Cigna Reports Fourth Quarter and Full Year 2021 Results, Expects Continued Revenue and Attractive Earnings Per Share Growth in 2022
- Total revenues for 2021 were
$174.1 billion , and adjusted revenues1 for 2021 were$174.1 billion
- Shareholders' net income for 2021 was
$5.4 billion , or$15.73 per share
- Adjusted income from operations2 for 2021 was
$7.0 billion , or$20.47 per share
- Adjusted income from operations2,3 is projected to be at least
$6.95 billion in 2022, or at least$22.40 per share3
- Board of Directors declared a 12% increase in the quarterly dividend rate, to
$1.12 per share
Global health services company
"We performed well in 2021 as we supported the growing needs of our clients, customers and patients," said
Total revenues for 2021 were
Shareholders' net income for 2021 was
Cigna's adjusted income from operations2 for 2021 was
Reconciliations of total revenues to adjusted revenues1 and of shareholders' net income to adjusted income from operations2 are provided on the following page and on Exhibit 1 of this earnings release.
CONSOLIDATED HIGHLIGHTS
The following table includes highlights of results and reconciliations of total revenues to adjusted revenues1 and shareholders' net income to adjusted income from operations2:
Consolidated Financial Results (dollars in millions): |
||||
Three Months Ended |
Year Ended |
|||
|
|
|
||
2021 |
2020 |
2021 |
2021 |
|
Total Revenues |
$ 45,688 |
$ 41,712 |
$ 44,288 |
$ 174,078 |
|
(12) |
(43) |
22 |
— |
Adjusted Revenues1 |
$ 45,676 |
$ 41,669 |
$ 44,310 |
$ 174,078 |
Consolidated Earnings, net of taxes |
||||
Shareholders' Net Income |
$ 1,116 |
$ 4,135 |
$ 1,621 |
$ 5,365 |
|
(59) |
(169) |
(42) |
(158) |
Amortization of Acquired Intangible Assets2 |
326 |
370 |
392 |
1,494 |
Special Items2 |
189 |
(3,069) |
(35) |
279 |
Adjusted Income from Operations2 |
$ 1,572 |
$ 1,267 |
$ 1,936 |
$ 6,980 |
Shareholders' Net Income, per share |
$ 3.39 |
$ 11.45 |
$ 4.80 |
$ 15.73 |
Adjusted Income from Operations2, per share |
$ 4.77 |
$ 3.51 |
$ 5.73 |
$ 20.47 |
- In 2021, the Company repurchased 35.2 million shares of common stock for
$7.7 billion . Year to date throughFebruary 2, 2022 , the Company repurchased 2.5 million shares of common stock for approximately$580 million .
- In 2021, the Company initiated a quarterly cash dividend and declared quarterly cash dividends of
$1.00 per share of Cigna common stock. OnFebruary 3, 2022 , the Company's Board of Directors declared a cash dividend of$1.12 per share of Cigna common stock to be paid onMarch 24, 2022 to shareholders of record as of the close of trading onMarch 9, 2022 .
- The debt-to-capitalization ratio was 41.7% at
December 31, 2021 , reflecting higher commercial paper balances and the impact of share repurchases on shareholders equity.
- The SG&A expense ratio4 was 7.3% for full year 2021 compared to 8.5% for full year 2020, driven by revenue growth, the repeal of the health insurance industry tax, and continued expense efficiency.
- Fourth quarter 2021 special items include an after-tax charge of
$119 million , or$0.36 per share, related to a strategic plan to further leverage the Company's ongoing growth to drive operational efficiency through enhancements to organizational structure and increased use of automation and shared services.
CUSTOMER RELATIONSHIPS
The following table summarizes Cigna's medical customers and overall customer relationships:
Customer Relationships (in thousands): |
|||
As of the Periods Ended |
|||
|
|
||
2021 |
2020 |
2021 |
|
Total Customer Relationships5 |
185,672 |
173,241 |
181,339 |
Total Pharmacy Customers5 |
107,298 |
98,850 |
103,612 |
|
13,854 |
13,626 |
13,788 |
|
1,510 |
1,387 |
1,517 |
|
1,717 |
1,637 |
1,701 |
Total Medical Customers5,6 |
17,081 |
16,650 |
17,006 |
Behavioral Care |
40,380 |
36,908 |
39,784 |
Dental |
17,731 |
17,542 |
17,753 |
Medicare Part D |
3,182 |
3,291 |
3,184 |
- The pharmacy customer base5 at the end of 2021 grew to 107.3 million, an organic increase of 8.4 million year to date, driven by strong ongoing retention and new sales.
- The total medical customer base5,6 at the end of 2021 grew to 17.1 million, an increase of 431,000 customers year to date, driven by net growth across each business within the
Cigna Healthcare segment.
HIGHLIGHTS OF SEGMENT RESULTS
See Exhibit 1 for a reconciliation of adjusted income (loss) from operations2 to shareholders' net income.
Evernorth
This segment includes a broad range of coordinated and point solution health services and capabilities, including pharmacy solutions, benefits management solutions, care delivery and care management solutions, and intelligence solutions, which are provided to health plans, employers, government organizations, and health care providers.
Financial Results (dollars in millions): |
||||
Three Months Ended |
Year Ended |
|||
|
|
|
||
2021 |
2020 |
2021 |
2021 |
|
Adjusted Revenues1 |
$ 35,086 |
$ 30,533 |
$ 33,614 |
$ 131,912 |
Adjusted Income from Operations, Pre-Tax2 |
$ 1,634 |
$ 1,589 |
$ 1,548 |
$ 5,818 |
Adjusted Margin, Pre-Tax7 |
4.7% |
5.2% |
4.6% |
4.4% |
- Fourth quarter 2021 adjusted revenues1 increased 15% relative to fourth quarter 2020 reflecting strong organic growth in specialty pharmacy services and increased retail network volumes, including the impact of COVID-19 vaccines.
- Fourth quarter 2021 adjusted income from operations, pre-tax2 increased 3% relative to fourth quarter 2020, reflecting continued affordability improvements for the benefit of our clients, customers and patients and business growth, partially offset by strategic investments in expanding partnerships, new businesses and solutions, and technology.
- Evernorth fulfilled 424 million adjusted pharmacy scripts8 in fourth quarter 2021, an increase of 9% over fourth quarter 2020 driven by strong organic growth and COVID-19 vaccine volumes.
This segment includes Cigna's
Financial Results (dollars in millions): |
||||
Three Months Ended |
Year Ended |
|||
|
|
|
||
2021 |
2020 |
2021 |
2021 |
|
Adjusted Revenues1,9 |
$ 11,214 |
$ 10,413 |
$ 11,222 |
$ 44,652 |
Adjusted Income from Operations, Pre-Tax2 |
$ 472 |
$ 285 |
$ 1,046 |
$ 3,609 |
Adjusted Margin, Pre-Tax7 |
4.2% |
2.7% |
9.3% |
8.1% |
- Fourth quarter 2021 adjusted revenues1,9 grew 8% over fourth quarter 2020, reflecting customer growth, premium increases, increased specialty contributions, and favorable net investment income.
- Fourth quarter 2021 adjusted income from operations, pre-tax² and adjusted margin, pre-tax7 increased relative to fourth quarter 2020 primarily due to increased specialty contributions, increased contributions from our
International Health business, the repeal of the health insurance industry tax, and favorable net investment income, partially offset by higher medical costs in ourU.S. Commercial andU.S. Government businesses.
The Cigna Healthcare medical care ratio4 ("MCR") of 87.0% for fourth quarter 2021 compares to 84.8% for fourth quarter 2020, reflecting higher medical costs in our stop loss andU.S. Commercial insured businesses, including net unfavorable COVID-19 related impacts, and the pricing effect of the repeal of the health insurance industry tax. These impacts were partially offset by favorable contributions from behavioral products.
- The Cigna Healthcare MCR4 of 84.0% for full year 2021 compares to 78.3% for full year 2020, reflecting the impact of higher medical costs in our
U.S. Commercial andU.S. Government businesses, including net unfavorable COVID-19 related impacts, lower Medicare Advantage risk adjustment revenues, and the pricing effect of the repeal of the health insurance industry tax. These impacts were partially offset by the absence of 2020 premium relief programs in response to the COVID-19 pandemic.
- Full year 2021 adjusted income from operations, pre-tax2 for Cigna's
U.S. Commercial andU.S. Government businesses combined, which were previously reported asU.S. Medical, was$3.43 billion 13. The combined MCR4 for these two businesses was 84.9% for full year 2021.
Cigna Healthcare net medical costs payable10 was$4.00 billion atDecember 31, 2021 ,$4.05 billion atSeptember 30, 2021 , and$3.46 billion atDecember 31, 2020 . Favorable prior year reserve development on a gross pre-tax basis was$219 million and$144 million through full year 2021 and 2020, respectively.
Corporate and Other Operations6, 11
Corporate reflects interest expense, as well as amounts not allocated to operating segments and includes intersegment eliminations. Additionally, this discussion includes items reported in our Other Operations segment which is comprised of the international life, accident, and supplemental benefits businesses held for sale pending divestiture6,
Financial Results (dollars in millions): |
||||
Three Months Ended |
Year Ended |
|||
|
|
|
||
2021 |
2020 |
2021 |
2021 |
|
Adjusted (Loss) from Operations, Pre-Tax2 |
$ (115) |
$ (236) |
$ (83) |
$ (450) |
- Fourth quarter 2021 adjusted loss from operations, pre-tax2 was favorable to fourth quarter 2020 reflecting higher contributions from our international life, accident, and supplemental benefits businesses, lower interest expense, and lower corporate operating expenses.
2022 OUTLOOK
Cigna's outlook for full year 2022 adjusted revenues1,3 is projected to be at least
(dollars in millions, except where noted and per share amounts) |
|
2022 Consolidated Metrics |
Projection for Full Year Ending |
Adjusted Revenues1,3 |
at least |
Adjusted Income from Operations2,3 |
at least |
Adjusted Income from Operations, per share2,3 |
at least |
SG&A Expense Ratio3,4 |
6.9% to 7.3% |
Adjusted Tax Rate3,12 |
22.0% to 22.5% |
Adjusted Margin, After-Tax3,7 |
~3.9% |
Cash Flow from Operations3 |
at least |
Capital Expenditures3 |
|
Shareholder Dividends3 |
|
Weighted Average Shares Outstanding (millions)3 |
308 to 312 |
2022 Evernorth Metrics |
|
Adjusted Income from Operations, Pre-Tax2,3 |
|
2022 Cigna Healthcare Metrics |
|
Adjusted Income from Operations, Pre-Tax2,3 |
|
Medical Care Ratio3,4 |
82.0% to 83.5% |
Total Medical Customer Growth (lives)3,5 |
at least 575,000 |
The foregoing statements represent the Company's current estimates of Cigna's 2022 consolidated and segment adjusted income from operations2,3 and other key metrics as of the date of this release. Actual results may differ materially depending on a number of factors. Investors are urged to read the Cautionary Note Regarding Forward-Looking Statements included in this release. Management does not assume any obligation to update these estimates.
This quarterly earnings release and the Quarterly Financial Supplement are available on Cigna's website in the Investor Relations section (https://investors.cigna.com/home/default.aspx). Management will be hosting a conference call to review full year 2021 results and discuss full year 2022 outlook beginning today at
The call-in numbers for the conference call are as follows:
Live Call
(888) 566-1253 (Domestic)
(773) 799-3825 (International)
Passcode: 232022
Replay
(866) 359-3779 (Domestic)
(203) 369-0147 (International)
It is strongly suggested you dial in to the conference call by
About Cigna
Cigna maintains sales capability in over 30 countries and jurisdictions, and has over 185 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
Notes: |
||
1. |
Adjusted revenues is used by Cigna's management because it permits analysis of trends in underlying revenue. The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and Cigna's share of certain realized investment results of its joint ventures reported in the |
|
2. |
Adjusted income (loss) from operations is a principal financial measure of profitability used by Cigna's management because it presents the underlying results of operations of Cigna's businesses and permits analysis of trends in underlying revenue, expenses and shareholders' net income. Adjusted income from operations is defined as shareholders' net income (or income before income taxes for the segment metric) excluding net realized investment results, amortization of acquired intangible assets and special items. Cigna's share of certain realized investment results of its joint ventures reported in the |
|
3. |
Management is not able to provide a reconciliation of adjusted income from operations to shareholders' net income (loss) or adjusted revenues to total revenues on a forward-looking basis because it is unable to predict, without unreasonable effort, certain components thereof including (i) future net realized investment results (from equity method investments with respect to adjusted revenues) and (ii) future special items. These items are inherently uncertain and depend on various factors, many of which are beyond Cigna's control. As such, any associated estimate and its impact on shareholders' net income and total revenues could vary materially. |
|
4. |
Operating ratios are defined as follows: |
|
• |
|
|
• |
The medical care ratio for Cigna's |
|
• |
SG&A expense ratio represents enterprise selling, general and administrative expenses excluding special items as a percentage of adjusted revenue at a consolidated level. |
|
5. |
Customer relationships are defined as follows: |
|
• |
Total medical customers includes individuals in the |
|
• |
|
|
• |
Pharmacy customer relationships. Effective |
|
• |
Policies issued by the businesses subject to the definitive agreement to sell certain of our international life, accident, and supplemental benefits businesses6 have been excluded from customer relationships. |
|
6. |
We entered into a definitive agreement in |
|
• |
The businesses to be retained by Cigna are reported in the newly created |
|
• |
The businesses to be sold pursuant to the Chubb Transaction are reported in Other Operations, which is included in "Corporate and Other Operations" in our earnings release and quarterly financial supplement. |
|
Segment results for the periods presented have been restated to conform to the new segment presentation. See Cigna's Current Report on Form 8-K filed on |
||
7. |
Adjusted margin, pre-tax, is calculated by dividing adjusted income (loss) from operations, pre-tax by adjusted revenues for each segment. |
|
8. |
For Evernorth adjusted pharmacy scripts, non-specialty network scripts filled through 90-day programs and home delivery scripts are multiplied by three. All other network and specialty scripts are counted as one script. |
|
9. |
Cigna owns a 50% non-controlling interest in its |
|
10. |
Medical costs payable within the |
|
11. |
Beginning first quarter 2021, in our earnings release and quarterly financial supplement, "Corporate and Other Operations" combines the results previously reported as "Corporate" and the segment previously reported as "Group Disability and Other", which is now reported as "Other Operations" in our securities filings. This change to simplify reporting was enabled by the sale of the Group Disability and Life business. |
|
12. |
The measure "adjusted tax rate" is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, "consolidated effective tax rate". We define adjusted tax rate as the consolidated income tax rate applicable to the Company's pre-tax income excluding net realized investment results, amortization of acquired intangible assets, and special items. Cigna's share of certain realized investment results of its joint ventures reported in the |
|
13. |
The aggregation of adjusted income from operations, pre-tax for Cigna's |
Financial Results (dollars in millions): |
||
Year Ended |
||
|
||
2021 |
||
Income before income taxes |
$ 3,646 |
|
Pre-tax adjustments required to reconcile to adjusted income from |
||
Net realized investment (gains) losses |
(239) |
|
Amortization of acquired intangible assets |
25 |
|
Adjusted income from operations, pre-tax |
$ 3,432 |
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This press release, and oral statements made in connection with this release, may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are based on Cigna's current expectations and projections about future trends, events and uncertainties. These statements are not historical facts. Forward-looking statements may include, among others, statements concerning our projected adjusted income from operations outlook for 2022 on a consolidated, per share, and segment basis; projected adjusted revenue outlook for 2022; projected total medical customer growth over year end 2021; projected medical care and SG&A expense ratios; projected consolidated adjusted tax rate; projected adjusted margin; projected cash flow from operations; projected capital expenditures; future dividends; projected weighted average shares outstanding; future financial or operating performance, including our ability to deliver affordable, personalized and innovative solutions for our customers and clients, including in light of the challenges presented by the COVID-19 pandemic; future growth, business strategy, strategic or operational initiatives; economic, regulatory or competitive environments, particularly with respect to the pace and extent of change in these areas; financing or capital deployment plans and amounts available for future deployment; our prospects for growth in the coming years; strategic transactions, including the sale of our international life, accident and supplemental benefits business; and other statements regarding Cigna's future beliefs, expectations, plans, intentions, liquidity, cash flows, financial condition or performance. You may identify forward-looking statements by the use of words such as "believe," "expect," "project," "plan," "intend," "anticipate," "estimate," "predict," "potential," "may," "should," "will" or other words or expressions of similar meaning, although not all forward-looking statements contain such terms.
Forward-looking statements are subject to risks and uncertainties, both known and unknown, that could cause actual results to differ materially from those expressed or implied in forward-looking statements. Such risks and uncertainties include, but are not limited to: our ability to achieve our strategic and operational initiatives; our ability to adapt to changes in an evolving and rapidly changing industry; the scale, scope and duration of the COVID-19 pandemic and its potential impact on our business, operating results, cash flows or financial condition; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations; risks related to strategic transactions and realization of the expected benefits of such transactions, including with respect to the sale of our international life, accident and supplemental benefits business, as well as integration difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of a potential cyberattack or other privacy or data security incident; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits, investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions, stock market or interest rate declines, risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; unfavorable industry, economic or political conditions; credit risk related to our reinsurers; as well as more specific risks and uncertainties discussed in our most recent report on Form 10-K and subsequent reports on Forms 10-K, 10-Q and 8-K available through the Investor Relations section of www.cigna.com. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results, and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Cigna undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law.
|
Exhibit 1 |
||||
COMPARATIVE SUMMARY OF FINANCIAL RESULTS (unaudited) |
|||||
(Dollars in millions, except per share amounts) |
|||||
Three Months Ended |
Years Ended |
Three Months |
|||
|
|
|
|||
2021 |
2020 |
2021 |
2020 |
2021 |
|
REVENUES |
|||||
Pharmacy revenues |
$ 32,328 |
$ 28,305 |
$ 121,413 |
$ 107,769 |
$ 31,013 |
Premiums |
10,342 |
10,699 |
41,154 |
42,627 |
10,275 |
Fees and other revenues |
2,638 |
2,337 |
9,962 |
8,761 |
2,532 |
Net investment income |
380 |
371 |
1,549 |
1,244 |
468 |
Total Revenues |
45,688 |
41,712 |
174,078 |
160,401 |
44,288 |
Net realized investment results from certain equity method investments |
(12) |
(43) |
— |
(130) |
22 |
Special item related to contractual adjustment for a former client |
— |
— |
— |
(204) |
— |
Adjusted revenues (1) |
$ 45,676 |
$ 41,669 |
$ 174,078 |
$ 160,067 |
$ 44,310 |
SHAREHOLDERS' NET INCOME |
|||||
Shareholders' net income |
$ 1,116 |
$ 4,135 |
$ 5,365 |
$ 8,458 |
$ 1,621 |
After-tax adjustments to reconcile adjusted income from operations |
|||||
Net realized investment (gains) losses (2) |
(59) |
(169) |
(158) |
(244) |
(42) |
Amortization of acquired intangible assets |
326 |
370 |
1,494 |
1,431 |
392 |
Special Items |
|||||
Charge for organizational efficiency plan |
119 |
— |
119 |
24 |
— |
Debt extinguishment costs |
— |
— |
110 |
151 |
— |
Integration and transaction-related (benefits) costs |
70 |
148 |
71 |
404 |
(35) |
(Benefits) charges associated with litigation matters |
— |
— |
(21) |
19 |
— |
Risk corridors recovery |
— |
— |
— |
(76) |
— |
Contractual adjustment for a former client |
— |
— |
— |
(155) |
— |
(Gain) on sale of business |
— |
(3,217) |
— |
(3,217) |
— |
Adjusted income from operations |
$ 1,572 |
$ 1,267 |
$ 6,980 |
$ 6,795 |
$ 1,936 |
Pre-tax adjusted income (loss) from operations by segment |
|||||
Evernorth |
$ 1,634 |
$ 1,589 |
$ 5,818 |
$ 5,363 |
$ 1,548 |
|
472 |
285 |
3,609 |
4,031 |
1,046 |
Corporate and Other Operations |
(115) |
(236) |
(450) |
(586) |
(83) |
Consolidated pre-tax adjusted income from operations |
1,991 |
1,638 |
8,977 |
8,808 |
2,511 |
Adjusted income tax expense |
(419) |
(371) |
(1,997) |
(2,013) |
(575) |
Consolidated after-tax adjusted income from operations |
$ 1,572 |
$ 1,267 |
$ 6,980 |
$ 6,795 |
$ 1,936 |
DILUTED EARNINGS PER SHARE |
|||||
Shareholders' net income |
$ 3.39 |
$ 11.45 |
$ 15.73 |
$ 22.96 |
$ 4.80 |
After-tax adjustments to reconcile to adjusted income from operations |
|||||
Net realized investment (gains) losses (2) |
(0.18) |
(0.47) |
(0.46) |
(0.66) |
(0.12) |
Amortization of acquired intangible assets |
0.99 |
1.03 |
4.38 |
3.88 |
1.15 |
Special items |
|||||
Charge for organizational efficiency plan |
0.36 |
— |
0.35 |
0.07 |
— |
Debt extinguishment costs |
— |
— |
0.32 |
0.41 |
— |
Integration and transaction-related (benefits) costs |
0.21 |
0.41 |
0.21 |
1.10 |
(0.10) |
(Benefits) charges associated with litigation matters |
— |
— |
(0.06) |
0.05 |
— |
Risk corridors recovery |
— |
— |
— |
(0.21) |
— |
Contractual adjustment for a former client |
— |
— |
— |
(0.42) |
— |
(Gain) on sale of business |
— |
(8.91) |
— |
(8.73) |
— |
Adjusted income from operations (3) |
$ 4.77 |
$ 3.51 |
$ 20.47 |
$ 18.45 |
$ 5.73 |
Weighted average shares (in thousands) |
329,641 |
361,115 |
340,966 |
368,389 |
337,579 |
Common shares outstanding (in thousands) |
322,948 |
354,771 |
331,400 |
||
SHAREHOLDERS' EQUITY at |
$ 47,112 |
$ 50,321 |
|||
SHAREHOLDERS' EQUITY PER SHARE at |
$ 145.88 |
$ 141.84 |
(1) Adjusted revenues is defined as total revenues excluding the following adjustments: special items and Cigna's share of certain realized investment results of its joint ventures reported in the |
|||||
(2) Includes the Company's share of certain realized investments results of its joint ventures reported in the |
|||||
(3) Adjusted income (loss) from operations is defined as shareholders' net income (or income before income taxes for the segment metric) excluding the following adjustments: net realized investment results, amortization of acquired intangible assets and special items. Cigna's share of certain realized investment results of its joint ventures reported in the |
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INVESTOR RELATIONS CONTACT:
[email protected]
MEDIA CONTACT:
[email protected]
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