Cigna Group (CI) 10-K risk factor changes: FY2023 vs FY2022

- attract and retain sufficient numbers of qualified employees, particularly in [removed: an increasingly] [added: a] competitive job market;

- technological changes and rapid shifts in the use of technology, such as [removed: telehealth;][added: telehealth and AI;]

- [added: impacts to distribution channels, including] changes [removed: in] [added: to] the United States Postal Service or the consolidation of shipping carriers;

- changes in the [removed: generic] [added: generic/biosimilar] drug market or the failure of new [removed: generic] [added: generic/biosimilar] drugs to come to market; or

As described in greater detail in the description of our business in Item 1 of this Form 10-K, [removed: one of] our key clients in the Evernorth Health Services segment [removed: is] [added: include] the [removed: United States Department of Defense.][added: DoD, Prime and Centene.]

Our clients are well informed and typically have knowledgeable consultants that seek competing bids from our competitors before [added: contract renewal.]

[added: If providers refuse to contract with us, use] their market position to negotiate more favorable contracts or place us at a competitive disadvantage, our ability to market products or to be profitable in those areas could be materially adversely affected.

If such collaborative arrangements do not result in the lower medical costs that we project or if we fail to attract health care providers to such arrangements, or are less successful at implementing such arrangements [removed: than our competitors, our attractiveness to customers may be reduced and our ability to profitably grow our business may be adversely affected.]

Out-of-network providers [added: for non-Medicare services] are not limited by any agreement with us in the amounts they bill.

Additionally, certain of our products and services are sold in part through [removed: nonexclusive] [added: non-exclusive] producers and consultants for whose services and allegiance we compete.

Our contracts with pharmaceutical manufacturers are typically [removed: nonexclusive] [added: non-exclusive] and terminable on relatively short notice by either party.

More than 67,000 pharmacies participated in one or more of our networks as of December 31, [removed: 2022.][added: 2023.]

Contracts with retail pharmacies are generally [removed: nonexclusive] [added: non-exclusive] and are terminable on relatively short notice by either party.

Changes in the overall composition of our pharmacy networks, or reduced pharmacy access under our networks, could have a negative [added: impact on our claims volume or our competitiveness in the marketplace, which could cause us to fall short of certain guarantees in our contracts with clients or otherwise impair our business or results of operations.]

If our data were found to be inaccurate or unreliable due to fraud or other error, or if we, or any of the third-party providers [added: or subcontractors that] we [added: or they] engage, were to fail to maintain information systems and data integrity effectively, we could experience operational disruptions that may impact our clients, customers and health care providers and hinder our ability to provide or establish appropriate pricing for products and services, retain and attract clients and customers, establish reserves and report financial results timely and accurately and maintain regulatory compliance, among other things.

Our business depends on our clients' and customers' willingness to entrust us with their health-related and other [removed: sensitive] personal [removed: information, including] information [added: ("PI"), including Protected Health Information ("PHI")] that is subject to privacy, security or data breach notification laws.

Computer [added: networks or] systems may be vulnerable to [removed: physical break-ins,] [added: intrusion,] computer viruses or malware, programming errors, attacks by third parties or similar disruptive problems.

Human or technological error has and could in the future result in, for example, unauthorized access to, acquisition, disclosure, modification, misuse, loss, or destruction of company, customer, or other third-party data or systems; theft of sensitive, regulated, or confidential data including [removed: personal information] [added: PI] and intellectual property; the loss of access to critical data or systems through ransomware, destructive attacks or other means; and business delays, service or system disruptions or denials of service.

As we increase the amount of [removed: personal information] [added: PI] that we store and share digitally, our exposure to unauthorized [added: uses and] disclosures, [added: and] data privacy and related cybersecurity risks increases, including the risk of undetected attacks, damage, loss or unauthorized access or acquisition or misappropriation of proprietary or personal information, and the cost of attempting to protect against these risks also increases.

The health care data ecosystem is complex and requires data exchange with vendors, business partners, [added: health care professionals,] the government and others.

If disruptions, [added: data] disclosures, security incidents or breaches are not detected quickly, their effect could be compounded.

We have dedicated significant resources to implement [added: privacy and] security technologies, processes and procedures to [removed: protect consumer identity and provide]

[added: protect PI and provide] employee awareness training around phishing, malware and other cyber risks; however, there are no assurances that such measures will be effective against all types of security incidents or breaches.

Further, we depend on many vendors to support and assist our business, which requires such vendors to generate, store and use [removed: sensitive personal information.][added: PI.]

For example, there [removed: has been] [added: continues to be] an increase in new financial fraud schemes akin to ransomware attacks on large companies whereby a cybercriminal installs a type of malicious software, or malware, that prevents a user or enterprise from accessing computer files, systems or networks and demands payment of a ransom for their return.

Those parties may also attempt to fraudulently induce employees, customers or other users of our systems to disclose [removed: sensitive information] [added: or inadvertently provide access to systems] in order to gain access to our data or that of our customers.

In addition, the unauthorized access, acquisition, use, disclosure or dissemination of [removed: sensitive] personal information, proprietary information or confidential information about us, our customers or other third parties could expose our customers' and their private information to the risk of financial or medical identity theft.

- price controls or other pricing issues and exchange controls; restrictions that prevent us from transferring funds out of the countries in which we operate; foreign currency exchange rates and fluctuations and restrictions on converting currencies [removed: from foreign operations into other currencies; uncertainty with respect to the interpretation of tax positions;]

- acts of civil unrest, war and terrorism, [added: including the ongoing conflict in the Middle East] as well as other political and economic conflicts such as through imposition of economic or political sanctions;

- man-made disasters, natural disasters (including those arising as a result of climate change) and [removed: pandemics, such as the COVID-19 pandemic,] [added: pandemics] in locations where we operate; and

Our failure to comply with laws and regulations governing our conduct outside of the United States or to establish constructive relations with non-U.S. regulators [added: could have a material adverse effect on our business, results of operations, financial condition, liquidity and long-term growth.]

Strategic transactions involve risks and we may not realize the expected benefits because of integration [added: or separation] difficulties, underperformance relative to our expectations and other challenges.

As of December 31, [removed: 2022,] [added: 2023,] our goodwill and other intangible assets had a carrying value of approximately [removed: $78] [added: $75] billion, representing [removed: 54%] [added: 49%] of our total consolidated assets.

See Note [removed: 19] [added: 20] to the Consolidated Financial Statements for more information on goodwill and [removed: intangibles.]

[added: For example, noncompliance with] any [added: privacy or] security [added: laws and regulations, any security] breach involving one of our third-party vendors or a dispute between us and a third-party vendor related to our arrangement could have a material adverse effect on our business, results of operations, financial condition, liquidity and reputation.

A disruption, or threat of disruption, in our supply chain, including as a result of [removed: the COVID-19 pandemic,] [added: future pandemics] or [added: public health emergencies, or] inability to access or deliver products that meet requisite quality safety standards and patient needs in a timely and efficient manner could adversely impact our business.

We also provide in-home care through health care providers that we employ, as well [removed: as,] [added: as] through third-party contractors.

Existing or future laws, rules, [added: U.S. Presidential Executive Orders,] regulatory interpretations or judgments could force us to change how we conduct our business, affect the products and services we offer and where we offer them, restrict revenue and enrollment growth, increase our costs, including medical, operating, health care technology and administrative costs, and require enhancements to our compliance infrastructure and internal controls environment.

For example, health care reforms or the invalidation, modification, repeal or replacement of the ACA or portions thereof could result in material changes to the way we conduct our business, as well as [removed: the loss of subsidies related to our IFP offerings and could impact the market for our products.]

Existing or future laws and rules could also require or lead us to take other actions such as changing our business [removed: practices,] [added: practices] and could increase our liability.

than our competitors, our attractiveness to customers may be reduced and our ability to profitably grow our business may be adversely affected.

For Medicare Advantage, out-of-network providers can only receive the same rate that CMS pays for Medicare services.

Additionally, laws such as the Inflation Reduction Act have granted CMS the ability to negotiate drug prices for certain Part D and Part B drugs, and other federal and state legislative proposals may lead to changes in drug pricing for federal health care programs.

Our use of artificial intelligence and machine learning present regulatory and legal challenges that could negatively affect our business and our reputation.

Our use of artificial intelligence (“AI”), including machine learning (“ML”) technologies, as well as more recent technological advances in AI/ML, pose risks to us and subject us to new and existing laws and regulations.

While we are committed to responsible use of AI/ML and following applicable laws and regulations, and while we have made progress developing governance as to use of AI/ML by our organization, any failure to use AI/ML responsibly and to adhere to such laws, regulations and governance could have a material unfavorable effect on our business, results of operations, and financial condition.

Depending on how existing laws and regulations are interpreted, and as new laws are passed, we may have to make changes to our business practices to comply with such obligations.

These obligations may make it harder for us to conduct our business using AI/ML, lead to regulatory fines or penalties, require us retrain our AI/ML, or prevent or limit our use of AI/ML.

Our use of AI/ML technologies could also result in additional compliance costs, regulatory investigations and actions, and consumer or other lawsuits.

If we are unable to use AI/ML, or if regulators restrict our ability to use AI/ML for certain purposes, it could make our business less efficient, result in competitive disadvantages, and subject us to potential unfavorable business impacts.

To the extent that we rely on or use the output of AI/ML, any inaccuracies, biases or errors could have unfavorable impacts on us, our business and our results of operations or financial condition.

The impact of regulatory and legal risks associated with AI/ML is largely unknown.

from foreign operations into other currencies; uncertainty with respect to the adoption of new tax laws and the interpretation of tax positions;

- general economic and political conditions, including conditions that may become unpredictable during a U.S. presidential election year.

Please see "—Legal and Compliance Risks" below.

For example, in January 2024 we announced the HCSC transaction, which is subject to regulatory approvals and other closing conditions.

We may be unable to satisfy the closing conditions in a timely manner to complete the HCSC transaction, or we may otherwise fail to receive the anticipated benefits from the transaction, even if it is completed.

intangibles.

Regulators, customers, investors, employees and other stakeholders are increasingly focusing on ESG matters and related disclosures.

These changing rules, regulations and stakeholder expectations have resulted in, and are likely to continue to result in, increased general and administrative expenses and increased management time and attention spent complying with such regulations or meeting such expectations.

For example, the European Union's ("EU’s") Corporate Sustainability Reporting Directive (“CSRD”) will require expansive disclosures on various sustainability topics such as climate change, biodiversity, workforce, supply chain, and business ethics by in-scope EU entities and certain non-EU entities with significant cross-border business in EU markets.

In addition, California’s recently-enacted Climate Corporate Data Accountability Act will require annual disclosures of covered companies’ Scope 1, 2 and 3 greenhouse gas emissions.

We are assessing our obligations under CSRD and other enhanced reporting requirements, and expect that compliance could require substantial effort in the future.

Overall, ESG matters and related stakeholder reaction may impact our reputation and have other business impacts which could adversely affect our business.

the loss of subsidies related to our IFP offerings and could impact the market for our products.

These legal matters could include benefit claims, breach of contract actions, tort claims (including claims related to the delivery of health care services, such as medical malpractice by staff at our affiliates' facilities, or by

These audits could result in repayments to the government.

For example, the FTC is conducting an ongoing study of the pharmacy benefit manager industry and the impact of pharmacy benefit managers on the accessibility and affordability of prescription drugs.

In June 2022, the FTC issued an enforcement policy statement indicating the FTC would scrutinize the impact of rebates and fees paid by pharmaceutical manufacturers to pharmacy benefit managers and other intermediaries to determine if laws such as the FTC Act, the Clayton Act, the Robinson-Patman Act and the Sherman Act may have been violated.

In July 2023, the FTC voted to issue a statement cautioning against reliance on prior advocacy letters that advocated against proposals to increase regulatory oversight and transparency of pharmacy benefit managers.

The FTC previously required three group purchasing organizations to provide information and records on business practices and the six largest pharmacy benefit managers to provide information and records on topics including rebate contracts and ancillary agreements, documents related to strategies, conditions and plans for formulary placement, formulary exclusion, formulary tier assignment, and prior authorization regarding rebated drug products, and annual pharmacy reimbursement data for drugs on specialty drug lists and for rebated drug products.

For example, in September 2023, we resolved certain matters related to our Medicare Advantage Business and risk adjustment practices by entering into the Corporate Integrity Agreement (the “CIA”) with the HHS-OIG.

The CIA imposes various compliance, reporting and governance obligations on us for five years and requires record reviews by an independent review organization.

Our failure to meet these obligations could result in monetary penalties and our exclusion from participation in federal healthcare programs (such as Medicare and Medicaid), which could adversely impact our business, cash flows, financial condition, results of operations and reputation.

Any failure, or alleged failure, to comply with various state and federal health care laws

contract renewal.

If providers refuse to contract with us, use

impact on our claims volume or our competitiveness in the marketplace, which could cause us to fall short of certain guarantees in our contracts with clients or otherwise impair our business or results of operations.

The scale, scope and duration of the ongoing COVID-19 pandemic continues to be unknown and the overall impact on our business, operating results, cash flows or financial condition has been and may continue to be material.

The COVID-19 pandemic has adversely affected, and is continuing to affect, global economies, financial markets and the overall environment for our business, and the extent to which it may impact our future results of operations and overall financial performance remains uncertain.

While vaccination rates continue to rise, the COVID-19 pandemic, including vaccination efficacy, the implementation of and reaction to vaccination and testing mandates and the occurrence of new variants, could continue to effect such economies and financial markets as well as the health and availability of our workforce.

As a result, we may experience new disruptions to our business operations and our business could be adversely affected further, directly or indirectly, by the ongoing pandemic.

The COVID-19 pandemic has in some instances, and may continue to, heighten the potential adverse effects on our business, operating results, cash flows or financial condition as described below or in other risk factors within this section of the Form 10-K including, but not limited to, the likelihood of and impact from:

- unfavorable economic conditions on our clients and customers (both employers and individuals), health care and pharmacy providers, pharmaceutical manufacturers and third-party vendors, as well as federal and state entities and programs;

- changes in medical claims submission and processing patterns or procedures; changes in customer base and product mix; changes in utilization of prescription drugs, medical or other covered items or services, including increased behavioral health services utilization; changes in medical cost trends; changes in our health management practices; and the introduction of new benefits and products causing actual claims to exceed our estimates;

- changes in health care utilization patterns, provider billing practices and other external events that we cannot forecast or project and over which we have little or no control impacting our ability to accurately predict, price for and manage health care costs and ultimately our profitability, including impacts from care deferral on, among other things, risk adjustment revenue and acuity of future care;

- increased costs or reductions in revenue, including costs for COVID-19-related care, testing and treatment; vaccine and other coverage mandates; inflation; and support for employees, clients, customers and providers;

- compliance with substantial government regulation, including privacy and security requirements associated with providing telehealth and remote care options and new laws or regulations or changes in existing laws or regulations, such as vaccine, testing and coverage mandates and premium deferrals, which laws or regulations may vary significantly by jurisdiction;

- cyberattacks or other privacy or data security incidents, including as a result of the transition to a hybrid work environment by substantially all of our workforce and the workforces of third parties with whom we contract;

- significant shifts in the structure of the industry which could alter dynamics and, if we fail to adapt, negatively impact our business;

- risks inherent in foreign operations, including political, legal, operational, regulatory, economic and other risks;

- economic and market conditions affecting the value of our financial instruments and the value of particular assets and liabilities; and

- fluctuations in equity market prices, interest rates and credit spreads limiting our ability to raise or deploy capital and affecting our overall liquidity.

We believe COVID-19 and its variants' adverse impact on our business, operating results, cash flows or financial condition will be driven primarily by the severity and duration of the pandemic, including the impact of the breadth and timing of implementation and the efficacy and costs of vaccination programs, the pandemic's continued impact on our employees, clients, customers, suppliers and partners, as well as the U.S. and global economies and the continued actions taken by governmental authorities and other third parties in response to the pandemic.

Those primary drivers are largely beyond our knowledge and control, and may be more adverse than our current expectations.

Given these uncertainties, we cannot estimate the full impact COVID-19 will have on our business, operating results, cash flows or financial condition, but the adverse impact could be material.

- general economic and political conditions.

could have a material adverse effect on our business, results of operations, financial condition, liquidity and long-term growth.

For example, noncompliance with any privacy or security laws and regulations,

plans.

intervene.

These audits could result in significant adjustments in payments made to our health plans, which could adversely affect our results of operations.

A rise in interest rates would likely reduce the value of our investment portfolio, increase interest expense on our indebtedness and increase investment income as investment assets mature and are replaced.

Each of the rating agencies reviews

[removed: | *[Liquidity] [added: Risks to Liquidity] and Capital [removed: Resources](#ic821d5f440e6453dbe77c0f7576c993a_646)* | | | [58](#ic821d5f440e6453dbe77c0f7576c993a_646) | | |][added: Resources]

| *[Critical Accounting [removed: Estimates](#ic821d5f440e6453dbe77c0f7576c993a_670)*] [added: Estimates](#ibc59a92ac8bc42f794e728f24ce1b626_814)*] | | | [removed: [63](#ic821d5f440e6453dbe77c0f7576c993a_670)] [added: [61](#ibc59a92ac8bc42f794e728f24ce1b626_814)] | | |

| *[Evernorth Health [removed: Services](#ic821d5f440e6453dbe77c0f7576c993a_688)*] [added: Services](#ibc59a92ac8bc42f794e728f24ce1b626_832)*] | | | [removed: [67](#ic821d5f440e6453dbe77c0f7576c993a_688)] [added: [65](#ibc59a92ac8bc42f794e728f24ce1b626_832)] | | |

*Management's Discussion and Analysis of Financial Condition and Results of Operations ("MD&A") is intended to provide information to assist you in better understanding and evaluating The Cigna Group's financial condition as of December 31, [removed: 2022] [added: 2023] compared with December 31, [removed: 2021] [added: 2022] and our results of operations for [removed: 2022] [added: 2023] compared with [removed: 2021] [added: 2022] and [removed: 2020] [added: 2021] and is intended to help you understand the ongoing trends in our business.

For comparisons of our results of operations for [removed: 2021] [added: 2022] compared with [removed: 2020,] [added: 2021,] please refer to the previously filed MD&A included in Part II, Item 7 of our Form 10-K for the year ended December 31, [removed: 2021.][added: 2022.]

See Note [removed: 2] [added: 22] to the Consolidated Financial Statements in this Form 10-K for additional information regarding [removed: the Company's significant accounting policies.][added: these restrictions.]

The Cigna [removed: Group has] [added: Group, together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our") is] a [added: global health company with a] mission of helping those we serve improve their health and vitality.

For further information on our business and strategy, see [added: Part 1,] Item 1, "Business" [removed: in] [added: of] this Form 10-K.

| *(Dollars in millions, except per share amounts)* | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 2022] [added: 2023] | | | | | | [removed: 2021] [added: 2022] | | | | | | [removed: 2020] [added: 2021] | | | | | | [removed: 2022] [added: 2023] vs. [removed: 2021] [added: 2022] | | | | | | [removed: 2021] [added: 2022] vs. [removed: 2020] [added: 2021] | | | | | |

| Evernorth Health Services | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | [removed: 140,335] [added: 153,499] | | | | | $ | [removed: 131,912] [added: 140,335] | | | | | $ | [removed: 116,130] [added: 131,912] | | | | | [removed: 6] [added: 9] | | | % | | | [removed: 14] [added: 6] | | | % | | |

| Other Operations | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 2,262] [added: 596] | | | | | | [removed: 3,989] [added: 2,263] | | | | | | [removed: 8,446] [added: 3,989] | | | | | | [removed: (43)] [added: (74)] | | | | | | [removed: (53)] [added: (43)] | | | | | |

| Corporate, net of eliminations | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (6,991)] [added: (9,978)] | | | | | | [removed: (6,475)] [added: (6,991)] | | | | | | [removed: (5,644)] [added: (6,475)] | | | | | | [removed: (8)] [added: (43)] | | | | | | [removed: (15)] [added: (8)] | | | | | |

| Net realized investment results from certain equity method investments | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (126)] [added: (57)] | | | | | | [removed: —] [added: (126)] | | | | | | [removed: 130] [added: —] | | | | | | [removed: N/M] [added: 55] | | | | | | N/M | | | | | |

| Adjusted income from operations | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | [removed: 7,284] [added: 7,448] | | | | | $ | [removed: 6,980] [added: 7,313] | | | | | $ | [removed: 6,795] [added: 6,982] | | | | | [removed: 4] [added: 2] | | | % | | | [removed: 3] [added: 5] | | | % | | |

| Adjusted income from operations | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | [removed: 23.27] [added: 25.09] | | | | | $ | [removed: 20.47] [added: 23.36] | | | | | $ | [removed: 18.45] [added: 20.48] | | | | | [removed: 14] [added: 7] | | | % | | | [removed: 11] [added: 14] | | | % | | |

| Evernorth Health Services | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | [removed: 6,127] [added: 6,442] | | | | | $ | [removed: 5,818] [added: 6,127] | | | | | $ | [removed: 5,363] [added: 5,818] | | | | | 5 | | | % | | | [removed: 8] [added: 5] | | | % | | |

| Corporate, net of eliminations | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (1,466)] [added: (1,698)] | | | | | | [removed: (1,339)] [added: (1,466)] | | | | | | [removed: (1,552)] [added: (1,339)] | | | | | | [removed: (9)] [added: (16)] | | | | | | [removed: 14] [added: (9)] | | | | | |

| Consolidated pre-tax adjusted income from operations | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 9,233] [added: 9,318] | | | | | | [removed: 8,977] [added: 9,269] | | | | | | [removed: 8,808] [added: 8,983] | | | | | | [removed: 3] [added: 1] | | | | | | [removed: 2] [added: 3] | | | | | |

| Income attributable to noncontrolling interests | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 84] [added: 146] | | | | | | [removed: 58] [added: 84] | | | | | | [removed: 37] [added: 58] | | | | | | [removed: 45] [added: 74] | | | | | | [removed: 57] [added: 45] | | | | | |

| Net realized investment (losses) gains (1) | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (621)] [added: (135)] | | | | | | [removed: 196] [added: (613)] | | | | | | [removed: 279] [added: 198] | | | | | | [removed: N/M] [added: 78] | | | | | | [removed: (30)] [added: N/M] | | | | | |

| Amortization of acquired intangible assets | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (1,876)] [added: (1,819)] | | | | | | [removed: (1,998)] [added: (1,876)] | | | | | | [removed: (1,982)] [added: (1,998)] | | | | | | [removed: 6] [added: 3] | | | | | | [removed: (1)] [added: 6] | | | | | |

| Special items | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 1,533] [added: (1,997)] | | | | | | [removed: (451)] [added: 1,533] | | | | | | [removed: 3,726] [added: (451)] | | | | | | N/M | | | | | | N/M | | | | | |

[removed: *(1)* *Includes] [added: *(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.*

| *(Dollars in millions)* | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 2022] [added: 2023] | | | | | | [removed: 2021] [added: 2022] | | | | | | [removed: 2020] [added: 2021] | | | | | | [removed: 2022] [added: 2023] vs. [removed: 2021] [added: 2022] | | | | | | | | | | | | [removed: 2021] [added: 2022] vs. [removed: 2020] [added: 2021] | | | | | | | | | | | |

| Pharmacy revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | [removed: 128,566] [added: 137,243] | | | | | $ | [removed: 121,413] [added: 128,566] | | | | | $ | [removed: 107,769] [added: 121,413] | | | | | $ | [removed: 7,153] [added: 8,677] | | | | | [removed: 6] [added: 7] | | | % | | | $ | [removed: 13,644] [added: 7,153] | | | | | [removed: 13] [added: 6] | | | % | | |

| Net investment income | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 1,155] [added: 1,166] | | | | | | [removed: 1,549] [added: 1,155] | | | | | | [removed: 1,244] [added: 1,549] | | | | | | [removed: (394)] [added: 11] | | | | | | [removed: (25)] [added: 1] | | | | | | [removed: 305] [added: (394)] | | | | | | [removed: 25] [added: (25)] | | | | | |

| Pharmacy and other service costs | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 124,834] [added: 133,801] | | | | | | [removed: 117,553] [added: 124,834] | | | | | | [removed: 103,484] [added: 117,553] | | | | | | [removed: 7,281] [added: 8,967] | | | | | | [removed: 6] [added: 7] | | | | | | [removed: 14,069] [added: 7,281] | | | | | | [removed: 14] [added: 6] | | | | | |

| Amortization of acquired intangible assets | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 1,876] [added: 1,819] | | | | | | [removed: 1,998] [added: 1,876] | | | | | | [removed: 1,982] [added: 1,998] | | | | | | [removed: (122)] [added: (57)] | | | | | | [removed: (6)] [added: (3)] | | | | | | [removed: 16] [added: (122)] | | | | | | [removed: 1] [added: (6)] | | | | | |

| Interest expense and other | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: (1,228)] [added: (1,446)] | | | | | | [removed: (1,208)] [added: (1,228)] | | | | | | [removed: (1,438)] [added: (1,208)] | | | | | | [removed: (20)] [added: (218)] | | | | | | [removed: (2)] [added: (18)] | | | | | | [removed: 230] [added: (20)] | | | | | | [removed: 16] [added: (2)] | | | | | |

| Debt extinguishment costs | | | | | | | | | | | | | | | | | | | | | | | | | | | — | | | | | | [removed: (141)] [added: —] | | | | | | [removed: (199)] [added: (141)] | | | | | | [removed: 141] [added: —] | | | | | | N/M | | | | | | [removed: 58] [added: 141] | | | | | | [removed: 29] [added: N/M] | | | | | |

| [removed: Gain] [added: (Loss) gain] on sale of businesses | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 1,662] [added: (1,499)] | | | | | | [removed: —] [added: 1,662] | | | | | | [removed: 4,203] [added: —] | | | | | | [removed: 1,662] [added: (3,161)] | | | | | | N/M | | | | | | [removed: (4,203)] [added: 1,662] | | | | | | N/M | | | | | |

| Less: Net income attributable to noncontrolling interests | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 78] [added: 208] | | | | | | [removed: 50] [added: 78] | | | | | | [removed: 31] [added: 50] | | | | | | [removed: 28] [added: 130] | | | | | | [removed: 56] [added: 167] | | | | | | [removed: 19] [added: 28] | | | | | | [removed: 61] [added: 56] | | | | | |

| Consolidated effective tax rate | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 19.2] [added: 2.6] | | | % | | | [removed: 20.2] [added: 19.2] | | | % | | | [removed: 21.9] [added: 20.2] | | | % | | | [removed: (100)] [added: (1,660)] | | | bps | | | | | | | | | [removed: (170)] [added: (100)] | | | bps | | | | | | | | |

| Medical customers (in thousands) | | | | | | | | | | | | | | | | | | | | | | | | | | | [removed: 18,004] [added: 19,780] | | | | | | [removed: 17,081] [added: 18,004] | | | | | | [removed: 16,650] [added: 17,081] | | | | | | [removed: 923] [added: 1,776] | | | | | | [removed: 5] [added: 10] | | | % | | | [removed: 431] [added: 923] | | | | | | [removed: 3] [added: 5] | | | % | | |

| | | | | | | | | | | | | | | | | | | [removed: 2022] [added: 2023] | | | | | | | | | [removed: 2021] [added: 2022] | | | | | | | | | [removed: 2020] [added: 2021] | | | | | | | | | | | |

| [removed: *(Dollars in] [added: *(In] millions)* | | | | | | | | | | | | | | | | | | | | | | | | Pre-tax | | | After-tax | | | | | | Pre-tax | | | After-tax | | | | | | Pre-tax | | | After-tax | | |

| Amortization of acquired intangible assets | | | | | | | | | | | | | | | | | | | | | | | | [removed: 1,876] [added: 1,819] | | | [removed: 1,345] [added: 1,413] | | | | | | [removed: 1,998] [added: 1,876] | | | [removed: 1,494] [added: 1,345] | | | | | | [removed: 1,982] [added: 1,998] | | | [removed: 1,431] [added: 1,494] | | |

| Integration and transaction-related costs | | | | | | | | | | | | | | | | | | | | | | | | [removed: 135] [added: 45] | | | [removed: 103] [added: 35] | | | | | | [removed: 169] [added: 135] | | | [removed: 71] [added: 103] | | | | | | [removed: 527] [added: 169] | | | [removed: 404] [added: 71] | | |

| Charge for organizational efficiency plan | | | | | | | | | | | | | | | | | | | | | | | | [removed: 22] [added: 252] | | | [removed: 17] [added: 193] | | | | | | [removed: 168] [added: 22] | | | [removed: 119] [added: 17] | | | | | | [removed: 31] [added: 168] | | | [removed: 24] [added: 119] | | |

| [removed: (Benefits) charges] [added: Charges (benefits)] associated with litigation matters | | | | | | | | | | | | | | | | | | | | | | | | [removed: (28)] [added: 201] | | | [removed: (20)] [added: 171] | | | | | | [removed: (27)] [added: (28)] | | | [removed: (21)] [added: (20)] | | | | | | [removed: 25] [added: (27)] | | | [removed: 19] [added: (21)] | | |

| *[Executive Overview](#ibc59a92ac8bc42f794e728f24ce1b626_706)* | | | [52](#ibc59a92ac8bc42f794e728f24ce1b626_706) | | |

| *[Liquidity and Capital Resources](#ibc59a92ac8bc42f794e728f24ce1b626_784)* | | | [56](#ibc59a92ac8bc42f794e728f24ce1b626_784) | | |

| *[Segment Reporting](#ibc59a92ac8bc42f794e728f24ce1b626_826)* | | | [65](#ibc59a92ac8bc42f794e728f24ce1b626_826) | | |

| *[Cigna Healthcare](#ibc59a92ac8bc42f794e728f24ce1b626_841)* | | | [67](#ibc59a92ac8bc42f794e728f24ce1b626_841) | | |

| *[Other Operations](#ibc59a92ac8bc42f794e728f24ce1b626_850)* | | | [68](#ibc59a92ac8bc42f794e728f24ce1b626_850) | | |

| *[Corporate](#ibc59a92ac8bc42f794e728f24ce1b626_856)* | | | [69](#ibc59a92ac8bc42f794e728f24ce1b626_856) | | |

| *[Investment Assets](#ibc59a92ac8bc42f794e728f24ce1b626_865)* | | | [69](#ibc59a92ac8bc42f794e728f24ce1b626_865) | | |

We adopted amended accounting guidance for long-duration insurance contracts effective January 1, 2023.

This MD&A has been retrospectively adjusted to conform to the new basis of accounting.

The impact of this amended guidance is immaterial.

Additionally, during the fourth quarter of 2023, our U.S. Commercial and U.S. Government operating segments were merged to form the U.S. Healthcare operating segment within the Cigna Healthcare reportable segment.

See Note 2 to the Consolidated Financial Statements in this Form 10-K for additional information regarding the Company's significant accounting policies and additional information regarding the adoption of amended accounting guidance for long-duration insurance contracts effective January 1, 2023.

Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts.

Prior period financial highlights and results of operations have been retrospectively adjusted to conform to this new basis of accounting.

The impact of this amended guidance is immaterial.

| Cigna Healthcare | | | | | | | | | | | | | | | | | | | | | | | | | | | 51,205 | | | | | | 45,037 | | | | | | 44,643 | | | | | | 14 | | | | | | 1 | | | | | |

| Adjusted revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 195,322 | | | | | | 180,644 | | | | | | 174,069 | | | | | | 8 | | | | | | 4 | | | | | |

| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |

| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |

| Total revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 195,265 | | | | | $ | 180,518 | | | | | $ | 174,069 | | | | | 8 | | | % | | | 4 | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 5,164 | | | | | $ | 6,704 | | | | | $ | 5,370 | | | | | (23) | | | % | | | 25 | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 17.39 | | | | | $ | 21.41 | | | | | $ | 15.75 | | | | | (19) | | | % | | | 36 | | | % | | |

| Cigna Healthcare | | | | | | | | | | | | | | | | | | | | | | | | | | | 4,478 | | | | | | 4,099 | | | | | | 3,601 | | | | | | 9 | | | | | | 14 | | | | | |

| Other Operations | | | | | | | | | | | | | | | | | | | | | | | | | | | 96 | | | | | | 509 | | | | | | 903 | | | | | | (81) | | | | | | (44) | | | | | |

| Income before income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 5,513 | | | | | $ | 8,397 | | | | | $ | 6,790 | | | | | (34) | | | % | | | 24 | | | % | | |

| Premiums | | | | | | | | | | | | | | | | | | | | | | | | | | | 44,237 | | | | | | 39,916 | | | | | | 41,154 | | | | | | 4,321 | | | | | | 11 | | | | | | (1,238) | | | | | | (3) | | | | | |

| Fees and other revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 12,619 | | | | | | 10,881 | | | | | | 9,953 | | | | | | 1,738 | | | | | | 16 | | | | | | 928 | | | | | | 9 | | | | | |

| Total revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 195,265 | | | | | | 180,518 | | | | | | 174,069 | | | | | | 14,747 | | | | | | 8 | | | | | | 6,449 | | | | | | 4 | | | | | |

| Medical costs and other benefit expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 36,287 | | | | | | 32,184 | | | | | | 33,565 | | | | | | 4,103 | | | | | | 13 | | | | | | (1,381) | | | | | | (4) | | | | | |

| Selling, general and administrative expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 14,822 | | | | | | 13,174 | | | | | | 13,012 | | | | | | 1,648 | | | | | | 13 | | | | | | 162 | | | | | | 1 | | | | | |

| Total benefits and expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 186,729 | | | | | | 172,068 | | | | | | 166,128 | | | | | | 14,661 | | | | | | 9 | | | | | | 5,940 | | | | | | 4 | | | | | |

| Income from operations | | | | | | | | | | | | | | | | | | | | | | | | | | | 8,536 | | | | | | 8,450 | | | | | | 7,941 | | | | | | 86 | | | | | | 1 | | | | | | 509 | | | | | | 6 | | | | | |

| Net realized investment (losses) gains | | | | | | | | | | | | | | | | | | | | | | | | | | | (78) | | | | | | (487) | | | | | | 198 | | | | | | 409 | | | | | | 84 | | | | | | (685) | | | | | | N/M | | | | | |

| Income before income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | 5,513 | | | | | | 8,397 | | | | | | 6,790 | | | | | | (2,884) | | | | | | (34) | | | | | | 1,607 | | | | | | 24 | | | | | |

| Total income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | 141 | | | | | | 1,615 | | | | | | 1,370 | | | | | | (1,474) | | | | | | (91) | | | | | | 245 | | | | | | 18 | | | | | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | | | | 5,372 | | | | | | 6,782 | | | | | | 5,420 | | | | | | (1,410) | | | | | | (21) | | | | | | 1,362 | | | | | | 25 | | | | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 5,164 | | | | | $ | 6,704 | | | | | $ | 5,370 | | | | | $ | (1,540) | | | | | (23) | | | % | | | $ | 1,334 | | | | | 25 | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 5,164 | | | | | | | | $ | 6,704 | | | | | | | | $ | 5,370 | |

| Net realized investment losses (gains) (1) | | | | | | | | | | | | | | | | | | | | | | | | $ | 135 | | 114 | | | | | | $ | 613 | | 496 | | | | | | $ | (198) | | (161) | | |

| Deferred tax (benefits), net | | | | | | | | | | | | | | | | | | | | | | | | — | | | (1,071) | | | | | | — | | | — | | | | | | — | | | — | | |

| | | | | | |

| --- | --- | --- | --- | --- | --- |

| *[Executive Overview](#ic821d5f440e6453dbe77c0f7576c993a_568)* | | | [53](#ic821d5f440e6453dbe77c0f7576c993a_568) | | |

| *[Segment Reporting](#ic821d5f440e6453dbe77c0f7576c993a_682)* | | | [66](#ic821d5f440e6453dbe77c0f7576c993a_682) | | |

| *[Cigna Healthcare](#ic821d5f440e6453dbe77c0f7576c993a_691)* | | | [69](#ic821d5f440e6453dbe77c0f7576c993a_691) | | |

| *[Other Operations](#ic821d5f440e6453dbe77c0f7576c993a_694)* | | | [71](#ic821d5f440e6453dbe77c0f7576c993a_694) | | |

| *[Corporate](#ic821d5f440e6453dbe77c0f7576c993a_697)* | | | [71](#ic821d5f440e6453dbe77c0f7576c993a_697) | | |

| *[Investment Assets](#ic821d5f440e6453dbe77c0f7576c993a_700)* | | | [72](#ic821d5f440e6453dbe77c0f7576c993a_700) | | |

The Cigna Group, together with its subsidiaries, is a global health company.

On February 13, 2023, we changed our corporate name from Cigna Corporation to The Cigna Group.

We will not distinguish between our prior and current corporate name and will refer to our current corporate name throughout this Annual Report on Form 10-K.

As such, unless expressly indicated or the context requires otherwise, the terms "Company," "we," "us," and "our" in this document refer to The Cigna Group, a Delaware corporation, and, where appropriate, its subsidiaries.

On February 13, 2023, we also changed the name of our Evernorth segment to Evernorth Health Services.

We will not distinguish between our prior and current segment name and will refer to our current segment name throughout this Annual Report on Form 10-K.

Our common stock continues to be listed with, and trades on, the New York Stock Exchange under the ticker symbol "CI".

| Cigna Healthcare | | | | | | | | | | | | | | | | | | | | | | | | | | | 45,036 | | | | | | 44,652 | | | | | | 41,135 | | | | | | 1 | | | | | | 9 | | | | | |

| Adjusted revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 180,642 | | | | | | 174,078 | | | | | | 160,067 | | | | | | 4 | | | | | | 9 | | | | | |

| Special item related to contractual adjustment for a former client | | | | | | | | | | | | | | | | | | | | | | | | | | | — | | | | | | — | | | | | | 204 | | | | | | N/M | | | | | | N/M | | | | | |

| Total revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 180,516 | | | | | $ | 174,078 | | | | | $ | 160,401 | | | | | 4 | | | % | | | 9 | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 6,668 | | | | | $ | 5,365 | | | | | $ | 8,458 | | | | | 24 | | | % | | | (37) | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 21.30 | | | | | $ | 15.73 | | | | | $ | 22.96 | | | | | 35 | | | % | | | (31) | | | % | | |

| Cigna Healthcare | | | | | | | | | | | | | | | | | | | | | | | | | | | 4,072 | | | | | | 3,609 | | | | | | 4,031 | | | | | | 13 | | | | | | (10) | | | | | |

| Other Operations | | | | | | | | | | | | | | | | | | | | | | | | | | | 500 | | | | | | 889 | | | | | | 966 | | | | | | (44) | | | | | | (8) | | | | | |

| Income before income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 8,353 | | | | | $ | 6,782 | | | | | $ | 10,868 | | | | | 23 | | | % | | | (38) | | | % | | |

| Premiums | | | | | | | | | | | | | | | | | | | | | | | | | | | 39,915 | | | | | | 41,154 | | | | | | 42,627 | | | | | | (1,239) | | | | | | (3) | | | | | | (1,473) | | | | | | (3) | | | | | |

| Fees and other revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 10,880 | | | | | | 9,962 | | | | | | 8,761 | | | | | | 918 | | | | | | 9 | | | | | | 1,201 | | | | | | 14 | | | | | |

| Total revenues | | | | | | | | | | | | | | | | | | | | | | | | | | | 180,516 | | | | | | 174,078 | | | | | | 160,401 | | | | | | 6,438 | | | | | | 4 | | | | | | 13,677 | | | | | | 9 | | | | | |

| Medical costs and other benefit expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 32,206 | | | | | | 33,562 | | | | | | 32,710 | | | | | | (1,356) | | | | | | (4) | | | | | | 852 | | | | | | 3 | | | | | |

| Selling, general and administrative expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 13,186 | | | | | | 13,030 | | | | | | 14,072 | | | | | | 156 | | | | | | 1 | | | | | | (1,042) | | | | | | (7) | | | | | |

| Total benefits and expenses | | | | | | | | | | | | | | | | | | | | | | | | | | | 172,102 | | | | | | 166,143 | | | | | | 152,248 | | | | | | 5,959 | | | | | | 4 | | | | | | 13,895 | | | | | | 9 | | | | | |

| Income from operations | | | | | | | | | | | | | | | | | | | | | | | | | | | 8,414 | | | | | | 7,935 | | | | | | 8,153 | | | | | | 479 | | | | | | 6 | | | | | | (218) | | | | | | (3) | | | | | |

| Net realized investment (losses) gains | | | | | | | | | | | | | | | | | | | | | | | | | | | (495) | | | | | | 196 | | | | | | 149 | | | | | | (691) | | | | | | N/M | | | | | | 47 | | | | | | 32 | | | | | |

| Income before income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | 8,353 | | | | | | 6,782 | | | | | | 10,868 | | | | | | 1,571 | | | | | | 23 | | | | | | (4,086) | | | | | | (38) | | | | | |

| Total income taxes | | | | | | | | | | | | | | | | | | | | | | | | | | | 1,607 | | | | | | 1,367 | | | | | | 2,379 | | | | | | 240 | | | | | | 18 | | | | | | (1,012) | | | | | | (43) | | | | | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | | | | 6,746 | | | | | | 5,415 | | | | | | 8,489 | | | | | | 1,331 | | | | | | 25 | | | | | | (3,074) | | | | | | (36) | | | | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 6,668 | | | | | $ | 5,365 | | | | | $ | 8,458 | | | | | $ | 1,303 | | | | | 24 | | | % | | | $ | (3,093) | | | | | (37) | | | % | | |

| Shareholders' net income | | | | | | | | | | | | | | | | | | | | | | | | | | | $ | 6,668 | | | | | | | | $ | 5,365 | | | | | | | | $ | 8,458 | |

| Net realized investment losses (gains) (1) | | | | | | | | | | | | | | | | | | | | | | | | $ | 621 | | 503 | | | | | | $ | (196) | | (158) | | | | | | $ | (279) | | (244) | | |

| Risk corridors recovery | | | | | | | | | | | | | | | | | | | | | | | | — | | | — | | | | | | — | | | — | | | | | | (101) | | | (76) | | |

| Contractual adjustment for a former client | | | | | | | | | | | | | | | | | | | | | | | | — | | | — | | | | | | — | | | — | | | | | | (204) | | | (155) | | |

The Cigna Group, together with its [removed: subsidiaries,] [added: subsidiaries (either individually or collectively referred to as the "Company," "we," "us," or "our"),] is a global health company.

| | | | The Cigna Group is a global health company committed to [added: creating] a better future built on the vitality of every individual and every community. [removed: Our employees are trailblazers,] [added: We] relentlessly [removed: partnering] [added: challenge ourselves to partner] and [removed: innovating] [added: innovate] solutions for better health. [removed: This captures who we are today –] [added: Powered by our people] and [removed: who] [added: our brands,] we [removed: aspire] [added: advance our mission] to [removed: be in] [added: improve] the [removed: future. We are undergoing a revolution in health.] [added: health and vitality of those we serve.] | | | | | |

| | | | •Partnering with others to accelerate innovation and [removed: achieve greater] [added: create sustainable] impact. | | | | | |

Evernorth Health Services is our [removed: pharmacy, care] [added: pharmacy benefits, specialty] and [removed: benefits] [added: care] solution that is highly attractive to our clients and partners because of the depth of its capabilities and expertise.

Cigna Healthcare is the health benefits provider of The Cigna Group, serving customers and clients for our U.S. [removed: Commercial, U.S. Government] [added: Healthcare] and International Health operating segments, and it allows us to harness our partnership relationship with physicians to deliver affordable and coordinated health [removed: care to employers and individuals.][added: care.]

Together, Evernorth Health Services and Cigna Healthcare provide a strong and diverse foundation that allows us to capitalize on growth opportunities by leading with our strengths – [removed: medical and] pharmacy [added: and medical] solutions – and then expanding those relationships by addressing additional client needs and innovating and delivering new services and solutions.

When considering our broad portfolio of businesses, we have strong foundational businesses that [removed: will] [added: we expect to] continue to grow.

These businesses often serve as the key entry point for clients with either a [added: pharmacy relationship, a medical relationship or both.]

Our capabilities include: 1) a broad portfolio of solutions and services, some of which can be offered on a stand-alone basis; 2) integrated behavioral, medical and pharmacy management solutions; 3) leading specialty pharmacy, clinical and care management expertise; and 4) advanced analytics that help us engage more meaningfully with [removed: individuals, the plan sponsors] [added: those] we [removed: serve and our provider partners.][added: serve.]

We present the financial results of our businesses in the following segments (see "Executive Overview" section of [removed: the Management] [added: Management's] Discussion and Analysis of Financial Condition and Results of Operations ("MD&A") located in Part II, Item 7 of this Form 10-K for a Financial Summary):

Evernorth Health Services [removed: includes a broad range of coordinated and point solution health services and capabilities, as well as those from] partners [removed: across the health care system, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to] [added: with] health plans, employers, [removed: government] [added: governmental] organizations and health care [removed: providers.][added: providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.]

Within Evernorth Health Services, [removed: Pharmacy Benefits] [added: pharmacy benefits] and [removed: Home Delivery Pharmacy] [added: home delivery pharmacy] are foundational growth businesses and [removed: Specialty Pharmacy, Distribution,] [added: specialty pharmacy, specialty distribution,] and [removed: Care Delivery] [added: care delivery] and [removed: Management Solutions] [added: management solutions] are accelerated growth businesses.

Cigna Healthcare includes the U.S. [removed: Commercial, U.S. Government] [added: Healthcare] and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers.

Within Cigna Healthcare, U.S. [removed: Commercial] [added: Employer] and International Health are [removed: our] foundational growth [removed: businesses and U.S. Government is our accelerated growth business.][added: businesses.]

Other Operations comprises the remainder of our business operations, which includes certain ongoing businesses and [removed: exiting] [added: exited] businesses.

Our run-off businesses include (i) [added: variable annuity reinsurance business (formerly referred to as] guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") [removed: business,] [added: business),] (ii) settlement annuity business and (iii) individual life insurance and annuity and retirement benefits businesses.

Our [removed: exiting] [added: exited] businesses include [removed: our interest in a joint venture in Türkiye, which was sold to our partner in December 2022,] the international life, accident and supplemental benefits businesses sold [removed: on] [added: in] July [removed: 1,] 2022 and [removed: the Group Disability and Life business] [added: our interest in a joint venture in Türkiye] sold [removed: on] [added: in] December [removed: 31, 2020.][added: 2022.]

[removed: On July 1, 2022, the Company completed the sale of its] [added: We offered] life, accident and supplemental benefits [removed: businesses] [added: insurance products and services] in [removed: six countries (Hong] [added: Hong] Kong, Indonesia, New Zealand, South Korea, Taiwan and [removed: Thailand)] [added: Thailand until completion of the sale of these businesses in July 2022] to Chubb INA Holdings, Inc. [removed: ("Chubb") for approximately $5.4 billion in cash (the "Chubb transaction") (see Note 4 to the Consolidated Financial Statements included in Part II, Item 8 of this Form 10-K).][added: ("Chubb").]

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

The financial information included in this Form 10-K for the fiscal year ended December 31, [removed: 2022] [added: 2023] is in conformity with accounting principles generally accepted in the United States of America ("GAAP") unless otherwise indicated.

[removed: See] Note [removed: 24] [added: 25] to the Consolidated Financial Statements of this Form 10-K for definitions of those terms.

Industry rankings and percentages set forth herein are for the year ended December 31, [removed: 2022,] [added: 2023,] unless otherwise indicated.

The Cigna Group companies hold over [removed: 320] [added: 400] United States patents.

In [removed: 2022,] [added: 2023,] Evernorth Health Services reported adjusted revenues of [removed: $140.3] [added: $153.5] billion and pre-tax adjusted income from operations of [removed: $6.1] [added: $6.4] billion.

| [removed: Driving] [added: Pharmacy Benefit Services - Driving] Foundational Growth | | | Pharmacy Benefits | | | Express Scripts PBM, [added: National Preferred Formulary,] myMatrixx®, [removed: Care Continuum,] Express Scripts MedRx ManagementSM, [removed: Embarc Benefit Protection®, FamilyPathSM,] Advanced Utilization Management, Enhanced Fraud, Waste & Abuse, Ascent Health Services, [removed: Econdisc, SaveOnSP,] [added: Econdisc Contracting Solutions, Copay Assurance®,] Inside Rx®, Evernorth Wholesale MarketplaceSM, Value-Based Programs (Express Scripts SafeGuardRx®, Express Scripts Patient [removed: Assurance®), National Preferred Formulary, Advanced Opioid Management®, ScreenRx®] [added: Assurance®, EncircleRxSM)] | | | Clients, Customers, Health Care Providers, Consultants, Health Plans, Commercial and Government Payors, Self-paying Customers, Pharmacy Providers | | | Health Plans, Independent Pharmacy Benefit Managers ("PBMs"), Managed Care PBMs, Third-Party Benefit Administrators, Group Purchasing Organizations, Clinical Solutions and Health Care Data Analytics Companies | | |

| Home Delivery Pharmacy | | | Express Scripts Pharmacy® | | | Clients, Customers, Health Care Providers | | | [removed: Independent PBMs, Managed Care PBMs,] Retail [added: Pharmacies, Home Delivery] Pharmacies | | | | | |

| [removed: Driving] [added: Specialty and Care Services - Driving] Accelerated Growth | | | Specialty Pharmacy | | | Accredo®, Freedom Fertility Pharmacy®, Therapeutic Resource Center® | | | Clients, Customers, Health Care Providers, Specialty Drug Distributors | | | Specialty Pharmacies | | |

| [removed: Distribution] [added: Specialty Distribution] | | | CuraScript SD® | | | Clinics, [removed: Hospitals] [added: Hospitals, Physicians' Offices, Pharmacies, Alternative Sites of Care] | | | Specialty Drug Distributors | | | | | |

| Care Delivery and Management Solutions | | | [removed: Evernorth Care Group, Evernorth Care Services, Evernorth Care Solutions,] [added: eviCore Healthcare®,] Evernorth [removed: Direct] [added: Behavioral] Health, Evernorth Home-Based Care, [removed: eviCore Healthcare®,] MDLIVE®, [removed: Evernorth Behavioral Health,] inMyndSM, Health Connect 360®, RationalMed®, Evernorth Digital Health [removed: FormularySM, Evernorth Labs, Trend Central®, HealthPredictSM, MediCUBE®, ScriptVision®] [added: FormularySM] | | | Clients, Customers, Health Care [removed: Providers] [added: Providers, VillageMD, Health Plans] | | | Managed Care Organizations, Care Delivery and Care Management Solutions Providers, Third-Party Benefit Administrators, Health Care Data Analytics Companies | | | | | |

[added: - *Pharmacy Benefits.*] We drive high-quality, cost-effective [added: pharmacy] care through [removed: prescription drug utilization and cost management] [added: a range of] services.

We [removed: dispense] [added: adjudicate] drug claims [removed: via] [added: from] Express Scripts Pharmacy, Accredo and [removed: our] retail [removed: networks by integrating retail] network [added: participants, and provide retail] pharmacy [added: network] administration, benefit design consultation, drug utilization review, drug formulary management and [removed: pharmacy fulfillment] [added: other] services.

[removed: ◦*Drug] [added: *◦Drug] Utilization Review Program.* When pharmacies submit claims for prescription drugs to us, we review them electronically in real time for health and safety.

◦*myMatrixx.* myMatrixx is a [removed: unique] PBM with an exclusive focus on workers' compensation.

Our solutions apply utilization management, site of care management and claims prepayment review to effectively reduce wasteful spend, while providing services tailored to customers [removed: ensuring] [added: helping ensure] safety and healthier outcomes.

◦*Retail [removed: Network] Pharmacy [added: Network] Administration.* We contract with retail pharmacies to provide prescription drugs to customers of the pharmacy benefit plans [removed: we manage.][added: our clients offer.]

We negotiate with pharmacies throughout the United States to discount drug prices [removed: provided to customers] and [removed: manage] [added: offer] national and regional [removed: networks] [added: network options] responsive to client preferences related to cost containment, convenience of access for customers and network performance.

[removed: ◦*Drug Formulary Management.* Formularies] [added: ▪Formularies] are lists of drugs with designations that may be used to determine drug coverage, customer out-of-pocket costs and communicate plan preferences in competitive drug categories.

[removed: We] [added: ▪We] administer specific formularies [removed: on behalf of] [added: for] our clients, including standard formularies developed [removed: and offered] by Express Scripts and custom formularies in which we play a more limited role.

◦*Advanced Utilization Management.* These programs include prior authorization, drug quantity management and step therapy designed to [removed: decrease] [added: ensure clinically appropriate medication use and avoid unnecessary] client [removed: spend on pharmacy.][added: pharmacy spend.]

◦*Enhanced Fraud, Waste & Abuse.* We help plan sponsors identify [removed: potential problem] customers and prescribers with [added: potentially] unusual or excessive utilization patterns.

| | | | Core Strengths | | | | | |

At The Cigna Group, we relentlessly challenge ourselves to partner and innovate solutions for better health.

Our global workforce of approximately 72,500 colleagues work to fulfill our mission to improve the health and vitality of over 164 million customer relationships in more than 30 markets and jurisdictions.

During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment.

U.S. Healthcare provides commercial medical plans and specialty benefits and solutions for insured and self-insured clients (U.S. Employer), Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans.

International Health provides health care solutions in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.

In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC") for $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction").

Cross-enterprise Leverage

Cross-enterprise leverage enables us to uniquely use the depth and breadth of our wide-ranging capabilities across the enterprise to create more value, expand our reach and drive growth.

We look across our enterprise at our client relationships within both Evernorth Health Services and Cigna Healthcare and seek to deepen them by leveraging our entire suite of capabilities.

Cross-enterprise leverage brings teams from across the enterprise together in a quick, efficient and organized manner to move from ideation to solution creation to meet client's evolving needs.

Evernorth Health Services offerings, such as the Express Scripts PBM, Accredo Specialty Pharmacy, and Evernorth Care behavioral health solutions, are available within Cigna Healthcare solutions.

This broadens Evernorth Health Services’s presence in the total health care delivery system, and expands the breadth and depth of offerings available to Cigna Healthcare clients and customers while improving affordability, access, quality of care, care innovations and transparency.

A recent product innovation is Pathwell Bone & Joint - a Cigna Healthcare solution powered by Evernorth Health Services.

Pathwell Bone & Joint delivers affordability to clients via an enhanced digital customer experience and customized clinical navigation through a care advocate.

During 2023, this program was offered to Cigna Healthcare U.S. Employer clients.

See

The Cigna Group, through its predecessor companies, was incorporated in Delaware in 1981.

Evernorth Health Services includes a broad range of independent and coordinated health solutions and capabilities designed to enable the health care system to work better and help people live richer, healthier lives.

Health plans, employers, governmental organizations and health care providers partner with Evernorth Health Services to solve their biggest challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.

Since the launch of the Evernorth Health Services brand, we have continued to grow and serve more people.

Today, Evernorth Health Services is made up of dozens of businesses across pharmacy benefit, specialty and care services.

All products and services below are part of the Evernorth Health Services offering.

| | | | | | | | | |

| --- | --- | --- | --- | --- | --- | --- | --- | --- |

| | | | How We Deliver | | | | | |

| | | | •Deep clinical expertise when evaluating medicines, digital therapeutics and other health solutions for efficacy and value to assist clients in selecting a cost effective formulary. | | | | | |

| | | | •Affordable solutions that provide more value and drive risk-sharing and value-based care. | | | | | |

| | | | •Flexible solutions tailored to client needs, using Evernorth Health Services' combined strengths and capabilities, as well as strategic partnerships, to deliver: better, more efficient care for patients; better experiences for clients, providers and customers; and enhanced choices for clients and customers through our open architecture model. | | | | | |

| | | | •Talented, experienced and caring people who work as consultative partners to solve complex problems across a fragmented health care ecosystem, fueled by data and expertise that drives purposeful innovation. | | | | | |

Pharmacy Benefit Services

◦*Drug Formulary Management.*

Many of our clients select standard formularies, governed by our National Pharmacy & Therapeutics Committee ("P&T Committee"), our Therapeutic Assessment Committee ("TAC") and our Value Assessment Committee ("VAC").

These committees work together to develop recommendations for formularies that first consider clinical results independent of price

considerations.

Only after these clinical reviews are completed and codified are other factors such as net cost, market share and drug utilization trends considered for the final development of our formularies.

▪One of the ways we manage our drug formulary is through negotiating to secure additional affordability for the benefit of our clients based on the utilization of certain prescription drugs and supplies which can be paid to us in the form of a rebate.

With respect to our clients' rebate arrangements, most chose to receive the greater of a minimum rebate guarantee or a contractually agreed-upon percentage of rebates.

In some rebate arrangements, Express Scripts PBM takes on the risk of securing the rebate value necessary to meet the value guaranteed to its client.

The actual amount of value secured by Express Scripts PBM is dependent upon the result of its negotiations for rebates.

On February 13, 2023, we changed our corporate name from Cigna Corporation to The Cigna Group.

We will not distinguish between our prior and current corporate name and will refer to our current corporate name throughout this Annual Report on Form 10-K.

As such, unless expressly indicated or the context requires otherwise, the terms "Company," "we," "us," and "our" in this document refer to The Cigna Group, a Delaware corporation, and, where appropriate, its subsidiaries.

On February 13, 2023, we also changed the name of our Evernorth segment to Evernorth Health Services.

We will not distinguish between our prior and current segment name and will refer to our current segment name throughout this Annual Report on Form 10-K.

Our common stock continues to be listed with, and trades on, the New York Stock Exchange under the ticker symbol "CI".

| | | | How We Win | | | | | |

The last couple of years have reoriented every person, every organization and every community toward a deeper relationship with health.

We believe that achieving both health and vitality for those we serve must fuel the actions of our over 70,000 colleagues around the world, each and every day.

pharmacy relationship, a medical relationship or both.

The Cigna Group's employees are champions for the people we serve and over the past decade, our focus has shifted to helping individuals and families thrive by offering solutions to prevent and better manage health challenges.

When sickness or disability do occur, we support our customers by offering broad choices to help them best access high quality, affordable, whole person care.

We see three primary ways to help individuals maintain, improve or recover their physical or mental health: 1) behavioral and lifestyle changes – with health coaches helping individuals set and meet health goals; 2) affordable, effective medication options – with access to our leading pharmacy services improving health and driving affordability; and 3) targeted medical and surgical interventions – with a clear and proven strategy around partnerships and value-based care quality programs, powered by data and analytics and aligned incentives.

We maximize use of evidence-based care, while delivering best-in-class service for our customers with acute and chronic conditions through enhanced real-time insights across an expanded platform with industry-leading solutions to support care decisions.

We offer a differentiated set of pharmacy, medical, behavioral, dental and supplemental products and services, primarily through two growth platforms: Evernorth Health Services and Cigna Healthcare.

We differentiate ourselves in the market through a number of capabilities.

We improve whole-person health, in body and mind by treating physical and behavioral health together to improve outcomes and by providing early behavioral and lifestyle interventions.

We make it easier to access quality care by improving navigation at every step in a patient's health journey and by meeting customers wherever they are - virtually, digitally and in home.

We connect care for the most pressing conditions by closing gaps between hospitals, primary care providers, specialists and other health care providers.

We also develop personalized treatment paths across every dimension of care.

We continue to build upon our network of value-based provider arrangements for better customer experiences, better overall health outcomes and greater affordability, with a significant number of our eligible customers aligned to our Accountable Care programs nationally.

We make medicine more affordable by reducing costs from start to finish, including those related to drug access, delivery and treatment and by identifying appropriate medication alternatives.

We partner and innovate to enable us to deliver differentiated value and broaden our reach in new geographies or through the introduction of new solutions and offerings.

Our key to success revolves around how deeply we care about our customers, patients and co-workers.

We intend to create a better future together by innovating and adapting, acting with speed and purpose, partnering, collaborating and keeping our promises.

Cigna Holding Company (formerly Cigna Corporation) was incorporated in Delaware in 1981.

Halfmoon Parent, Inc. was incorporated in Delaware in March 2018.

Halfmoon Parent, Inc. was renamed Cigna Corporation and Cigna Holding Company became its subsidiary concurrent with the consummation of the combination with Express Scripts on December 20, 2018.

Evernorth Health Services 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 Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to health plans, employers, government organizations and health care providers.

These offerings are also integrated into our Cigna Healthcare solutions to span the total health care delivery system, further

reducing the total cost of care for our clients and customers.

On February 13, 2023, we changed the name of our Evernorth segment to Evernorth Health Services.

| | | |

| --- | --- | --- |

| HOW WE WIN | | |

| Evernorth Health Services accelerates delivery of comprehensive, connected solutions to create value and meet the diverse needs of health plans, employers, health care providers and government organizations by: •Partnering in unconventional ways to solve complex problems across a fragmented health care ecosystem, fueled by data and expertise that drives purposeful innovation •Creating flexible solutions tailored to client needs, using Evernorth Health Services' combined strengths and capabilities, as well as strategic partnerships, to deliver: better, more efficient care for patients; better experiences for clients, providers and customers; and enhanced choices for clients and customers through our open architecture model •Evaluating medicines, digital therapeutics and other health solutions for efficacy, adherence, value and price to assist clients in selecting a cost-effective formulary •Offering home delivery, virtual and in-person care, and specialty customer-centric solutions that meet the needs of our clients and customers in ways that unlock greater value and better health services while providing better and specialized clinical care •Delivering more affordable solutions that provide more discounts and drive risk-sharing and value-based care •Promoting the use of generics and lowest-cost, clinically effective brands of medications | | |

- *Pharmacy Benefits.* Express Scripts Pharmacy dispenses approximately 1.6 billion adjusted prescriptions(1) annually to members of pharmacy plans managed by our Express Scripts PBM.

We support our clients' plan design selections to deliver balanced affordability, choice, simplicity and convenience.

We focus our solutions to align with our clients' service, care and cost management needs.

As a result, we believe we deliver better care, healthier outcomes, higher customer satisfaction and a more affordable prescription drug benefit.

The information contained under [removed: "Litigation Matters"] [added: "Legal] and [removed: "Regulatory] [added: Regulatory] Matters" in Note [removed: 23] [added: 24] to the Consolidated Financial Statements of this Form 10-K is incorporated herein by reference.

[removed: ][added: ]

| For the fiscal year [removed: ended December] [added: ended December] 31, [removed: 2022] [added: 2023] | | | | | |

The aggregate market value of the voting stock held by non-affiliates of the registrant as of June 30, [removed: 2022] [added: 2023] was approximately $82.8 billion.

As of January 31, [removed: 2023, 297,059,973] [added: 2024, 292,355,022] shares of the registrant's Common Stock were outstanding.

Part III of this Form 10-K incorporates by reference information from the registrant's definitive proxy statement related to the [removed: 2023] [added: 2024] annual meeting of shareholders.

| [Key Transactions and Business [removed: Developments](#ic821d5f440e6453dbe77c0f7576c993a_598)] [added: Developments](#ibc59a92ac8bc42f794e728f24ce1b626_745)] | | | [removed: [56](#ic821d5f440e6453dbe77c0f7576c993a_598)] [added: [55](#ibc59a92ac8bc42f794e728f24ce1b626_745)] | | |

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| [Item [removed: 9.](#ic821d5f440e6453dbe77c0f7576c993a_838)] [added: 9.](#ibc59a92ac8bc42f794e728f24ce1b626_1018)] | | | [Changes in and Disagreements with Accountants on Accounting and Financial [removed: Disclosure](#ic821d5f440e6453dbe77c0f7576c993a_838)] [added: Disclosure](#ibc59a92ac8bc42f794e728f24ce1b626_1018)] | | | | | | [removed: [138](#ic821d5f440e6453dbe77c0f7576c993a_838)] [added: [137](#ibc59a92ac8bc42f794e728f24ce1b626_1018)] | | |

| [Item [removed: 9B.](#ic821d5f440e6453dbe77c0f7576c993a_841)] [added: 9B.](#ibc59a92ac8bc42f794e728f24ce1b626_1021)] | | | [Other [removed: Information](#ic821d5f440e6453dbe77c0f7576c993a_841)] [added: Information](#ibc59a92ac8bc42f794e728f24ce1b626_1021)] | | | | | | [removed: [138](#ic821d5f440e6453dbe77c0f7576c993a_841)] [added: [137](#ibc59a92ac8bc42f794e728f24ce1b626_1021)] | | |

| [Item [removed: 9C.](#ic821d5f440e6453dbe77c0f7576c993a_844)] [added: 9C.](#ibc59a92ac8bc42f794e728f24ce1b626_1024)] | | | [Disclosure Regarding Foreign Jurisdictions that Prevent [removed: Inspections](#ic821d5f440e6453dbe77c0f7576c993a_844)] [added: Inspections](#ibc59a92ac8bc42f794e728f24ce1b626_1024)] | | | | | | [removed: [138](#ic821d5f440e6453dbe77c0f7576c993a_844)] [added: [137](#ibc59a92ac8bc42f794e728f24ce1b626_1024)] | | |

| [Item [removed: 10.](#ic821d5f440e6453dbe77c0f7576c993a_850)] [added: 10.](#ibc59a92ac8bc42f794e728f24ce1b626_1030)] | | | [Directors, Executive Officers and Corporate [removed: Governance](#ic821d5f440e6453dbe77c0f7576c993a_850)] [added: Governance](#ibc59a92ac8bc42f794e728f24ce1b626_1030)] | | | | | | [removed: [139](#ic821d5f440e6453dbe77c0f7576c993a_850)] [added: [138](#ibc59a92ac8bc42f794e728f24ce1b626_1030)] | | |

| [Item [removed: 11.](#ic821d5f440e6453dbe77c0f7576c993a_853)] [added: 11.](#ibc59a92ac8bc42f794e728f24ce1b626_1033)] | | | [Executive [removed: Compensation](#ic821d5f440e6453dbe77c0f7576c993a_853)] [added: Compensation](#ibc59a92ac8bc42f794e728f24ce1b626_1033)] | | | | | | [removed: [139](#ic821d5f440e6453dbe77c0f7576c993a_853)] [added: [138](#ibc59a92ac8bc42f794e728f24ce1b626_1033)] | | |

| [Item [removed: 12.](#ic821d5f440e6453dbe77c0f7576c993a_856)] [added: 12.](#ibc59a92ac8bc42f794e728f24ce1b626_1036)] | | | [Security Ownership of Certain Beneficial Owners and Management and Related Stockholder [removed: Matters](#ic821d5f440e6453dbe77c0f7576c993a_856)] [added: Matters](#ibc59a92ac8bc42f794e728f24ce1b626_1036)] | | | | | | [removed: [140](#ic821d5f440e6453dbe77c0f7576c993a_856)] [added: [139](#ibc59a92ac8bc42f794e728f24ce1b626_1036)] | | |

| [Item [removed: 13.](#ic821d5f440e6453dbe77c0f7576c993a_859)] [added: 13.](#ibc59a92ac8bc42f794e728f24ce1b626_1039)] | | | [Certain Relationships and Related Transactions, and Director [removed: Independence](#ic821d5f440e6453dbe77c0f7576c993a_859)] [added: Independence](#ibc59a92ac8bc42f794e728f24ce1b626_1039)] | | | | | | [removed: [140](#ic821d5f440e6453dbe77c0f7576c993a_859)] [added: [139](#ibc59a92ac8bc42f794e728f24ce1b626_1039)] | | |

| [Item [removed: 14.](#ic821d5f440e6453dbe77c0f7576c993a_862)] [added: 14.](#ibc59a92ac8bc42f794e728f24ce1b626_1042)] | | | [Principal Accountant Fees and [removed: Services](#ic821d5f440e6453dbe77c0f7576c993a_862)] [added: Services](#ibc59a92ac8bc42f794e728f24ce1b626_1042)] | | | | | | [removed: [140](#ic821d5f440e6453dbe77c0f7576c993a_862)] [added: [139](#ibc59a92ac8bc42f794e728f24ce1b626_1042)] | | |

| [Item [removed: 15.](#ic821d5f440e6453dbe77c0f7576c993a_868)] [added: 15.](#ibc59a92ac8bc42f794e728f24ce1b626_1048)] | | | [Exhibits and Financial Statement [removed: Schedules](#ic821d5f440e6453dbe77c0f7576c993a_868)] [added: Schedules](#ibc59a92ac8bc42f794e728f24ce1b626_1048)] | | | | | | [removed: [141](#ic821d5f440e6453dbe77c0f7576c993a_868)] [added: [140](#ibc59a92ac8bc42f794e728f24ce1b626_1048)] | | |

| [Item [removed: 16.](#ic821d5f440e6453dbe77c0f7576c993a_874)] [added: 16.](#ibc59a92ac8bc42f794e728f24ce1b626_1054)] | | | [Form 10-K [removed: Summary](#ic821d5f440e6453dbe77c0f7576c993a_874)] [added: Summary](#ibc59a92ac8bc42f794e728f24ce1b626_1054)] | | | | | | [removed: [149](#ic821d5f440e6453dbe77c0f7576c993a_874)] [added: [147](#ibc59a92ac8bc42f794e728f24ce1b626_1054)] | | |

| [Index to Financial Statement [removed: Schedules](#ic821d5f440e6453dbe77c0f7576c993a_880)] [added: Schedules](#ibc59a92ac8bc42f794e728f24ce1b626_1060)] | | | | | | | | | [removed: [FS-](#ic821d5f440e6453dbe77c0f7576c993a_880)[1](#ic821d5f440e6453dbe77c0f7576c993a_880)] [added: [FS-1](#ibc59a92ac8bc42f794e728f24ce1b626_1060)] | | |

Forward-looking statements may include, among others, statements concerning future financial or operating performance, including our ability to improve the health and vitality of those we serve; future growth, business strategy and strategic or operational initiatives; economic, regulatory or competitive environments, particularly with respect to the pace and extent of change in these areas and the impact of developing inflationary and interest rate pressures; financing or capital deployment plans and amounts available for future deployment; our prospects for growth in the coming years; strategic transactions; [removed: the impact of the Inflation Reduction Act (as defined below);] expectations related to our [removed: CMS (as defined below) Star Ratings and] Medicare Advantage Capitation Rates; and other statements regarding The Cigna Group's future beliefs, expectations, plans, intentions, liquidity, cash flows, financial condition or performance.

Such risks and uncertainties include, but are not limited to: our ability to achieve our strategic and operational initiatives; our ability to adapt to changes in an evolving and rapidly changing industry; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition, inflation and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of a potential cyberattack or other privacy or data security incident; [removed: the scale, scope and duration] [added: risks related to our use] of [removed: the COVID-19 pandemic] [added: artificial intelligence] and [removed: its potential impact on our business, operating results, cash flows or financial condition;] [added: machine learnings;] political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; risks related to strategic transactions and realization of the expected benefits of such transactions, as well as integration or separation difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits and investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions, [removed: including] the risk of a recession or other economic downturn and resulting impact on employment metrics, stock market or changes in interest rates and risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; [removed: unfavorable industry, economic or political conditions;] credit risk related to our reinsurers; as well as more specific risks and uncertainties discussed in Part I, Item 1A – Risk Factors and Part II, Item 7 – Management's Discussion and Analysis of Financial Condition and Results of Operations of this Form 10-K and as described from time to time in our future reports filed with the Securities and Exchange Commission (the "SEC").

| [Risk Factors](#ibc59a92ac8bc42f794e728f24ce1b626_979) | | | [30](#ibc59a92ac8bc42f794e728f24ce1b626_979) | | |

| [Executive Overview](#ibc59a92ac8bc42f794e728f24ce1b626_706) | | | [52](#ibc59a92ac8bc42f794e728f24ce1b626_706) | | |

| [Segment Information](#ibc59a92ac8bc42f794e728f24ce1b626_646) | | | [132](#ibc59a92ac8bc42f794e728f24ce1b626_646) | | |

| [Revenues by Product Type](#ibc59a92ac8bc42f794e728f24ce1b626_673) | | | [136](#ibc59a92ac8bc42f794e728f24ce1b626_673) | | |

| [Cautionary Statement](#ibc59a92ac8bc42f794e728f24ce1b626_931) | | | | | | | | |

| [PART I](#ibc59a92ac8bc42f794e728f24ce1b626_934) | | | | | | | | |

| [Item 1.](#ibc59a92ac8bc42f794e728f24ce1b626_937) | | | [Business](#ibc59a92ac8bc42f794e728f24ce1b626_937) | | | [1](#ibc59a92ac8bc42f794e728f24ce1b626_937) | | |

| | | | [Overview](#ibc59a92ac8bc42f794e728f24ce1b626_940) | | | [1](#ibc59a92ac8bc42f794e728f24ce1b626_940) | | |

| | | | [Cigna Healthcare](#ibc59a92ac8bc42f794e728f24ce1b626_952) | | | [8](#ibc59a92ac8bc42f794e728f24ce1b626_952) | | |

| | | | [Other Operations](#ibc59a92ac8bc42f794e728f24ce1b626_955) | | | [13](#ibc59a92ac8bc42f794e728f24ce1b626_955) | | |

| | | | [Miscellaneous](#ibc59a92ac8bc42f794e728f24ce1b626_973) | | | [14](#ibc59a92ac8bc42f794e728f24ce1b626_973) | | |

| | | | [Investment Management](#ibc59a92ac8bc42f794e728f24ce1b626_958) | | | [14](#ibc59a92ac8bc42f794e728f24ce1b626_958) | | |

| | | | [Strategic Investments](#ibc59a92ac8bc42f794e728f24ce1b626_961) | | | [15](#ibc59a92ac8bc42f794e728f24ce1b626_961) | | |

| | | | [Environmental, Social and Governance](#ibc59a92ac8bc42f794e728f24ce1b626_970) | | | [18](#ibc59a92ac8bc42f794e728f24ce1b626_970) | | |

| | | | [Regulation](#ibc59a92ac8bc42f794e728f24ce1b626_976) | | | [18](#ibc59a92ac8bc42f794e728f24ce1b626_976) | | |

| [Item 1C.](#ibc59a92ac8bc42f794e728f24ce1b626_985) | | | [Cybersecurity](#ibc59a92ac8bc42f794e728f24ce1b626_985) | | | [45](#ibc59a92ac8bc42f794e728f24ce1b626_985) | | |

| [Item 2.](#ibc59a92ac8bc42f794e728f24ce1b626_988) | | | [Properties](#ibc59a92ac8bc42f794e728f24ce1b626_988) | | | [47](#ibc59a92ac8bc42f794e728f24ce1b626_988) | | |

| [PART II](#ibc59a92ac8bc42f794e728f24ce1b626_1000) | | | | | | | | | | | |

| [Item 6.](#ibc59a92ac8bc42f794e728f24ce1b626_1012) | | | [\[Reserved\]](#ibc59a92ac8bc42f794e728f24ce1b626_1012) | | | | | | [50](#ibc59a92ac8bc42f794e728f24ce1b626_1012) | | |

| [Item 9A.](#ibc59a92ac8bc42f794e728f24ce1b626_880) | | | [Controls and Procedures](#ibc59a92ac8bc42f794e728f24ce1b626_880) | | | | | | [137](#ibc59a92ac8bc42f794e728f24ce1b626_877) | | |

| [PART III](#ibc59a92ac8bc42f794e728f24ce1b626_1027) | | | | | | | | | | | |

| [PART IV](#ibc59a92ac8bc42f794e728f24ce1b626_1045) | | | | | | | | | | | |

| [Signatures](#ibc59a92ac8bc42f794e728f24ce1b626_1057) | | | | | | | | | [148](#ibc59a92ac8bc42f794e728f24ce1b626_1057) | | |

| [Risk Factors](#ic821d5f440e6453dbe77c0f7576c993a_811) | | | [33](#ic821d5f440e6453dbe77c0f7576c993a_811) | | |

| [Executive Overview](#ic821d5f440e6453dbe77c0f7576c993a_568) | | | [53](#ic821d5f440e6453dbe77c0f7576c993a_568) | | |

| [Segment Information](#ic821d5f440e6453dbe77c0f7576c993a_526) | | | [134](#ic821d5f440e6453dbe77c0f7576c993a_526) | | |

| [Revenues by Product Type](#ic821d5f440e6453dbe77c0f7576c993a_541) | | | [137](#ic821d5f440e6453dbe77c0f7576c993a_541) | | |

| [Cautionary Statement](#ic821d5f440e6453dbe77c0f7576c993a_766) | | | | | | | | |

| [PART I](#ic821d5f440e6453dbe77c0f7576c993a_769) | | | | | | | | |

| [Item 1.](#ic821d5f440e6453dbe77c0f7576c993a_772) | | | [Business](#ic821d5f440e6453dbe77c0f7576c993a_772) | | | [1](#ic821d5f440e6453dbe77c0f7576c993a_772) | | |

| | | | [Overview](#ic821d5f440e6453dbe77c0f7576c993a_775) | | | [1](#ic821d5f440e6453dbe77c0f7576c993a_775) | | |

| | | | [Cigna Healthcare](#ic821d5f440e6453dbe77c0f7576c993a_787) | | | [11](#ic821d5f440e6453dbe77c0f7576c993a_787) | | |

| | | | [Other Operations](#ic821d5f440e6453dbe77c0f7576c993a_790) | | | [17](#ic821d5f440e6453dbe77c0f7576c993a_790) | | |

| | | | [Investment Management](#ic821d5f440e6453dbe77c0f7576c993a_796) | | | [18](#ic821d5f440e6453dbe77c0f7576c993a_796) | | |

| | | | [Strategic Investments](#ic821d5f440e6453dbe77c0f7576c993a_799) | | | [18](#ic821d5f440e6453dbe77c0f7576c993a_799) | | |

| | | | [Environmental, Social and G](#ic821d5f440e6453dbe77c0f7576c993a_1099511632300)[overnance](#ic821d5f440e6453dbe77c0f7576c993a_1099511632300) | | | [21](#ic821d5f440e6453dbe77c0f7576c993a_1099511632300) | | |

| | | | [Miscellaneous](#ic821d5f440e6453dbe77c0f7576c993a_805) | | | [21](#ic821d5f440e6453dbe77c0f7576c993a_805) | | |

| | | | [Regulation](#ic821d5f440e6453dbe77c0f7576c993a_808) | | | [21](#ic821d5f440e6453dbe77c0f7576c993a_808) | | |

| [Item 2.](#ic821d5f440e6453dbe77c0f7576c993a_817) | | | [Properties](#ic821d5f440e6453dbe77c0f7576c993a_817) | | | [48](#ic821d5f440e6453dbe77c0f7576c993a_817) | | |

| [PART II](#ic821d5f440e6453dbe77c0f7576c993a_829) | | | | | | | | | | | |

| [Item 6.](#ic821d5f440e6453dbe77c0f7576c993a_832) | | | [\[Reserved\]](#ic821d5f440e6453dbe77c0f7576c993a_832) | | | | | | [51](#ic821d5f440e6453dbe77c0f7576c993a_832) | | |

| [Item 9A.](#ic821d5f440e6453dbe77c0f7576c993a_715) | | | [Controls and Procedures](#ic821d5f440e6453dbe77c0f7576c993a_715) | | | | | | [138](#ic821d5f440e6453dbe77c0f7576c993a_712) | | |

| [PART III](#ic821d5f440e6453dbe77c0f7576c993a_847) | | | | | | | | | | | |

| [PART IV](#ic821d5f440e6453dbe77c0f7576c993a_865) | | | | | | | | | | | |

| [Signatures](#ic821d5f440e6453dbe77c0f7576c993a_877) | | | | | | | | | [150](#ic821d5f440e6453dbe77c0f7576c993a_877) | | |

Cybersecurity Strategy and Risk Management

The Cigna Group’s comprehensive cybersecurity program is supported by policies and procedures designed to protect our systems and operations as well as the sensitive personal information and data of our clients and customers from foreseeable cybersecurity threats.

This program is an integral component of our enterprise risk management program.

Core to our security model is our defense-in-depth framework, comprising multiple layers of processes and technologies that help prevent, detect, and respond to threats.

Our approach to safeguarding against external threats incorporates a suite of preventive technologies, including malicious email blocking, defenses against automated attacks and multifactor authentication.

These strategies act to proactively intercept and neutralize cyber threats to help ensure data remains secure within our environment.

Event monitoring technologies run continuously, detecting suspected intrusion attempts and alerting our Cybersecurity Incident Response team.

The Cigna Group undertakes a number of critical security processes to mitigate and protect against cybersecurity risks, which include but are not limited to:

- *Identity and Access Management*.

Employees are provided with the minimum amount of access required to perform their jobs using role-based access control methodology, which defines access to our information systems based on job function.

Privileged or elevated access to our systems is subject to supplemental approval requirements, increased authentication processes, and additional logging and monitoring.

- *Security Awareness and Training*.

Events and education activities are hosted throughout the year, such as the Cybersecurity Awareness Month, expos, videos, training programs and frequent phishing simulations.

The Cigna Group continuously trains workforce members on the importance of preserving the confidentiality and integrity of customer data.

All new hires have mandatory information protection and privacy training as part of their onboarding, and all workforce members complete an annual cybersecurity refresh training.

- *Security Operations and Monitoring.* Our operational monitoring processes provide valuable insight into the effectiveness of our security program.

A centralized system collects security logs and performs event correlation that creates an alert if a trigger occurs.

We review any deviations from our established targets and implement corrective actions.

*•Change Management*.

Changes to hardware, software, network components, and/or processes introduced into any production environments are managed by a formal change control process.

These requests include the submission of required documentation as well as the business justification for the change.

- *Disaster Recovery / Business Continuity*.

These processes are designed to maintain service to our customers, providers and members through a wide range of adverse circumstances.

Methods of recovery include rerouting business functions, relocating to an alternative site, independent “hot sites”, mobile recovery and work at home.

- *Intelligence Feeds*.

These are used to monitor the security industry for the latest global security threats, exposures and patches to help keep company servers current with the latest security service packs, patches and hot fixes.

- Physical Security.

Our physical security system is utilized in an effort to properly identify appropriate individuals, authorize entry and define the working areas to which they have access.

Additional controls at our data centers includes a combination of guard service, access keys and magnetic card systems.

- *Third-Party Vendor Security Reviews*.

Suppliers that have access to, host, or pass sensitive data are subject to a rigorous vendor security review which includes questionnaires, security controls and maturity assessments, inspection of evidence of compliance and remediation or acceptance of items identified during a Risk Assessment.

- *Vulnerability Management / Patching*.

Any discovered vulnerability is rated by severity and assigned a timeline for remediation.

Patching activities are centrally managed with a focus on the identification, remediation, and analysis and closure of vulnerabilities throughout the vulnerability management lifecycle.

- *Cybersecurity Incident Reporting*.

Our incident reporting protocol assists prompt and efficient response to cybersecurity threats.

This includes links on our internal site listing globally accessible contact numbers for immediate incident reporting, a user-friendly phishing reporting tool in Outlook, and group email boxes that are monitored 24/7 for incident submissions.

We routinely manage cybersecurity risks through a defined framework that includes activities aimed at the identification, assessment, treatment and monitoring of risks.

Cybersecurity risk assessment results are used by senior management to make informed decisions about where to allocate resources to reduce cybersecurity risks and improve overall security posture.

We examine our entire program annually with third-parties and measure the program against generally accepted industry standards and frameworks, such as an internationally recognized security control framework established by the NIST and used by companies to assess and improve their ability to prevent, detect and respond to cyberattacks.

At the end of [removed: 2022,] [added: 2023,] our global real estate portfolio consisted of approximately [removed: 9.8] [added: 9.2] million square feet of owned and leased properties to support the operations of our reporting segments.

Our domestic portfolio had approximately [removed: 8.9] [added: 8.3] million square feet in [removed: 42] [added: 49] states, the District of [removed: Columbia] [added: Columbia,] and the U.S. Virgin Islands.

Our international properties contain approximately [removed: 906] [added: 934] thousand square feet located throughout the following countries: Australia, Bahrain, Belgium, Canada, Cayman Islands, China, France, Germany, Hong Kong, India, Kenya, Kuwait, Lebanon, Malaysia, Oman, [added: Saudi Arabia,] Singapore, Spain, Switzerland, United Arab [removed: Emirates] [added: Emirates,] and the United Kingdom.

Our principal domestic office locations include the Wilde Building located at 900 Cottage Grove Road in Bloomfield, Connecticut (our corporate headquarters), [removed: Two Liberty Place located at 1601 Chestnut Street in Philadelphia, Pennsylvania and] Evernorth Health Services' corporate offices located at and around One Express Way in St. Louis, [removed: Missouri.][added: Missouri and Two Liberty Place located at 1601 Chestnut Street in Philadelphia, Pennsylvania.]

The Wilde Building measures approximately [removed: 893,000] [added: 893 thousand] square feet and is owned.

The St. Louis campus measures approximately [removed: 986,000] [added: 999 thousand] square feet of leased space and Two Liberty Place measures approximately [removed: 237,000] [added: 209 thousand] square feet of leased space.

The pharmacy operations consist of [removed: 10] [added: 13] home delivery pharmacies, [removed: 33] [added: 31] specialty pharmacies and four high-volume automated dispensing pharmacies located throughout the United States.

In the fourth quarter of 2023, we approved a strategic initiative to drive operational improvements and efficiencies.

This initiative includes a reduction in the square footage of leased properties and changes how sites are utilized.

See Note 17 to the Consolidated Financial Statements of this Form 10-K for additional information.

The principal occupations and employment histories of our executive officers (as of February [removed: 23, 2023)] [added: 29, 2024)] are listed below.

DAVID BRAILER, [removed: 63,] [added: 64,] Executive Vice President and Chief Health Officer of The Cigna Group beginning September 2022; and Founder and Chairman of Health Evolution beginning in 2011.

CORDANI, [removed: 57,] [added: 58,] Chairman of the Board of The Cigna Group beginning January 2022; Chief Executive Officer beginning December 2009; Director since October 2009; President beginning June 2008; and Chief Operating Officer from June 2008 until December 2009.

EDER, [removed: 53,] [added: 54,] Executive Vice President, Global Chief Information Officer of The Cigna Group beginning September [removed: 2020;] [added: 2020, with responsibility for the Company's technology and operations function beginning September 2023;] Executive Vice President, Chief Information and Digital Officer at Hilton Worldwide Holdings from March 2018 until August 2020; Executive Vice President, Chief Card Customer Experience Officer at Capital One Financial Corporation from November 2016 until 2018; and Executive Vice President, Customer Experience and Operations at Capital One Financial Corporation from September 2014 until November 2016.

EVANKO, [removed: 46,] [added: 47,] Executive Vice [added: President, Chief Financial Officer of The Cigna Group and] President and Chief [added: Executive Officer, Cigna Healthcare beginning January 2024; Executive Vice President and Chief] Financial Officer of The Cigna Group [removed: beginning] [added: from] January [removed: 2021;] [added: 2021 to January 2024;] President, Government Business from November 2017 to January 2021; and President, U.S. Individual Business from August 2013 to November 2017.

JONES, [removed: 52,] [added: 53,] Executive Vice [added: President, Chief Administrative Officer, and General Counsel for The Cigna Group beginning September 2023; Executive Vice] President and General Counsel of The Cigna Group beginning June [removed: 2011;] [added: 2011 to September 2023;] Senior Vice President and General Counsel of Lincoln Financial Group from May 2010 until June 2011; Vice President and Deputy General Counsel of The Cigna Group from April 2008 until May 2010; and Corporate Secretary from September 2006 until April 2010.

PALMER, [removed: 46,] [added: 47, Executive Vice President, Enterprise Strategy of The Cigna Group and] President and Chief Executive [added: Officer, Evernorth Health Services beginning January 2024; President and Chief Executive] Officer of Evernorth Health Services beginning January [removed: 2022;] [added: 2022 to January 2024;] President and Chief Operating Officer from January 2021 until December 2021; Executive Vice President and Chief Financial Officer of The Cigna Group from June 2017 to January 2021; Deputy Chief Financial Officer from February 2017 until June 2017; Senior Vice President, Chief Business Financial Officer from November 2015 to February 2017; and Vice President, Business Financial Officer, Health Care from April 2012 to November 2015.

TRIPLETT, [removed: 61,] [added: 62, Special Advisor beginning January 2024;] President, U.S. Commercial of Cigna Healthcare beginning February [removed: 2017;] [added: 2017 to January 2024;] and Regional Segment Lead from June 2009 to February 2017.

CHARLES G.

BERG, 65, Senior Advisor of The Cigna Group beginning January 2023; President, U.S. Government Business of Cigna Healthcare from January 2022 until January 2023; Executive Chairman of DaVita Medical Group from November 2016 until December 2017; and Non-Executive Chairman of WellCare Health Plans, Inc. from January 2011 until May 2013.

EVERETT NEVILLE, 58, Executive Vice President, Solutions and Corporate Development of The Cigna Group beginning September 2022; Executive Vice President, Strategy, Corporate Development & Solutions from October 2021 to September 2022; Executive Vice President, Strategy and Business Development from January 2021 to October 2021; Senior Vice President, Value Creation and Solutions from January 2020 until January 2021; Chief Value Officer from December 2018 until January 2020; Executive Vice President, Strategy, Supply Chain & Specialty, Express Scripts from January 2018 until December 2018; Senior Vice President, Strategy, Supply Chain & Specialty from November 2016 until January 2018; and Senior Vice President, Supply Chain from March 2015 until November 2016.

CYNTHIA RYAN, 49, Executive Vice President, Chief Human Resources Officer of The Cigna Group beginning August 2021; Senior Vice President, Human Resources from December 2018 to August 2021; Vice President, Human Resources from January 2017 to December 2018; and Vice President, Talent Management from May 2014 to January 2017.

JASON D.

SADLER, 54, President, International Health of Cigna Healthcare beginning June 2014; and President, Global Individual Health, Life and Accident from July 2010 until June 2014.

PAUL SANFORD, 55, Executive Vice President, Operations of The Cigna Group beginning September 2021; Senior Vice President, Operations and Solutions Delivery from January 2021 to September 2021; Senior Vice President, Solutions Delivery from February 2017 to December 2020; and Vice President, Operating Effectiveness from September 2008 to February 2017.

As of December 31, [removed: 2022,] [added: 2023,] the number of shareholders of record was [removed: 28,205.][added: 23,435.]

In [removed: 2022,] [added: 2023,] The Cigna Group declared and paid quarterly cash dividends of [removed: $1.12] [added: $1.23] per share of The Cigna Group common stock.

[removed: In 2021,] The Cigna Group paid quarterly cash dividends of [added: $1.12 per share in 2022 and] $1.00 per share [removed: of The Cigna Group common stock.][added: in 2021.]

See Note [removed: 8] [added: 9] to the Consolidated Financial Statements for further information on dividend payments.

For information on securities authorized for issuance under our existing equity compensation plans, see Item 12 under the heading "Security Ownership of Certain Beneficial Owners and Management and [removed: Rebated] [added: Related] Stockholder Matters."

The following table provides information about The Cigna Group's share repurchase activity for the quarter ended December 31, [removed: 2022:][added: 2023:]

| Period | | | | | | Total # of shares purchased (1) | | | | | | Average price paid per share (1) | | | | | | Total # of shares purchased as part of publicly announced program (2) | | | | | | Approximate dollar value of shares that may yet be purchased as part of publicly announced program (3) [added: (in millions)] | | |

Employees tendered [removed: 833] [added: 199] shares in October, [removed: 1,162] [added: 3,106] shares in November and [removed: 961] [added: 3,213] shares in December [removed: 2022.][added: 2023.*]

See Note [removed: 8] [added: 9] to the Consolidated Financial Statements for further [removed: details] [added: information] on [removed: the average share price for total shares purchased under the] [added: our] ASR [removed: agreements.][added: agreements.*]

*(3)Approximate dollar value of shares is as of the last date of the applicable [removed: month.*][added: month and excludes the impact of excise tax.*]

The graph below compares the cumulative total shareholder return on our common stock for the five years ended December 31, [removed: 2022] [added: 2023] with the cumulative total return of the Standard & Poor's ("S&P") 500 Index and the S&P 500 Health Care Index.

[removed: ][added: ]

On February 2, 2024, the Board of Directors declared the first quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on March 21, 2024 to shareholders of record on March 6, 2024.

| October 1-31, 2023 | | | | | | 1,520,890 | | | | | | $ | 300.75 | | | | | 1,520,691 | | | | | | $ | 1,346 | |

| November 1-30, 2023 | | | | | | 131,656 | | | | | | $ | 313.82 | | | | | 128,550 | | | | | | $ | 1,306 | |

| December 1-31, 2023 | | | | | | 3,213 | | | | | | $ | 287.87 | | | | | — | | | | | | $ | 11,306 | |

| Total | | | | | | 1,655,759 | | | | | | $ | 301.76 | | | | | 1,649,241 | | | | | | N/A | | |

In December 2023, the Board increased repurchasing authority by an additional $10.0 billion.

In February 2024, as part of our existing share repurchase program, we entered into accelerated share repurchase agreements ("2024 ASR agreements") to repurchase $3.2 billion of common stock in aggregate.

We received an initial delivery of approximately 7.6 million shares of our common stock representing $2.6 billion of the total $3.2 billion remitted.

Including the impact of the 2024 ASR agreements, from January 1, 2024 through February 28, 2024, we repurchased 10.1 million shares for approximately $4.0 billion.

Share repurchase authority was $7.3 billion as of February 28, 2024.

In 2020, The Cigna Group paid a yearly cash dividend of $0.04 per share.

| October 1-31, 2022 | | | | | | 833 | | | | | | $ | 286.84 | | | | | — | | | | | | $ | 5,323,335,866 | |

| November 1-30, 2022 | | | | | | 5,499,088 | | | | | | see (1) below | | | | | | 5,497,926 | | | | | | $ | 4,165,793,043 | |

| December 1-31, 2022 | | | | | | 1,803,379 | | | | | | $ | 330.62 | | | | | 1,802,418 | | | | | | $ | 3,569,880,748 | |

| Total | | | | | | 7,303,300 | | | | | | see (1) below | | | | | | 7,300,344 | | | | | | N/A | | |

Amount purchased in November 2022 also reflects the final settlement of 1.9 million shares pursuant to the Accelerated Share Repurchase ("ASR") agreements.

Such repurchase was made pursuant to the Company's share repurchase program described in note (2), below.

Average price paid per share for the period November 1 to November 30, 2022 for shares not purchased pursuant to the ASR agreements was $315.56.*

From January 1, 2023 through February 22, 2023, the Company repurchased 2.1 million shares for approximately $646 million, leaving repurchase authority at $2.9 billion as of February 22, 2023.*

We have audited the accompanying consolidated balance sheets of The Cigna Group and its subsidiaries (the "Company") as of December 31, [removed: 2022] [added: 2023] and [removed: 2021,] [added: 2022,] 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, [removed: 2022,] [added: 2023,] including the related notes and financial statement schedules listed in the index appearing on page FS-1 of this Form 10-K (collectively referred to as the "consolidated financial statements").

We also have audited the Company's internal control over financial reporting as of December 31, [removed: 2022,] [added: 2023,] 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, [removed: 2022] [added: 2023] and [removed: 2021,] [added: 2022,] and the results of its operations and its cash flows for each of the three years in the period ended December 31, [removed: 2022] [added: 2023] 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, [removed: 2022,] [added: 2023,] based on criteria established in *Internal Control - Integrated Framework* (2013) issued by the COSO.

[removed: Fair] [added: The fair] value of a reporting unit is generally estimated based on [removed: both a] discounted cash flow analysis and [removed: a] market approach [added: models] using assumptions that management believes a hypothetical market participant would use to determine a current transaction price.

A discount rate is selected to correspond with each reporting unit's weighted average cost of [removed: capital.][added: capital, consistent with]

Future cash flows [removed: for the U.S. Government reporting unit is] [added: are] primarily driven by forecasted revenues, benefit expenses, operating expenses and long-term growth rates.

These procedures included testing the effectiveness of controls relating to [removed: management's goodwill impairment assessment,] [added: (i) management’s assessment of held for sale classification and (ii) management’s estimation of the loss on sale of businesses,] including controls over [removed: management's methodology, inputs, and assumptions used in developing] the fair value [removed: estimate] [added: estimation] of the [removed: U.S. Government] reporting [removed: unit.][added: unit, including goodwill allocated to businesses held for sale using relative fair value.]

These procedures also included, among [removed: others] [added: others,] (i) [added: evaluating the reasonableness of management’s assessment of held for sale classification, which included reading the written agreement in place between the parties related to the sale; (ii)] testing [removed: management's] [added: management’s] process for [added: estimating the loss on sale of businesses and] developing the fair value estimate of the reporting [removed: unit; (ii)] [added: unit, including goodwill allocated to businesses held for sale using relative fair value; (iii)] evaluating the appropriateness of the discounted cash flow analysis and market [removed: approach; (iii)] [added: approach used by management; (iv)] testing the completeness and accuracy of underlying data used in the discounted cash flow analysis and market approach; and [removed: (iv)] [added: (v)] evaluating the reasonableness of the significant assumptions used by management.

Evaluating [removed: the reasonableness of the] [added: management’s] significant assumptions involved [removed: consideration of] [added: evaluating whether the assumptions used by management were reasonable considering] (i) the current and past performance of the reporting unit; (ii) the consistency with external market and industry data; and (iii) whether these assumptions were consistent with evidence obtained in other areas of the [removed: audit, as applicable.][added: audit.]

Professionals with specialized skill and knowledge were used to assist in [removed: the evaluation of] [added: evaluating] the reasonableness [removed: related to] [added: of] the discount rate and long-term growth rates significant assumptions.

[removed: February 23, 2023][added: | 2023 | | | | | | | | | | | |]

| *(In millions, except per share amounts)* | | | | | | | | | | | | | | | [removed: 2022] [added: 2023] | | | | | | [removed: 2021] [added: 2022 (1)] | | | | | | [removed: 2020] [added: 2021 (1)] | | |

| Pharmacy revenues | | | | | | | | | | | | | | | $ | [removed: 128,566] [added: 137,243] | | | | | $ | [removed: 121,413] [added: 128,566] | | | | | $ | [removed: 107,769] [added: 121,413] | |

| Fees and other revenues | | | | | | | | | | | | | | | [removed: 10,880] [added: 12,619] | | | | | | [removed: 9,962] [added: 10,881] | | | | | | [removed: 8,761] [added: 9,953] | | |

| Net investment income | | | | | | | | | | | | | | | [removed: 1,155] [added: 1,166] | | | | | | [removed: 1,549] [added: 1,155] | | | | | | [removed: 1,244] [added: 1,549] | | |

| Pharmacy and other service costs | | | | | | | | | | | | | | | [removed: 124,834] [added: 133,801] | | | | | | [removed: 117,553] [added: 124,834] | | | | | | [removed: 103,484] [added: 117,553] | | |

| Medical costs and other benefit expenses | | | | | | | | | | | | | | | [removed: 32,206] [added: 36,287] | | | | | | [removed: 33,562] [added: 32,184] | | | | | | [removed: 32,710] [added: 33,565] | | |

| Selling, general and administrative expenses | | | | | | | | | | | | | | | [removed: 13,186] [added: 14,822] | | | | | | [removed: 13,030] [added: 13,174] | | | | | | [removed: 14,072] [added: 13,012] | | |

| Amortization of acquired intangible assets | | | | | | | | | | | | | | | [removed: 1,876] [added: 1,819] | | | | | | [removed: 1,998] [added: 1,876] | | | | | | [removed: 1,982] [added: 1,998] | | |

| TOTAL BENEFITS AND EXPENSES | | | | | | | | | | | | | | | [removed: 172,102] [added: 186,729] | | | | | | [removed: 166,143] [added: 172,068] | | | | | | [removed: 152,248] [added: 166,128] | | |

| Interest expense and other | | | | | | | | | | | | | | | [removed: (1,228)] [added: (1,446)] | | | | | | [removed: (1,208)] [added: (1,228)] | | | | | | [removed: (1,438)] [added: (1,208)] | | |

| Debt extinguishment costs | | | | | | | | | | | | | | | — | | | | | | [removed: (141)] [added: —] | | | | | | [removed: (199)] [added: (141)] | | |

| [removed: Gain] [added: (Gain)] on sale of businesses | | | | | | [added: —] | | | | | | [added: —] | | | [removed: 1,662] | | | [added: (1,662)] | | | [added: | | |] — | | | | | | [removed: 4,203] [added: (1,662)] | | |

| Net realized investment (losses) gains | | | | | | | | | | | | | | | [removed: (495)] [added: (78)] | | | | | | [removed: 196] [added: (487)] | | | | | | [removed: 149] [added: 198] | | |

| Income [added: (loss)] before income taxes | | | | | | [added: $] | [added: 3,908] | | | | | [added: $] | [added: 3,804] | | [removed: 8,353] | | | [added: $] | [added: 868] | | [removed: 6,782] | | | [added: $] | [added: (1,790)] | | [removed: 10,868] | | | [added: $ | 6,790 | |]

| Less: Net income attributable to noncontrolling interests | | | | | | | | | | | | | | | [removed: 78] [added: 208] | | | | | | [removed: 50] [added: 78] | | | | | | [removed: 31] [added: 50] | | |

| *(In millions)* | | | | | | | | | | | | | | | [removed: 2022] [added: 2023] | | | | | | [removed: 2021] [added: 2022 (1)] | | | | | | [removed: 2020] [added: 2021 (1)] | | |

| Net unrealized [removed: depreciation] [added: appreciation (depreciation)] on securities and derivatives | | | | | | | | | | | | | | | [removed: (1,005)] [added: 503] | | | | | | [removed: (215)] [added: (1,598)] | | | | | | [removed: (75)] [added: (302)] | | |

| Net translation gains (losses) on foreign currencies | | | | | | | | | | | | | | | [removed: 72] [added: 5] | | | | | | [removed: (232)] [added: 77] | | | | | | [removed: 252] [added: (232)] | | |

| Postretirement benefits liability adjustment | | | | | | | | | | | | | | | [removed: 420] [added: 1] | | | | | | [removed: 410] [added: 420] | | | | | | [removed: (105)] [added: 410] | | |

| Other comprehensive [removed: (loss) income,] [added: income (loss),] net of tax | | | | | | | | | | | | | | | [removed: (513)] [added: 5] | | | | | | [removed: (37)] [added: 77] | | | | | | [removed: 72] [added: (232)] | | |

| Net income attributable to redeemable noncontrolling interests | | | | | | | | | | | | | | | [removed: 11] [added: 180] | | | | | | [removed: 19] [added: 11] | | | | | | [removed: 14] [added: 19] | | |

| Net income attributable to other noncontrolling interests | | | | | | | | | | | | | | | [removed: 67] [added: 28] | | | | | | [removed: 31] [added: 67] | | | | | | [removed: 17] [added: 31] | | |

| Other comprehensive loss attributable to redeemable noncontrolling interests | | | | | | | | | | | | | | | [removed: (2)] [added: —] | | | | | | [removed: (14)] [added: (2)] | | | | | | [removed: (8)] [added: (14)] | | |

| Total comprehensive income attributable to noncontrolling interests | | | | | | | | | | | | | | | [removed: 76] [added: 208] | | | | | | [removed: 36] [added: 76] | | | | | | [removed: 23] [added: 36] | | |

| *(In millions)* | | | [added: | | | 2023 | | | | | |] 2022 [added: (1)] | | | | | | [removed: 2021] [added: 2021(1)] | | |

| Cash and cash equivalents | | | $ | [removed: 5,924] [added: 7,822] | | | | | $ | [removed: 5,081] [added: 5,924] | |

| Investments | | | [removed: 905] [added: 925] | | | | | | [removed: 920] [added: 905] | | |

| Accounts receivable, net | | | [removed: 17,218] [added: 17,722] | | | | | | [removed: 15,071] [added: 17,218] | | |

*Assessment of Held for Sale and Associated Loss on Sale*

As described in Notes 6 and 20 to the consolidated financial statements, the Company determined that the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses met the criteria to be classified as held for sale and aggregated and classified the assets and liabilities as held for sale in the Consolidated Balance Sheet as of December 31, 2023.

The Company measured the assets and liabilities held for sale at estimated fair value less costs to sell and recognized an estimated loss of $1.5 billion pre-tax that was included within (Loss) gain on sale of businesses in the Consolidated Statement of Income for the year ended December 31, 2023.

The estimated loss on sale represents primarily asset write-downs and estimated costs to sell.

Following a change in reporting units or held for sale determination, goodwill is allocated using relative fair value.

The principal considerations for our determination that performing procedures relating to the assessment of held for sale classification and the associated loss on sale is a critical audit matter are (i) the significant judgment by management when determining the held for sale classification and developing the fair value estimate of the reporting unit, including goodwill allocated to businesses held for sale using relative fair value; (ii) a high degree of auditor judgment, subjectivity, and effort in performing procedures and evaluating audit evidence related to (a) management's determination of the held for sale classification, and (b) management’s significant assumptions used to develop the fair value estimate of the reporting unit, including goodwill allocated to businesses held for sale using relative fair value related to the discount rate, forecasted revenues, benefit expenses, operating expenses and long-term growth rates (collectively referred to as the "significant assumptions"); and (iii) the audit effort involved the use of professionals with specialized skill and knowledge.

February 29, 2024

| Premiums | | | | | | | | | | | | | | | 44,237 | | | | | | 39,916 | | | | | | 41,154 | | |

| TOTAL REVENUES | | | | | | | | | | | | | | | 195,265 | | | | | | 180,518 | | | | | | 174,069 | | |

| Income from operations | | | | | | | | | | | | | | | 8,536 | | | | | | 8,450 | | | | | | 7,941 | | |

| Income before income taxes | | | | | | | | | | | | | | | 5,513 | | | | | | 8,397 | | | | | | 6,790 | | |

| TOTAL INCOME TAXES | | | | | | | | | | | | | | | 141 | | | | | | 1,615 | | | | | | 1,370 | | |

| Net income | | | | | | | | | | | | | | | 5,372 | | | | | | 6,782 | | | | | | 5,420 | | |

| SHAREHOLDERS' NET INCOME | | | | | | | | | | | | | | | $ | 5,164 | | | | | $ | 6,704 | | | | | $ | 5,370 | |

| Basic | | | | | | | | | | | | | | | $ | 17.57 | | | | | $ | 21.66 | | | | | $ | 15.89 | |

| Diluted | | | | | | | | | | | | | | | $ | 17.39 | | | | | $ | 21.41 | | | | | $ | 15.75 | |

*(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts ("LDTI") in 2023.

| Net income | | | | | | | | | | | | | | | $ | 5,372 | | | | | $ | 6,782 | | | | | $ | 5,420 | |

| Net long-duration insurance and contractholder liabilities measurement adjustments | | | | | | | | | | | | | | | (715) | | | | | | 509 | | | | | | 67 | | |

| Total comprehensive income | | | | | | | | | | | | | | | 5,166 | | | | | | 6,190 | | | | | | 5,363 | | |

| SHAREHOLDERS' COMPREHENSIVE INCOME | | | | | | | | | | | | | | | $ | 4,958 | | | | | $ | 6,114 | | | | | $ | 5,327 | |

*(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

| *(In millions)* | | | 2023 | | | | | | 2022 (1) | | |

| Reinsurance recoverables | | | 4,835 | | | | | | 5,416 | | |

| TOTAL ASSETS | | | $ | 152,761 | | | | | $ | 143,885 | |

| Liabilities of businesses held for sale, non-current | | | 591 | | | | | | — | | |

| TOTAL LIABILITIES | | | 106,410 | | | | | | 99,131 | | |

| Retained earnings | | | 41,652 | | | | | | 37,940 | | |

| Total equity | | | 46,244 | | | | | | 44,688 | | |

*(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

| Cumulative effect of adopting LDTI (ASU 2018-12) | | | | | | | | | | | | | | | | | | (164) | | | | | | 25 | | | | | | | | | | | | (139) | | | | | | | | | | | | (139) | | | | | | | | |

| Balance at December 31, 2020, as retrospectively restated | | | | | | 4 | | | | | | 28,975 | | | | | | (1,025) | | | | | | 28,600 | | | | | | (6,372) | | | | | | 50,182 | | | | | | 7 | | | | | | 50,189 | | | | | | 58 | | |

| Balance at December 31, 2021, as retrospectively restated | | | | | | $ | 4 | | | | | $ | 29,574 | | | | | $ | (1,068) | | | | | $ | 32,623 | | | | | $ | (14,175) | | | | | $ | 46,958 | | | | | $ | 18 | | | | | $ | 46,976 | | | | | $ | 54 | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | 6,704 | | | | | | | | | | | | 6,704 | | | | | | 67 | | | | | | 6,771 | | | | | | 11 | | |

| Balance at December 31, 2022, as retrospectively restated | | | | | | $ | 4 | | | | | $ | 30,233 | | | | | $ | (1,658) | | | | | $ | 37,940 | | | | | $ | (21,844) | | | | | $ | 44,675 | | | | | $ | 13 | | | | | $ | 44,688 | | | | | $ | 66 | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | 5,164 | | | | | | | | | | | | 5,164 | | | | | | 28 | | | | | | 5,192 | | | | | | 180 | | |

| Balance at December 31, 2023 | | | | | | $ | 4 | | | | | $ | 30,669 | | | | | $ | (1,864) | | | | | $ | 41,652 | | | | | $ | (24,238) | | | | | $ | 46,223 | | | | | $ | 21 | | | | | $ | 46,244 | | | | | $ | 107 | |

| Net income | | | | | | $ | 5,372 | | | | | $ | 6,782 | | | | | $ | 5,420 | |

| Insurance liabilities | | | | | | 584 | | | | | | (336) | | | | | | 805 | | |

*(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023.

*Goodwill Impairment Assessment - U.S. Government Reporting Unit*

As described in Note 19 to the consolidated financial statements, as of December 31, 2022, goodwill in the Cigna Healthcare segment was $10.7 billion, of which a portion of the balance 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.

The principal considerations for our determination that performing procedures relating to the goodwill impairment assessment of the U.S. Government reporting unit is a critical audit matter are the significant judgment by management when developing the fair value estimate of the reporting unit.

This in turn led to a high degree of auditor judgment, subjectivity, and effort in performing procedures and evaluating management's significant assumptions related to the discount rate, forecasted revenues, benefit expenses, operating expenses, and long-term growth rates (collectively referred to as the "significant assumptions").

In addition, the audit effort involved the use of professionals with specialized skill and knowledge.

| Premiums | | | | | | | | | | | | | | | 39,915 | | | | | | 41,154 | | | | | | 42,627 | | |

| TOTAL REVENUES | | | | | | | | | | | | | | | 180,516 | | | | | | 174,078 | | | | | | 160,401 | | |

| Income from operations | | | | | | | | | | | | | | | 8,414 | | | | | | 7,935 | | | | | | 8,153 | | |

| TOTAL INCOME TAXES | | | | | | | | | | | | | | | 1,607 | | | | | | 1,367 | | | | | | 2,379 | | |

| Net income | | | | | | | | | | | | | | | 6,746 | | | | | | 5,415 | | | | | | 8,489 | | |

| SHAREHOLDERS' NET INCOME | | | | | | | | | | | | | | | $ | 6,668 | | | | | $ | 5,365 | | | | | $ | 8,458 | |

| Basic | | | | | | | | | | | | | | | $ | 21.54 | | | | | $ | 15.87 | | | | | $ | 23.17 | |

| Diluted | | | | | | | | | | | | | | | $ | 21.30 | | | | | $ | 15.73 | | | | | $ | 22.96 | |

| Net income | | | | | | | | | | | | | | | $ | 6,746 | | | | | $ | 5,415 | | | | | $ | 8,489 | |

| Total comprehensive income | | | | | | | | | | | | | | | 6,233 | | | | | | 5,378 | | | | | | 8,561 | | |

| SHAREHOLDERS' COMPREHENSIVE INCOME | | | | | | | | | | | | | | | $ | 6,157 | | | | | $ | 5,342 | | | | | $ | 8,538 | |

| Reinsurance recoverables | | | 4,743 | | | | | | 4,970 | | |

| Other assets | | | 3,426 | | | | | | 3,405 | | |

| TOTAL ASSETS | | | $ | 143,932 | | | | | $ | 154,889 | |

| TOTAL LIABILITIES | | | 98,981 | | | | | | 107,705 | | |

| Retained earnings | | | 37,874 | | | | | | 32,593 | | |

| Total equity | | | 44,885 | | | | | | 47,130 | | |

| 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) | | | | | | | | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | 8,458 | | | | | | | | | | | | 8,458 | | | | | | 17 | | | | | | 8,475 | | | | | | 14 | | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | 5,365 | | | | | | | | | | | | 5,365 | | | | | | 31 | | | | | | 5,396 | | | | | | 19 | | |

| Balance at December 31, 2021 | | | | | | $ | 4 | | | | | $ | 29,574 | | | | | $ | (884) | | | | | $ | 32,593 | | | | | $ | (14,175) | | | | | $ | 47,112 | | | | | $ | 18 | | | | | $ | 47,130 | | | | | $ | 54 | |

| Net income | | | | | | | | | | | | | | | | | | | | | | | | 6,668 | | | | | | | | | | | | 6,668 | | | | | | 67 | | | | | | 6,735 | | | | | | 11 | | |

| Balance at December 31, 2022 | | | | | | $ | 4 | | | | | $ | 30,233 | | | | | $ | (1,395) | | | | | $ | 37,874 | | | | | $ | (21,844) | | | | | $ | 44,872 | | | | | $ | 13 | | | | | $ | 44,885 | | | | | $ | 66 | |

| Net income | | | | | | $ | 6,746 | | | | | $ | 5,415 | | | | | $ | 8,489 | |

| Insurance liabilities | | | | | | 291 | | | | | | 967 | | | | | | 841 | | |

| Repayment of term loan | | | | | | — | | | | | | — | | | | | | (1,400) | | |

| Net proceeds on issuance of long-term debt | | | | | | — | | | | | | 4,260 | | | | | | 3,465 | | |

*(1)* *Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.*

| | | | | | | | | |

| --- | --- | --- | --- | --- | --- | --- | --- | --- |

| [7](#ic821d5f440e6453dbe77c0f7576c993a_172) | | | [Debt](#ic821d5f440e6453dbe77c0f7576c993a_172) | | | [94](#ic821d5f440e6453dbe77c0f7576c993a_172) | | |

| [10](#ic821d5f440e6453dbe77c0f7576c993a_241) | | | [Reinsurance](#ic821d5f440e6453dbe77c0f7576c993a_241) | | | [102](#ic821d5f440e6453dbe77c0f7576c993a_241) | | |

Management assessed the effectiveness of the Company's internal control over financial reporting as of December 31, [removed: 2022.][added: 2023.]

In making this assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission ("COSO") in *Internal Control-Integrated Framework (2013).* Based on management's assessment and the criteria set forth by COSO, it was determined that the Company's internal control over financial reporting is effective as of December 31, [removed: 2022.][added: 2023.]

There have been no changes in our internal control over financial reporting during the quarter ended December 31, [removed: 2022] [added: 2023] that have materially affected, or are reasonably likely to materially affect, The Cigna Group's internal control over financial reporting.

Rule 10b5-1 Plan Elections

During the three months ended December 31, 2023, no director or officer of the Company adopted, modified or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(a) of Regulation S-K.

None.

The information under the captions "Corporate Governance Matters – Board of Directors' Nominees" and "Corporate Governance Matters – Board Meetings and Committees" (as it relates to Audit Committee disclosure) in The Cigna Group's definitive proxy statement related to the [removed: 2023] [added: 2024] annual meeting of shareholders ("the [removed: 2023] [added: 2024] Proxy Statement") is incorporated herein by reference.

The information under the caption "Corporate Governance Matters – Codes of Ethics" in the [removed: 2023] [added: 2024] Proxy Statement is incorporated herein by reference.

The information under the caption "Ownership of The Cigna Group Common Stock – Delinquent Section 16(a) Reports", if included in the [removed: 2023] [added: 2024] Proxy Statement, is incorporated herein by reference.

The information under the captions "Corporate Governance Matters – Non-Employee Director Compensation," "Certain Transactions – Compensation Committee Interlocks and [removed: Inside] [added: Insider] Participation," "Compensation Matters – Compensation Discussion and Analysis," "Compensation Matters – Report of the People Resources Committee" and "Compensation Matters – Executive Compensation Tables" in the [removed: 2023] [added: 2024] Proxy Statement is incorporated herein by reference.

The following table presents information regarding The Cigna Group's equity compensation plans as of December 31, [removed: 2022:][added: 2023:]

*(i) [removed: 64,250] [added: 57,961] restricted stock units, [removed: 58,849] [added: 34,015] deferred shares and [removed: 1,560,744] [added: 1,372,834] strategic performance shares that are reported at the maximum 200% payout rate granted under the Cigna Long-Term Incentive Plan, the Cigna Corporation Stock Plan and the Cigna Corporation Director Equity Plan; and*

*(ii) [removed: 256,005] [added: 235,858] shares of common stock underlying stock option awards granted under the Express Scripts Holding Company 2016 Long-Term Incentive Plan, [removed: 530,191] [added: 390,212] shares of common stock underlying stock option awards granted under the Express Scripts, Inc. 2011 Long-Term Incentive Plan, and [removed: 216,008] [added: 182,865] shares of common stock underlying stock option awards granted under the Medco Health Solutions, Inc. 2002 Stock Incentive Plan that were all approved by the applicable company's shareholders before The Cigna Group's acquisition of Express Scripts in December 2018.*

The outstanding stock options assumed due to The Cigna Group's acquisition of Express Scripts, in aggregate, have a weighted-average exercise price of [removed: $156.88.][added: $154.55.]

Excluding the assumed options from this acquisition results in a weighted-average exercise price of [removed: $191.51.*][added: $208.54.*]

*(3)Represents [removed: 16,567,134] [added: 14,371,589] shares of common stock available as of the close of business December 31, [removed: 2022] [added: 2023] for future issuance under the Cigna Long-Term Incentive Plan.

The information under the captions "Ownership of The Cigna Group Common Stock – Stock Held by Directors, Nominees and Executive Officers" and "Ownership of The Cigna Group Common Stock – Stock Held by Certain Beneficial Owners" in the [removed: 2023] [added: 2024] Proxy Statement is incorporated herein by reference.

| Equity Compensation Plans Approved by Security Holders | | | | | | 8,161,152 | | | | | | $ | 202.02 | | | | | 14,371,589 | | |

| Total | | | | | | 8,161,152 | | | | | | $ | 202.02 | | | | | 14,371,589 | | |

| Equity Compensation Plans Approved by Security Holders | | | | | | 8,676,085 | | | | | | $ | 186.54 | | | | | 16,567,134 | | |

| Total | | | | | | 8,676,085 | | | | | | $ | 186.54 | | | | | 16,567,134 | | |

The information under the captions "Corporate Governance Matters – Director Independence" and "– Certain Transactions" in the [removed: 2023] [added: 2024] Proxy Statement is incorporated herein by reference.

The information under the captions "Audit Matters – Policy for the Pre-Approval of Audit and Non-Audit Services" and "Audit Matters – Fees to Independent Registered Public Accounting Firm" in the [removed: 2023] [added: 2024] Proxy Statement is incorporated herein by reference.

Consolidated Statements of Income for the years ended December 31, [removed: 2022, 2021] [added: 2023, 2022] and [removed: 2020.][added: 2021.]

Consolidated Statements of Comprehensive Income for the years ended December 31, [removed: 2022, 2021] [added: 2023, 2022] and [removed: 2020.][added: 2021.]

Consolidated Balance Sheets as of December 31, [removed: 2022] [added: 2023] and [removed: 2021.][added: 2022.]

Consolidated Statements of Changes in Total Equity for the years ended December 31, [removed: 2022, 2021] [added: 2023, 2022] and [removed: 2020.][added: 2021.]

Consolidated Statements of Cash Flows for the years ended December 31, [removed: 2022, 2021] [added: 2023, 2022] and [removed: 2020.][added: 2021.]

| 3.2 | | | [Restated Certificate of Incorporation of the registrant effective as of [removed: February 13, 2023](http://www.sec.gov/Archives/edgar/data/1739940/000095015923000019/ex3-2.htm)] [added: April 26, 2023](http://www.sec.gov/Archives/edgar/data/1739940/000173994023000016/exhibit31-thecignagroupxre.htm)] | | | Filed by the registrant as Exhibit [removed: 3.2] [added: 3.1] to the [removed: Current] [added: Quarterly] Report on Form [removed: 8-K on February 13,] [added: 10-Q for the period ended March 31,] 2023 and incorporated herein by reference. | | |