Third Quarter 2023 Press Release
Press Release
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860-787-7968 [email protected]
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The Cigna Group Reports Strong Third Quarter 2023 Results,
Raises 2023 Adjusted EPS, Revenue, and Cash Flow Outlook
- Total revenues in the third quarter were
$49.0 billion - Shareholders' net income for the third quarter was
$1.4 billion , or$4.74 per share - Adjusted income from operations1 for the third quarter was
$2.0 billion , or$6.77 per share - 2023 outlook2 for adjusted income from operations1,2 increased to at least
$24.75 per share2
"We continued to drive growth in the third quarter by harnessing our deep clinical expertise and service capabilities across our company, supporting high-quality care, improved affordability and better outcomes," said
Shareholders' net income for the third quarter 2023 was
A reconciliation of shareholders' net income to adjusted income from operations1 is provided on the following page and on Exhibit 1 of this earnings release.
2
CONSOLIDATED HIGHLIGHTS
The following table includes highlights of results and reconciliations of total revenues to adjusted revenues5 and shareholders' net income to adjusted income from operations1:
Consolidated Financial Results (dollars in millions):
Three Months Ended |
Nine Months |
|||||||
Ended |
||||||||
|
|
|
||||||
2023 |
20223 |
2023 |
2023 |
|||||
Total Revenues |
$ |
49,048 |
$ |
45,281 |
$ |
48,586 |
$ |
144,151 |
Net Realized Investment Losses from Equity |
30 |
80 |
30 |
22 |
||||
Method Investments5 |
||||||||
Adjusted Revenues5 |
$ |
49,078 |
$ |
45,361 |
$ |
48,616 |
$ |
144,173 |
Consolidated Earnings, net of taxes |
||||||||
Shareholders' Net Income |
$ |
1,408 |
$ |
2,757 |
$ |
1,460 |
$ |
4,135 |
Net Realized Investment Losses1 |
41 |
145 |
9 |
56 |
||||
Amortization of Acquired Intangible Assets1 |
363 |
322 |
346 |
1,053 |
||||
Special Items1 |
199 |
(1,365) |
5 |
205 |
||||
Adjusted Income from Operations1 |
$ |
2,011 |
$ |
1,859 |
$ |
1,820 |
$ |
5,449 |
Shareholders' Net Income, per share |
$ |
4.74 |
$ |
8.97 |
$ |
4.92 |
$ |
13.89 |
Adjusted Income from Operations1, per share |
$ |
6.77 |
$ |
6.05 |
$ |
6.13 |
$ |
18.31 |
- Total revenues and adjusted revenues5 for the third quarter 2023 each increased 8% from the third quarter 2022, reflecting strong growth across
Evernorth Health Services and Cigna Healthcare . - Shareholders' net income for the third quarter 2023 was
$1.4 billion , or$4.74 per share, compared with$2.8 billion , or$8.97 per share, for the third quarter 20223, which included an after-tax gain of$1.4 billion , or$4.52 per share, from the Chubb Transaction4. - Adjusted income from operations1 for the third quarter 2023 increased 8% from the third quarter 2022, reflecting strong contributions from
Evernorth Health Services and Cigna Healthcare . - The SG&A expense ratio6 and adjusted SG&A expense ratio6 were 7.7% and 7.3%, respectively, for the third quarter 2023 compared to 7.0% and 6.9%, respectively, for the third quarter 2022, reflecting increased investments to support business growth and expand our capabilities.
- The debt-to-capitalization ratio was 40.5% at
September 30, 2023 compared to 41.9% atJune 30, 2023 . - Year to date through
November 1, 2023 , the Company repurchased 7.7 million shares of common stock for approximately$2.2 billion .
3
CUSTOMER RELATIONSHIPS
The following table summarizes
Customer Relationships (in thousands): |
||||
As of the Periods Ended |
||||
|
|
|
||
2023 |
2022 |
2023 |
2022 |
|
Total Pharmacy Customers7 |
||||
98,325 |
94,846 |
98,638 |
93,905 |
|
|
16,009 |
14,761 |
15,999 |
14,852 |
|
1,970 |
1,381 |
1,883 |
1,354 |
|
1,628 |
1,812 |
1,624 |
1,798 |
Total Medical Customers7 |
19,607 |
17,954 |
19,506 |
18,004 |
Behavioral Care |
25,100 |
44,522 |
26,383 |
44,841 |
Dental |
18,593 |
18,380 |
18,634 |
18,397 |
Medicare Part D |
2,544 |
2,902 |
2,542 |
2,874 |
Total Customer Relationships7 |
164,169 |
178,604 |
165,703 |
178,021 |
- Total pharmacy customers7 at
September 30, 2023 increased 5% fromDecember 31, 2022 to 98.3 million due to new sales and the continued expansion of relationships. - Total medical customers7 at
September 30, 2023 grew 9% fromDecember 31, 2022 to 19.6 million, an increase of 1.6 million customers, primarily driven by growth inU.S. Commercial fee-based customers as well as in Individual and Medicare Advantage customers. - Customer relationships7 were impacted by the non-renewal of a supplemental behavioral coverage contract with
New York Life , which was insignificant to total revenues and adjusted income from operations1. Excluding the impact of this contract7, behavioral care and total customer relationships7 atSeptember 30, 2023 increased 2% and 4%, respectively, fromDecember 31, 2022 .
4
HIGHLIGHTS OF SEGMENT RESULTS
See Exhibit 1 for a reconciliation of adjusted income (loss) from operations1 to shareholders' net income.
This segment offers a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in Pharmacy Benefits,
Financial Results (dollars in millions): |
||||||||
Three Months Ended |
Nine Months |
|||||||
Ended |
||||||||
|
|
|
||||||
2023 |
2022 |
2023 |
2023 |
|||||
Adjusted Revenues5 |
||||||||
$ |
38,596 |
$ |
35,698 |
$ |
38,205 |
$ |
112,980 |
|
Adjusted Income from Operations, Pre-Tax1 |
$ |
1,716 |
$ |
1,625 |
$ |
1,516 |
$ |
4,552 |
Adjusted Margin, Pre-Tax8 |
4.4% |
4.6% |
4.0% |
4.0% |
- Third quarter 2023 adjusted revenues5 increased 8% relative to third quarter 2022, reflecting strong organic growth in specialty and care delivery and management solutions.
- Third quarter 2023 adjusted income from operations, pre-tax1, increased 6% relative to third quarter 2022, reflecting growth in specialty and continued affordability improvements, partially offset by increased strategic investments in technology to support the onboarding of new clients and continued advancement of our digital capabilities and care solutions.
- Third quarter 2023 adjusted margin, pre-tax8, was 4.4% compared to 4.6% for third quarter 2022, reflecting continued strategic investments in technology to support the onboarding of new clients and expansion of existing client relationships.
5
This segment includes
Financial Results (dollars in millions): |
||||||||
Three Months Ended |
Nine Months |
|||||||
Ended |
||||||||
|
|
|
||||||
2023 |
20223 |
2023 |
2023 |
|||||
Adjusted Revenues5,9 |
$ |
12,768 |
$ |
11,177 |
$ |
12,714 |
$ |
38,200 |
Adjusted Income from Operations, Pre-Tax1 |
$ |
1,222 |
$ |
1,050 |
$ |
1,172 |
$ |
3,509 |
Adjusted Margin, Pre-Tax8 |
9.6% |
9.4% |
9.2% |
9.2% |
- Third quarter 2023 adjusted revenues5,9 grew 14% over third quarter 2022, reflecting customer growth and premium rate increases to cover underlying medical cost trends.
- Third quarter 2023 adjusted income from operations, pre-tax1 increased 16% relative to third quarter 2022, primarily driven by a lower
U.S. Commercial MCR6 and higher net investment income. - The Cigna Healthcare MCR6 was 80.5% for third quarter 2023 compared to 80.8% for third quarter 2022, reflecting continued strong performance in our
U.S. Commercial business driven by affordability initiatives and effective pricing execution, partially offset by business mix, reflecting higher customer growth inU.S. Government . Cigna Healthcare net medical costs payable10 was$5.09 billion atSeptember 30, 2023 ,$4.05 billion atSeptember 30, 2022 , and$3.96 billion atDecember 31, 2022 . The increases are primarily driven by customer growth and business mix. Favorable prior year reserve development on a gross pre-tax basis was$237 million and$278 million for the nine months endedSeptember 30, 2023 andSeptember 30, 2022 , respectively.
Corporate and Other Operations
Corporate reflects interest expense, amounts not allocated to operating segments and includes intersegment eliminations. Additionally, this discussion includes items reported in Other Operations, which is comprised of
Financial Results (dollars in millions): |
||||||
Three Months Ended |
Nine Months |
|||||
Ended |
||||||
|
|
|
||||
2023 |
20223 |
2023 |
2023 |
|||
Adjusted (Loss) from Operations, Pre-Tax1 |
$ |
(409) $ |
(295) $ |
(394) |
$ |
(1,202) |
- Third quarter 2023 adjusted loss from operations, pre-tax1, was
$409 million compared to$295 million for third quarter 2022, primarily reflecting the impact of higher interest rates on interest expense and pension costs.
6
2023 OUTLOOK2
(dollars in millions, except where noted and per share amounts)
Projection for Full Year Ending |
Change from |
|
2023 Consolidated Metrics |
|
Prior Projection |
Adjusted Revenues2,5 |
at least |
|
Adjusted Income from Operations1,2 |
at least |
|
Adjusted Income from Operations, per share1,2 |
at least |
|
Adjusted SG&A Expense Ratio2,6 |
~7.4% |
+10 bps |
Adjusted Effective Tax Rate2,11 |
20.5% to 21.0% |
-50 bps at the midpoint |
Cash Flow from Operations2 |
at least |
|
Weighted Average Shares Outstanding (millions)2 |
296 to 298 |
-1 at the midpoint |
2023 Evernorth Metrics |
||
Adjusted Income from Operations, Pre-Tax1,2 |
at least |
|
2023 Cigna Healthcare Metrics |
||
Adjusted Income from Operations, Pre-Tax1,2 |
at least |
|
Medical Care Ratio2,6 |
81.5% to 82.0% |
-15 bps at the midpoint |
Total Medical Customer Growth2,7 |
at least 1,600,000 |
+200,000 |
7
The foregoing statements represent the Company's current estimates of
This quarterly earnings release and the Quarterly Financial Supplement are available on
The call-in numbers for the conference call are as follows:
Live Call
- 566-1889 (Domestic)
- 799-3989 (International) Passcode: 11022023
Replay
- 839-1171 (Domestic)
- 369-3030 (International)
It is strongly suggested you dial in to the conference call by
About
Notes:
1. Adjusted income (loss) from operations is a principal financial measure of profitability used by The
8
- 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
The Cigna Group's control. As such, any associated estimate and its impact on shareholders' net income and total revenues could vary materially.
The Company's outlook excludes the potential effects of any other business combinations that may occur after the date of this earnings release. The Company's outlook includes the potential effects of expected future share repurchases and anticipated 2023 dividends.
As announced inJanuary 2021 ,The Cigna Group 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 ofThe 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 of Directors may deem relevant.
The timing and actual number of shares repurchased will depend on a variety of factors, including price, general business and market conditions, and alternate uses of capital. The share repurchase program may be effected through open market purchases in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended, including through Rule 10b5-1 trading plans, or privately negotiated transactions. The program may be suspended or discontinued at any time. - Effective
January 1, 2023 ,The Cigna Group adopted ASU 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts, and related amendments. Prior year results have been restated to reflect the adoption of the new accounting guidance. - On
July 1, 2022 , the Company completed the sale of its life, accident and supplemental benefits businesses in six countries (Hong Kong ,Indonesia ,New Zealand ,South Korea ,Taiwan andThailand ) toChubb INA Holdings, Inc. ("Chubb") for approximately$5.4 billion in cash (the "Chubb transaction"). InDecember 2022 , the Company divested its ownership interest in a joint venture in Türkiye. - Adjusted revenues is used by
The Cigna Group'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 andThe Cigna Group's share of certain realized investment results of its joint ventures reported in theCigna 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. Adjusted revenues is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, total revenues. See Exhibit 1 for a reconciliation of consolidated adjusted revenues to total revenues. - Operating ratios are defined as follows:
-
The Cigna Healthcare medical care ratio ("MCR") represents medical costs as a percentage of premiums for allU.S. Commercial risk products, including medical, pharmacy, dental, stop loss and behavioral products provided through guaranteed cost or experience-rated funding arrangements, as well as Medicare Advantage, Medicare Part D, Medicare Supplement, individual on and off-exchange products, and health care products within ourInternational Health business, within theCigna Healthcare segment.- SG&A expense ratio on a GAAP basis for the third quarter 2023 represents enterprise selling, general and administrative expenses of
$3,788 million as a percentage of Total revenue of$49.0 billion at a consolidated level. SG&A expense ratio on a GAAP basis for the third quarter 2022 represents enterprise selling, general and administrative expenses of$3,151 million as a percentage of Total revenue of$45.3 billion at a consolidated level.
9
-
- Adjusted SG&A expense ratio for the third quarter 2023 represents enterprise selling, general and administrative expenses of
$3,574 million excluding special items of$214 million as a percentage of adjusted revenue at a consolidated level. Adjusted SG&A expense ratio for the third quarter 2022 represents enterprise selling, general and administrative expenses of$3,127 million excluding special items of$24 million as a percentage of adjusted revenue at a consolidated level.
- Adjusted SG&A expense ratio for the third quarter 2023 represents enterprise selling, general and administrative expenses of
- Customer relationships are defined as follows:
-
- Total medical customers includes individuals in the
Cigna Healthcare segment who meet any one of the following criteria: are covered under a medical insurance policy, managed care arrangement, or service agreement issued byCigna Healthcare ; have access toCigna Healthcare's provider network for covered services under their medical plan; or have medical claims and services that are administered byCigna Healthcare . International Health medical customers excludes medical customers served by less than 100% owned subsidiaries, as well as certain customers served by our third-party administrator.International Health customers as ofSeptember 30, 2023 reflect the transition of certain runoff business to Other Operations beginningJanuary 1, 2023 .- Effective
January 1, 2023 , total pharmacy customers have been updated to reflect customer filled prescriptions through Inside Rx. Previously these customers had been estimated based on active customers over a period of time. Total pharmacy customers for prior periods have been restated to reflect this change. - Behavioral care and total customer relationships as of
December 31, 2022 excluding the impact of the supplemental behavioral coverage contract withNew York Life were 24,696 thousand and 157,876 thousand, respectively.
- Total medical customers includes individuals in the
- Adjusted margin, pre-tax, is calculated by dividing adjusted income (loss) from operations, pre-tax by adjusted revenues for each segment.
The Cigna Group owns noncontrolling interests in certain operating joint ventures. As such, the adjusted revenues for theCigna Healthcare segment only include the Company's share of the joint ventures' earnings reported in Fees and Other Revenues using the equity method of accounting under GAAP.- Medical costs payable within the
Cigna Healthcare segment are presented net of reinsurance and other recoverables. The gross medical costs payable balance was$5.32 billion as ofSeptember 30, 2023 ,$4.18 billion as ofDecember 31, 2022 , and$4.25 billion as ofSeptember 30, 2022 . - The measure "adjusted effective 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 effective tax rate as the consolidated income tax rate applicable to the Company's pre-tax income 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 theCigna Healthcare segment using the equity method of accounting are also excluded. Management is not able to provide a reconciliation to the consolidated effective tax rate on a forward-looking basis because we are unable to predict, without unreasonable effort, certain components thereof include (i) future net realized investment results and (ii) future special items.
10
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
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; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition, inflation and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of potential cyberattack or other privacy or data security incidents; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; risks related to strategic transactions and realization of the expected benefits of such transactions, as well as integration or separation difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits and investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions, the risk of a recession or other economic downtuand resulting impact on employment metrics, stock market or changes in interest rates and risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; 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-Q and 8-K available through the Investor Relations section of www.thecignagroup.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.
Attachments
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Third Quarter 2023 Financial Supplement
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