Item 1. FINANCIAL STATEMENTS

The Cigna Group Consolidated Statements of Income
									Unaudited
									Three Months Ended March 31,
(In millions, except per share amounts)															2024						2023
Revenues
Pharmacy revenues															$	42,036					$	32,144
Premiums															11,603						11,025
Fees and other revenues															3,326						3,071
Net investment income															290						277
TOTAL REVENUES															57,255						46,517
Benefits and expenses
Pharmacy and other service costs															41,431						31,459
Medical costs and other benefit expenses															9,440						9,046
Selling, general and administrative expenses															3,705						3,538
Amortization of acquired intangible assets															423						459
TOTAL BENEFITS AND EXPENSES															54,999						44,502
Income from operations															2,256						2,015
Interest expense and other															(322)						(358)
Loss on sale of businesses															(19)						—
Net realized investment losses															(1,836)						(56)
Income before income taxes															79						1,601
TOTAL INCOME TAXES															291						295
Net (loss) income															(212)						1,306
Less: Net income attributable to noncontrolling interests															65						39
SHAREHOLDERS' NET (LOSS) INCOME															$	(277)					$	1,267
Shareholders' net (loss) income per share
Basic															$	(0.97)					$	4.28
Diluted															$	(0.97)					$	4.24

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

The Cigna Group Consolidated Statements of Comprehensive Income
									Unaudited
									Three Months Ended March 31,
(In millions)															2024						2023
Net (loss) income															$	(212)					$	1,306
Other comprehensive income (loss), net of tax
Net unrealized appreciation on securities and derivatives															121						194
Net long-duration insurance and contractholder liabilities measurement adjustments															(560)						(331)
Net translation (losses) gains on foreign currencies															(26)						16
Postretirement benefits liability adjustment															5						10
Other comprehensive loss, net of tax															(460)						(111)
Total comprehensive (loss) income															(672)						1,195
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests															—						34
Net income attributable to other noncontrolling interests															65						5
Total comprehensive income attributable to noncontrolling interests															65						39
SHAREHOLDERS' COMPREHENSIVE (LOSS) INCOME															$	(737)					$	1,156

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

The Cigna Group Consolidated Balance Sheets
			Unaudited
			As of March 31,						As of December 31,
(In millions)			2024						2023
Assets
Cash and cash equivalents			$	8,439					$	7,822
Investments			1,108						925
Accounts receivable, net			20,563						17,722
Inventories			4,630						5,645
Other current assets			2,263						2,169
Assets of businesses held for sale			6,354						3,068
Total current assets			43,357						37,351
Long-term investments			16,025						17,985
Reinsurance recoverables			4,672						4,835
Property and equipment			3,607						3,695
Goodwill			44,258						44,259
Other intangible assets			30,491						30,863
Other assets			3,293						3,421
Separate account assets			7,416						7,430
Assets of businesses held for sale, non-current			—						2,922
TOTAL ASSETS			$	153,119					$	152,761
Liabilities
Current insurance and contractholder liabilities			$	5,788					$	5,514
Pharmacy and other service costs payable			24,284						19,815
Accounts payable			8,118						8,553
Accrued expenses and other liabilities			8,857						9,955
Short-term debt			1,715						2,775
Liabilities of businesses held for sale			3,215						2,104
Total current liabilities			51,977						48,716
Non-current insurance and contractholder liabilities			10,641						10,904
Deferred tax liabilities, net			7,029						7,173
Other non-current liabilities			3,653						3,441
Long-term debt			31,053						28,155
Separate account liabilities			7,416						7,430
Liabilities of businesses held for sale, non-current			—						591
TOTAL LIABILITIES			111,769						106,410
Contingencies — Note 16
Redeemable noncontrolling interests			—						107
Shareholders' equity
Common stock (1)			4						4
Additional paid-in capital			30,292						30,669
Accumulated other comprehensive loss			(2,324)						(1,864)
Retained earnings			40,978						41,652
Less: Treasury stock, at cost			(27,769)						(24,238)
TOTAL SHAREHOLDERS' EQUITY			41,181						46,223
Other noncontrolling interests			169						21
Total equity			41,350						46,244
Total liabilities and equity			$	153,119					$	152,761

*(1)*Par value per share, $0.01; shares issued, 402 million as of March 31, 2024 and 400 million as of December 31, 2023; authorized shares, 600 million.

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

The Cigna Group
Consolidated Statements of Changes in Total Equity
Unaudited
Three Months Ended March 31, 2024
(In millions)			Common Stock						Additional Paid-in Capital						Accumulated Other Comprehensive (Loss)						Retained Earnings						Treasury Stock						Shareholders' Equity						Other Non- controlling Interests						Total Equity						Redeemable Noncontrolling Interests
Balance at December 31, 2023			$	4					$	30,669					$	(1,864)					$	41,652					$	(24,238)					$	46,223					$	21					$	46,244					$	107
Effects of issuing stock for employee benefits plans									263																		(114)						149												149
Other comprehensive loss															(460)																		(460)												(460)						—
Net (loss) income																					(277)												(277)						65						(212)						—
Common dividends declared (per share: $1.40)																					(397)												(397)												(397)
Repurchase of common stock									(640)																		(3,417)						(4,057)												(4,057)
Other transactions impacting noncontrolling interests									—																								—						83						83						(107)
Balance at March 31, 2024			$	4					$	30,292					$	(2,324)					$	40,978					$	(27,769)					$	41,181					$	169					$	41,350					$	—
Three Months Ended March 31, 2023
(In millions)			Common Stock						Additional Paid-in Capital						Accumulated Other Comprehensive (Loss)						Retained Earnings						Treasury Stock						Shareholders' Equity						Other Non- controlling Interests						Total Equity						Redeemable Noncontrolling Interests
Balance at December 31, 2022			$	4					$	30,233					$	(1,658)					$	37,940					$	(21,844)					$	44,675					$	13					$	44,688					$	66
Effect of issuing stock for employee benefit plans									99																		(104)						(5)												(5)
Other comprehensive loss															(111)																		(111)												(111)						—
Net income																					1,267												1,267						5						1,272						34
Common dividends declared (per share: $1.23)																					(366)												(366)												(366)
Repurchase of common stock									—																		(958)						(958)												(958)
Other transactions impacting noncontrolling interests									—																								—						(2)						(2)						(22)
Balance at March 31, 2023			$	4					$	30,332					$	(1,769)					$	38,841					$	(22,906)					$	44,502					$	16					$	44,518					$	78

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

The Cigna Group

Consolidated Statements of Cash Flows

						Unaudited
						Three Months Ended March 31,
(In millions)						2024						2023
Cash Flows from Operating Activities
Net (loss) income						$	(212)					$	1,306
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization						741						749
Realized investment losses, net						1,836						56
Deferred income tax benefit						(102)						(108)
Loss on sale of businesses						19						—
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net						(2,687)						(479)
Inventories						1,015						566
Reinsurance recoverable and Other assets						68						72
Insurance liabilities						532						1,533
Pharmacy and other service costs payable						4,637						539
Accounts payable and Accrued expenses and other liabilities						(1,068)						690
Other, net						61						104
NET CASH PROVIDED BY OPERATING ACTIVITIES						4,840						5,028
Cash Flows from Investing Activities
Proceeds from investments sold:
Debt securities and equity securities						268						196
Investment maturities and repayments:
Debt securities and equity securities						179						257
Commercial mortgage loans						4						4
Other sales, maturities and repayments (primarily short-term and other long-term investments)						272						160
Investments purchased or originated:
Debt securities and equity securities						(180)						(2,794)
Commercial mortgage loans						(32)						—
Other (primarily short-term and other long-term investments)						(594)						(377)
Property and equipment purchases, net						(300)						(408)
Divestitures, net of cash sold						—						22
Other, net						(112)						(43)
NET CASH USED IN INVESTING ACTIVITIES						(495)						(2,983)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds						43						45
Withdrawals and benefit payments from contractholder deposit funds						(65)						(48)
Net change in short-term debt						(364)						(9)
Repayment of long-term debt						(2,210)						(80)
Net proceeds on issuance of long-term debt						4,462						1,491
Repurchase of common stock						(4,022)						(962)
Issuance of common stock						181						30
Common stock dividend paid						(401)						(368)
Other, net						(153)						(136)
NET CASH USED IN FINANCING ACTIVITIES						(2,529)						(37)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash						(9)						5
Net increase in cash, cash equivalents and restricted cash						1,807						2,013
Cash, cash equivalents and restricted cash January 1,						8,337						5,976
Cash, cash equivalents and restricted cash, March 31, (1)						10,144						7,989
Cash and cash equivalents reclassified to assets of businesses held for sale						(1,660)						—
Cash, cash equivalents and restricted cash March 31, per Consolidated Balance Sheets (1)						$	8,484					$	7,989
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds						$	110					$	77
Interest paid						$	336					$	322

*(1)*Restricted cash and cash equivalents were reported in other long-term investments.

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

THE CIGNA GROUP

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

TABLE OF CONTENTS

Note Number			Footnote			Page
B****USINESS AND C****APITAL S****TRUCTURE
1			Description of Business			9
2			Summary of Significant Accounting Policies			9
3			Accounts Receivable, Net			10
4			Supplier Finance Program			10
5			Assets and Liabilities of Businesses Held for Sale			11
6			Earnings Per Share			11
7			Debt			12
8			Common and Preferred Stock			14
I****NSURANCE I****NFORMATION
9			Insurance and Contractholder Liabilities			15
10			Reinsurance			19
I****NVESTMENTS
11			Investments			20
12			Fair Value Measurements			23
13			Variable Interest Entities			27
14			Accumulated Other Comprehensive Income (Loss)			27
COMPLIANCE, R****EGULATION AND C****ONTINGENCIES
15			Income Taxes			28
16			Contingencies and Other Matters			29
R****ESULTS D****ETAILS
17			Segment Information			30

Note 1 – Description of Business

The Cigna Group, together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our"), is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. Powered by our people and our brands, we advance our mission to improve the health and vitality of those we serve.

Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services. The majority of these products and services are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:

The Evernorth Health Services reportable segment now presents the Pharmacy Benefit Services and the Specialty and Care Services operating segments, which partner with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.

Pharmacy Benefit Services drives high-quality, cost-effective pharmacy care through various services such as drug claim adjudication, retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and access to our home delivery pharmacy. Specialty and Care Services provides specialty drugs for the treatment of complex and rare diseases, specialty distribution of pharmaceuticals and medical supplies, as well as clinical programs to help our clients drive better whole-person health outcomes through Care Delivery and Management Solutions. The Company's reporting units remain aligned with its operating segments and goodwill was allocated on a relative fair value basis.

The Cigna Healthcare reportable segment includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Healthcare provides medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Stand-Alone Prescription Drug 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 approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction"). See Note 5 to the Consolidated Financial Statements for further information.

Other Operations comprises the remainder of our business operations, which includes our continuing business (corporate-owned life insurance ("COLI")) and our run-off and other non-strategic businesses. Our run-off businesses include (i) variable annuity reinsurance business that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses which were sold through reinsurance agreements.

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate 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 eliminations for products and services sold between segments.

Note 2 – Summary of Significant Accounting Policies

Basis of Presentation

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

Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout

these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.

These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2023 Annual Report on Form 10-K ("2023 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.

Recent Accounting Pronouncements

The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.

Note 3 – Accounts Receivable, Net

The following amounts were included within Accounts receivable, net:

(In millions)			March 31, 2024						December 31, 2023
Noninsurance customer receivables			$	9,735					$	8,044
Pharmaceutical manufacturers receivables			9,512						8,169
Insurance customer receivables			2,045						2,359
Other receivables			230						272
Total			$	21,522					$	18,844
Accounts receivable, net classified as assets of businesses held for sale			(959)						(1,122)
Total			$	20,563					$	17,722

These accounts receivable are reported net of our allowances of $4.5 billion as of March 31, 2024 and $3.7 billion as of December 31, 2023. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain accounts receivable from third-party payors, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments.

The Company's allowance for current expected credit losses was $91 million as of March 31, 2024 and $90 million as of December 31, 2023.

Accounts Receivable Factoring Facility

The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution. The Facility's total capacity is $1.0 billion and began in July 2023 with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.

For the three months ended March 31, 2024, we sold $1.9 billion of accounts receivable under the Facility and factoring fees paid were not material. As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.

Note 4 – Supplier Finance Program

The Company facilitates a voluntary supplier finance program (the "Program") that provides suppliers the opportunity to sell their accounts receivable due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require. Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K.

As of March 31, 2024 and December 31, 2023, $1.6 billion and $1.5 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the Program by the financial institution and are reflected in Accounts payable in the Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. As of March 31, 2024, we have been informed by the financial institution that $327 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.

Note 5 – Assets and Liabilities of Businesses Held for Sale

In January 2024, the Company entered into the HCSC transaction for a total purchase price of approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025.

The assets and liabilities of businesses held for sale were as follows:

(In millions)			March 31, 2024						December 31, 2023
Cash and cash equivalents			$	1,660					$	467
Investments			1,341						1,438
Accounts receivable, net			959						1,122
Other assets, including Goodwill (1)			2,394						2,963
Total assets of businesses held for sale			6,354						5,990
Insurance and contractholder liabilities			2,081						1,636
All other liabilities			1,134						1,059
Total liabilities of businesses held for sale			$	3,215					$	2,695

(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.

Integration and Transaction-related Costs

In 2024, the Company incurred costs related to the HCSC transaction. In 2023, the Company incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs. These costs were $37 million pre-tax ($29 million after-tax) for the three months ended March 31, 2024 and $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023.

Note 6 – Earnings Per Share

Basic and diluted earnings per share were computed as follows:

			Three Months Ended
			March 31, 2024																		March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)			Basic						Effect of Dilution						Diluted						Basic						Effect of Dilution						Diluted
Shareholders' net (loss) income			$	(277)											$	(277)					$	1,267											$	1,267
Shares:
Weighted average			286,465												286,465						295,706												295,706
Common stock equivalents									—						—												3,293						3,293
Total shares			286,465						—						286,465						295,706						3,293						298,999
Earnings per share			$	(0.97)					$	—					$	(0.97)					$	4.28					$	(0.04)					$	4.24

Due to the Shareholders' net loss for the three months ended March 31, 2024, 8.2 million outstanding employee stock options, unvested restricted stock grants and units and strategic performance shares were excluded in the computation of diluted earnings per share because their effect was anti-dilutive. For the three months ended March 31, 2023, 0.9 million outstanding employee stock options were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.

The Company held approximately 117.8 million shares of common stock in treasury at March 31, 2024, 107.4 million shares as of December 31, 2023 and 102.7 million shares as of March 31, 2023.

The increase in Treasury stock as of March 31, 2024 and the reduction in weighted average shares outstanding for the three months ended March 31, 2024 was driven in part by 7.6 million shares of our common stock repurchased in February 2024 under the accelerated share repurchase agreements (the "ASR agreements"). Additionally, we expect final settlement of the ASR agreements to occur in the second quarter of 2024. See Note 8 for additional information.

Note 7 – Debt

The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:

(In millions)						March 31, 2024						December 31, 2023
Short-term debt
Commercial paper						$	884					$	1,237
$500 million, 0.613% Notes due March 2024						—						500
$790 million, 3.500% Notes due June 2024 (1)						789						996
Other, including finance leases						42						42
Total short-term debt						$	1,715					$	2,775
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)						881						882
$1,216 million, 4.125% Notes due November 2025 (1)						1,214						2,197
$1,284 million, 4.500% Notes due February 2026 (1)						1,285						1,502
$550 million, 1.250% Notes due March 2026 (1)						549						798
$700 million, 5.685% Notes due March 2026						698						698
$1,500 million, 3.400% Notes due March 2027						1,454						1,450
$259 million, 7.875% Debentures due May 2027						259						259
$600 million, 3.050% Notes due October 2027						598						597
$3,800 million, 4.375% Notes due October 2028						3,788						3,787
$1,000 million, 5.000% Notes due May 2029						994						—
$1,400 million, 2.400% Notes due March 2030 (1)						1,394						1,493
$1,500 million, 2.375% Notes due March 2031 (2)						1,382						1,397
$750 million, 5.125% Notes due May 2031						745						—
$45 million, 8.080% Step Down Notes due January 2033 (3)						45						45
$800 million, 5.400% Notes due March 2033						794						794
$1,250 million, 5.250% Notes due February 2034						1,242						—
$190 million, 6.150% Notes due November 2036						190						190
$2,200 million, 4.800% Notes due August 2038						2,193						2,193
$750 million, 3.200% Notes due March 2040						744						744
$121 million, 5.875% Notes due March 2041						119						119
$448 million, 6.125% Notes due November 2041						487						487
$317 million, 5.375% Notes due February 2042						315						315
$1,500 million, 4.800% Notes due July 2046						1,467						1,467
$1,000 million, 3.875% Notes due October 2047						989						989
$3,000 million, 4.900% Notes due December 2048						2,970						2,970
$1,250 million, 3.400% Notes due March 2050						1,237						1,237
$1,500 million, 3.400% Notes due March 2051						1,479						1,479
$1,500 million, 5.600% Notes due February 2054						1,482						—
Other, including finance leases						59						66
Total long-term debt						$	31,053					$	28,155

*(1)*Included in the February 2024 debt tender offers discussed below.

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

*(3)*Interest rate step down to 8.080% effective January 15, 2023.

Short-term and Credit Facilities Debt

Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including providing liquidity support if necessary under our commercial paper program discussed below. As of March 31, 2024, there were no outstanding balances under these revolving credit agreements.

In April 2024, The Cigna Group replaced our existing $4.0 billion five-year revolving credit and letter of credit agreement maturing in April 2028 and a $1.0 billion 364-day revolving credit agreement maturing in April 2024 by entering into the following revolving credit agreements (the "Credit Agreements"):

• a $5.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2029 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $5.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.

• a $1.5 billion 364-day revolving credit agreement that will mature in April 2025. The Company can borrow up to $1.5 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.

The increase in the aggregate size of our revolving credit agreements from $5.0 billion to $6.5 billion will provide enhanced liquidity to support the continued growth of our business.

Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $1.5 billion across both facilities for a maximum total commitment of $8.0 billion. The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the two facilities is diversified among 22 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of March 31, 2024. Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60% subject to certain exceptions upon the consummation of an acquisition.

Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The weighted average interest rate of our commercial paper was 5.54% at March 31, 2024.

Long-term debt

Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

Principal						Maturity Date						Interest Rate						Net Proceeds
$1,000 million (1)						May 15, 2029						5.000%						$995 million
$750 million (2)						May 15, 2031						5.125%						$746 million
$1,250 million (3)						February 15, 2034						5.250%						$1,244 million
$1,500 million (4)						February 15, 2054						5.600%						$1,485 million

(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.

(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.

(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.

(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.

In the first quarter of 2024, the Company completed the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes that were tendered to the Company pursuant to cash tender offers.

Interest Expense

Interest expense on long-term and short-term debt was $369 million for the three months ended March 31, 2024 and $345 million for the three months ended March 31, 2023.

Debt Covenants

The Company was in compliance with its debt covenants as of March 31, 2024.

Note 8 – Common and Preferred Stock

Dividends

In the first quarter of 2024, The Cigna Group declared quarterly cash dividends of $1.40 per share of the Company's common stock. In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock.

The following table provides details of the Company's dividend payments:

Record Date			Payment Date			Amount per Share			Total Amount Paid (in millions)
2024
March 6, 2024			March 21, 2024			$1.40			$401
2023
March 8, 2023			March 23, 2023			$1.23			$368

On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 2024. The Company currently intends to pay regular quarterly dividends, with future declarations subject to approval by its Board of Directors and the Board's determination that the declaration of dividends remains in the best interests of The Cigna Group and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board may deem relevant.

Accelerated Share Repurchase Agreements

In February 2024, as part of our share repurchase program, we entered into separate accelerated share repurchase agreements with Deutsche Bank AG and Bank of America, N.A. (collectively, the "Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024, representing $2.6 billion of the total remitted. The final number of shares to be received under the ASR agreements will be determined based on the daily volume-weighted average share price ("VWAP") of our common stock over the term of the agreements, less a discount and subject to adjustments pursuant to the terms and conditions of the ASR agreements.

We recorded the payment to the Counterparties as a reduction to Total shareholders' equity, consisting of a $2.6 billion increase in Treasury stock, which reflects the value of the initial 7.6 million shares received, and a $640 million decrease in Additional paid-in capital, which reflects the value of the stock hold-back by the Counterparties pending final settlement of the ASR agreements. The $640 million recorded in Additional paid-in capital will be reclassified to Treasury stock upon settlement of the ASR agreements in the second quarter of 2024. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted earnings per share.

Note 9 – Insurance and Contractholder Liabilities

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

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

			March 31, 2024																		December 31, 2023																		March 31, 2023
(In millions)			Current						Non-current						Total						Current						Non-current						Total						Total
Unpaid claims and claim expenses
Cigna Healthcare			$	5,786					$	77					$	5,863					$	5,017					$	75					$	5,092					$	4,959
Other Operations			99						161						260						99						154						253						272
Future policy benefits
Cigna Healthcare			92						515						607						97						518						615						601
Other Operations			163						3,297						3,460						163						3,375						3,538						3,631
Contractholder deposit funds
Cigna Healthcare			11						130						141						12						133						145						163
Other Operations			365						6,087						6,452						362						6,178						6,540						6,670
Market risk benefits			26						865						891						37						966						1,003						1,220
Unearned premiums			815						21						836						846						22						868						1,440
Total			7,357						11,153						18,510						6,633						11,421						18,054
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)			(1,569)						(512)						(2,081)						(1,119)						(517)						(1,636)
Total insurance and contractholder liabilities			$	5,788					$	10,641					$	16,429					$	5,514					$	10,904					$	16,418					$	18,956

(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.

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

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

This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.

The total of incurred but not reported liabilities plus expected development on reported claims and reported claims in process was $5.4 billion at March 31, 2024 and $4.6 billion at March 31, 2023. This increase was primarily due to claim submission and payment process disruptions related to a third-party cyber incident.

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

			Three Months Ended March 31,
(In millions)			2024 (1)						2023
Beginning balance			$	5,092					$	4,176
Less: Reinsurance and other amounts recoverable			236						221
Beginning balance, net			4,856						3,955
Incurred costs related to:
Current year			9,452						9,041
Prior years			(226)						(144)
Total incurred			9,226						8,897
Paid costs related to:
Current year			5,072						5,316
Prior years			3,352						2,795
Total paid			8,424						8,111
Ending balance, net			5,658						4,741
Add: Reinsurance and other amounts recoverable			205						218
Ending balance			$	5,863					$	4,959

(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.

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

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

			Three Months Ended March 31,
			2024												2023
(Dollars in millions)			$						% (1)						$						% (2)
Actual completion factors			$	76					0.2			%			$	1					—			%
Medical cost trend			150						0.4						143						0.5
Total favorable variance			$	226					0.6			%			$	144					0.5			%

*(1)*Percentage of current year incurred costs as reported for the year ended December 31, 2023.

*(2)*Percentage of current year incurred costs as reported for the year ended December 31, 2022.

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

**C.**Future Policy Benefits

Cigna Healthcare

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:

			As of
			March 31, 2024						March 31, 2023
Interest accretion rate			2.56		%				2.59		%
Current discount rate			5.11		%				5.29		%
Weighted average duration			7.8 years						8.1 years

The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses. The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows:

			Three Months Ended March 31,
(In millions)			2024 (1)						2023
Present value of expected net premiums
Beginning balance			$	9,233					$	8,557
Reversal of effect of beginning of period discount rate assumptions			1,154						1,537
Issuances and lapses			446						306
Net premiums collected			(350)						(326)
Interest and other (2)			73						56
Ending balance at original discount rate			10,556						10,130
Effect of end of period discount rate assumptions			(1,309)						(1,312)
Ending balance (3)			$	9,247					$	8,818
Present value of expected policy benefits
Beginning balance			$	9,633					$	8,945
Reversal of effect of discount rate assumptions			1,220						1,611
Issuances and lapses			457						307
Benefit payments			(362)						(326)
Interest and other (2)			71						58
Ending balance at original discount rate			11,019						10,595
Effect of discount rate assumptions			(1,381)						(1,378)
Ending balance (4)			$	9,638					$	9,217
Liability for future policy benefits			$	391					$	399
Other (5)			216						202
Total liability for future policy benefits (6)(7)			$	607					$	601

*(1)*Includes future policy benefits amounts classified as liabilities of businesses held for sale.

*(2)*Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.

*(3)*As of March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.

*(4)*As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 billion, respectively.

*(5)*The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.

(6)**$72 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

*(7)*Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.

Other Operations

The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:

			As of
			March 31, 2024						March 31, 2023
Interest accretion rate			5.64		%				5.64		%
Current discount rate			5.16		%				4.95		%
Weighted average duration			11.3 years						11.7 years

Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations' traditional insurance contracts, which are in run-off, have no premium remaining to be collected; therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.

Future policy benefits for Other Operations includes deferred profit liability of $379 million as of March 31, 2024 and $392 million as of March 31, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of March 31, 2024 and $3.2 billion as

of each of December 31, 2023, March 31, 2023, and December 31, 2022. The change in future policy benefits reserves year-to-date was primarily driven by benefit payments, as well as changes in the current discount rate. Undiscounted expected future policy benefits were $4.4 billion as of March 31, 2024 and $4.6 billion as of March 31, 2023. As of both March 31, 2024 and March 31, 2023, $1.0 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.

**D.**Contractholder Deposit Funds

Contractholder deposit fund liabilities within Other Operations were $6.5 billion as of March 31, 2024 and December 31, 2023 and $6.7 billion as of March 31, 2023 and December 31, 2022. Approximately 38% of the balance is reinsured externally. Activity in these liabilities is presented net of reinsurance in the Consolidated Statements of Cash Flows. The net year-to-date decrease in contractholder deposit fund liabilities generally relates to withdrawals and benefit payments from contractholder deposit funds, partially offset by deposits and interest credited to contractholder deposit funds.

As of March 31, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.33%, $3.0 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2023 were 3.25%, $3.2 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of March 31, 2024 and the $4.1 billion liability as of March 31, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.2 billion represented contracts with policies at the guarantee. At both of these same period ends, $1.2 billion was 50-150 basis points ("bps") above the guarantee and the remaining $1.6 billion as of March 31, 2024 and $1.7 billion as of March 31, 2023 represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. More than 90% of these contracts have actual cash values of at least 110% of the guaranteed cash value.

**E.**Market Risk Benefits

Liabilities for market risk benefits consist of variable annuity reinsurance contracts in Other Operations. These liabilities arise under annuities and riders to annuities written by ceding companies that guarantee the benefit received at death and, for a subset of policies, also provide contractholders the option, within 30 days of a policy anniversary after the appropriate waiting period, to elect minimum income payments. The Company's capital market risk exposure on variable annuity reinsurance contracts arises when the reinsured guaranteed minimum benefit exceeds the contractholder's account value in the related underlying mutual funds at the time the insurance benefit is payable under the respective contract. The Company receives and pays premium periodically based on the terms of the reinsurance agreements.

Market risk benefits activity was as follows:

			Three Months Ended March 31,
(Dollars in millions)			2024			2023
Balance, beginning of year			$	1,003		$	1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)			1,085			1,379
Changes due to expected run-off			(3)			(6)
Changes due to capital markets versus expected			(113)			(41)
Changes due to policyholder behavior versus expected			(14)			6
Assumption changes			—			(33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)			955			1,305
Nonperformance risk (own credit risk), end of period			(64)			(85)
Balance, end of period			$	891		$	1,220
Reinsured market risk benefit, end of period			$	951		$	1,301

The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.

(Dollars in millions, excludes impact of reinsurance ceded)			March 31, 2024						March 31, 2023
Net amount at risk			$	1,441					$	2,183
Average attained age of contractholders (weighted by exposure)			77.7 years						75.4 years

Note 10 – Reinsurance

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

**A.**Reinsurance Recoverables

The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.

The Company's reinsurance recoverables as of March 31, 2024 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:

(In millions)						Fair value of collateral contractually required to meet or exceed carrying value of recoverable						Collateral provisions exist that may mitigate risk of credit loss (1)						No collateral						Total
Ongoing Operations
A- equivalent and higher current ratings (2)						$	—					$	—					$	85					$	85
BBB- to BBB+ equivalent current credit ratings (2)						—						—						60						60
Not rated						145						7						188						340
Total recoverables related to ongoing operations						145						7						333						485
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York						—						2,619						—						2,619
Empower Annuity Insurance Company						—						—						128						128
Prudential Insurance Company of America						351						—						—						351
Life Insurance Company of North America						—						334						—						334
Other						167						23						14						204
Not rated						—						6						4						10
Total recoverables related to acquisition, disposition or run-off activities						518						2,982						146						3,646
Total reinsurance recoverables before market risk benefits						$	663					$	2,989					$	479					$	4,131
Allowance for uncollectible reinsurance																								(35)
Market risk benefits																								951
Total reinsurance recoverables (3)																								$	5,047

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

*(2)*Certified by an NRSRO.

*(3)*Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 million of reinsurance recoverables classified as assets of businesses held for sale.

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

**B.**Effective Exit of Variable Annuity Reinsurance Business

The Company entered into an agreement with Berkshire to effectively exit the variable annuity reinsurance business via a reinsurance transaction in 2013. Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 9 to the Consolidated Financial Statements. Berkshire reinsured 100% of the Company's future cash flows in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall

limit with approximately $3.1 billion remaining at March 31, 2024. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.

(In millions)
Reinsurer (1)						March 31, 2024						December 31, 2023						Collateral and Other Terms at March 31, 2024
Berkshire						$	777					$	873					100% were secured by assets in a trust.
Sun Life Assurance Company of Canada						79						92
Liberty Re (Bermuda) Ltd.						91						104						100% were secured by assets in a trust.
SCOR SE						27						31						75% were secured by a letter of credit.
Market risk benefits (2)						$	974					$	1,100

*(1)*All reinsurers are rated A- equivalent and higher by an NRSRO.

*(2)*Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three months ended March 31, 2024 and March 31, 2023.

Note 11 – Investments

The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 to the Consolidated Financial Statements for information about the valuation of the Company's investment portfolio. Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.

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

						March 31, 2024																		December 31, 2023
(In millions)						Current						Long-term						Total						Current						Long-term						Total
Debt securities						$	604					$	8,876					$	9,480					$	590					$	9,265					$	9,855
Equity securities						18						1,553						1,571						31						3,331						3,362
Commercial mortgage loans						197						1,365						1,562						182						1,351						1,533
Policy loans						—						1,186						1,186						—						1,211						1,211
Other long-term investments						—						4,301						4,301						—						4,181						4,181
Short-term investments						374						—						374						206						—						206
Total						$	1,193					$	17,281					$	18,474					$	1,009					$	19,339					$	20,348
Investments classified as assets of businesses held for sale (1)						(85)						(1,256)						(1,341)						(84)						(1,354)						(1,438)
Investments per Consolidated Balance Sheets						$	1,108					$	16,025					$	17,133					$	925					$	17,985					$	18,910

(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long-term investments.

**A.**Investment Portfolio

Debt Securities

The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:

(In millions)						Amortized Cost						Fair Value
Due in one year or less						$	633					$	619
Due after one year through five years						3,768						3,587
Due after five years through ten years						3,144						2,921
Due after ten years						2,186						2,000
Mortgage and other asset-backed securities						389						353
Total						$	10,120					$	9,480

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

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

(In millions)						Amortized Cost						Allowance for Credit Loss						Unrealized Appreciation						Unrealized Depreciation						Fair Value
March 31, 2024
Federal government and agency						$	289					$	—					$	21					$	(10)					$	300
State and local government						37						—						2						(1)						38
Foreign government						354						—						8						(14)						348
Corporate						9,051						(50)						122						(682)						8,441
Mortgage and other asset-backed						389						—						—						(36)						353
Total						$	10,120					$	(50)					$	153					$	(743)					$	9,480
December 31, 2023
Federal government and agency						$	251					$	—					$	24					$	(8)					$	267
State and local government						37						—						2						(1)						38
Foreign government						355						—						10						(13)						352
Corporate						9,338						(33)						158						(630)						8,833
Mortgage and other asset-backed						398						—						1						(34)						365
Total						$	10,379					$	(33)					$	195					$	(686)					$	9,855

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

• severity of decline;

• financial health and specific prospects of the issuer; and

• changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.

The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.

						March 31, 2024																								December 31, 2023
(Dollars in millions)						Fair Value						Amortized Cost						Unrealized Depreciation						Number of Issues						Fair Value						Amortized Cost						Unrealized Depreciation						Number of Issues
One year or less
Investment grade						$	562					$	576					$	(14)					232						$	330					$	338					$	(8)					142
Below investment grade						133						137						(4)						253						161						170						(9)						135
More than one year
Investment grade						5,284						5,946						(662)						1,561						5,441						6,036						(595)						1,590
Below investment grade						598						661						(63)						367						701						775						(74)						486
Total						$	6,577					$	7,320					$	(743)					2,413						$	6,633					$	7,319					$	(686)					2,353

Equity Securities

The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:

						March 31, 2024												December 31, 2023
(In millions)						Cost						Carrying Value						Cost						Carrying Value
Equity securities with readily determinable fair values						$	647					$	39					$	656					$	51
Equity securities with no readily determinable fair value						3,281						1,532						3,248						3,311
Total						$	3,928					$	1,571					$	3,904					$	3,362

We are a minority owner in VillageMD, a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in equity securities with no readily determinable fair value in the above table. As of March 31, 2024, we determined our investment in VillageMD was impaired and wrote down the carrying value to an estimated fair value of $0.9 billion, resulting in a $1.8 billion loss recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 90% of our investments in equity securities are in the health care sector.

Commercial Mortgage Loans

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

The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.

The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:

(Dollars in millions)						March 31, 2024																		December 31, 2023
Loan-to-Value Ratio						Carrying Value						Average Debt Service Coverage Ratio						Average Loan-to-Value Ratio						Carrying Value						Average Debt Service Coverage Ratio						Average Loan-to-Value Ratio
Below 60%						$	810					2.12												$	802					2.13
60% to 79%						594						1.75												574						1.77
80% to 100%						158						0.63												157						0.65
Total						$	1,562					1.81						64			%			$	1,533					1.82						64			%

Other Long-Term Investments

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

Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments:

						Carrying Value as of
(In millions)						March 31, 2024						December 31, 2023
Real estate investments						$	1,696					$	1,606
Securities partnerships						2,423						2,400
Other						182						175
Total						$	4,301					$	4,181

**B.**Derivative Financial Instruments

The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt.

As of March 31, 2024, there have been no material changes to the Company's derivative financial instruments. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.

**C.**Realized Investment Gains and Losses

Net realized investment losses, before income taxes were $1,836 million for the three months ended March 31, 2024 and $56 million for the three months ended March 31, 2023. This increase was primarily driven by the impairment of equity securities in 2024. These amounts exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders.

Note 12 – Fair Value Measurements

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

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

The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).

For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.

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

The following table provides information about the Company's financial assets and liabilities carried at fair value. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 9E to the Consolidated Financial Statements. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:

(In millions)						Quoted Prices in Active Markets for Identical Assets (Level 1)												Significant Other Observable Inputs (Level 2)												Significant Unobservable Inputs (Level 3)												Total
						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency						$	165					$	130					$	135					$	137					$	—					$	—					$	300					$	267
State and local government						—						—						38						38						—						—						38						38
Foreign government						—						—						348						352						—						—						348						352
Corporate						—						—						8,072						8,432						369						401						8,441						8,833
Mortgage and other asset-backed						—						—						300						319						53						46						353						365
Total debt securities						165						130						8,893						9,278						422						447						9,480						9,855
Equity securities (1)						2						4						37						47						—						—						39						51
Short-term investments						—						—						374						206						—						—						374						206
Derivative assets						—						—						147						131						—						1						147						132
Financial liabilities at fair value
Derivative liabilities						$	—					$	—					$	4					$	4					$	—					$	—					$	4					$	4

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

Level 3 Financial Assets and Financial Liabilities

Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. Additionally, as discussed in Note 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.

Quantitative Information about Unobservable Inputs

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

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

						Fair Value as of																		Unobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)						March 31, 2024						December 31, 2023						Unobservable Input March 31, 2024						March 31, 2024						December 31, 2023
Debt securities
Corporate						$	369					$	401					Liquidity						55 - 1230 (280)			bps			70 - 1235 (310)			bps
Mortgage and other asset-backed securities						53						46						Liquidity						110 - 605 (280)			bps			95 - 640 (310)			bps
Total Level 3 debt securities						$	422					$	447

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

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

The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.

															Three Months Ended March 31,
(In millions)															2024						2023
Debt and Equity Securities
Beginning balance															$	447					$	447
(Losses) gains included in Shareholders' net (loss) income															(21)						1
(Losses) gains included in Other comprehensive loss															(3)						5
Purchases, sales and settlements
Purchases															—						4
Settlements															(14)						(9)
Total purchases, sales and settlements															(14)						(5)
Transfers into/(out of) Level 3
Transfers into Level 3															16						39
Transfers out of Level 3															(3)						(16)
Total transfers into/(out of) Level 3															13						23
Ending balance															$	422					$	471
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date															$	(21)					$	1
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period															$	(4)					$	5

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

Gains and losses included in Other comprehensive loss, net of tax in the tables above are reflected in Net unrealized appreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2024 and 2023 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. See discussion under Quantitative Information about Unobservable Inputs above for more information.

Separate Accounts

The investment income and fair value gains and losses of Separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. The separate account activity for the three months ended March 31, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account investments.

Fair values of Separate account assets were as follows:

						Quoted Prices in Active Markets for Identical Assets (Level 1)												Significant Other Observable Inputs (Level 2)												Significant Unobservable Inputs (Level 3)												Total
(In millions)						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023						March 31, 2024						December 31, 2023
Guaranteed separate accounts (See Note 16)						$	230					$	226					$	339					$	352					$	—					$	—					$	569					$	578
Non-guaranteed separate accounts (1)						158						158						5,794						5,797						229						217						6,181						6,172
Subtotal						$	388					$	384					$	6,133					$	6,149					$	229					$	217					6,750						6,750
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)																																										666						680
Total																																										$	7,416					$	7,430

*(1)*Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.

Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three months ended March 31, 2024 or 2023.

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

						Fair Value as of												Unfunded Commitment as of March 31, 2024						Redemption Frequency (if currently eligible)						Redemption Notice Period
(In millions)						March 31, 2024						December 31, 2023
Securities partnerships						$	412					$	419					$	252					Not applicable						Not applicable
Real estate funds						251						258						—						Quarterly						30 - 90 days
Hedge funds						3						3						—						Up to annually, varying by fund						30 - 90 days
Total						$	666					$	680					$	252

As of March 31, 2024, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception.

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

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

For the three months ended March 31, 2024, our equity investment in VillageMD was written down to an estimated fair value of $0.9 billion resulting in an investment loss of $1.8 billion recorded in Net realized investment losses in the Company's Consolidated Statements of Income. For the three months ended March 31, 2023, impairments recognized requiring these assets to be measured at fair value were not material. Observable price changes for other equity securities with no readily determinable fair value were not material for the three months ended March 31, 2024 and March 31, 2023.

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

The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:

						Classification in Fair Value Hierarchy						March 31, 2024												December 31, 2023
(In millions)									Fair Value						Carrying Value						Fair Value						Carrying Value
Commercial mortgage loans						Level 3						$	1,451					$	1,562					$	1,430					$	1,533
Long-term debt, including current maturities, excluding finance leases						Level 2						$	29,806					$	31,783					$	28,033					$	29,585

Note 13 – Variable Interest Entities

We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined that it was not a primary beneficiary in any material variable interest entity as of March 31, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure.

Note 14 – Accumulated Other Comprehensive Income (Loss)

Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive loss, net of tax, for the three months ended March 31, 2024 and March 31, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method.

Changes in the components of AOCI were as follows:

									Three Months Ended March 31,
(In millions)															2024						2023
Securities and Derivatives
Beginning balance															$	171					$	(332)
Unrealized appreciation on securities and derivatives															143						252
Tax (expense)															(39)						(54)
Net unrealized appreciation on securities and derivatives															104						198
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)															22						(5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income															(5)						1
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income															17						(4)
Other comprehensive income, net of tax															121						194
Ending balance															$	292					$	(138)

									Three Months Ended March 31,
(In millions)															2024						2023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance															$	(971)					$	(256)
Current period change in discount rate for certain long-duration liabilities															(732)						(411)
Tax benefit															186						101
Net current period change in discount rate for certain long-duration liabilities															(546)						(310)
Current period change in instrument-specific credit risk for market risk benefits															(18)						(26)
Tax benefit															4						5
Net current period change in instrument-specific credit risk for market risk benefits															(14)						(21)
Other comprehensive (loss), net of tax															(560)						(331)
Ending balance															$	(1,531)					$	(587)

									Three Months Ended March 31,
(In millions)															2024						2023
Translation of foreign currencies
Beginning balance															$	(149)					$	(154)
Translation of foreign currencies															(24)						15
Tax (expense) benefit															(2)						1
Other comprehensive (loss) income, net of tax															(26)						16
Ending balance															$	(175)					$	(138)

									Three Months Ended March 31,
(In millions)															2024						2023
Postretirement benefits liability
Beginning balance															$	(915)					$	(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)															8						13
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income															(3)						(3)
Other comprehensive income, net of tax															5						10
Ending balance															$	(910)					$	(906)

									Three Months Ended March 31,
(In millions)															2024						2023
Total Accumulated other comprehensive loss
Beginning balance															$	(1,864)					$	(1,658)
Shareholders' other comprehensive (loss), net of tax															(460)						(111)
Ending balance															$	(2,324)					$	(1,769)

Note 15 – Income Taxes

Income Tax Expense

The effective tax rate for the three months ended March 31, 2024 increased due to a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution. The 368.4% effective tax rate for the three months ended March 31, 2024 was higher than the 18.4% rate for the three months ended March 31, 2023.

As of March 31, 2024, we had approximately $664 million in deferred tax assets ("DTAs") associated with the impairment of equity securities, as well as unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $427 million, which drove the higher effective tax rate, was established in the three months ended March 31, 2024, almost entirely related to the impairment of equity securities. For the remainder of the DTAs, we have determined that a valuation allowance is not currently required based on the Company's ability to carry back losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any additional valuation allowance.

Note 16 – Contingencies and Other Matters

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

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

The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of March 31, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $410 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of March 31, 2024. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.

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

**B.**Certain Other Guarantees

The Company had indemnification obligations as of March 31, 2024 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with laws or regulations or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a stated dollar amount or a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no recorded liabilities for these indemnification obligations as of March 31, 2024.

**C.**Guaranty Fund Assessments

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

There were no material charges or credits resulting from existing or new guaranty fund assessments for the three months ended March 31, 2024.

**D.**Legal and Regulatory Matters

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

Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company's accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in this ongoing litigation matter or any future claims or litigation.

Litigation Matters

Express Scripts Litigation with Elevance. In March 2016, Elevance filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Elevance also requested that the court enter declaratory judgment that Express Scripts is required to provide Elevance competitive benchmark pricing, that Elevance can terminate the agreement and that Express Scripts is required to provide Elevance with post-termination services at competitive benchmark pricing for one year following any termination by Elevance. Elevance claimed it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Elevance and $150 million damages for service issues ("Elevance's Allegations"). On April 19, 2016, in response to Elevance's complaint, Express Scripts filed its answer denying Elevance's Allegations in their entirety and asserting affirmative defenses and counterclaims against Elevance. The court subsequently granted Elevance's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Elevance completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. On March 31, 2022, the court granted summary judgment in favor of Express Scripts on all of Elevance's pricing claims for damages totaling $14.8 billion and on most of Elevance's claims relating to service issues. Elevance's only remaining service claims relate to the review or processing of prior authorizations, with alleged damages over $100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retains the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retains the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance filed its opening appellate brief on April 24, 2024.

Note 17 – Segment Information

See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services transactions between the Evernorth Health Services and Cigna Healthcare segments.

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

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

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

The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:

									Three Months Ended March 31,
															2024												2023
(In millions)																											Pre-tax						After-tax						Pre-tax						After-tax
Integration and transaction-related costs (Selling, general and administrative expenses)																											$	37					$	29					$	1					$	1
Loss (gain) on sale of businesses																											19						(43)						—						—
Deferred tax expenses, net (Income taxes, less amount attributable to noncontrolling interests)																											—						17						—						—
Total impact from special items																											$	56					$	3					$	1					$	1

Summarized segment financial information was as follows:

(In millions)						Evernorth Health Services						Cigna Healthcare						Other Operations						Corporate and Eliminations						Total
Three months ended March 31, 2024
Revenues from external customers						$	44,886					$	12,012					$	66					$	1					$	56,965
Intersegment revenues						1,281						1,124						25						(2,430)
Net investment income						59						149						75						7						290
Total revenues						46,226						13,285						166						(2,422)						57,255
Net realized investment results from certain equity method investments						—						(8)						—						—						(8)
Adjusted revenues						$	46,226					$	13,277					$	166					$	(2,422)					$	57,247
(Loss) income before income taxes						$	(436)					$	943					$	18					$	(446)					$	79
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests						(77)						—						—						—						(77)
Net realized investment losses (1)						1,456						372						—						—						1,828
Amortization of acquired intangible assets						417						6						—						—						423
Special items
Integration and transaction-related costs						—						—						—						37						37
Loss on sale of businesses						—						19						—						—						19
Pre-tax adjusted income (loss) from operations						$	1,360					$	1,340					$	18					$	(409)					$	2,309
(In millions)						Evernorth Health Services						Cigna Healthcare						Other Operations						Corporate and Eliminations						Total
Three months ended March 31, 2023
Revenues from external customers						$	34,511					$	11,650					$	79					$	—					$	46,240
Intersegment revenues						1,618						963						—						(2,581)
Net investment income						50						143						78						6						277
Total revenues						36,179						12,756						157						(2,575)						46,517
Net realized investment results from certain equity method investments						—						(38)						—						—						(38)
Adjusted revenues						$	36,179					$	12,718					$	157					$	(2,575)					$	46,479
Income (loss) before income taxes						$	918					$	1,077					$	21					$	(415)					$	1,601
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests						(42)						(1)						—						—						(43)
Net realized investment losses (gains) (1)						—						24						(6)						—						18
Amortization of acquired intangible assets						444						15						—						—						459
Special items
Integration and transaction-related costs						—						—						—						1						1
Pre-tax adjusted income (loss) from operations						$	1,320					$	1,115					$	15					$	(414)					$	2,036

*(1)*Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as 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, which are presented within Fees and other revenues in our Consolidated Statements of Income.

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

												Three Months Ended March 31,
(In millions)																		2024						2023
Products (Pharmacy revenues) (ASC 606)
Network revenues																		$	24,166					$	15,748
Home delivery and specialty revenues																		16,458						16,025
Other revenues																		2,546						1,867
Total Evernorth Health Services																		43,170						33,640
Total Other Operations																		17						—
Intercompany eliminations																		(1,151)						(1,496)
Total Pharmacy revenues																		42,036						32,144
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured																		4,393						4,080
Medicare Advantage																		2,287						2,236
Stop loss																		1,668						1,503
Individual and Family Plans																		1,040						1,208
Other																		1,258						1,117
U.S. Healthcare																		10,646						10,144
International Health																		885						786
Total Cigna Healthcare																		11,531						10,930
Other																		48						79
Intercompany eliminations																		24						16
Total Premiums																		11,603						11,025
Services (Fees) (ASC 606)
Evernorth Health Services																		2,943						2,499
Cigna Healthcare																		1,571						1,606
Other Operations																		25						1
Other revenues																		90						66
Intercompany eliminations																		(1,303)						(1,101)
Total Fees and other revenues																		3,326						3,071
Total revenues from external customers																		$	56,965					$	46,240

*(1)*Cigna Healthcare includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. 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. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.

Financial and performance guarantees. Evernorth Health Services may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $1.9 billion as of March 31, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 15% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 13% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.