	$	816
Due after one year through five years	5,218		5,366
Due after five years through ten years	5,173		5,453
Due after ten years	4,067		4,805
Mortgage and other asset-backed securities	505		518
Total	$	15,775	$	16,958

Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties.

Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:


(In millions)	Amortized Cost		Allowance for Credit Loss		Unrealized Appreciation		Unrealized Depreciation		Fair Value
December 31, 2021
Federal government and agency	$	287	$	—	$	101	$	(1)	$	387
State and local government	154		—		17		—		171
Foreign government	2,468		—		194		(46)		2,616
Corporate	12,361		(23)		1,008		(80)		13,266
Mortgage and other asset-backed	505		—		17		(4)		518
Total	$	15,775	$	(23)	$	1,337	$	(131)	$	16,958
Investments supporting liabilities of the Company's run-off settlement annuity business (included in total above) (1)	$	2,262	$	(5)	$	720	$	(10)	$	2,967
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

(1) Net unrealized appreciation for these investments is excluded from accumulated other comprehensive income.

Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include:

severity of decline;
financial health and specific prospects of the issuer; and
changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. These debt securities are primarily corporate securities with a decline in fair value that reflects an increase in market yields since purchase. Our allowance for credit losses on debt securities was not material as of December 31, 2021 and December 31, 2020.


	December 31, 2021							December 31, 2020
(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	$	2,785	$	2,861	$	(76)	909	$	1,026	$	1,045	$	(19)	300
Below investment grade	561		578		(17)		781	381		405		(24)		232
More than one year
Investment grade	382		412		(30)		143	18		18		—		6
Below investment grade	162		170		(8)		53	90		100		(10)		33
Total	$	3,890	$	4,021	$	(131)	1,886	$	1,515	$	1,568	$	(53)	571

Equity Securities

Accounting policy. Equity securities with a readily determinable fair value consist primarily of mutual funds that invest in fixed income debt securities while those without a readily determinable fair value consist of private equity investments. Changes in the fair values of equity securities that have a readily determinable fair value are reported in Net realized investment gains (losses). Equity securities without a readily determinable fair value are carried at cost minus impairment, if any, plus or minus changes resulting from observable price changes.

The following table provides the values of the Company's equity security investments as of December 31, 2021 and December 31, 2020. The amount of impairments or value changes resulting from observable price changes on equity securities still held was not material to the financial statements as of December 31, 2021 or 2020.


	December 31, 2021				December 31, 2020
(In millions)	Cost		Carrying Value		Cost		Carrying Value
Equity securities with readily determinable fair values	$	257	$	207	$	238	$	246
Equity securities with no readily determinable fair value	270		396		225		255
Total	$	527	$	603	$	463	$	501

As of December 31, 2021, the Company had a commitment to purchase $550 million of equity securities in Bright Health Group, Inc., a technology-enabled health insurance carrier. This transaction was completed in January 2022.

Commercial Mortgage Loans

Accounting policy. Commercial mortgage loans are carried at unpaid principal balances, net of an allowance for expected credit losses, and classified as either current or long-term investments based on their contractual maturities. Changes in the allowance for expected credit losses are recognized as credit loss expense and presented in Realized investment gains and losses in the Company's Consolidated Statements of Income.

Each period, the Company establishes (or adjusts) its allowance for expected credit losses for commercial mortgage loans. The allowance for expected credit losses is based on a credit risk category that is assigned to each loan at origination using key credit quality indicators, including debt service coverage and loan-to-value ratios. Credit risk categories are updated as key credit quality indicators change. An expected loss rate, assigned based on the credit risk category, is applied to each loan's unpaid principal balance to develop the aggregate allowance for expected credit losses. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral.

Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties.

Credit quality**.** The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis.

Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan.

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio as of December 31, 2021 and December 31, 2020:


(Dollars in millions)	December 31, 2021					December 31, 2020
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%	$	560	2.18			$	533	2.28
60% to 79%	883		1.89			751		2.08
80% to 100%	129		1.47			141		1.33
Allowance for credit losses	(6)					(6)
Total	$	1,566	1.96	61	%	$	1,419	2.08	61	%

All commercial mortgage loans in the Company's portfolio are current as of December 31, 2021 and December 31, 2020.

Policy Loans

Accounting policy**.** Policy loans, primarily associated with our corporate-owned life insurance business, are carried at unpaid principal balances plus accumulated interest, the total of which approximates fair value. These loans are collateralized by life insurance policy cash values and therefore have minimal exposure to credit loss. Interest rates are reset annually based on a rolling average of benchmark interest rates.

Other Long-Term Investments

Accounting policy. Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans and healthcare related investments. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Depreciation is generally recorded using the straight-line method based on the estimated useful life of each asset. Investment real estate as of December 31, 2021 and 2020 is expected to be held longer than one year and may include real estate acquired through the foreclosure of commercial mortgage loans.

Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as "Other." See discussion below for information on the Company's accounting policies for derivative financial instruments.

Other long-term investments and related commitments are diversified by issuer, property type and geographic regions. These investments are primarily unconsolidated variable interest entities, see Note 13 for additional information. The following table provides unfunded commitment and carrying value information for these investments. The Company expects to disburse approximately 35% of the committed amounts in 2022.



					Unfunded Commitments as of
	Carrying value as of December 31,
(In millions)	2021		2020		December 31, 2021
Real estate investments	$	1,152	$	951	$	752
Securities partnerships	2,272		1,737		1,969
Other	150		144		—
Total	$	3,574	$	2,832	$	2,721

Short-Term Investments and Cash Equivalents

Accounting policy. Security investments with maturities of greater than three months to one year from time of purchase are classified as short-term, available for sale and carried at fair value that approximates cost. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase and are carried at cost that approximates fair value.

**B.**Derivative Financial Instruments

The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company's separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders.

Accounting policy. Derivatives are recorded on our Consolidated Balance Sheets at fair value and are classified as current or non-current according to their contractual maturities. Further information on our policies for determining fair value are discussed in Note 12. The Company applies hedge accounting when derivatives are designated, qualified and highly effective as hedges. Under hedge accounting, the changes in fair value of the derivative and the hedged risk are generally recognized together and offset each other when reported in Shareholders' net income. Various qualitative or quantitative methods appropriate for each hedge are used to formally assess and document hedge effectiveness at inception and each period throughout the life of a hedge.

The Company's derivative financial instruments are presented as follows:

Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds: Swap fair values are reported in Long-term investments or Other non-current liabilities. Offsetting changes in fair values attributable to the foreign exchange risk of the swap contracts and the hedged bonds are reported in Realized investment gains and losses. The portion of the swap contracts' changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities.
Fair value hedges of the interest rate exposure on the Company's long-term debt: Using fair value hedge accounting, the fair values of the swap contracts are reported in Other assets or Other liabilities. The critical terms of these swaps match those of the long-term debt being hedged. As a result, the carrying value of the hedged debt is adjusted to reflect changes in its fair value driven by the Secured Overnight Financing Rate ("SOFR"). The effects of those adjustments on interest expense are offset by the effects of corresponding changes in the swaps' fair value. The net impact from the hedge reported in Interest expense and other reflects interest expense on the hedged debt at the variable interest rate. Cash flows relating to these contracts are reported in Operating activities.
Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar: The fair values of the foreign currency swap and forward contracts are reported in Other assets or Other liabilities. The changes in fair values of these instruments are reported in Other comprehensive income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are

excluded from our effectiveness assessment and recognized in Interest expense and other over the term of the instrument. Cash flows relating to these contracts are reported in Investing activities.

Economic hedges for derivatives not designated as accounting hedges: Fair values of forward contracts are reported in Current investments or Accrued expenses and other liabilities. The changes in fair values are reported in Realized investment gains and losses. Cash flows relating to these contracts are reported in Investing activities.

The gross fair values of our derivative financial instruments are presented in Note 12. As of December 31, 2021 and December 31, 2020, the effects of derivative financial instruments used in these individual hedging strategies were not material to the Consolidated Financial Statements, including gains or losses reclassified from Accumulated other comprehensive income into Shareholders' net income, amounts excluded from the assessment of hedge effectiveness and fair values of assets posted or held as collateral supporting the fair values of these derivative financial instruments. The following table summarizes the types and notional quantity of derivative instruments held by the Company:


					Notional Value as of
(In millions)			December 31, 2021				December 31, 2020
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. A majority of these instruments are denominated in Euro, with the remaining instruments denominated in British Pound Sterling and Australian Dollars.		Foreign currency swap contracts			$	1,081			$	925
Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR.		Interest rate swap contracts			$	750			$	—
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 currencies other than the U.S. Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts are denominated in Euros, while foreign currency forward contracts are primarily denominated in Korean Won, with the remaining instruments denominated in New Zealand Dollar and Taiwan Dollar.		Foreign currency swap contracts			$	526			$	526
	Foreign currency forward contracts		$	1,380			$	636
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			$	720			$	538

Concentration of Risk

The Company did not have a concentration of investments in a single issuer or borrower exceeding 10% of shareholders' equity as of December 31, 2021 or 2020.

**C.**Net Investment Income

Accounting policy. When interest and principal payments on investments are current, the Company recognizes interest income when it is earned. The Company recognizes interest income on a cash basis when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured. For unconsolidated entities that are included in Other long-term investments, investment income is generally recognized according to the Company's share of the reported income or loss on the underlying investments. Investment income attributed to the Company's separate accounts is excluded from our earnings because associated gains and losses generally accrue directly to separate account policyholders.

The components of Net investment income for the years ended December 31 were as follows:


(In millions)	2021		2020		2019
Debt Securities	$	689	$	962	$	986
Equity securities	12		11		5
Commercial mortgage loans	60		80		88
Policy loans	63		64		66
Other long-term investments	758		127		167
Short-term investments and cash	26		52		131
Total investment income	1,608		1,296		1,443
Less investment expenses	59		52		53
Net investment income	$	1,549	$	1,244	$	1,390

Investment income for the year ended December 31, 2021 increased versus the year ended December 31, 2020 due to strong performance of assets underlying our limited partnership investments reported in Other long-term investments. The overall increase in investment income was partially offset by lower investment income from our debt securities as a result of lower invested asset levels following the divestiture of Cigna's U.S. Group Disability and Life business on December 31, 2020. The Company received income distributions of $568 million in 2021, $227 million in 2020 and $202 million in 2019 from its limited partnership investments reported in Other long-term investments.

D. Realized Investment Gains and Losses

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

The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:



(In millions)	2021		2020		2019
Net realized investment gains (losses), excluding credit loss expense and asset write-downs	$	194	$	186	$	189
Credit loss (expense) recoveries	2		(27)		—
Other investment asset write-downs	—		(10)		(12)
Net realized investment gains (losses), before income taxes	$	196	$	149	$	177

Net realized investment gains, excluding credit loss expense and asset write-downs for the year ended December 31, 2021 was primarily driven by mark-to-market gains on equity securities and gains on the sales of real estate partnerships, partially offset by mark-to-market losses on derivatives. This activity for the year ended December 31, 2020 was primarily driven by mark-to-market on equity securities and sales of debt securities, while activity for the year ended December 31, 2019 was primarily driven by gains on the sales of real estate partnerships and debt securities. Credit loss (expense) recoveries on invested assets reflect credit losses incurred on debt securities primarily relating to issuers in certain industries that have been impacted by the global COVID-19 pandemic.

Note 12 – Fair Value Measurements

The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.

Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.

The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's

fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).

The Company estimates fair values using prices from third parties or internal pricing methods. Fair value estimates received from third-party pricing services are based on reported trade activity and quoted market prices when available and other market information that a market participant would use to estimate fair value. The internal pricing methods are performed by the Company's investment professionals and generally involve using discounted cash flow analyses, incorporating current market inputs for similar financial instruments with comparable terms and credit quality as well as other qualitative factors. In instances where there is little or no market activity for the same or similar instruments, fair value is estimated using methods, models and assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. These valuation techniques involve some level of estimation and judgment that becomes significant with increasingly complex instruments or pricing models.

The Company is responsible for determining fair value and for assigning the appropriate level within the fair value hierarchy based on the significance of unobservable inputs. The Company reviews methodologies, processes and controls of third-party pricing services and compares prices on a test basis to those obtained from other external pricing sources or internal estimates. The Company performs ongoing analyses of both prices received from third-party pricing services and those developed internally to determine that they represent appropriate estimates of fair value. The controls executed by the Company include evaluating changes in prices and monitoring for potentially stale valuations. The Company also performs sample testing of sales values to confirm the accuracy of prior fair value estimates. The minimal exceptions identified during these processes indicate that adjustments to prices are infrequent and do not significantly impact valuations. An annual due-diligence review of the most significant pricing service is conducted to review their processes, methodologies and controls. This review includes a walk-through of inputs for a sample of securities held across various asset types to validate the documented pricing process.

**A.**Financial Assets and Financial Liabilities Carried at Fair Value

The following table provides information as of December 31, 2021 and December 31, 2020 about the Company's financial assets and liabilities carried at fair value. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to policyholders.


(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, 2021		As of December 31, 2020		As of December 31, 2021		As of December 31, 2020		As of December 31, 2021		As of December 31, 2020		As of December 31, 2021		As of December 31, 2020
Financial assets at fair value
Debt securities
Federal government and agency	$	147	$	207	$	240	$	249	$	—	$	—	$	387	$	456
State and local government	—		—		171		167		—		—		171		167
Foreign government	—		—		2,611		2,498		5		13		2,616		2,511
Corporate	—		—		12,606		13,878		660		684		13,266		14,562
Mortgage and other asset-backed	—		—		418		309		100		126		518		435
Total debt securities	147		207		16,046		17,101		765		823		16,958		18,131
Equity securities (1)	16		50		160		165		31		31		207		246
Short-term investments	—		—		428		325		—		—		428		325
Derivative assets (2)	—		—		143		72		—		—		143		72
Financial liabilities at fair value
Derivative liabilities	$	—	$	—	$	33	$	108	$	—	$	—	$	33	$	108

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

(2) Derivative assets above include $34 million as of December 31, 2020 that are presented in the Short-term investments category disclosed in Note 11. See Note 11 for more information on our Derivative Financial Instruments.

Level 1 Financial Assets

Inputs for instruments classified in Level 1 include unadjusted quoted prices for identical assets in active markets accessible at the measurement date. Active markets provide pricing data for trades occurring at least weekly and include exchanges and dealer markets.

Assets in Level 1 include actively-traded U.S. government bonds and exchange-listed equity securities. A relatively small portion of the Company's investment assets are classified in this category given the narrow definition of Level 1 and the Company's investment asset strategy to maximize investment returns.

Level 2 Financial Assets and Financial Liabilities

Inputs for instruments classified in Level 2 include quoted prices for similar assets or liabilities in active markets, quoted prices from those willing to trade in markets that are not active or other inputs that are market observable or can be corroborated by market data for the term of the instrument. Such other inputs include market interest rates and volatilities, spreads and yield curves. An instrument is classified in Level 2 if the Company determines that unobservable inputs are insignificant.

Debt and equity securities. Approximately 94% of the Company's investments in debt and equity securities are classified in Level 2 including most public and private corporate debt and equity securities, federal agency and municipal bonds, non-government mortgage-backed securities and preferred stocks. Third-party pricing services and internal methods often use recent trades of securities with similar features and characteristics because many debt securities do not trade daily. Pricing models are used to determine these prices when recent trades are not available. These models calculate fair values by discounting future cash flows at estimated market interest rates. Such market rates are derived by calculating the appropriate spreads over comparable U.S. Treasury securities based on the credit quality, industry and structure of the asset. Typical inputs and assumptions to pricing models include, but are not limited to, a combination of benchmark yields, reported trades, issuer spreads, liquidity, benchmark securities, bids, offers, reference data and industry and economic events. For mortgage-backed securities, inputs and assumptions may also include characteristics of the issuer, collateral attributes, prepayment speeds and credit rating.

Nearly all of these instruments are valued using recent trades or pricing models. Less than 1% of the fair value of investments classified in Level 2 represents foreign bonds that are valued using a single, unadjusted market-observable input derived by averaging multiple broker-dealer quotes, consistent with local market practice.

Short-term investments are carried at fair value that approximates cost. The Company compares market prices for these securities to recorded amounts on a regular basis to validate that current carrying amounts approximate exit prices. The short-term nature of the investments and corroboration of the reported amounts over the holding period support their classification in Level 2.

Derivative assets and liabilities classified in Level 2 represent over-the-counter instruments such as foreign currency forward and swap contracts. Fair values for these instruments are determined using market observable inputs including forward currency and interest rate curves and widely published market observable indices. Credit risk related to the counterparty and the Company is considered when estimating the fair values of these derivatives. However, the Company is largely protected by collateral arrangements with counterparties and determined that no adjustments for credit risk were required as of December 31, 2021 or December 31, 2020. The nature and use of these derivative financial instruments are described in Note 11.

Level 3 Financial Assets and Financial Liabilities

Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date.

The Company classifies certain newly-issued, privately-placed, complex or illiquid securities in Level 3. Approximately 5% of debt and equity securities are priced using significant unobservable inputs and classified in this category.

Fair values of mortgage and other asset-backed securities, as well as corporate and government debt securities, are primarily determined using pricing models that incorporate the specific characteristics of each asset and related assumptions including the investment type and structure, credit quality, industry and maturity date in comparison to current market indices, spreads and liquidity of assets with similar characteristics. Inputs and assumptions for pricing may also include characteristics of the issuer, collateral attributes and prepayment speeds for mortgage and other asset-backed securities. Recent trades in the subject security or similar securities are assessed when available, and the Company may also review published research in its evaluation, as well as the issuer's financial statements.

Quantitative Information about Unobservable Inputs

The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.

The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities as of December 31, 2021 and December 31, 2020. The range and weighted average basis point ("bps") amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.


	Fair Value as of					Unobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions )	December 31, 2021		December 31, 2020		Unobservable input December 31, 2021	December 31, 2021		December 31, 2020
Debt securities
Corporate and government debt securities	$	664	$	696	Liquidity	60 - 1060 (410)	bps	60 - 1370 (470)	bps
Mortgage and other asset-backed securities	100		126		Liquidity	60 - 390 (100)	bps	60 - 380 (80)	bps
Securities not priced by the Company (1)	1		1
Total Level 3 debt securities	$	765	$	823

(1) The fair values for these securities use single, unadjusted non-binding broker quotes not developed directly by the Company.

A significant increase in liquidity spread adjustments would result in a lower fair value measurement, while a decrease would result in a higher fair value measurement.

Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value

The following table summarizes the changes in financial assets and financial liabilities classified in Level 3 for the years ended December 31, 2021 and 2020. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.




(In millions)	2021		2020
Debt and Equity Securities
Beginning balance	$	854	$	555
Total gains (losses) included in shareholders' net income	(22)		(7)
Gains (losses) included in other comprehensive income	(6)		(12)
Gains (losses) required to adjust future policy benefits for settlement annuities (1)	(8)		7
Purchases, sales and settlements
Purchases	138		107
Sales	(36)		(121)
Settlements	(119)		(89)
Total purchases, sales and settlements	(17)		(103)
Transfers into/(out of) Level 3
Transfers into Level 3	207		774
Transfers out of Level 3	(212)		(360)
Total transfers into/(out of) Level 3	(5)		414
Ending balance	$	796	$	854
Total gains (losses) included in Shareholders' net income attributable to instruments held at the reporting date	$	(17)	$	(17)
Change in unrealized gains or losses included in Other comprehensive income for assets held at the end of the reporting period	$	(10)	$	(6)

(1) Amounts do not accrue to shareholders.

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

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

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2021 and 2020 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. Transfers into and out of Level 3 were higher in 2020 due to significant fluctuations in unobservable inputs experienced as a result of the uncertainty over the economic impacts related to COVID-19. See discussion under Quantitative Information about Unobservable Inputs above for more information.

Separate Accounts

Accounting policy. Separate account assets and liabilities are contractholder funds maintained in accounts with specific investment objectives. The assets of these accounts are legally segregated and are not subject to claims that arise out of any of the Company's other businesses. These separate account assets are carried at fair value with equal amounts recorded for related separate account liabilities. The investment income and fair value gains and losses of separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. Fees and charges earned for mortality risks, asset management or administrative services are reported in either Premiums or Fees and other revenues. Investments that are measured using the practical expedient of net asset value ("NAV") are excluded from the fair value hierarchy.

Fair values of Separate account assets at December 31, 2021 and December 31, 2020 were as follows:


(In millions)	Quoted Prices in Active Markets for Identical Assets (Level 1)				Significant Other Observable Inputs (Level 2)				Significant Unobservable Inputs (Level 3)				Total
	December 31, 2021		December 31, 2020		December 31, 2021		December 31, 2020		December 31, 2021		December 31, 2020		December 31, 2021		December 31, 2020
Guaranteed separate accounts (See Note 22)	$	227	$	226	$	276	$	297	$	—	$	—	$	503	$	523
Non-guaranteed separate accounts (1)	1,130		1,925		6,406		5,600		334		355		7,870		7,880
Subtotal	$	1,357	$	2,151	$	6,682	$	5,897	$	334	$	355	8,373		8,403
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)													842		683
Total													9,215
Separate account assets of businesses classified as held for sale (2)													(878)
Separate account assets per Consolidated Balance Sheets													$	8,337	$	9,086

*(1)*Non-guaranteed separate accounts included $4.5 billion as of December 31, 2021 and $4.2 billion as of December 31, 2020 in assets supporting the Company's pension plans, including $0.3 billion classified in Level 3 as of December 31, 2021 and December 31, 2020.

*(2)*Investments related to the international life, accident and supplemental benefits businesses that are held for sale. See Note 5 to the Consolidated Financial Statements for additional information.

Separate account assets classified as Level 1 primarily include exchange-listed equity securities. Level 2 assets primarily include:

corporate and structured bonds valued using recent trades of similar securities or pricing models that discount future cash flows at estimated market interest rates as described above; and
actively-traded institutional and retail mutual fund investments.

Separate account assets classified in Level 3 primarily support Cigna's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the year ended December 31, 2021 or 2020.

Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient) including changes in the fair values of its underlying investments. Substantially all of these assets support the Cigna Pension Plans. The following table provides additional information on these investments:


	Fair Value as of				Unfunded Commitment as of December 31, 2021		Redemption Frequency (if currently eligible)	Redemption Notice Period
(In millions)	December 31, 2021		December 31, 2020
Securities partnerships	$	513	$	463	$	275	Not applicable	Not applicable
Real estate funds	325		215		—		Quarterly	30 - 90 days
Hedge funds	4		5		—		Up to annually, varying by fund	30 - 90 days
Total	$	842	$	683	$	275

As of December 31, 2021, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception.

**B.**Assets and Liabilities Measured at Fair Value under Certain Conditions

Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.

For the years ended December 31, 2021 and 2020, no impairments were recognized requiring these assets to be measured at fair value. Realized investment gains and losses from these observable price changes for the years ended December 31, 2021 and December 31, 2020 were not material.

**C.**Fair Value Disclosures for Financial Instruments Not Carried at Fair Value

The following table includes the Company's financial instruments not recorded at fair value that are subject to fair value disclosure requirements at December 31, 2021 and December 31, 2020. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Financial Statements at amounts that approximate fair value are excluded from the following table:


	Classification in Fair Value Hierarchy		December 31, 2021						December 31, 2020
(In millions)		Fair Value			Carrying Value			Fair Value			Carrying Value
Commercial mortgage loans	Level 3		$	1,598		$	1,566		$	1,456		$	1,419
Long-term debt, including current maturities, excluding finance leases	Level 2		$	35,621		$	31,593		$	37,676		$	31,835

Note 13 – Variable Interest Entities

When the Company becomes involved with a variable interest entity and when there is a change in the Company's involvement with an entity, the Company must determine if it is the primary beneficiary and must consolidate the entity. The Company is considered the primary beneficiary if it has the power to direct the entity's most significant economic activities and has the right to receive benefits or obligation to absorb losses that could be significant to the entity. The Company evaluates the following criteria:

the structure and purpose of the entity;
the risks and rewards created by and shared through the entity; and
the Company's ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity including its sponsors, equity holders, guarantors, creditors and servicers.

The Company determined it was not a primary beneficiary in any material variable interest entity as of December 31, 2021 or December 31, 2020.

The Company's involvement in variable interest entities for which it is not the primary beneficiary is described below.

Securities limited partnerships and real estate limited partnerships. The Company owns interests in securities limited partnerships and real estate limited partnerships that are defined as unconsolidated variable interest entities. These partnerships invest in the equity or mezzanine debt of privately-held companies and real estate properties. General partners unaffiliated with the Company control decisions that most significantly impact the partnership's operations and the limited partners do not have substantive kick-out or participating rights. The Company has invested in approximately 180 limited partnerships that have a carrying value of $2.6 billion as of December 31, 2021 reported in Other long-term investments. We have commitments to contribute an additional $2.2 billion to these entities. The Company's maximum exposure to loss from these investments is $4.8 billion, calculated as the sum of our carrying value and the additional funding commitments. Our noncontrolling interest in each of these limited partnerships is generally less than 15% of the partnership ownership interests. See Note 11 for further information on the Company's accounting policy for Other long-term investments.

Other variable interest entities. The Company is involved in other types of variable interest entities, including certain asset-backed and corporate securities, real estate joint ventures that develop properties for residential and commercial use, independent physician associations (IPAs) that provide care management services and international healthcare joint ventures. The Company's maximum exposure to loss is $0.6 billion from certain asset-backed and corporate securities and $0.4 billion from real estate joint ventures, which represents the sum of our carrying value and the additional funding commitments for these entities. The carrying values and maximum exposures for remaining unconsolidated variable interest entities was not material as of December 31, 2021.

The Company has not provided, and does not intend to provide, financial support to any of the variable interest entities in excess of its maximum exposure. We perform ongoing qualitative analyses of our involvement with these variable interest entities to determine if consolidation is required.

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

AOCI includes unrealized appreciation on securities and derivatives (excluding appreciation on investments supporting future policy benefit liabilities of the run-off settlement annuity business) (see Note 11), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI were as follows:


	For the Years Ended December 31,
(In millions)		2021		2020		2019
Securities and Derivatives
Beginning balance		$	900	$	975	$	18
Appreciation (depreciation) on securities and derivatives		(230)		776		1,266
Tax (expense) benefit		31		(150)		(270)
Net appreciation (depreciation) on securities and derivatives		(199)		626		996
Reclassification adjustment for (gains) losses 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)		(21)		(26)		(49)
Reclassification adjustment for tax expense included in Shareholders' net income		5		187		10
Net (gains) losses reclassified from AOCI to Shareholders' net income		(16)		(701)		(39)
Other comprehensive income (loss), net of tax		(215)		(75)		957
Ending balance		$	685	$	900	$	975

Translation of foreign currencies
Beginning balance		$	(15)	$	(275)	$	(221)
Translation of foreign currencies		(213)		232		(57)
Tax (expense) benefit		(19)		12		(2)
Net translation of foreign currencies		(232)		244		(59)
Reclassification adjustment for (gains) losses included in Net income ((Gain) loss on sale of business)		—		11		—
Reclassification adjustment for tax expense (benefit) included in Net income		—		(3)		—
Net translation (gains) losses reclassified from AOCI to Net income		—		8		—


Other comprehensive income (loss), net of tax		(232)		252		(59)
Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests		(14)		(8)		(5)
Shareholders' other comprehensive income (loss), net of tax		(218)		260		(54)
Ending balance		$	(233)	$	(15)	$	(275)

Postretirement benefits liability
Beginning balance		$	(1,746)	$	(1,641)	$	(1,508)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)		85		70		62
Reclassification adjustment for settlement (Interest expense and other)		4		—		10
Reclassification adjustment for tax (benefit) included in Shareholders' net income		(21)		(17)		(15)
Net adjustments reclassified from AOCI to Shareholders' net income		68		53		57
Valuation update		448		(206)		(249)
Tax (expense) benefit		(106)		48		59
Net change due to valuation update		342		(158)		(190)
Other comprehensive income (loss), net of tax		410		(105)		(133)
Ending balance		$	(1,336)	$	(1,746)	$	(1,641)

Note 15 – Organizational Efficiency Plan

During the fourth quarter of 2021, we approved a strategic plan to further leverage the Company's ongoing growth to drive operational efficiency through enhancements to organizational structure and increased use of automation and shared services. As a result we recognized a charge in Selling, general and administrative expenses of $168 million, pre-tax ($119 million, after-tax) in the fourth quarter of 2021. This charge included $59 million of one-time expenses related to abandonment of leased assets and impairment of property and equipment as well as $109 million of accrued expenses primarily for severance costs related to headcount reductions. We expect most of the severance to be paid by 2023.

The following table summarizes a rollforward of the accrued liability recorded in "Accrued expenses and other liabilities":


(In millions)
Fourth quarter 2021 charge	$	109
2021 payments	(6)
Balance, December 31, 2021	$	103

Note 16 – Pension

**A.**About Our Plans

The Company sponsors U.S. and non-U.S. defined benefit pension plans; future benefit accruals for the domestic plans are frozen.

Accounting policy. The Company measures the assets and liabilities of its domestic pension plans as of December 31. Benefit obligations are measured at the present value of estimated future payments based on actuarial assumptions. The Company uses the "corridor" method to account for changes in the benefit obligation when actual results differ from those assumed, or when assumptions change. These changes are called net unrecognized actuarial gains (losses). Under the corridor method, net unrecognized actuarial gains (losses) are initially recorded in Accumulated other comprehensive loss. When the unrecognized gain (loss) exceeds 10% of the benefit obligation, that excess is amortized to expense over the expected remaining lives of plan participants. The net plan expense is reported in Interest expense and other in the Consolidated Statements of Income.

For balance sheet purposes, we measure plan assets at fair value. When the actual return differs from the expected return, those differences are reflected in the net unrealized actuarial gain (loss) discussed above. However, to measure pension benefit costs, we use a "market-related" asset valuation that differs from the actual fair value for domestic pension plan assets invested in non-fixed income investments. The "market-related" value recognizes the difference between actual and expected long-term returns in the portfolio over five years, a method that reduces the short-term impact of market fluctuations on pension costs. The market-related asset value was approximately $4.4 billion, compared with a fair value of approximately $4.8 billion at December 31, 2021.

**B.**Funded Status and Amounts Included in Accumulated Other Comprehensive Income

The following table summarizes the projected benefit obligations and assets related to our U.S. and non-U.S. pension plans as of and for the years ended December 31:


	Pension Benefits
(In millions)	2021		2020
Change in benefit obligation
Benefit obligation, January 1	$	5,600	$	5,314
Service cost	2		2
Interest cost	132		168

Actuarial (gains) losses, net (1)	(189)		416
Benefits paid from plan assets	(304)		(285)
Benefits paid – other	(18)		(15)
Benefit obligation, December 31	5,223		5,600
Change in plan assets
Fair value of plan assets, January 1	4,623		4,441
Actual return on plan assets	522		449
Benefits paid	(304)		(285)
Contributions	5		18
Fair value of plan assets, December 31	4,846		4,623
Funded status	$	(377)	$	(977)
Liability in Consolidated Balance Sheets
Accrued expenses and other liabilities	$	(14)	$	(15)
Other non-current liabilities	$	(363)	$	(962)

(1) 2021 gain reflects an increase in the discount rate; 2020 loss reflects a decrease in the discount rate, partially offset by a favorable change in the mortality assumption.

We fund our qualified pension plans at least at the minimum amount required by the Employee Retirement Income Security Act of 1974 and the Pension Protection Act of 2006. The Company made immaterial contributions to the qualified pension plans in 2021. For 2022, contributions to the qualified pension plans are expected to be immaterial. Future years' contributions will ultimately be based on a wide range of factors including but not limited to asset returns, discount rates and funding targets. Non-qualified pension and other postretirement benefit plans are generally funded on a pay-as-you-go basis as there are no plan assets for these plans.

Benefit payments. The following benefit payments are expected to be paid in:


(In millions)	Pension Benefits
2022	$	317
2023	$	318
2024	$	317
2025	$	315
2026	$	316
2027-2031	$	1,532

Amounts reflected in the pension liabilities shown above that have not yet been reported in net income and, therefore, have been included in Accumulated other comprehensive loss consisted of the following as of December 31:


	Pension Benefits
(In millions)	2021		2020
Unrecognized net (losses)	$	(1,753)	$	(2,277)
Unrecognized prior service cost	(5)		(5)
Postretirement benefits liability adjustment	$	(1,758)	$	(2,282)

**C.**Cost of Our Plans

Net pension cost was as follows:


	Pension Benefits
(In millions)	2021		2020		2019
Service cost	$	2	$	2	$	2
Interest cost	132		168		194
Expected long-term return on plan assets	(269)		(260)		(245)
Amortization of:
Prior actuarial losses, net	78		78		59

Litigation settlement – plan amendment	—		—		142
Settlement loss	4		—		10
Net (benefit) cost	$	(53)	$	(12)	$	162

The Cigna Pension Plan (the "Plan"), together with its Plan Sponsor, was a defendant in a class action lawsuit related to the Plan's conversion of certain employees from an annuity to a cash balance benefit in 1997. In the first quarter of 2019, the Plan implemented the court order resulting in an increase to the pension liability of $142 million. The Company reversed a litigation reserve for the expenses recognized for this matter in 2019 aggregating to the same amount resulting in no impact on net income.

**D.**Assumptions Used for Pension


	2021	2020
Discount rate:
Pension benefit obligation	2.82%	2.49%
Pension benefit cost	2.49%	3.30%
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 2021 projection scale	White Collar mortality table with MP 2020 projection scale

The Company develops discount rates by applying actual annualized yields for high quality bonds by duration to the expected pension plan liability cash flows. The bond yields represent a diverse mix of actively traded high quality fixed-income securities that have an above average return at each duration as management believes this approach is representative of the yield achieved through plan asset investment strategy.

The expected long-term return on plan assets was developed considering historical long-term actual returns, expected long-term market conditions, plan asset mix and management's plan asset investment strategy.

**E.**Pension Plan Assets

As of December 31, 2021, pension assets included $4.5 billion invested in the separate accounts of Connecticut General Life Insurance Company, a subsidiary of the Company, as well as an additional $0.3 billion, primarily invested directly in funds offered by an unaffiliated insurance company.

The fair values of pension assets by category are as follows as of December 31, 2021 and 2020:


(In millions)	2021		2020
Debt securities:
Federal government and agency	$	9	$	9
Corporate	1,653		1,680
Asset-backed	108		53
Fund investments	731		380
Total debt securities	2,501		2,122
Equity securities:
Domestic	789		978
International, including funds and pooled separate accounts (1)	358		471
Total equity securities	1,147		1,449
Securities partnerships	514		463
Real estate funds, including pooled separate accounts (1)	334		219
Commercial mortgage loans	77		95
Hedge funds	—		1
Guaranteed deposit account contract	91		98
Cash equivalents and other current assets, net	182		176
Total pension assets at fair value	$	4,846	$	4,623

(1) A pooled separate account has several participating benefit plans and each owns a share of the total pool of investments.

The Company's current target investment allocation percentages (58% fixed income, 25% public equity securities and 17% in other investments, including private equity (securities partnerships) and real estate) are developed by management as guidelines, although the fair values of each asset category are expected to vary as a result of changes in market conditions. The Company will evaluate further allocation changes to equity securities, other investments and fixed income securities as funding levels change.

See Note 12 for further details regarding how fair value is determined, including the level within the fair value hierarchy and the procedures we use to validate fair value measurements. The Company classifies substantially all debt securities in Level 2 for pension plan assets. These assets are valued using recent trades of similar securities or are fund investments priced using their daily net asset value that is the exit price. A substantial portion of domestic equity securities within pension assets are classified as Level 1, while international equity funds within pension assets are predominantly classified in Level 2 using daily net asset value.

Securities partnerships, real estate and hedge funds are valued using net asset value as a practical expedient and are excluded from the fair value hierarchy. See Note 12 for additional disclosures related to these assets invested in the separate accounts of the Company's subsidiaries. Certain securities as described in Note 12, as well as commercial mortgage loans and guaranteed deposit account contracts, are classified in Level 3 because unobservable inputs used in their valuation are significant.

**F.**401(k) Plans

The Company sponsors a 401(k) plan in which the Company matches a portion of employees' pre-tax contributions. Participants in the plan may invest in various funds that invest in the Company's common stock, several diversified stock funds, a bond fund or a fixed-income fund.

The Company may elect to increase its matching contributions if the Company's annual performance meets certain targets. The Company's annual expense for these plans was as follows:


(In millions)						2021						2020						2019
Expense						$	268					$	243					$	256

Note 17 – Employee Incentive Plans

**A.**About Our Plans

The People Resources Committee (the "Committee") of the Board of Directors awards stock options, restricted stock grants, restricted stock units, deferred stock and strategic performance shares to certain employees. The Company issues original issue shares for these awards.

The Company records compensation expense for stock and option awards over their vesting periods primarily based on the estimated fair value at the grant date. Fair value is determined differently for each type of award as discussed below.

Shares of common stock available for award at December 31, were as follows:


(In millions)						2021						2020						2019
Common shares available for award						19.1						20.6						23.2

**B.**Stock Options

Accounting policy. The Company awards options to purchase Cigna common stock at the market price of the stock on the grant date. Options vest over periods ranging from one year to three years and expire no later than 10 years from grant date. Fair value is estimated using the Black-Scholes option-pricing model by applying the assumptions presented below. That fair value is reduced by options expected to be forfeited during the vesting period. The Company estimates forfeitures at the grant date based on our experience and adjusts the expense to reflect actual forfeitures over the vesting period. The fair value of options, net of forfeitures, is recognized in Selling, general and administrative expenses on a straight-line basis over the vesting period.

Black-Scholes option-pricing model assumptions and the resulting fair value of options are presented in the following table:


	2021			2020			2019
Dividend yield	1.85		%	—		%	—		%
Expected volatility	30.0		%	30.0		%	30.0		%
Risk-free interest rate	0.5		%	1.4		%	2.5		%
Expected option life	4.5 years			4.5 years			4.4 years
Weighted average fair value of options	$	44.84		$	52.42		$	53.10

The dividend yield reflects expected future dividends. In 2021, the Company increased its dividend and expects to continue dividends at least at that level for the foreseeable future. The expected volatility reflects the past daily stock price volatility of Cigna stock. The Company does not consider volatility implied in the market prices of traded options to be a good indicator of future volatility because remaining traded options will expire within one year. The risk-free interest rate is derived using the four-year U.S. Treasury bond yield rate as of the award date for the primary annual grant. Expected option life reflects the Company's historical experience.

The following table shows the status of, and changes in, common stock options during the last three years:


(Options in thousands)	2021			2020			2019
	Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price
Outstanding - January 1	9,742	$	152.40	11,438	$	136.19	12,370	$	125.46
Granted	1,524	$	213.81	1,851	$	191.86	1,569	$	183.41
Exercised	(2,584)	$	129.08	(3,289)	$	115.38	(2,297)	$	106.75
Expired or canceled	(192)	$	199.10	(258)	$	188.79	(204)	$	180.08
Outstanding - December 31	8,490	$	169.47	9,742	$	152.40	11,438	$	136.19
Options exercisable at year-end	5,612	$	152.92	6,837	$	137.08	8,874	$	123.87

Compensation expense of $63 million related to unvested stock options at December 31, 2021 will be recognized over the next two years (weighted average period).

The table below summarizes information for stock options exercised during the last three years:


(In millions)	2021		2020		2019
Intrinsic value of options exercised	$	268	$	304	$	180
Cash received for options exercised	$	326	$	376	$	224
Tax benefit from options exercised	$	50	$	57	$	34

The following table summarizes information for outstanding common stock options at December 31, 2021:


	Options Outstanding		Options Exercisable
Number (in thousands)	8,490		5,612
Total intrinsic value (in millions)	$	511	$	430
Weighted average exercise price	$	169.47	$	152.92
Weighted average remaining contractual life	6.0 years		4.8 years

**C.**Restricted Stock

The Company awards restricted stock (grants and units) to the Company's employees that vest over periods ranging from one to three years. Recipients of restricted stock awards accumulate dividends during the vesting period, but generally forfeit their awards and accumulated dividends if their employment terminates before the vesting date.

Accounting policy. Fair value of restricted stock awards is equal to the market price of Cigna's common stock on the date of grant. This fair value is reduced by awards that are expected to forfeit. At the grant date, the Company estimates forfeitures based on experience and adjusts the expense to reflect actual forfeitures over the vesting period. This fair value, net of forfeitures, is recognized in Selling, general and administrative expenses over the vesting period on a straight-line basis.

The following table shows the status of and changes in restricted stock awards during the last three years:


(Awards in thousands)	2021			2020			2019
	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	1,600	$	186.12	1,945	$	178.78	2,138	$	168.12
Awarded	899	$	213.82	791	$	191.22	870	$	183.86
Vested	(866)	$	184.07	(1,026)	$	161.58	(964)	$	160.74
Forfeited	(109)	$	197.01	(110)	$	186.63	(99)	$	168.68
Outstanding - December 31	1,524	$	202.85	1,600	$	186.12	1,945	$	178.78

The fair value of vested restricted stock at the vesting date for the years ended December 31 was as follows:


(In millions)						2021						2020						2019
Fair value of vested restricted stock						$	183					$	190					$	171

Approximately 10,300 employees held 1.5 million restricted stock awards at the end of 2021 with $168 million of related compensation expense to be recognized over the next two years (weighted average period).

**D.**Strategic Performance Shares ("SPS")

The Company awards SPSs to executives and certain other key employees generally with a performance period of three years. Half of these shares are subject to a market condition (total shareholder return relative to industry peer companies) and half are subject to a performance condition (cumulative adjusted net income). These targets are set by the Committee at the beginning of the performance period. Holders of these awards receive shares of Cigna common stock at the end of the performance period ranging anywhere from 0 to 200% of the original awards.

Accounting policy. Compensation expense for SPSs is recorded over the performance period. Fair value is determined at the grant date for "market condition" SPSs using a Monte Carlo simulation model and not subsequently adjusted regardless of the final outcome. Expense is initially accrued for "performance condition" SPSs based on the most likely outcome, but evaluated for adjustment each period for updates in the expected outcome. Expense is adjusted to the actual outcome (number of shares awarded times the share price at the grant date) at the end of the performance period.

The following table shows the status of and changes in SPSs during the last three years:


	2021			2020			2019
(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	808	$	190.02	818	$	177.94	707	$	160.74
Awarded	331	$	213.90	362	$	191.52	389	$	184.72
Vested	(206)	$	196.29	(309)	$	159.67	(244)	$	139.27
Forfeited	(73)	$	197.38	(63)	$	187.76	(34)	$	178.98
Outstanding - December 31	860	$	197.07	808	$	190.02	818	$	177.94

The weighted average fair value per share of SPSs for expense purposes, including the Monte Carlo factor, at the award date for the years ended December 31, 2021, 2020 and 2019 was $239.57, $206.86 and $192.11, respectively.

The fair value of vested SPSs at the vesting date for the years ended December 31 was as follows:


	2021			2020			2019
(Shares in thousands; $ in millions)	Shares	Fair Value		Shares	Fair Value		Shares	Fair Value
Shares of Cigna common stock distributed upon SPS vesting	243	$	51	306	$	55	254	$	45

Approximately 500 employees held 860,000 SPSs at the end of 2021 and $66 million of related compensation expense is expected to be recognized over the next two years. The amount of expense for "performance condition" SPSs will vary based on actual performance in 2022 and 2023.

**E.**Compensation Cost and Tax Effects of Share-based Compensation

The Company records tax benefits in Shareholders' net income during the vesting period based on the amount of expense being recognized. The difference between tax benefits based on the expense and the actual tax benefit realized are also recorded in Net income when stock options are exercised, or when restricted stock and SPSs vest.


(In millions)	2021		2020		2019
Total compensation cost for shared-based awards	$	268	$	289	$	299
Tax benefits recognized	$	73	$	63	$	59

Note 18 – Goodwill, Other Intangibles and Property and Equipment

**A.**Goodwill

Accounting policy. Goodwill represents the excess of the cost of businesses acquired over the fair value of their net assets. The resulting goodwill is assigned to those reporting units expected to realize cash flows from the acquisition, based on those reporting units' relative fair values. As a result, goodwill is primarily reported in the Evernorth segment ($35.1 billion) and the Cigna Healthcare segment ($10.7 billion). The Company's reporting units are aligned with its operating segments as described in Note 1.

The Company conducts its annual quantitative evaluation for goodwill impairment during the third quarter at the reporting unit level and writes it down through shareholders' net income if impaired. On a quarterly basis, the Company performs a qualitative impairment assessment 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. Fair value of a reporting unit is generally estimated based on both a discounted cash flow analysis and a market approach using assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. The significant assumptions and estimates used in determining fair value primarily 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 that reporting unit. Projections of future cash flows differ by reporting unit and are consistent with our strategic projection processes. Future cash flows for Evernorth are primarily driven by the forecasted gross margins of the business, as well as operating expenses and long-term growth rates. Future cash flows for our other reporting units are primarily driven by forecasted revenues, benefit expenses, operating expenses and long-term growth rates.

Goodwill activity. Goodwill activity during 2021 and 2020 was as follows:


(In millions)	2021		2020
Balance at January 1,	$	44,648	$	44,602
Goodwill acquired, net	1,428		29
Impact of foreign currency translation	(31)		17
Total	46,045
Goodwill classified as Assets of businesses held for sale	(234)
Goodwill per Consolidated Balance Sheets at December 31,	$	45,811	$	44,648

**B.**Other Intangibles

Accounting policy. The Company's other intangible assets primarily include purchased customer and producer relationships, provider networks and trademarks. The fair value of purchased customer relationships and the amortization method were determined as of the dates of purchase using an income approach that relies on projected future net cash flows including key assumptions for customer attrition and discount rates. The Company's definite-lived intangible assets are amortized on an accelerated or straight-line basis, reflecting their pattern of economic benefits, over periods from three to 30 years. 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. Costs incurred to renew or extend the terms of these intangible assets are generally expensed as incurred.

The Company's amortized intangible assets are tested for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. If the total of the expected future undiscounted cash flows generated by the underlying asset group is less than the carrying amount of the asset group, the Company recognizes an impairment charge equal to the difference between the carrying value of the asset group and its estimated fair value. The Company's indefinite-lived intangible assets are each reviewed for impairment at least annually by comparing their fair value with their carrying value. If the carrying value exceeds fair value, that excess is recognized as an impairment loss.

There were no material impairments in the years ended December 31, 2021, 2020 or 2019.

Components of other assets, including other intangibles. Other intangible assets were comprised of the following at December 31:


(In millions)	Cost		Accumulated Amortization	Net Carrying Value
2021
Customer relationships	$	29,997	4,539	25,458
Trade Name - Express Scripts	8,400			8,400
Other	447		81	366
Other intangible assets	38,844		4,620	34,224
Value of business acquired ("VOBA" reported in Deferred policy acquisition costs)	646		171	475
Total (1)	$	39,490	4,791	34,699
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

(1) Includes $386 million of VOBA and $122 million of Other intangible assets classified as Assets of businesses held for sale.

The Company has indefinite-lived intangible assets totaling $8.5 billion at December 31, 2021 and $8.5 billion at December 31, 2020, largely consisting of trade names and licenses.

**C.**Property and Equipment

Accounting policy. Property and equipment is carried at cost less accumulated depreciation. Cost includes interest, real estate taxes and other costs incurred during construction when applicable. Internal-use software that is acquired, developed or modified solely to meet the Company's internal needs, with no plan to market externally, is also included in this category. Costs directly related to acquiring, developing or modifying internal-use software are capitalized.

The Company calculates depreciation and amortization principally using the straight-line method generally based on the estimated useful life of each asset as follows: buildings and improvements, 10 to 40 years; purchased software, three to five years; internally developed software, three to seven years and furniture and equipment (including computer equipment), three to 10 years. Improvements to leased facilities are depreciated over the lesser of the remaining lease term or the estimated life of the improvement. The Company considers events and circumstances that would indicate the carrying value of property, equipment or capitalized software might not be recoverable. An impairment charge is recorded if the Company determines the carrying value of any of these assets is not recoverable. The Company also reviews and shortens the estimated useful lives of these assets, if necessary.

Components of property and equipment. Property and equipment was comprised of the following as of December 31:


(In millions)	Cost		Accumulated Amortization		Net Carrying Value
2021
Internal-use software	$	7,869	$	5,060	$	2,809
Other property and equipment	2,839		1,653		1,186
Total	10,708		6,713		3,995
Property and equipment classified as Assets of businesses held for sale	(424)		(121)		(303)
Total Property and equipment per Consolidated Balance Sheets	$	10,284	$	6,592	$	3,692
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

Components of depreciation and amortization. Depreciation and amortization expense was comprised of the following for the years ended December 31:


(In millions)	2021		2020		2019
Internal-use software	$	1,097	$	971	$	850
Other property and equipment	253		276		284
Value of business acquired (reported in Deferred policy acquisition costs)	25		28		34
Other intangibles	1,548		1,527		2,483
Total depreciation and amortization	$	2,923	$	2,802	$	3,651

The Company estimates annual pre-tax amortization for intangible assets, including internal-use software, over the next five calendar years to be as follows:


(In millions)	Pre-tax Amortization
2022	$	2,651
2023	$	2,293
2024	$	1,961
2025	$	1,792
2026	$	1,543

Note 19 – Leases

The Company's leases are primarily for office space and certain computer and other equipment and have terms of up to 35 years.

Accounting policy. The Company determines if an arrangement is a lease and its lease classification (operating or finance) at inception. Both operating and finance leases result in (1) a right-of-use ("ROU") asset that represents our right to use the underlying asset for the lease term and (2) a lease liability that represents our obligation to make lease payments arising from the lease. ROU assets and lease liabilities are reflected in the following lines in the Company's Consolidated Balance Sheet:


	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

These lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the lease term. Most of the Company's leases do not provide an implicit rate, so the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The ROU asset also includes any lease pre-payments made and excludes lease incentives for operating leases. The Company's expected life of a lease may consider options to extend or terminate a lease when it is reasonably certain that the Company will exercise that option.

The Company has lease agreements with lease and non-lease components that are accounted for as a single lease component. Operating lease ROU assets are amortized on a straight-line basis over the lease term, which is representative of the pattern in which benefit is expected to be derived from the right to use the underlying asset. Variable lease payments are expensed as incurred and represent amounts that are neither fixed in nature, such as maintenance and other services provided by the lessor, nor tied to an index or rate.

The components of lease expense were as follows:


	For the Years Ended December 31,
(In millions)	2021		2020		2019
Operating lease cost	$	170	$	190	$	188
Finance lease cost:
Amortization of ROU assets	22		28		28
Interest on lease liabilities	2		3		3
Total finance lease cost	24		31		31
Variable lease cost	39		48		50
Total lease cost	$	233	$	269	$	269

In addition, the Company recognized $33 million of one-time selling, general and administrative expenses related to abandonment of leased assets associated with the Organizational Efficiency Plan. See Note 15 for further information.

Supplemental cash flow information related to leases was as follows:


	For the Years Ended December 31,
(In millions)	2021		2020		2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases	$	167	$	189	$	173
Operating cash outflows from finance leases	$	2	$	3	$	3
Financing cash outflows from finance leases	$	22	$	26	$	25

ROU assets obtained in exchange for lease obligations:
Operating leases	$	122	$	189	$	89
Finance leases	$	20	$	9	$	68

Operating and finance lease ROU assets and lease liabilities were as follows:


(In millions)	December 31, 2021		December 31, 2020
Operating leases: (1)
Operating lease ROU assets	$	478	$	552

Accrued expenses and other liabilities	$	159	$	152
Other non-current liabilities	436		491
Total operating lease liabilities	$	595	$	643

Finance leases:
Property and equipment, gross	$	101	$	98
Accumulated depreciation	(51)		(46)
Property and equipment, net	$	50	$	52

Short-term debt	$	23	$	18
Long-term debt	28		36
Total finance lease liabilities	$	51	$	54

(1) Operating leases include Assets of $27 million and Liabilities of $28 million in businesses held for sale.

As of December 31, 2021, the weighted average remaining lease term was 5 years for operating leases and 4 years for finance leases, and the weighted average discount rate was 2.81% for operating leases and 3.13% for finance leases.

Maturities of lease liabilities as of December 31, 2021 were as follows:


(In millions)	Operating Leases		Finance Leases
2022	$	152	$	25
2023	132		12
2024	107		6
2025	70		3
2026	66		3
Thereafter	114		6
Total lease payments	641		55
Less: imputed interest	46		4
Total (1)	$	595	$	51

(1) Operating leases include Liabilities of $28 million in businesses held for sale.

Note 20 – Shareholders' Equity and Dividend Restrictions

State insurance departments and foreign jurisdictions that regulate certain of the Company's subsidiaries prescribe accounting practices (differing in some respects from GAAP) to determine statutory net income and surplus. The Company's life, accident and health insurance and Health Maintenance Organization ("HMO") subsidiaries are regulated by such statutory requirements. The statutory net income of the Company's life, accident and health insurance and HMO subsidiaries for the years ended, and their statutory surplus as of December 31, were as follows:


(In billions)	2021		2020		2019
Net income	$	3.4	$	4.0	$	3.8
Surplus	$	13.3	$	12.9	$	13.8

The Company's HMO and life, accident and health insurance subsidiaries are also subject to minimum statutory surplus requirements and may be required to maintain investments on deposit with state departments of insurance or other regulatory bodies. Additionally, these subsidiaries may be subject to regulatory restrictions on the amount of annual dividends or other distributions (such as loans or cash advances) that insurance companies may extend to their parent companies without prior approval. As of December 31, 2021, these amounts, including restricted GAAP net assets of the Company's subsidiaries, were as follows:


(In billions)	2021
Minimum statutory surplus required by regulators (1),(2)	$	4.9
Investments on deposit with regulatory bodies (3)	$	0.3
Maximum dividend distributions permitted in 2022 without regulatory approval (4)	$	3.2
Maximum loans to the parent company permitted without regulatory approval	$	0.8
Restricted GAAP net assets of Cigna Corporation's subsidiaries (5)	$	12.9

(1) Excludes amounts associated with foreign operated equity method joint ventures.

(2) Includes approximately $1 billion associated with businesses held for sale.

(3) Includes approximately $40 million associated with businesses held for sale.

(4) Includes approximately $200 million associated with businesses held for sale.

(5) Includes approximately $3.0 billion associated with businesses held for sale.

Permitted practices used by the Company's insurance subsidiaries in 2021 that differed from prescribed regulatory accounting had an immaterial impact on statutory surplus.

Undistributed earnings for equity method subsidiaries are $1.1 billion as of December 31, 2021.

Note 21 – Income Taxes

Accounting policy. Deferred income taxes are reflected in the Consolidated Balance Sheets for differences between the financial and income tax reporting bases of the Company's underlying assets and liabilities, and are established based upon enacted tax rates and laws. Deferred income tax assets are recognized when available evidence indicates that realization is more likely than not and a valuation allowance is established to the extent this standard is not met. The deferred income tax provision generally represents the net change in deferred income tax assets and liabilities during the reporting period excluding adjustments to accumulated other comprehensive income or amounts recorded in connection with a business combination. The current income tax provision generally represents estimated amounts due on income tax returns for the year reported to various jurisdictions plus the effect of any uncertain tax positions. The Company recognizes a liability for uncertain tax positions if management believes the probability that the positions will be sustained is 50% or less. For uncertain positions that management believes are more likely than not to be sustained, the Company recognizes a liability based upon management's estimate of the most likely settlement outcome with the taxing authority. The liabilities for uncertain tax positions are classified as current when the position is expected to be settled within 12 months or the statute of limitation expires within 12 months.

Income taxes attributable to the Company's foreign operations are generally provided using the respective foreign jurisdictions' tax rate.

**A.**Income Tax Expense

The components of income taxes for the years ended December 31 were as follows:


(In millions)	2021		2020		2019
Current taxes
U.S. income taxes	$	1,268	$	2,128	$	1,476
Foreign income taxes	207		334		173
State income taxes	112		303		114
Total current taxes	1,587		2,765		1,763
Deferred taxes (benefits)
U.S. income taxes (benefits)	(167)		(217)		(236)
Foreign income taxes	69		11		16
State income tax (benefits)	(122)		(180)		(93)
Total deferred taxes (benefits)	(220)		(386)		(313)
Total income taxes	$	1,367	$	2,379	$	1,450

Total income taxes for the years ended December 31 were different from the amount computed using the nominal federal income tax rate for the following reasons:


	2021				2020				2019
(In millions)	$		%		$		%		$		%
Tax expense at nominal rate	$	1,424	21.0	%	$	2,282	21.0	%	$	1,380	21.0	%
Impact of sale of business	—		—		104		1.0		—		—
Effect of foreign earnings	(33)		(0.5)		(61)		(0.6)		24		0.4
Health insurance industry tax	—		—		93		0.9		—		—
State income tax (net of federal income tax benefit)	(9)		(0.1)		24		0.2		32		0.5
Other	(15)		(0.2)		(63)		(0.6)		14		0.2
Total income taxes	$	1,367	20.2	%	$	2,379	21.9	%	$	1,450	22.1	%

Consolidated pre-tax income from the Company's foreign operations was approximately 26% of the Company's pre-tax income in 2021, 14% in 2020 and 12% in 2019.

**B.**Deferred Income Taxes

Deferred income tax assets and liabilities as of December 31, were as follows:


(In millions)	2021		2020
Deferred tax assets
Employee and retiree benefit plans	$	304	$	477
Other insurance and contractholder liabilities	263		278
Loss carryforwards	278		177
Other accrued liabilities	412		358
Other	245		209
Deferred tax assets before valuation allowance	1,503		1,499
Valuation allowance for deferred tax assets	(246)		(207)
Deferred tax assets, net of valuation allowance	1,257		1,292
Deferred tax liabilities
Depreciation and amortization	698		660
Acquisition-related basis differences	8,726		8,989
Policy acquisition expenses	312		289
Unrealized appreciation on investments and foreign currency translation	104		171
Other	212		122
Total deferred tax liabilities	10,052		10,231
Net deferred income tax (liabilities)	(8,795)
Net deferred income tax (liabilities) assets classified as Liabilities of businesses held for sale	(449)
Net deferred income tax (liabilities) assets per Consolidated Balance Sheets	$	(8,346)	$	(8,939)

Management believes that future results will be sufficient to realize a majority of the Company's gross deferred tax assets. Valuation allowances are established against deferred tax assets when it is determined that it is more likely than not that the asset will not be recognized. Valuation allowances have been established against certain federal, state and foreign tax attributes. There are multiple expiration dates associated with these tax attributes.

**C.**Uncertain Tax Positions

Reconciliations of unrecognized tax benefits for the years ended December 31 were as follows:


(In millions)	2021		2020		2019
Balance at January 1,	$	1,210	$	1,018	$	928
Increase due to prior year positions	21		128		68

Increase due to current year positions	31		88		29
Reduction related to settlements with taxing authorities	(15)		—		—
Reduction related to lapse of applicable statute of limitations	(17)		(24)		(7)
Balance at December 31,	$	1,230	$	1,210	$	1,018

Substantially all unrecognized tax benefits would impact shareholders' net income if recognized.

The Company classifies net interest expense on uncertain tax positions as a component of income tax expense and in Accrued expenses and other liabilities on the balance sheet. In addition to the amounts in the table above, the liability for net interest expense on uncertain tax positions was approximately $148 million as of December 31, 2021, $127 million as of December 31, 2020 and $100 million as of December 31, 2019.

**D.**Other Tax Matters

The statute of limitations for Cigna's consolidated federal income tax returns through 2016 have closed. However, Cigna filed amended returns for both the 2015 and 2016 tax years, which are under review by the Internal Revenue Service ("IRS"). Additionally, the IRS is examining Cigna's returns for 2017 and 2018. The statute of limitations for Express Scripts' consolidated federal income tax returns through 2012 has closed. However, for 2010 through 2012 tax years, there remains a significant disputed matter. The IRS is also examining Express Scripts' consolidated federal income tax returns for 2013 through 2018. The Company has established adequate reserves for these matters.

The Company conducts business in a number of state and foreign jurisdictions and may be engaged in multiple audit proceedings at any given time. Generally, no further state or foreign audit activity is expected for tax years prior to 2013 for Cigna's entities and 2006 for Express Scripts' entities.

Note 22 – Contingencies and Other Matters

The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business.

**A.**Financial Guarantees: Retiree and Life Insurance Benefits

The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of December 31, 2021, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $440 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of December 31, 2021. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.

The Company does not expect that these financial guarantees will have a material effect on the Company's consolidated results of operations, liquidity or financial condition.

**B.**Certain Other Guarantees

The Company had indemnification obligations as of December 31, 2021 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with law or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no liabilities for these indemnification obligations as of December 31, 2021.

**C.**Guaranty Fund Assessments

The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.

There were no material charges or credits resulting from existing or new guaranty fund assessments for the year ended December 31, 2021.

**D.**Legal and Regulatory Matters

The Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator's filing of a complaint under court seal and other legal matters arising, for the most part, in the ordinary course of managing a global health services business. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions. See Note 21 for additional information on tax matters.

Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company's accruals for the matters discussed below under "Litigation Matters" and "Regulatory Matters" are not material. Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if

any) for these matters at this time. In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company. An adverse outcome in one or more of these matters could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in these ongoing litigation matters or any future claims or litigation.

Litigation Matters

Express Scripts Litigation with Anthem. In March 2016, Anthem filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Anthem also requested that the court enter declaratory judgment that Express Scripts is required to provide Anthem competitive benchmark pricing, that Anthem can terminate the agreement and that Express Scripts is required to provide Anthem with post-termination services at competitive benchmark pricing for one year following any termination by Anthem. Anthem claims it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Anthem and $150 million damages for service issues ("Anthem's Allegations"). On April 19, 2016, in response to Anthem's complaint, Express Scripts filed its answer denying Anthem's Allegations in their entirety and asserting affirmative defenses and counterclaims against Anthem. The court subsequently granted Anthem's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Anthem completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. There is no tentative trial date.

Medicare Advantage. A qui tam action that was filed by a relator in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020. The action asserts claims related to risk adjustment practices arising from certain health exams conducted as part of the Company's Medicare Advantage business. In September 2021, the qui tam action was transferred to the United States District Court for the Middle District of Tennessee. On January 11, 2022, the U.S. Department of Justice ("DOJ") (U.S. Attorney's Offices for the Southern District of New York and the Middle District of Tennessee) filed a motion to partially intervene which is pending before the court. The Company has opposed the DOJ's motion to intervene and the government filed its reply brief on February 1, 2022. The motion has been fully briefed and is under the court's review.

Regulatory Matters

Civil Investigative Demand. The DOJ is conducting industry-wide investigations of Medicare Advantage organizations' risk adjustment practices. For certain Medicare Advantage organizations, including Cigna, those investigations have resulted in litigation (see above). The Company is currently responding to information requests (civil investigative demand) from the DOJ (U.S. Attorney's Office for the Eastern District of Pennsylvania). The Company is cooperating with the DOJ and has responded and continues to respond to its requests.

Note 23 – Segment Information

See Note 1 for a description of our segments, including the segment change effective in the fourth quarter of 2021. Prior year segment information has been adjusted to reflect the segment change and a description of our basis of reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy related transactions between the Evernorth and Cigna Healthcare segments.

The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income from operations as income before income taxes excluding net realized investment results, amortization of acquired intangible assets, results of transitioning clients prior to 2020, and special items. Cigna's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.

The Company defines adjusted revenues as total revenues excluding the following adjustments: special items, revenue contribution from transitioning clients prior to 2020, and Cigna's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.

The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

The following tables present the special items recorded by the Company for the year ended December 31, 2021, 2020 and 2019:



(In millions)	2021	2020				2019
Description of Special Item Charges (Benefits) and Financial Statement Line Item(s)		After-tax		Before-tax		After-tax		Before-tax		After-tax		Before-tax
Charge for organizational efficiency plan (Selling, general and administrative expenses)		$	119	$	168	$	24	$	31	$	162	$	207
Debt extinguishment costs		110		141		151		199		—		—
Integration and transaction-related (benefits) costs (Selling, general and administrative expenses)		71		169		404		527		427		552
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)		(21)		(27)		19		25		41		51
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)		—		—

Total impact from special items		$	279	$	451	$	(2,850)	$	(3,726)	$	630	$	810

Summarized segment financial information was as follows:


(In millions)	Evernorth		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
2021
Revenues from external customers	$	127,692	$	41,378	$	3,459	$	—	$	172,529
Inter-segment revenues	4,203		2,271		—		(6,474)
Net investment income	17		1,003		530		(1)		1,549
Total revenues	131,912		44,652		3,989		(6,475)		174,078
Net realized investment results from certain equity method investments	—		—		—		—		—

Adjusted revenues	$	131,912	$	44,652	$	3,989	$	(6,475)	$	174,078
Depreciation and amortization	$	2,316	$	551	$	52	$	4	$	2,923
Income (loss) before taxes	$	3,908	$	3,812	$	852	$	(1,790)	$	6,782
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(31)		(3)		(24)		—		(58)
Net realized investment (gains) losses (1)	4		(247)		47		—		(196)
Amortization of acquired intangible assets	1,937		47		14		—		1,998
Special items
Charge for organizational efficiency plan	—		—		—		168		168
Debt extinguishment costs	—		—		—		141		141
Integration and transaction-related (benefits) costs	—		—		—		169		169
(Benefits) charges associated with litigation matters	—		—		—		(27)		(27)




Pre-tax adjusted income (loss) from operations	$	5,818	$	3,609	$	889	$	(1,339)	$	8,977

(In millions)	Evernorth		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
2020
Revenues from external customers	$	112,647	$	38,826	$	7,684	$	—	$	159,157
Inter-segment revenues	3,655		1,966		23		(5,644)
Net investment income	32		473		739		—		1,244
Total revenues	116,334		41,265		8,446		(5,644)		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	$	41,135	$	8,446	$	(5,644)	$	160,067
Depreciation and amortization	$	2,248	$	458	$	71	$	25	$	2,802
Income (loss) before taxes	$	3,684	$	4,291	$	5,227	$	(2,334)	$	10,868
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(17)		(1)		(19)		—		(37)
Net realized investment (gains) losses (1)	(17)		(202)		(60)		—		(279)
Amortization of acquired intangible assets	1,917		44		21		—		1,982
Special items
Charge for organizational efficiency plan	—		—		—		31		31
Debt extinguishment costs	—		—		—		199		199
Integration and transaction-related (benefits) costs	—		—		—		527		527
(Benefits) 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	$	4,031	$	966	$	(1,552)	$	8,808

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


(In millions)	Evernorth		Cigna Healthcare		Other Operations		Corporate and Eliminations		Total
2019
Revenues from external customers	$	107,354	$	37,455	$	7,367	$	—	$	152,176
Inter-segment revenues	2,380		1,168		26		(3,574)
Net investment income (loss)	60		510		822		(2)		1,390
Total revenues	109,794		39,133		8,215		(3,576)		153,566
Revenue contributions from transitioning clients	(13,347)		—		—		—		(13,347)
Net realized investment results from certain equity method investments	—		(44)		—		—		(44)

Adjusted revenues	$	96,447	$	39,089	$	8,215	$	(3,576)	$	140,175
Depreciation and amortization	$	3,071	$	492	$	85	$	3	$	3,651
Income (loss) before taxes	$	3,983	$	4,071	$	1,180	$	(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)	—		(159)		(62)		—		(221)
Amortization of acquired intangible assets	2,839		81		29		—		2,949
Special items
Charge for organizational efficiency plan	—		—		—		207		207

Integration and transaction-related (benefits) costs	—		—		—		552		552
(Benefits) charges associated with litigation matters	—		(30)		—		81		51




Pre-tax adjusted income (loss) from operations	$	5,092	$	3,963	$	1,131	$	(1,824)	$	8,362

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

Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type for the year ended December 31:



(In millions)	2021		2020		2019
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	64,992	$	56,365	$	51,430
Home delivery and specialty revenues	54,391		49,906		49,226
Other	6,428		5,403		4,900
Intercompany eliminations	(4,398)		(3,905)		(2,457)
Total pharmacy revenues	121,413		107,769		103,099
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Commercial
Insured	14,315		13,389		12,523
Stop loss	4,868		4,614		4,328
Other	1,290		1,135		1,040
U.S. Government
Medicare Advantage	8,362		7,565		6,314
Medicare Part D	1,499		1,593		1,699
Other	4,815		4,301		4,185
International Health	2,588		2,472		2,382
Total Cigna Healthcare	37,737		35,069		32,471
International businesses held for sale	3,205		3,039		2,884
Domestic disability, life and accident	—		4,423		4,225
Other	221		124		147
Intercompany eliminations	(9)		(28)		(13)
Total premiums	41,154		42,627		39,714
Services (Fees) (ASC 606)

Evernorth	6,070		4,611		4,165
Cigna Healthcare	5,743		5,491		6,022
Other Operations	19		116		123
Other revenues	197		254		157
Intercompany eliminations	(2,067)		(1,711)		(1,104)
Total fees and other revenues	9,962		8,761		9,363
Total revenues from external customers	$	172,529	$	159,157	$	152,176

Foreign and U.S. revenues from external customers for the three years ended December 31 are shown below. The Company's foreign revenues are generated by its foreign operating entities. In the periods shown, no foreign country contributed more than 2% of consolidated revenues from external customers.


(In millions)	2021		2020		2019
United States	$	166,626	$	154,042	$	147,332
Foreign countries (1)	5,903		5,115		4,844
Total	$	172,529	$	159,157	$	152,176

(1) International life, accident and supplemental benefits businesses in seven countries to be sold pursuant to the Chubb Transaction as described in Note 1 comprised of $3.2 billion, $3.1 billion and $2.9 billion in 2021, 2020 and 2019, respectively.

Revenues from U.S. Federal Government agencies, under a number of contracts, were 14% of consolidated revenues in 2021, 15% in 2020 and 14% in 2019. These amounts were reported in the Evernorth and Cigna Healthcare segments.

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