Cigna

“Our results of operations depend on our ability to contract for these services at competitive prices. In any particular market, physicians, hospitals and health service providers may enter into exclusive arrangements with competitors or simply refuse to contract with us, demand higher payments, or take other actions that could result in higher medical costs or less desirable products or services for our customers. In some markets, certain providers, particularly hospitals, physician/hospital organizations and multi-specialty physician groups, may have significant or controlling market positions that could result in a diminished bargaining position for us.”

Annual report 2025A · The company itself

“We provide our customers with a national network of participating health care providers; hospitals; and other facilities, pharmacies and providers of health care services and supplies. As of December 31, 2025, our U.S. network had approximately 1.7 million physicians, including specialists, and over 6,000 hospitals.”

Annual report 2025A · The company itself

“SEGMENT REPORTING Evernorth Health Services Segment Evernorth Health Services includes our Pharmacy Benefit Services and Specialty and Care Services operating segments, which provide independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live healthier lives.”

Annual report 2025A · The company itself

“Cigna Healthcare Segment Cigna Healthcare includes our U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers.”

Annual report 2025A · The company itself

“At The Cigna Group our global workforce of approximately 67,700 colleagues strives to fulfill our mission to improve the health and vitality of more than 185 million customer relationships in more than 30 markets and jurisdictions (as of December 31, 2025).”

Annual report 2025A · The company itself

“We provide services to managed care organizations, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers' compensation plans, government health programs, providers, clinics, hospitals and others.”

Annual report 2025A · The company itself

“While we compete on the basis of many service- and quality-related factors, we expect that price will continue to be a significant basis of competition. Our client contracts are subject to negotiation as clients seek to contain their costs, including by reducing benefits offered.”

Annual report 2025A · The company itself

“•Revenue growth includes increases to premium rates in consideration of anticipated medical cost increases, customer growth driven by new clients and customers, and increased fee revenue from the expansion of products and services to existing clients and customers, including solutions provided by Evernorth Health Services. •Higher medical costs (also referred to as higher medical cost trend) are impacted by utilization (the quantity of medical services consumed by our customers), unit costs (the cost per medical service) and mix of services. •MCR represents medical costs as a percentage of premiums for our segment's insured businesses, and it is impacted by medical cost trend and premium rates.”

Annual report 2025A · The company itself

“U.S. Healthcare Benefits and Solutions The following benefits and solutions are offered nationwide with various funding options to enhance the benefits from our health care medical plans. •Behavioral Health solutions consist of a broad national network of providers, including one of the largest virtual networks in the United States; specialty case and utilization management; a 24/7-accessible crisis intervention phone line; employee assistance programs; and work/life programs. •Consumer Health Engagement solutions include an array of health management, disease management and wellness programs to improve customers' health and well-being. •Cost Containment Programs are designed to reduce the cost of covered health care services and supplies by reducing out-of-network costs, protecting customers from balance billing and educating customers regarding the availability of lower cost in-network services.”

Annual report 2025A · The company itself

“We offer administrative services only ("ASO") and insurance funding options to employers, groups and individuals along with other health care benefits and solutions to improve the quality of care, lower costs and help customers achieve better health outcomes.”

Annual report 2025A · The company itself

“•Individual and Family Plans ("IFP") are Patient Protection and Affordable Care Act and related amendments ("ACA") compliant exclusive provider organizations ("EPOs") or HMO plans marketed to individuals under age 65 without access to health care coverage through an employer or government program such as Medicare or Medicaid.”

Annual report 2025A · The company itself

“Our primary competitors include national insurers, local health plans, TPAs, dental insurers, independent and managed care pharmacy benefit managers, global insurers, and local non-U.S. insurers.”

Annual report 2025A · The company itself

“Healthcare Medical Plans •Employer Medical Plans are offered by our insurance companies, health maintenance organizations ("HMOs") and third-party administrators ("TPAs"), and include Open Access Plus, LocalPlus® and HMO options. These plans use cost-sharing incentives to encourage the use of "in-network" rather than "out-of-network" health care providers.”

Annual report 2025A · The company itself

“We offer administrative services only ("ASO") and insurance funding options to employers, groups and individuals along with other health care benefits and solutions to improve the quality of care, lower costs and help customers achieve better health outcomes.”

Annual report 2025A · The company itself

“Plan sponsors (i.e., employers, unions and other groups) create self-funded group health plans to fund all claims and may purchase stop-loss insurance to limit exposure. We earn fees for providing access to our participating provider networks, claims administration services, and other benefits and solutions.”

Annual report 2025A · The company itself

“Market Segments Cigna Healthcare serves medical customers across the following market segments: •National Accounts. Employers with 3,000 or more eligible employees. •Middle Market. Employers with 500 to 2,999 eligible employees, solutions for third-party payors, Taft-Hartley plans and other groups. •Select.”

Annual report 2025A · The company itself

“Strong competition within the pharmacy benefit business has generated greater demand for lower product and service pricing, increased revenue sharing, and enhanced product and service offerings. These competitive factors have historically applied pressure on our operating margins and caused many companies, including us, to reduce the prices charged for products and services while sharing with clients a greater portion of the formulary rebates and related fees received from pharmaceutical manufacturers.”

Annual report 2025A · The company itself

“Principal Products and Services Pharmacy Benefit Services •Pharmacy Benefits. We drive high-quality, cost-effective pharmacy care through a range of services. We adjudicate drug claims from retail network participants and provide retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and other services. ◦Retail Pharmacy Network Administration.”

Annual report 2025A · The company itself

“We operate in a highly competitive and evolving business environment, and our failure to compete effectively or differentiate our products and services from those of our competitors could materially adversely affect our results of operations, financial position and cash flows. We operate in a highly competitive, evolving and rapidly changing industry.”

Annual report 2025A · The company itself

“Evernorth Health Services has three clients that each drive significant revenues for the segment: •Express Scripts and Centene Corporation ("Centene") have a multiyear agreement, which began January 1, 2024, to manage pharmacy benefit services for Centene's customers, providing them with access to the extensive Express Scripts national network of retail pharmacies. •Express Scripts and Prime Therapeutics LLC ("Prime") have agreements to deliver improved choice and affordability for Prime's clients and customers by enhancing retail pharmacy networks, providing access to Accredo and Express Scripts Pharmacy, and providing pharmaceutical manufacturer value. •The Department of War (previously the Department of Defense) TRICARE® is the military health care program available to active-duty service members, active-duty family members, National Guard and Reserve members and their family members, retirees and retiree family members, survivors and certain former spouses.”

Annual report 2025A · The company itself

“We offer clinical programs to help our clients, including third-party administrators, drive better whole-person health outcomes through our Care Delivery (MD Live by Evernorth® ("MD Live") virtual care) and Care Management (EviCore by Evernorth® ("EviCore") benefits management, behavioral health services, network services and health coaching capabilities) offerings.”

Annual report 2025A · The company itself

“We provide services to managed care organizations, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers' compensation plans, government health programs, providers, clinics, hospitals and others.”

Annual report 2025A · The company itself

“Additionally, to further deliver value for the benefit of those we serve and to build a more sustainable model for health care, the Company will incur investment and transition costs to support its recently announced rebate-free model for pharmacy benefits, designed to lower 40 medication costs, improve transparency and support local pharmacies.”

Annual report 2025A · The company itself

“Our Evernorth EnGuideSM Pharmacy ("EnGuide Pharmacy") was established in 2025 to focus on the growing population of customers that are prescribed GLP-1 medications requiring clinical support.”

Annual report 2025A · The company itself

“EVERNORTH HEALTH SERVICES Evernorth Health Services includes our Pharmacy Benefit Services and Specialty and Care Services operating segments, which provide independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live healthier lives. Evernorth Health Services offers a full suite of products and services that both (a) enables our clients to combine our products and services to create a comprehensive benefit offering designed to manage prescription drugs and provide independent and coordinated health solutions and capabilities and (b) addresses the needs of a shared customer base across both operating segments of Evernorth Health Services.”

Annual report 2025A · The company itself

“Specialty and Care Services •Specialty Pharmacy. Specialty medications are primarily characterized as high-cost medications for the treatment of complex and rare diseases. These medications broadly include those with frequent dosing adjustments, intensive clinical monitoring, the need for customer training, specialized product administration requirements or medications limited to certain specialty pharmacy networks by manufacturers.”

Annual report 2025A · The company itself

“Primary Distribution Channels •Brokers and Consultants. Sales representatives distribute our products and solutions through a broad group of brokerage and consulting firms as well as individuals. •Direct.”

Annual report 2025A · The company itself

“The ACA subjects individual and small group policy rate increases above an identified threshold to review by the United States Department of Health and Human Services ("HHS"), and our U.S. Healthcare medical plans are subject to minimum MLR requirements.”

Annual report 2025A · The company itself

“Federal and state regulatory agencies may restrict or prevent entirely our ability to implement changes in premium rates or collect certain administrative fees.”

Annual report 2025A · The company itself

“We expect federal and state governments to continue to enact legislative and regulatory reforms that will or could materially impact various aspects of the health services system, including pharmacy benefits manager, drug pricing or insurance market reforms. These reforms could result in material changes to the way we conduct our business and could impact the market for our products.”

Annual report 2025A · The company itself

“Existing or future laws, regulations, actions by governmental or regulatory authorities, or judgments could force us to change how we conduct our business; affect the products and services we offer and where we offer them; restrict revenue and enrollment growth; increase our costs, including medical, operating, health care technology and administrative costs; increase our liability; and require enhancements to our compliance infrastructure and internal controls environment. For example, we are required to obtain and maintain approvals from state boards of pharmacy, departments of insurance, and other federal and state regulatory agencies to, among other things, market many of our products, expand into additional geographic or product markets, increase prices for certain regulated products, and consummate some of our acquisitions and dispositions.”

Annual report 2025A · The company itself

“Contracts in the prescription drug industry, including our contracts with retail pharmacy networks and our pharmacy and specialty pharmacy clients, generally use pricing metrics published by third parties as benchmarks to establish pricing for prescription drugs. If these benchmarks are no longer published by third parties; if we, or our contractual partners, adopt other pricing benchmarks for establishing prices within the industry; if legislation or regulation requires the use of other pricing benchmarks; or if future changes in drug prices substantially deviate from our expectations, the short- or long-term impacts may have a material adverse effect on our business and results of operations.”

Annual report 2025A · The company itself

“Additionally, laws such as the Inflation Reduction Act have granted CMS the ability to negotiate drug prices for high-cost Medicare Part D and Part B drugs, and other federal and state legislative proposals and executive actions can lead to residual effects as drug companies adjust pricing strategies for broader marketplaces, impacting which medications are prioritized.”

Annual report 2025A · The company itself

“We purchase pharmaceuticals either directly from manufacturers or through authorized wholesalers. Evernorth Health Services uses one wholesaler for approximately half of our pharmaceutical purchases, but holds contracts with other wholesalers if needs for an alternate source arise.”

Annual report 2025A · The company itself

“Our health care costs are also affected by external events that we cannot forecast or project and over which we have little or no control, including changes in laws and regulations, costly new treatments, new treatment guidelines, provider billing practices, inflation and changes in customers' health care utilization patterns, pandemics, natural disasters, and other large-scale medical emergencies.”

Annual report 2025A · The company itself

“At The Cigna Group our global workforce of approximately 67,700 colleagues strives to fulfill our mission to improve the health and vitality of more than 185 million customer relationships in more than 30 markets and jurisdictions (as of December 31, 2025).”

Annual report 2025A · The company itself

“At The Cigna Group our global workforce of approximately 67,700 colleagues strives to fulfill our mission to improve the health and vitality of more than 185 million customer relationships in more than 30 markets and jurisdictions (as of December 31, 2025).”

Annual report 2025A · The company itself

“Our health care costs are also affected by external events that we cannot forecast or project and over which we have little or no control, including changes in laws and regulations, costly new treatments, new treatment guidelines, provider billing practices, inflation and changes in customers' health care utilization patterns, pandemics, natural disasters, and other large-scale medical emergencies.”

Annual report 2025A · The company itself

“Our health care costs are also affected by external events that we cannot forecast or project and over which we have little or no control, including changes in laws and regulations, costly new treatments, new treatment guidelines, provider billing practices, inflation and changes in customers' health care utilization patterns, pandemics, natural disasters, and other large-scale medical emergencies.”

Annual report 2025A · The company itself

“•The composition of claims generally considers the types of drugs, including the mix of claims among branded and higher priced specialty drugs compared to generic or biosimilar alternatives. We manage pharmaceutical manufacturer increases in prices through programs designed to reduce drug spend, providing positive impacts on our clients, our customers and us.”

Annual report 2025A · The company itself

“Fiscal or other concerns related to the government-sponsored programs in which we participate may cause decreasing reimbursement rates, delays in premium payments, restrictions on implementing changes in premium rates or insufficient increases in reimbursement rates.”

Annual report 2025A · The company itself

“Healthcare provides medical plans and other benefits and solutions for insured and self-insured clients as well as for individual and family plan customers. International Health provides health care solutions in our international markets, as well as health solutions for globally mobile individuals and employees of multinational organizations.”

Annual report 2025A · The company itself

“International Health •Global Health Care offerings include medical, dental, pharmacy, vision, life, accidental death and dismemberment, and disability risks. We provide products and services that meet the needs of multinational employers, intergovernmental and nongovernmental organizations, and globally mobile individuals with a focus on keeping employees healthy and productive.”

Annual report 2025A · The company itself

“Products and services are offered worldwide except as limited by applicable law and include ASO, GC and ER funding options. •Local Health Care offerings include medical, dental, pharmacy and vision as well as life coverage. Customers include employers and individuals located in specific geographies (China, Singapore, Hong Kong, Spain and India, along with various countries in the Middle East) where the products and services are purchased.”

Annual report 2025A · The company itself

“Products and services are offered worldwide except as limited by applicable law and include ASO, GC and ER funding options. •Local Health Care offerings include medical, dental, pharmacy and vision as well as life coverage. Customers include employers and individuals located in specific geographies (China, Singapore, Hong Kong, Spain and India, along with various countries in the Middle East) where the products and services are purchased.”

Annual report 2025A · The company itself

“International Health •Global Health Care offerings include medical, dental, pharmacy, vision, life, accidental death and dismemberment, and disability risks. We provide products and services that meet the needs of multinational employers, intergovernmental and nongovernmental organizations, and globally mobile individuals with a focus on keeping employees healthy and productive.”

Annual report 2025A · The company itself

“Healthcare provides medical plans and other benefits and solutions for insured and self-insured clients as well as for individual and family plan customers. International Health provides health care solutions in our international markets, as well as health solutions for globally mobile individuals and employees of multinational organizations.”

Annual report 2025A · The company itself