- Company name
- The Cigna Group
- Sector
- Health insurance & pharmacy services
- About
- The Cigna Group has two main businesses. Evernorth Health Services provides pharmacy benefit services and specialty pharmacy and care services. Cigna Healthcare sells medical plans and stop loss coverage, mainly to U.S. employers, and health plans in international markets. At September 30, 2026, Cigna had 18.5 million medical customers and 117.7 million pharmacy customers. Total revenues were $213.8 billion in the first nine months of 2026. Cigna sold its Medicare Advantage business to Health Care Service Corporation in March 2025 and plans to exit the Individual and Family Plans medical business on January 1, 2027. Brian Evanko is President and CEO.
- Thesis
- The market prices Cigna for pressure on the profits of its pharmacy benefit business. Clients and government programs press pharmacy benefit managers to lower drug costs, and Cigna is moving to a rebate-free model that it announced in October 2025. Pre-tax adjusted income from Pharmacy Benefit Services fell 27% in Q2 2026 and 22% in Q3 2026 because of large client contract renewals and strategic investments. Pharmacy customers fell 5% in the first nine months of 2026 as some clients left. For the gap to close, three things must be true. Specialty and Care Services must keep growing, as in Q3 2026, when its pre-tax adjusted income rose 15%. Pharmacy Benefit Services profit must stabilize after the move to the new model. Cigna must deliver adjusted EPS of at least $30.60 in 2026, its outlook raised in November 2026, and growth of 10% to 14% a year through 2030, the target from its Investor Day on September 30, 2026. The 2027 outlook with the Q4 2026 report, estimated for about February 5, 2027, is the next test. If these checks pass, the gap can close over the next four to six quarters. The main reason it may not close is new laws or rules on pharmacy benefit managers that cut their profits more than Cigna expects.
- Risks
- New laws, rules or client demands can change how pharmacy benefit managers earn money. Pre-tax adjusted income from Pharmacy Benefit Services fell 27% in Q2 2026 and 22% in Q3 2026 after large contract renewals. Further changes can cut profits more.
The Cigna Healthcare medical care ratio was 85.0% in Q3 2026, up from 84.8% a year earlier, after 84.5% in Q2 2026. Higher medical costs than Cigna priced for lower insurance margins.
Pharmacy customers fell 5% in the first nine months of 2026 because of client transitions and lower membership at health plan clients. The loss of more large clients lowers revenue and profit.
Total debt was $31.1 billion at September 30, 2026, and much of the cash is held at regulated subsidiaries. The debt to capitalization ratio was 41.8%.
- Balance sheet
- Cash: $6.2B
Debt: $31.1B
Net debt: $25.0B
Interest cover: 7.1×
Undrawn credit line: $6.5B, to April 2030
Debt due within 12 months: $2.3B
Cigna funds itself with senior notes and commercial paper. At September 30, 2026, short-term debt was $2.29 billion and long-term debt was $28.85 billion, for total debt of $31.14 billion, down from $31.88 billion at June 30, 2026. Commercial paper of about $0.5 billion was outstanding. Cash and cash equivalents were $6.19 billion. Of $6.5 billion of cash and short-term investments, about $1.2 billion was held by the parent company or non-regulated subsidiaries, and the rest by regulated subsidiaries. The $6.5 billion revolving credit agreement, which matures in April 2030, was undrawn. Debt to capitalization was 41.8%. Cigna repaid $550 million of 1.250% notes that matured in March 2026. Interest cover is income from operations divided by interest expense and other for the first nine months of 2026.
As of Sep 30, 2026.
- Checkpoints
- Nov 5, 2026: Q3 2026 earnings: pharmacy benefit profit. Passed. Watch: Adjusted EPS guidance of at least $30.45 kept or raised and a smaller decline in Pharmacy Benefit Services income pass; a guidance cut or a larger decline fail. Outcome: Cigna raised its 2026 outlook to adjusted EPS of at least $30.60, and the fall in Pharmacy Benefit Services income was 22%, smaller than the 27% of Q2 2026.
Feb 5, 2027 (estimate): 2027 outlook. Pending. Watch: 2027 adjusted EPS guidance within the 10% to 14% long-term growth target pass; guidance below that range fails.
- Recent events
- Nov 5, 2026: Cigna reported Q3 2026 results. Total revenues rose 6% to $73.7 billion, and adjusted EPS was $7.98, up from $7.83. Pre-tax adjusted income from Specialty and Care Services rose 15%, while Pharmacy Benefit Services fell 22%. The Cigna Healthcare medical care ratio was 85.0%. Cigna raised its 2026 outlook to adjusted EPS of at least $30.60 and bought back 1.8 million shares for about $500 million in 2026 through November 4.
Sep 30, 2026: Cigna held its Investor Day and introduced its Lead to One vision. It announced $3 billion of multi-year modernization and productivity initiatives, reaffirmed its 2026 guidance of adjusted EPS of at least $30.45, and set a target of 10% to 14% average annual adjusted EPS growth through 2030.
Jul 30, 2026: Cigna reported Q2 2026 results. Total revenues rose 7% to $71.7 billion, and adjusted EPS was $7.78, up from $7.20. Pre-tax adjusted income from Specialty and Care Services rose 22%, while Pharmacy Benefit Services fell 27%. The Cigna Healthcare medical care ratio was 84.5%. Cigna raised its 2026 outlook to adjusted EPS of at least $30.45.
Apr 30, 2026: Cigna reported Q1 2026 results, with adjusted EPS of $7.79 and total revenues of $68.5 billion. In April 2026, it also announced that it will exit the Individual and Family Plans medical business on January 1, 2027.