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How CI rewrote its risk factors

10-K ITEM 1A · FY2024 → FY2025

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BUSINESS OVERVIEW 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.
Our Focused Mission The Cigna Group is a global health company committed to creating a better future for every individual and every community.
Powered by our dedicated people and valued brands, we advance our mission to improve the health and vitality of those we serve by staying grounded in the needs of our customers and patients - delivering a personalized, transparent and affordable health care experience.
We focus on leading the way to partner and innovate solutions for better health.
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).
We play an important role in the health care system, and the breadth and depth of our customer relationships - as well as our approximately 1.7 million relationships with health care providers, clinics and facilities - give us opportunities to drive positive change.
We have two segments: Evernorth Health Services ® and Cigna Healthcare ® .
The Evernorth Health Services segment, through our Pharmacy Benefit Services and Specialty and Care Services operating segments, provides independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live healthier lives.
Cigna Healthcare, the health benefits segment of The Cigna Group, provides comprehensive medical and coordinated solutions to customers and clients served by our U.S.
Together, Evernorth Health Services and Cigna Healthcare combine pharmacy and medical capabilities to create solutions that improve affordability, transparency and health outcomes.
This combination helps us anticipate needs, accelerate innovation and deliver personalized experiences for customers and patients at scale.
Information about Segments We present the financial results of our businesses in the following segments (see the "Executive Overview" section of Management's Discussion and Analysis of Financial Condition and Results of Operations ("MD&A") located in Part II, Item 7 of this Form 10-K for a financial summary): 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.
Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers.
See the "Executive Overview - Key Transactions and Business Developments" section of our Management's Discussion and Analysis of Financial Condition and Results of Operations located in Part II, Item 7 of this Form 10-K for discussion of key developments impacting the segments.
Commitments to Better Through our Commitments to Better, we embarked on a new, multiyear chapter to accelerate our ongoing evolution and industry leadership.
We know we play an important role in a health care system that needs changing for the better, and we are determined to lead that change for the health and vitality of those we serve.
We have many roles in the health care system to deliver better outcomes to our customers, including helping to make healthcare more affordable, administering health care claims and working to reduce health care waste.
The Cigna Group has established five key areas of focus, and several initial specific actions, to improve the health of its customers and increase the value it provides: • Easier access to care: address challenges customers face by making processes simpler, easier and faster. • Better support: provide customers with more support and resources to navigate the health care system. • Better value: drive better value for customers and patients. • Accountability: stand behind our commitments to our customers and patients. • Transparency: provide information on how we are continuously improving to serve our customers better.
The financial information included in this Form 10-K for the fiscal year ended December 31, 2025 is presented in conformity with accounting principles generally accepted in the United States of America ("GAAP") unless otherwise indicated.
Industry rankings and percentages set forth herein are for the year ended December 31, 2025, unless otherwise indicated.
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.
Our ability to deliver this broad array of health care services on either a standalone or combined basis between its two operating segments enables us to drive incremental growth.
Additionally, many Evernorth Health Services offerings are available within Cigna Healthcare solutions.
How We Deliver • Deep clinical expertise in evaluating medicines, digital therapeutics and other health solutions for efficacy and value to assist clients in selecting a cost-effective formulary as well as in leveraging evidence-based guidelines to ensure patients receive the most medically appropriate treatments. • Affordable solutions that provide more value and align incentives between the patient, health care professional and plan sponsor. • Modular portfolio tailored to client needs, using the combined strengths and capabilities of Evernorth Health Services, as well as strategic partnerships, to deliver better, more efficient care for patients; better experiences for clients, providers and customers; and enhanced choices for clients and customers through our open architecture model. • Talented, experienced and caring people who operate in a culture of innovation and partnership to solve complex problems across a fragmented health care ecosystem, fueled by data and expertise that drives purposeful innovation. • Commitment to improving the health care experience for patients and physicians through easier access to care, better support, better value, accountability and transparency.
Clients may also choose to enroll in programs that result in communications about potential therapy concerns being sent to prescribers after the initial claim submission. ◦ Drug Formulary Management. ▪ Formularies are lists of drugs with designations that may be used to determine one component of drug coverage and customer out-of-pocket costs as well as communicate plan preferences in competitive therapeutic drug categories.
Our formulary management services support clients in establishing formularies that assist customers and physicians in choosing clinically appropriate, cost-effective drugs and prioritize access, safety and affordability. ▪ We administer specific formularies for our clients, including standard formularies developed by Express Scripts ® Pharmacy Benefit Services ("Express Scripts") and custom formularies in which we play a more limited role.
Many of our clients select standard formularies, governed by both internal and independent committees that make recommendations for formularies that first consider clinical results separate from price considerations. ▪ We manage our clients' rebate arrangements, with most choosing to receive the greater of a minimum rebate guarantee or a contractually agreed-upon percentage of rebates.
In 2025, for clients covered under our pharmacy benefit contracts, Express Scripts shared over 95% of the drug formulary management rebates it received with its integrated clients, and more than two-thirds of clients received 100% of rebates. ◦ Medical Drug Management.
These programs include SafeGuardRx ® , Express Scripts Patient Assurance ® , Evernorth EncircleRx SM and Evernorth EnReachRx SM . ◦ Evernorth Wholesale Marketplace.
These offerings are captured under either our drug formulary administrative service arrangements or our formulary processing arrangements. ◦ Transparent Rebate-free Model.
Evernorth Health Services has announced a transformative new pharmacy benefits model to make discounts negotiated with drug companies available upfront to customers buying their medications, lowering their costs at the counter.
Cigna Healthcare will adopt this new model for its fully insured customers beginning in 2027.
It will become the standard model available for Evernorth Health Services pharmacy benefit clients beginning in 2028. • Home Delivery Pharmacy.
Our Express Scripts ® Pharmacy offers free standard shipping of medications nationwide, usually in a 90-day supply, directly to the customer's home and allows for automatic refills on eligible medications and unrestricted telephone access to customer care advocates and specially trained pharmacists.
Our Evernorth EnGuide SM Pharmacy ("EnGuide Pharmacy") was established in 2025 to focus on the growing population of customers that are prescribed GLP-1 medications requiring clinical support.
Express Scripts Pharmacy operations consist of 11 licensed pharmacies, inclusive of four fulfillment pharmacies located in Arizona, Indiana, Missouri and New Jersey.
EnGuide Pharmacy operations consist of two licensed pharmacies, inclusive of one fulfillment pharmacy located in Ohio.
The front-end of our pharmacy, anchored by Accredo ® Specialty Pharmacy ("Accredo"), is organized into Therapeutic Resource Centers, where pharmacists focus their practice of pharmacy by condition.
Our Specialty Pharmacy operations consist of 35 licensed pharmacies. • Health System Services.

and 314 more.

Gone since FY2024

BUSINESS OVERVIEW The Cigna Group SM , together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our"), is a global health company.
Our Purpose and Mission The Cigna Group is a global health company committed to creating a better future for 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 Pathways to Growth To deliver differentiated value to our customers, patients, clients, communities and investors, we will continue to cultivate our portfolio of businesses to provide sustained foundational and accelerated growth through cross-enterprise leverage - today and in the future.
Our Differentiated Approach • Clinical expertise and longitudinal data provide enhanced care and value. • Relentless focus on value and affordability improves the cost of care for our clients and customers. • Culture of innovation and partnership brings new services and capabilities to market.
At The Cigna Group, we relentlessly challenge ourselves to partner and innovate solutions for better health.
Our global workforce of approximately 73,500 colleagues strives to fulfill our mission to improve the health and vitality of approximately 182 million customer and patient relationships in more than 30 countries and jurisdictions (as of December 31, 2024).
We have two growth platforms: Evernorth Health Services ® and Cigna Healthcare ® .
Evernorth Health Services, through our Pharmacy Benefit Services and Specialty and Care Services operating segments, provides independent and coordinated health solutions and capabilities to enable the health care system to work better and help people live richer, healthier lives.
In addition to serving a wide variety of clients, Evernorth Health Services also enables us to deepen existing relationships across our entire book of business.
Cigna Healthcare is the health benefits segment of The Cigna Group and serves customers and clients for our U.S.
Together, Evernorth Health Services and Cigna Healthcare provide a strong and diverse foundation that allows us to capitalize on growth opportunities by leading with our strengths – pharmacy and medical solutions – and then expanding those relationships by addressing additional client needs and innovating and delivering new services and solutions.
When considering our broad portfolio of businesses, we have strong foundational businesses that we expect to continue to grow.
These businesses often serve as the key entry point for clients with either a pharmacy relationship, a medical relationship or both.
We also have accelerated growth businesses, both scaled and emerging, which build upon our foundational relationships or provide exposure to adjacent high-growth areas.
Evernorth Health Services and Cigna Healthcare work together to enable cross-enterprise leverage by uniquely using the depth and breadth of our wide-ranging capabilities across the enterprise to efficiently move from ideation to solution creation to meet clients' evolving needs while creating more value, expanding our reach and driving growth.
Information about Segments We present the financial results of our businesses in the following segments (see "Executive Overview" section of Management's Discussion and Analysis of Financial Condition and Results of Operations ("MD&A") located in Part II, Item 7 of this Form 10-K for a financial summary): 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 richer, healthier lives.
Healthcare and International Health operating segments, which provide comprehensive medical plan services and coordinated solutions to clients and customers.
See the "Executive Overview - Key Transactions and Business Developments" section of our MD&A located in Part II, Item 7 of this Form 10-K for discussion of key developments impacting the segments.
The financial information included in this Form 10-K for the fiscal year ended December 31, 2024 is presented in conformity with accounting principles generally accepted in the United States of America ("GAAP") unless otherwise indicated.
Industry rankings and percentages set forth herein are for the year ended December 31, 2024, unless otherwise indicated.
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 richer, healthier lives.
Within Evernorth Health Services, Pharmacy Benefit Services is a foundational growth business, and Specialty and Care Services is an accelerated growth business.
Evernorth Health Services offers a full suite of products and services that both (a) enables our customers 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.
Our ability to deliver this broad array of health care services on both a standalone or combined basis between its two operating segments enables us to drive incremental growth.
Additionally, many Evernorth Health Services offerings are available within Cigna Healthcare solutions to drive cross-enterprise leverage.
How We Deliver • Deep clinical expertise in evaluating medicines, digital therapeutics and other health solutions for efficacy and value to assist clients in selecting a cost-effective formulary as well as in leveraging evidence-based guidelines to ensure patients receive the most medically appropriate treatments. • Affordable solutions that provide more value and align incentives between the patient, health care professional and plan sponsor. • Modular portfolio tailored to client needs, using the combined strengths and capabilities of Evernorth Health Services, as well as strategic partnerships, to deliver better, more efficient care for patients; better experiences for clients, providers and customers; and enhanced choices for clients and customers through our open architecture model. • Talented, experienced and caring people who operate in a culture of innovation and partnership to solve complex problems across a fragmented health care ecosystem, fueled by data and expertise that drives purposeful innovation.
Clients may also choose to enroll in programs that result in communications about potential therapy concerns being sent to prescribers after the initial claim submission. ◦ Drug Formulary Management. ▪ Formularies are lists of drugs with designations that may be used to determine drug coverage and customer out-of-pocket costs as well as communicate plan preferences in competitive drug categories.
Our formulary management services support clients in establishing formularies that assist customers and physicians in choosing clinically appropriate, cost-effective drugs and prioritize access, safety and affordability. ▪ We administer specific formularies for our clients, including standard formularies developed by Express Scripts by Evernorth ® ("Express Scripts") and custom formularies in which we play a more limited role.
Many of our clients select standard formularies, governed by both internal and independent committees that make recommendations for formularies that first consider clinical results separate from price considerations. ▪ One of the ways we manage our drug formulary is through negotiating to secure additional affordability for the benefit of our clients based on the utilization of certain prescription drugs and supplies which can be paid to us in the form of a rebate.
With respect to our clients' rebate arrangements, most choose to receive the greater of a minimum rebate guarantee or a contractually agreed-upon percentage of rebates.
In 2024, for clients covered under our pharmacy benefit contracts, Express Scripts shared over 95% of the drug formulary management rebates it received with its integrated clients, and more than two-thirds of clients received 100% of rebates. ◦ Medical Drug Management.
These programs include SafeGuardRx ® , Express Scripts Copay Assurance SM , Express Scripts Patient Assurance ® and Evernorth EncircleRx SM . ◦ Evernorth Wholesale Marketplace.
These offerings are captured under either our drug formulary administrative service arrangements or our formulary processing arrangements. • Home Delivery Pharmacy.
Our Express Scripts Pharmacy by Evernorth ® ("Express Scripts Pharmacy") offers free standard shipping of medications nationwide, usually in a 90-day supply, directly to the customer's home and allows for automatic refills on eligible medications and unrestricted telephone access to customer care advocates and specially trained pharmacists.
The Home Delivery Pharmacy operations consist of 13 licensed pharmacies, including 4 fulfillment pharmacies.
Our fulfillment pharmacies are located in Arizona, Indiana, Missouri and New Jersey.
The front-end of our pharmacy, anchored by Accredo by Evernorth ® ("Accredo"), is organized into Therapeutic Resource Centers, where pharmacists focus their practice of pharmacy by condition.
Our Specialty Pharmacy operations consist of 35 licensed pharmacies. • Specialty Distribution.

and 393 more.

Sentence-level comparison of Item 1A in the two most recent 10-Ks (FY2024 ↗, FY2025 ↗). A reworded sentence counts as one dropped and one added, so heavy edits read as low “kept”. Headings and page furniture are stripped; nothing is summarised by a model.

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